B 细胞亚群的显著差异是慢性移植物抗宿主病相关低丙种球蛋白血症患者的特征。

Significant differences in B-cell subpopulations characterize patients with chronic graft-versus-host disease-associated dysgammaglobulinemia.

机构信息

Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Vienna, Austria.

出版信息

Blood. 2011 Feb 17;117(7):2265-74. doi: 10.1182/blood-2010-07-295766. Epub 2010 Nov 9.

Abstract

Manifestations of chronic graft-versus-host disease (cGVHD) can resemble those seen in immunodeficiency states and autoimmune disorders. Reports by us and others suggest an involvement of B cells in the pathogenesis of cGVHD. We investigated B-lymphocyte subpopulations in cGVHD cohorts defined by serum immunoglobulin G (IgG) levels to characterize novel biomarkers for impairment of humoral immunity after allogeneic hematopoietic stem cell transplantation. Seventy-six patients were enrolled a median of 46 months after hematopoietic stem cell transplantation. The hypogammaglobulinemia group had significantly diminished CD19(+) B cells (165 vs 454 vs 417 × 10⁶L) with elevated CD19(+)CD21(low) immature (16.5%, 7.7%, and 9.1%) and CD19(+)CD21(int-high)CD38(high)IgM(high) transitional (10.5% vs 4.2% vs 6.3%) B-cell proportions compared with the normogammaglobulinemia and hypergammaglobulinemia groups. CD19(+)CD10(-)CD27(-)CD21(high) naive B cells were highly elevated in all patients with cGVHD. CD19(+)CD27(+)IgD(+) non-class-switched (4 vs 12 vs 11 × 10⁶/L) and class-switched (7 vs 35 vs 42 × 10⁶/L) memory B cells were significantly lower in the hypogammaglobulinemia group compared with the others. Besides significantly higher B-cell activation factor/B-cell ratios, significantly more cGVHD patients with hypergammaglobulinemia had autoantibodies compared with the hypogammaglobulinemia subgroup (68% vs 24%, P = .024). In conclusion, B-cell subpopulations can serve as novel cellular biomarkers for immunodeficiency and autoimmunity indicating different pathogenetic mechanisms of cGVHD and encouraging future prospective longitudinal studies.

摘要

慢性移植物抗宿主病(cGVHD)的表现类似于免疫缺陷状态和自身免疫性疾病。我们和其他人的报告表明 B 细胞参与了 cGVHD 的发病机制。我们研究了根据血清免疫球蛋白 G(IgG)水平定义的 cGVHD 队列中的 B 淋巴细胞亚群,以表征异基因造血干细胞移植后体液免疫受损的新型生物标志物。76 名患者在造血干细胞移植后中位数为 46 个月时入组。低丙种球蛋白血症组的 CD19(+)B 细胞明显减少(165 与 454 与 417×10⁶/L),幼稚 CD19(+)CD21(low)(16.5%、7.7%和 9.1%)和 CD19(+)CD21(int-high)CD38(high)IgM(high)过渡(10.5%与 4.2%与 6.3%)B 细胞比例升高,与正常丙种球蛋白血症和高丙种球蛋白血症组相比。所有 cGVHD 患者的 CD19(+)CD10(-)CD27(-)CD21(high)幼稚 B 细胞高度升高。CD19(+)CD27(+)IgD(+)未类别转换(4 与 12 与 11×10⁶/L)和类别转换(7 与 35 与 42×10⁶/L)记忆 B 细胞在低丙种球蛋白血症组明显低于其他组。除了 B 细胞激活因子/B 细胞比值明显升高外,高丙种球蛋白血症组中 cGVHD 患者自身抗体的比例也明显高于低丙种球蛋白血症亚组(68%与 24%,P=0.024)。总之,B 细胞亚群可作为免疫缺陷和自身免疫的新型细胞生物标志物,表明 cGVHD 的不同发病机制,并鼓励未来进行前瞻性纵向研究。

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