内皮损伤在移植物抗宿主病发生发展中作用的研究进展

Research progress of endothelial injury in the development of graft-versus-host disease

移植物抗宿主病(GVHD)是异基因造血干细胞移植(allo-HSCT)后严重的并发症之一。免疫介导的血管内皮损伤是GVHD的重要环节。Allo-HSCT前在放化疗以及感染等因素造成内皮损伤的基础上,供者T细胞与受者受损内皮细胞抗原直接接触,分泌细胞因子和炎性介质杀伤内皮细胞,炎性细胞浸润,导致内皮细胞进一步凋亡及耗竭,加剧靶器官的功能损害及全身多系统损伤。探索GVHD的内皮损伤机制,为GVHD的预防和治疗提供新思路。

Graft-versus-host disease(GVHD)is one of the most serious complications after allogeneic hematopoietic stem cell transplantation(allo-HSCT),resulting a very high mortality risk and no effective diagnosis and treatment method.Although an increasing number of studies suggest that immune-mediated vascular endothelial damage plays an important role in GVHD,the specific mechanism remains elusive.On the basis of endothelial injury caused by radiotherapy and chemotherapy before allo-HSCT and infection,the donor T cells directly contact with the damaged endothelial cell antigen,secrete cytokines and inflammatory mediators to kill endothelial cells,leading to further apoptosis and depletion of endothelial cells,and exacerbating the functional damage of target organs and multi-system injury of the body.To explore the endothelial injury mechanism of GVHD.This review provides a new idea for the prevention and treatment of GVHD.