急性移植物抗宿主病患者血浆中细胞因子的水平及其意义

Plasma cytokines in the patients with acute graft-versus-host disease and significance

目的 探讨异基因外周血干细胞移植发生急性移植物抗宿主病 (aGVHD)时血浆中相关细胞因子水平及其与aGVHD的关系。方法 酶联免疫吸附法测定 2 0例恶性血液病患者异基因外周血干细胞移植前后及发生aGVHD时的血浆白细胞介素 18(IL 18)、白细胞介素 2受体 (IL 2R)、肿瘤坏死因子α(TNF α)及白细胞介素 10 (IL 10 )水平。结果 所有患者的造血功能均获得重建 ;发生Ⅰ～Ⅱ度aGVHD者 8例 ,Ⅲ～Ⅳ度aGVHD者 3例 ;发生aGVHD者血浆IL 18及IL 2R水平显著高于无aGVHD者 ,且IL 18水平与aGVHD的严重程度呈正相关 ;TNF α水平在移植前后无显著变化 ;发生aGVHD者的IL 10水平明显下降 ,而无aGVHD者则较移植前显著上升。结论 来源于TH1细胞的Ⅰ类细胞因子和来源于TH2细胞的Ⅱ类细胞因子在aGVHD发生中具有相反作用。

Objective To study the relationship between type 1 and type 2 cytokines and human acute graft-versus-host disease (aGVHD).Methods In 20 patients undergoing allogeneic peripheral blood stem cell transplantation (allo-PBSCT), plasma concentrations of interleukin-18 (IL-18), interleukin-2R (IL-2R), tumor necrosis factor-a (TNF-α) and interleukin-10 (IL-10) were measured by using enzyme-linked immunosorbent assay (ELISA).Results All the patients achieved engraftment. Eight cases deve- loped grade Ⅰ-Ⅱ aGVHD and 3 cases developed Ⅲ-Ⅳ aGVHD. The concentrations of IL-18 and IL-2R in the patients with aGVHD were significantly higher than those without aGVHD. The levels of IL-18 were correlated with the severity of aGVHD; The levels of TNF-α showed no difference between the patients with or without aGVHD; The concentrations of IL-10 in the patients with aGVHD were significantly declined but in those without aGVHD were significantly increased.Conclusion Type 1 and type 2 cytokines play an important opposite role in development of aGVHD.