外周血miR-200c水平对移植异基因造血干细胞后急性移植物抗宿主病发生的预测作用

Peripheral blood miR-200c level predicts the occurence of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

目的探讨外周血miR-200c水平对移植异基因造血干细胞后急性移植物抗宿主病(aGVHD)发生的预测作用。方法选择2014年1月至2018年10月在昆明医科大学第一附属医院血液科行异基因造血干细胞移植(Allo-HSCT)的51例患者作为研究对象,根据移植后是否发生aGVHD原则分为实验组(发生aGVHD)33例、对照组(未发生aGVHD)18例。抽取肘部外周血5 mL,RT-qPCR检测两组miR-200c,分析两组miR-200c表达差异。结果两组患者均移植成功,且恢复造血功能,恢复时间为18 d,其中33例发生aGVHD,18例未发生aGVHD,发生率为64.71%;实验组在移植前、移植后7、14、及72 d时,miR-200c表达均低于对照组(P<0.05);aGVHD发生后外周血中miR-200c显著低于发生前(P<0.001);与aGVHDⅠ度相比,aGVHDⅡ度患者外周血中miR-200c表达下调(P<0.05),与Ⅱ度相比,aGVHDⅢ度患者外周血中miR-200c表达下调(P<0.001);miR-200c高表达组患者2年总生存率高于低表达组(P<0.05);miR-200c对aGVHD疾病产生诊断价值较好。结论miR-200c水平降低与异基因造血干细胞移植后aGVHD的发生相关;随着aGVHD严重程度升高miR-200c表达水平降低,miR-200c低表达患者生存率较差。miR-200c可作为早期诊断和预测aGVHD的标志物。

Objective To investigate the predictive function of miR-200c level in peripheral blood on acute graft-versus-host disease(aGVHD)after allogeneic hematopoietic stem cell transplantation.Methods Fifty-one patients who received allo-HSCT in hematology department of our hospital from January 2014 to October 2018 were selected as the research subjects.According to the principle of whether agVHD occurred after transplantation,33 patients were in the experimental group(with aGVHD)and 18 patients were in the control group(without aGVHD).RT-qPCR was used to detect miR-200c in two groups and the differences in miR-200c expression between the two groups were analyzed.Results The transplantation was successful in both groups,and the hematopoietic function was restored.The recovery time was 18 days,among which 33 patients developed aGVHD and 18 patients did not develop aGVHD,with an incidence of 64.71%.The expression of miR-200c in experimental group was lower than that in control group before transplantation and 7,14,and 72 d after transplantation(P<0.05).MiR-200c in peripheral blood after the occurrence of aGVHD was significantly lower than that before the occurrence(P<0.001).Compared with aGVHDⅡ,the expression of miR-200c in peripheral blood of aGVHDⅡpatients was down-regulated(P<0.05);as compared with aGVHDⅢpatients,the expression of miR-200c in peripheral blood of aGVHDⅢpatients was down-regulated(P<0.001);the 2-year survival rate in the high expression group of miR-200c was higher than that in the low expression group(P<0.05).Conclusions The reduced level of miR-200c is associated with the occurrence of aGVHD after allogeneic hematopoietic stem cell transplantation.With the increase of the severity of aGVHD the expression level of miR-200c is decreased,and the survival rate of patients with low miR-200c expression is low,so the expression of miR-200 is a potential marker for early diagnosis and prediction of aGVHD.