Pediatric Hemato-Oncology and Bone Marrow Transplant Department, Meyer Children's Hospital, Rambam Health Care Campus, 8 Ha'liyah Strteet, Haifa, Israel.
Bone Marrow Transplant. 2010 Dec;45(12):1728-31. doi: 10.1038/bmt.2010.61. Epub 2010 Mar 29.
Hematopoietic SCT (HSCT) from HLA-matched donors is sometimes complicated by GVHD or graft rejection, because of mismatched mHA. This study presents data suggesting the involvement of glutathione S-transferase theta-1 (GSTT1), a phase II detoxifying enzyme encoded by GSTT1, in Ab-mediated rejection of HSCT in children with congenital hemoglobinopathies (CHs). Mismatch of GSTT1, which often features a deletion polymorphism variant, can have major consequences in solid organ transplantation outcome. In liver transplantation, it has been shown to lead to de novo hepatitis, whereas in kidney transplantation, chronic allograft rejection has been documented. In this study on 18 children with CH who underwent HSCT, five cases of graft rejection occurred, all in GSTT1-null patients, four of which featured anti-GSTT1 antibodies. The data suggest that when GSTT1-null patients are transplanted with a GSTT1-positive graft, rejection due to an Ab-mediated immune response against GSTT1 displayed on transplanted stem cells may take place. Thus, it seems that detection of anti-GSTT1 antibodies in patients with a GSTT1-null genotype before transplantation may be predictive of graft rejection in the event of a GSTT1-positive donor.
造血干细胞移植（HSCT）来自 HLA 匹配的供体有时会因错配 mHA 而导致移植物抗宿主病或排斥反应。本研究提供的数据表明，谷胱甘肽 S-转移酶 theta-1（GSTT1），一种由 GSTT1 编码的 II 相解毒酶，参与了先天性血红蛋白病（CHs）儿童 HSCT 中抗体介导的排斥反应。GSTT1 的错配，通常表现为缺失多态性变体，在实体器官移植结果中可能会产生重大影响。在肝移植中，已证明它会导致新发性肝炎，而在肾移植中，已记录到慢性移植物排斥反应。在这项对 18 名接受 HSCT 的 CH 儿童的研究中，发生了 5 例移植物排斥反应，均发生在 GSTT1 缺失的患者中，其中 4 例存在抗 GSTT1 抗体。这些数据表明，当 GSTT1 缺失的患者接受 GSTT1 阳性移植物移植时，可能会发生针对 GSTT1 阳性干细胞上显示的 GSTT1 的抗体介导的免疫反应引起的排斥反应。因此，似乎在 GSTT1 缺失基因型的患者在 GSTT1 阳性供体的情况下接受移植前检测抗 GSTT1 抗体可能预测移植物排斥反应。
