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非清髓性造血干细胞移植后的淋巴细胞重建遵循两种模式,这取决于年龄以及供体/受体嵌合情况。

Lymphocyte reconstitution following non-myeloablative hematopoietic stem cell transplantation follows two patterns depending on age and donor/recipient chimerism.

作者信息

Savage W J, Bleesing J J, Douek D, Brown M R, Linton G M, Malech H L, Horwitz M E

机构信息

Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Building 10 Room 11N113, Bethesda, MD 20892-1886, USA.

出版信息

Bone Marrow Transplant. 2001 Sep;28(5):463-71. doi: 10.1038/sj.bmt.1703176.

Abstract

The effect of mixed chimerism on the pace of post-transplant immune reconstitution is unknown. Using flow cytometry, recall and neo-antigen vaccine responses, and T cell receptor recombination excision circle (TREC) quantification, we evaluated phenotypic and functional characteristics of T and B cells in nine patients following non-myeloablative, HLA-identical peripheral blood stem cell transplantation for chronic granulomatous disease. Engraftment of T cell, B cell, and myeloid lineages proceeded at similar paces within each patient, but engraftment kinetics segregated patients into two groups: adults, who became full donor T cell chimeras before 6 months (rapid engrafters) and children, who became full donor T cell chimeras after 6 months or not at all (slow engrafters). Quantitative B cell recovery was achieved by 6 weeks after transplantation in children, but was delayed until 1 year in adults. Early quantitative B cell recovery was not accompanied by an early humoral immune response to tetanus toxoid (TT). Emergence of TT-specific T cell responses coincided with naive T cell reconstitution, as measured by CD4/CD45RA T cell recovery and TREC quantification. These data suggest that immune reconstitution occurs faster in pediatric patients who have prolonged mixed hematopoietic chimerism compared to adults, who have rapid donor stem cell engraftment.

摘要

混合嵌合状态对移植后免疫重建速度的影响尚不清楚。我们运用流式细胞术、回忆性和新抗原疫苗反应以及T细胞受体重组切除环(TREC)定量分析,对9例慢性肉芽肿病患者在接受非清髓性、HLA相合同胞外周血干细胞移植后的T细胞和B细胞的表型及功能特征进行了评估。在每位患者体内,T细胞、B细胞和髓系细胞系的植入进程相似,但植入动力学将患者分为两组:在6个月前成为完全供体T细胞嵌合体的成年人(快速植入者)和在6个月后才成为完全供体T细胞嵌合体或根本未成为完全供体T细胞嵌合体的儿童(缓慢植入者)。儿童在移植后6周实现了B细胞数量的恢复,但成年人则延迟至1年。早期B细胞数量的恢复并未伴随着对破伤风类毒素(TT)的早期体液免疫反应。通过CD4/CD45RA T细胞恢复和TREC定量分析测定,TT特异性T细胞反应的出现与初始T细胞重建同时发生。这些数据表明,与供体干细胞快速植入的成年人相比,具有延长混合造血嵌合状态的儿科患者的免疫重建速度更快。

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