间充质干细胞移植后免疫重建和抗巨细胞病毒的免疫作用

Immune reconstruction and anti-cytomegalovirus immunity of mesenchymal stem cells after transplantation

背景:异基因造血干细胞移植是治愈白血病等恶性血液病、重症再生障碍性贫血和遗传性血液病的最有效方法,但移植后早期常因免疫重建延迟,显著增加巨细胞病毒感染/再激活的风险。只有促进早期免疫重建,才能激发机体产生巨细胞病毒特异性免疫应答,真正有效的长期控制病毒复制。目的:总结间充质干细胞移植后免疫重建和抗巨细胞病毒免疫作用的研究进展,并分析目前面临的问题及其未来发展方向。

BACKGROUND:Allogeneic hematopoietic stem cell transplantation is the most effective method to cure leukemia and other malignant hematological diseases,severe aplastic anemia,and hereditary hematological diseases.However,immune reconstitution is often delayed in the early stage after transplantation,which significantly increases the risk of cytomegalovirus infection/reactivation.Only promoting early immune reconstitution can produce a cytomegalovirus-specific immune response and truly and effectively control virus replication for a long time.OBJECTIVE:To summarize the research progress of immune reconstruction and anti-cytomegalovirus immune function of mesenchymal stem cells after transplantation,and analyze the current problems and future development directions.METHODS:The PubMed database was searched with“allogeneic hematopoietic stem cell transplantation,mesenchymal stem cells,immune reconstruction,CMV”as key words.The search time limit was from 2016 to 2020.Repetitive articles irrelevant to the research purpose of the article were excluded,and 46 articles that met the criteria were included for review.RESULTS AND CONCLUSION:The restoration of thymus function is beneficial to promote the restoration of the diversity of T cell response pools,and is the key to immune reconstitution and antiviral therapy optimization.The latest progress of immunology indicates that mesenchymal stem cells may have the functions of reversing thymic aging,repairing thymus damage and promoting thymus regeneration,and exert antiviral effects through multiple targets and multiple mechanisms and protect the host from virus attack.However,there are still many limitations.The miR-21 genetically modified mesenchymal stem cells are expected to provide new ideas and new strategies for immune reconstruction and anti-viral immunity after transplantation.These will be the direction of future cell therapy.