环孢菌素A联合霉酚酸酯预防小鼠H-2半相合非清髓性骨髓移植后GVHD的发生

Cyclosporine A and Mycophenolate Mofetile as Prophylactics for GVHD in a Murine Model of H-2 Haploidentical Nonmyeloablative Bone Marrow Transplanatation

为探讨环孢菌素A(CSA)联合霉酚酸酯 (MMF)方案对小鼠主要组织相容性抗原 (H 2 )半相合非清髓性骨髓移植后急性移植物抗宿主病 (aGVHD)的预防作用 ,建立了H 2半相合小鼠 (供鼠为C5 7BL/6J,受鼠为C5 7BL/6J×BALB/C杂交F1代小鼠 )的非清髓性骨髓移植模型。采用CSA +MMF或CSA +MTX作为aGVHD预防方案 ,观察 5 0天 ,记录受鼠发生aGVHD情况。结果显示 ,未做aGVHD预防的小鼠在移植后 2 2 - 2 5天出现典型的aGVHD症状 ,aGVHD发生率为 75 % (15 /2 0 ) ,致死率为 10 0 % (15 /15 )。接受aGVHD预防的小鼠 ,aGVHD症状和病理表现均明显减轻 ,CSA +MTX方案组aGVHD发生率为 4 0 % (8/2 0 ) ,致死率为 6 2 .5 % (5 /8) ,CSA +MMF方案组aGVHD发生率为 30 % (6 /2 0 ) ,致死率为 5 0 % (3/6 ) ,均显著低于未预防组 (P <0 .0 5 ) ,但两预防组之间无显著性差异。结论 :CSA +MTX预防方案能有效降低H 2半相合非清髓性骨髓移植小鼠aGVHD的发生率和致死率 ,而CSA +MMF方案能进一步减轻aGVHD的症状及病理损害程度。

In order to research the prophylactic effect of cyclosporine A (CSA) and mycophenolate mofetile (MMF) on GVHD in mice with H 2 haploidentical nonmyeloablative bone marrow transplantation, a murine model was established by using of C57BL/6J mouse as donor and (C57BL/6J×BALB/C) F 1 mouse as the recipient. The recipient mice were given CSA+MTX or CSA+MMF for prophylaxis of acute GVHD (aGVHD). The survival rate, hematopoietic recovery, and morbidity and mortality of aGVHD were observed for 50 days after transplantation. The results showed that typical aGVHD developed in the tranplanted mice without prophylactic treatment during 22 to 25 days after transplantantion. The morbidity of aGVHD was 75%(15/20), 40%(8/20) and 30%(6/20) and mortality was 100%(15/15), 62.5%(5/8) and 50%(3/6) respectively in unprophylactic group (control), CSA+MTX and CSA+MMF groups. In conclusion, CSA and MTX reduce the morbidity and mortality of aGVHD in mice with haploidentical nonmyeloablative bone marrow transplantation, and the effect of CSA+MMF is better than that of CSA+MTX.