Helbig Grzegorz, Krzemień Sławomira, Francuz Tomasz, Wojnar Jerzy, Hołowiecki Jerzy
Department of Hematology and Bone Marrow Transplantation, Silesian Medical University, Katowice, Poland.
Med Sci Monit. 2008 Nov;14(11):CR584-8.
The potential role of elastin in patients with myeloid leukemia treated with hematopoietic stem cell transplantation (HSCT) has not been investigated so far. The objective of the study was to evaluate elastin metabolism before and at two time-points after HSCT.
MATERIAL/METHODS: Forty patients (22 male and 18 female, median age: 34 years, range: 14-54) were included. The diagnoses were acute myeloid leukemia (AML, n=25) and chronic myeloid leukemia (CML, n=15). Busulfan and cyclophosphamide (4+2) were administered as conditioning. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate. Twenty-three patients experienced acute GVHD and 17 developed chronic GVHD. Plasma elastase activity (EA) and plasma elastin-derived peptide concentration (EDPc) were measured.
There were statistically significant differences in EA before HSCT (1.3 U/ml) compared with day +30 (2.9 U/ml) and day +100 (3.2 U/ml) after HSCT (p<0.001 for both). EA was also higher in patients with chronic GVHD than in those who did not develop chronic GVHD. EDPc was significantly higher on days +30 (49.3 U/ml) and +100 (57.7 U/ml) after HSCT than on day -10 before HSCT (15.5 U/ml, p<0.001 for both). EDPc was significantly higher in patients with chronic GVHD.
EA and EDPc were increased in patients after HSCT. If the role of elastase in the pathogenesis of GVHD is confirmed, it will be possible to apply inhibitors of elastases in the treatment of this condition in the near future.
迄今为止，尚未研究弹性蛋白在接受造血干细胞移植（HSCT）治疗的髓系白血病患者中的潜在作用。本研究的目的是评估HSCT前及HSCT后两个时间点的弹性蛋白代谢情况。
材料/方法：纳入40例患者（男性22例，女性18例，中位年龄：34岁，范围：14 - 54岁）。诊断为急性髓系白血病（AML，n = 25）和慢性髓系白血病（CML，n = 15）。采用白消安和环磷酰胺（4 + 2）进行预处理。移植物抗宿主病（GVHD）预防方案包括环孢素和甲氨蝶呤。23例患者发生急性GVHD，17例发生慢性GVHD。检测血浆弹性蛋白酶活性（EA）和血浆弹性蛋白衍生肽浓度（EDPc）。
HSCT前EA为1.3 U/ml，与HSCT后第30天（2.9 U/ml）和第100天（3.2 U/ml）相比，差异有统计学意义（两者p < 0.001）。慢性GVHD患者的EA也高于未发生慢性GVHD的患者。HSCT后第30天（49.3 U/ml）和第100天（57.7 U/ml）的EDPc显著高于HSCT前第 - 10天（15.5 U/ml，两者p < 0.001）。慢性GVHD患者的EDPc显著更高。
HSCT后患者的EA和EDPc升高。如果弹性蛋白酶在GVHD发病机制中的作用得到证实，在不久的将来有可能应用弹性蛋白酶抑制剂来治疗这种疾病。
