Fuji Shigeo, Kapp Markus, Einsele Hermann
Department of Internal Medicine II, Division of Hematology, University Hospital of Würzburg , Würzburg , Germany ; Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital , Tokyo , Japan.
Front Immunol. 2013 Sep 17;4:276. doi: 10.3389/fimmu.2013.00276.
The clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT) has been significantly improved during the last decades with regard to the reduction in organ failure, infection, and severe acute graft-versus-host disease. However, severe complications due to infectious diseases are still one of the major causes of morbidity and mortality after allogeneic HSCT, in particular in patients receiving haploidentical HSCT or cord blood transplant due to a slow and often incomplete immune reconstitution. In order to improve the immune control of pathogens without an increased risk of alloreactivity, adoptive immunotherapy using highly enriched pathogen-specific T cells offers a promising approach. In order to identify patients who are at high risk for infectious diseases, several monitoring assays have been developed with potential for the guidance of immunosuppressive drugs and adoptive immunotherapy in clinical practice. In this article, we aim to give a comprehensive overview regarding current developments of T-cell monitoring techniques focusing on T cells against viruses and fungi. In particular, we will focus on rather simple, fast, non-labor-intensive, cellular assays which could be integrated in routine clinical screening approaches.
在过去几十年中，异基因造血干细胞移植（HSCT）后的临床结局在器官衰竭、感染及严重急性移植物抗宿主病的减少方面有了显著改善。然而，传染病导致的严重并发症仍是异基因HSCT后发病和死亡的主要原因之一，尤其是在接受单倍体HSCT或脐血移植的患者中，因为免疫重建缓慢且往往不完全。为了在不增加同种异体反应风险的情况下改善对病原体的免疫控制，使用高度富集的病原体特异性T细胞进行过继性免疫治疗提供了一种有前景的方法。为了识别有传染病高风险的患者，已经开发了几种监测检测方法，有可能在临床实践中指导免疫抑制药物和过继性免疫治疗。在本文中，我们旨在全面概述T细胞监测技术的当前发展，重点关注针对病毒和真菌的T细胞。特别是，我们将关注可整合到常规临床筛查方法中的相当简单、快速、非劳动密集型的细胞检测方法。
