Bowden R A, Dobbs S, Amos D, Meyers J D
Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, Washington 98104.
Transplantation. 1990 Jul;50(1):38-42. doi: 10.1097/00007890-199007000-00008.
Forty-five patients were prospectively studied during the first 100 days after allogeneic marrow transplant to determine the relationship between cytomegalovirus-specific gamma-interferon and interleukin 2 production by peripheral blood mononuclear cells and CMV infection. IL-2 production was significantly lower than normal throughout the study period (P = 0.0001). In contrast, mitogen-induced gamma-interferon production was in the normal range by days 41-60 while CMV antigen induced gamma-interferon production by PBMC was normal by 81-100 days after transplant. Antibody- and complement-depletion studies showed that T4 helper cells were capable of gamma-interferon production in response to CMV antigen despite deficient IL-2 production. Neither gamma-interferon nor IL-2 production distinguished CMV-infected from uninfected patients. However, CMV-infected patients had significantly more T8 cytotoxic/suppressor cells than did uninfected patients by 81-100 days after transplant (P = 0.001). In vitro addition of IL-2 significantly increased gamma-interferon production by PBMC from patients with reduced production, suggesting that decreased gamma-interferon production may be related to deficient IL-2 production. Deficiencies in both CMV-specific IL-2 and gamma-interferon production may contribute to the high frequency and severity of CMV infection after marrow transplantation.
对45例接受异基因骨髓移植的患者进行了为期100天的前瞻性研究,以确定外周血单个核细胞产生的巨细胞病毒特异性γ干扰素和白细胞介素2与巨细胞病毒感染之间的关系。在整个研究期间,白细胞介素2的产生显著低于正常水平(P = 0.0001)。相比之下,在第41 - 60天时,丝裂原诱导的γ干扰素产生处于正常范围,而移植后81 - 100天时,巨细胞病毒抗原诱导的外周血单个核细胞γ干扰素产生正常。抗体和补体耗竭研究表明,尽管白细胞介素2产生不足,但T4辅助细胞能够对巨细胞病毒抗原产生γ干扰素。无论是γ干扰素还是白细胞介素2的产生,都无法区分巨细胞病毒感染患者和未感染患者。然而,在移植后81 - 100天时,巨细胞病毒感染患者的T8细胞毒性/抑制细胞明显多于未感染患者(P = 0.001)。体外添加白细胞介素2可显著增加产生减少的患者外周血单个核细胞的γ干扰素产生,这表明γ干扰素产生减少可能与白细胞介素2产生不足有关。巨细胞病毒特异性白细胞介素2和γ干扰素产生的不足可能导致骨髓移植后巨细胞病毒感染的高发生率和严重程度。