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重组人白细胞介素-11与重组人粒细胞集落刺激因子联合治疗供体对降低异基因骨髓移植后致死性移植物抗宿主病发生率的意义

[Significance of donors treatment with combination of recombinant human interleukin-11 and recombinant human granulocyte-colony stimulating factor in reduction of incidence of lethal grafts versus host disease after allogeneic bone marrow transplantation].

作者信息

Zhao Jie, Zhao Xiang-yu, Huang Xiao-jun

机构信息

Institute of Hematology & People's Hospital, Peking University, Beijing 100044, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 Sep 14;85(35):2497-502.

Abstract

OBJECTIVE

To investigate the effects of donor treatment with combination of recombinant human interleukin-11 (rhIL-11) and recombinant human granulocyte-colony stimulating factor (rhG-CSF) on incidence of lethal graft versus host disease (GVHD) after allogeneic bone marrow transplantation (BMT).

METHODS

Forty C57BL/6 mice, as donors, were treated with phosphate buffered saline (PBS), or optimal doses of rhG-CSF, rhIL-11, or rhG-CSF + rhIL-11 for five consecutive days. Fifty BALB/C mice, as recipients, received a lethal dose of 8.0 Gy total body irradiation (TBI) 4-6 h before the transplantation. Ten C57BL/6 mice without transplantation were used as pure radiation control group (group A). The other 40 C57BL/6 mice received the allogeneic bone marrow from the donors treated with PBS (group B), rhG-CSF (group C), rhIL-11 (group D), or rhG-CSF + rgIL-11 (group E) 14 and 30 days after the transplantation, suspensions of bone marrow cells were prepared from the 4 groups. Monoclone antibody of PE-H-2D(b) was added. The percentage of the H-2D(b) positive cells was observed by flow cytometry to detect the chimerism to determine the proportion of the cells of donor origin. The liver, spleen, intestine, and skin tissues of the mice presenting symptoms of GVHD were taken out before the diseased mice died. The long-surviving mice were killed 60 days after the transplantation and the above-mentioned tissues were taken out. Light microscopy was used to observe the pathological changes. 14 days after transplantation, the spleen cells of the different groups were obtained to undergo mixed leucocyte reaction (MLR), and 14 days after transplantation another spleen cells of groups B, C, D, and E were obtained to prepare suspension of mononuclear cells to test the levels of IL-4, interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha by ELISA.

RESULT

The survival time of group E was 38 d +/- 19 d, significantly longer than the other groups (all P < 0.01). The survival times of groups C and D were 23 d +/- 8 d and 25 d +/- 15 d respectively, both significantly longer than that of group B (14 d +/- 4 d, both P < 0.01). The mice of group A all died within 8 days with a survival time of 6.2 d +/- 1.3 d. The GVHD pathological changes were milder in group E than in the other groups. 14 and 30 days after transplantation, the percentage of H-2D(b) antibody positive cells was over 95% in all surviving transplanted mice. All the mice of group B developed GVHD, and the earlier GVHD appeared the severer the pathological changes. In group E 3 mice developed GVHD more than 20 days after transplantation, 7 mice survived more than 30 days, and 4 survived 60 days without any sign of GVHD. The pathological changes in the tissues of the mice that died within 20 days were more remarkable than those of the mice that died 20 days or more after transplantation. The levels of IFN-gamma of group C, D, and E were significantly lower than that of group B, and the levels of IL-4 of group C, D, and E were significantly higher than that of group B (all P < 0.01). The level of IFN-gamma of group E was significantly lower than those of groups C and D, and the level of IL-4 of group E was significantly higher than those of groups C and D (all P < 0.05). The levels of group D and E were significantly lower than those of group B and C (all P < 0.01). The MLR 14 days after transplantation showed that the proliferation to host alloantigen of group E was 0.22 +/- 0.08, significantly lower than those of groups B, C, and D (0.87 +/- 0.14, 0.54 +/- 0.21, and 0.49 +/- 0.18 respectively, all P < 0.01).

CONCLUSION

Donor treatment with the combination of rhIL-11 and rhG-CSF shows a synergic function in inducing immune tolerance, and significantly reduces the incidence of lethal GVHD after BMT.

摘要

目的

探讨重组人白细胞介素-11(rhIL-11)与重组人粒细胞集落刺激因子(rhG-CSF)联合处理供体对异基因骨髓移植(BMT)后致死性移植物抗宿主病(GVHD)发生率的影响。

方法

40只C57BL/6小鼠作为供体,连续5天分别用磷酸盐缓冲液(PBS)、最佳剂量的rhG-CSF、rhIL-11或rhG-CSF + rhIL-11处理。50只BALB/C小鼠作为受体,在移植前4 - 6小时接受8.0 Gy的致死性全身照射(TBI)。10只未进行移植的C57BL/6小鼠作为单纯辐射对照组(A组)。另外40只C57BL/6小鼠在移植后14天和30天分别接受经PBS处理(B组)、rhG-CSF处理(C组)、rhIL-11处理(D组)或rhG-CSF + rhIL-11处理(E组)的供体的异基因骨髓。从这4组制备骨髓细胞悬液,加入PE-H-2D(b)单克隆抗体,通过流式细胞术观察H-2D(b)阳性细胞百分比以检测嵌合情况,确定供体来源细胞的比例。在出现GVHD症状的小鼠死亡前取出其肝脏、脾脏、肠道和皮肤组织。移植后60天处死长期存活的小鼠并取出上述组织,用光学显微镜观察病理变化。移植后14天,获取不同组的脾细胞进行混合淋巴细胞反应(MLR),移植后14天,再获取B、C、D、E组的脾细胞制备单核细胞悬液,通过ELISA检测白细胞介素-4(IL-4)、干扰素(IFN)-γ和肿瘤坏死因子(TNF)-α水平。

结果

E组存活时间为38 d±19 d,显著长于其他组(均P < 0.01)。C组和D组存活时间分别为23 d±8 d和25 d±15 d,均显著长于B组(14 d±4 d,均P < 0.01)。A组小鼠均在8天内死亡,存活时间为6.2 d±1.3 d。E组GVHD病理变化较其他组轻。移植后14天和30天,所有存活的移植小鼠中H-2D(b)抗体阳性细胞百分比均超过95%。B组所有小鼠均发生GVHD,且GVHD出现越早,病理变化越严重。E组3只小鼠在移植后20多天发生GVHD,7只小鼠存活超过30天,4只存活60天且无任何GVHD迹象。在20天内死亡的小鼠组织病理变化比移植后20天或更久死亡的小鼠更显著。C、D、E组IFN-γ水平显著低于B组,C、D、E组IL-4水平显著高于B组(均P < 0.01)。E组IFN-γ水平显著低于C组和D组,E组IL-4水平显著高于C组和D组(均P < 0.05)。D组和E组TNF-α水平显著低于B组和C组(均P < 0.01)。移植后14天的MLR显示,E组对宿主同种异体抗原的增殖为0.22±0.08,显著低于B、C、D组(分别为0.87±0.14、0.54±0.21和0.49±0.18,均P < 0.01)。

结论

rhIL-11与rhG-CSF联合处理供体在诱导免疫耐受方面具有协同作用,并显著降低BMT后致死性GVHD的发生率。

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