CD40L表达在异基因造血干细胞移植中GVHD发生的意义

Significance of the expressions of CD40 and CD40 ligand to graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

目的 初步探讨在异基因造血干细胞移植 (HSCT)中发生移植物抗宿主病 (GVHD)患者CD40L表达的变化以及意义。方法 HSCT治疗重型 β 地中海贫血 (n =1 2 )和遗传性溶血性贫血 (n =1 )成功植入的儿童患者 ,其中脐血移植 (UCBT)8例 ,异基因外周血造血干细胞移植 (allo PBSCT ) 5例 ,在移植前、移植后发生GVHD时采用流式细胞仪检测和比较外周血中CD40L和CD40的表达。结果 3例UCBT无GVHD ,其余均发生了Ⅰ～Ⅳ度急性GVHD。急性GVHD发生时CD4+CD40L+和CD8+CD40L+T细胞表达明显升高 ,allo PBSCT者更明显 ;慢性GVHD发生时患者的CD40L+、CD2 5+和CD69+在CD4+和CD8+T细胞上的表达亦增加。CD1 9+CD40 +B细胞的表达在UCBT和allo PBSCT的 3个月内则一直处于低于正常的水平。结论 CD40L高表达与GVHD的发生相关 ,提示CD40

Objective To analyze the changes of CD40 and CD40L levels and investigate their significances the children patients with graft versus host disease (GVHD)after allogeneic hematopoietic stem cell transplantation(HSCT). Methods 12 patients with β thalassemia major and one patient with congenital inherent hemolytic anemia accepted umbilical cord blood transplantation(UCBT) and allogeneic periphe ral blood stem cell transplantation (allo PBSCT) respectively. Peripheral blood samples were obtained before transplantation,and at the time when GVHD happened for measurement of the expressions of CD40 and CD40L by using immunofluorescence assay.Results 3 patients had no acute GVHD. 10 patients had acute GVHD(Ⅰ-Ⅳ degree). The expressions of CD40L on CD4 + and CD8 + T cells in patients with acute GVHD increased, es pecially in allo PBSCT; The expressions of CD40L +,CD25 + and CD69 + on CD4 + and CD8 + T cells in patients with chronic GVHD increased obviously. The expression of CD19 +CD40 + was lower than normal within 3 months after transplantation. Conclusion The high expression of CD40L is related to the development of GVHD in HSCT, and this indicates that CD40 CD40L co stimulatory pathway plays an important role in GVHD.