Blood and Marrow Transplant Program, The University of Michigan, Ann Arbor, MI 48109-5942, USA.
Blood. 2012 Mar 22;119(12):2960-3. doi: 10.1182/blood-2011-10-387357. Epub 2012 Jan 27.
The lower gastrointestinal tract (LGI) and liver are the GVHD target organs most associated with treatment failure and nonrelapse mortality. We recently identified regenerating islet-derived 3-α (REG3α) as a plasma biomarker of LGI GVHD. We compared REG3α with 2 previously reported GI and liver GVHD diagnostic biomarkers, hepatocyte growth factor (HGF) and cytokeratin fragment 18, in 954 hematopoietic cell transplantation patients. All 3 biomarkers were significantly elevated in LGI GVHD compared with non-GVHD diarrhea; REG3α discerned LGI GVHD from non-GVHD diarrhea better than HGF and cytokeratin fragment 18. Although all 3 biomarkers predicted nonresponse to therapy at day 28 in LGI GVHD patients, only REG3α and HGF concentrations predicted 1-year nonrelapse mortality (P = .01 and P = .02, respectively). Liver GVHD without GI involvement at GVHD onset and non-GVHD liver complications were uncommon; all 3 biomarkers were elevated in liver GVHD, but did not distinguish GVHD from other causes of hyperbilirubinemia.
下胃肠道（LGI）和肝脏是与治疗失败和非复发死亡率最相关的 GVHD 靶器官。我们最近发现再生胰岛衍生 3-α（REG3α）是 LGI GVHD 的血浆生物标志物。我们将 REG3α与 2 种先前报道的 GI 和肝脏 GVHD 诊断生物标志物，肝细胞生长因子（HGF）和细胞角蛋白 18，在 954 例造血细胞移植患者中进行了比较。与非 GVHD 腹泻相比，所有 3 种生物标志物在 LGI GVHD 中均显著升高；与 HGF 和细胞角蛋白 18 相比，REG3α更能区分 LGI GVHD 与非 GVHD 腹泻。尽管所有 3 种生物标志物均预测 LGI GVHD 患者在第 28 天对治疗无反应，但只有 REG3α 和 HGF 浓度预测了 1 年非复发死亡率（分别为 P =.01 和 P =.02）。GVHD 发作时无 GI 受累的肝脏 GVHD 和非 GVHD 肝脏并发症并不常见；所有 3 种生物标志物在肝脏 GVHD 中均升高，但不能区分 GVHD 与其他高胆红素血症的原因。
