异基因造血干细胞移植后人巨细胞病毒再激活的主要分子事件

Major molecular events of reactivation of human cytomegalovirus after allogeneic hematopoietic stem cell transplantation

异基因造血干细胞移植(allo-HSCT)所致的机体免疫缺陷是引起潜伏状态人巨细胞病毒(HCMV再激活的始动因素。allo-HSCT受者HCMV再激活的危险因素包括供受者HCMV血清学状况、人类白细胞抗原(HLA)匹配程度及预处理方式等。HCMV再激活与病毒基因组中主要即刻早期启动子/增强子(MIEP)过表达诱发的系列病毒裂解增殖蛋白的表达相关。本文就引起allo-HSCT术后HCMV再激活的危险因素、维持HCMV潜伏感染相关的分子变化、MIEP过表达在HCMV再激活过程中的关键作用、参与allo-HSCT术后HCMV再激活的分子通路进行综述,探讨allo-HSCT后HCMV再激活的主要分子事件,为allo-HSCT后巨细胞病毒病(CMVD)的防治提供参考。

Immune deficiency of the host caused by allogeneic hematopoietic stem cell transplantation(alloHSCT)is the initial factor of reactivation of latent human cytomegalovirus(HCMV).The risk factors of reactivation of HCMV in allo-HSCT recipients consist of the serological status of HCMV in donors and recipients,the matching degree of human leukocyte antigen(HLA)and pretreatment patterns,etc.The reactivation of HCMV is associated with the expression of a series of viral cleavage and proliferation proteins induced by the overexpression of major immediate early promoter/enhancer(MIEP)in the viral genome.In this article,the risk factors of reactivation of HCMV after alloHSCT,the molecular changes related to maintaining latent infection of HCMV,the key role of MIEP overexpression in reactivation of HCMV,and the molecular pathways involved in reactivation of HCMV after allo-HSCT were reviewed and the major molecular events of reactivation of HCMV after allo-HSCT were elucidated,aiming to provide reference for the prevention and treatment of cytomegaloviral disease(CMVD)after allo-HSCT.