异基因免疫治疗中控制GVHD发生的研究进展

目前,异基因造血干细胞移植(allo-HSCT)已成为治疗某些恶性血液病的有效手段之一,然而伴随其而来的移植物抗宿主病(GVHD)是导致移植后患者死亡的重要并发症之一。因此,如何诱导移植后免疫耐受来控制GVHD,尤其是控制急性移植物抗宿主病(a GVHD)的发生及已成为研究的重要内容。GVHD的发生机制非常复杂,但最终为供者骨髓内的成熟T淋巴细胞识别受者体内的细胞表面的MHC-I和MHC-II及所递呈的多肽而导致供者的T细胞的激活、增殖并浸润到GVHD的靶器官如皮肤、小肠及肝脏并导致靶器官的损伤1]。临床移植学和移植免疫学主要攻克的内容之一就是如何控制GVHD的发生发展。其预防和治疗是决定着同种异基因造血干细胞移植(allo-HSCT)是否成功的关键所在,移植个体是否长期存活的主要因素之一。本文章就导致GVHD现象的原因及最新进展做一总结。

Allogeneic Immune Therapy in the Research on Controlling GVHD Occurrence

Allogeneic hematopoietic stem cell transplantation has become one of the effective means of treatment of certain malignancies. But with its of graft versus host disease (GVHD) is one of the important complications of death patients after transplantation. Therefore, how to induce GVHD after transplantation immune tolerance to control, especially control the occurrence of acute graft versus host disease (aGVHD) has become an important part of the study. The occurrence of GVHD mechanism is very complicated. But ultimately identify for mature T cells within the bone marrow donor recipient cells on the surface of the MHC - I and MHC II and caused peptides presented by donor T cell activation, proliferation and infiltration of GVHD target organs such as skin, small intestine and the liver and lead to target organs damage. Clinical implantology and transplantation immunology is one of the contents of the main crack how to control the occurrence of GVHD development. The prevention and treatment is the key to success of allogeneic hematopoietic stemcell transplantation. Individual transplantation is one of the main factors of long-term survival. Related cytokines application and related mechanism research, to a great extent, effective control of the development of GVHD. such as CD4+CD25+Tregs, ecto-59-nucleotidase( CD73), natural killer cell(NK cells), Granulocyte colony-stimulating-factor (G-CSF), Mesenchymal stem cells(MSC), Inducible T cell costimnlator(ICOS) and so on.This article about the cause of GVHD phenomenon and summarize the latest progress.