Dickinson Anne M, Charron Dominique
Haematological Sciences, School of Clinical and Laboratory Sciences, The Medical School, Framlington Place, Newcastle upon Tyne, UK.
Curr Opin Immunol. 2005 Oct;17(5):517-25. doi: 10.1016/j.coi.2005.07.017.
Hematopoietic stem cell transplantation (HSCT) provides a unique environment in which to evaluate the role of immunogenetics of both the donor and the recipient to success of the procedure. The central role of HLA matching in HSCT has been established; however, recipients of allogeneic HSCT incur the risk of graft versus host disease (GVHD) even when the donor is a sibling who shares the major histocompatibility genes. Therefore, the perfect HLA match does not represent the optimal genetic make up. Other genetic systems operate and affect the various outcomes of HSCT, including GVHD, infections, transplant-related mortality, and overall survival. Minor histocompatibility antigens contribute to the control of GVHD as well as graft versus leukaemia reactions. In addition, genes controlling inflammatory processes, including cytokines, chemokines and their receptors, can modulate GVHD, and genes from both arms of the immune response (innate and adaptive) are strong candidates for susceptibility factors to infections in allogenic transplantation.
造血干细胞移植（HSCT）提供了一个独特的环境，可用于评估供体和受体的免疫遗传学对该治疗成功的作用。HLA配型在HSCT中的核心作用已得到确立；然而，即使供体是共享主要组织相容性基因的同胞，异基因HSCT的受者仍有发生移植物抗宿主病（GVHD）的风险。因此，完美的HLA匹配并不代表最佳的基因组成。其他遗传系统也发挥作用并影响HSCT的各种结果，包括GVHD、感染、移植相关死亡率和总生存率。次要组织相容性抗原有助于控制GVHD以及移植物抗白血病反应。此外，控制炎症过程的基因，包括细胞因子、趋化因子及其受体，可调节GVHD，并且免疫反应（固有免疫和适应性免疫）两个分支的基因都是同种异体移植中感染易感性因素的有力候选者。
