Chang Y-J, Huang X-J
Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
1] Peking University People's Hospital and Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China [2] Peking-Tsinghua Center for Life Sciences, Beijing, China.
Bone Marrow Transplant. 2014 Jul;49(7):873-9. doi: 10.1038/bmt.2014.19. Epub 2014 Feb 24.
Research on the different mechanisms for crossing HLA barriers has progressed over the past 10 years. General outlines have come into view for a solution to this issue and are often presented as 'haploidentical SCT' immunology. In this review, we discuss several mechanisms that have recently been described in ex vivo and in vivo settings that can either avoid GVHD or promote hematopoietic reconstitution in haploidentical settings. The host and donor T-cell responses to allogeneic HLA molecules are a fundamental obstacle to the successful application of haploidentical transplantation, which results in unacceptably high incidences of GVHD and graft rejection. Thus, the T-cell response is a central factor in the establishment of a novel haploidentical transplant protocol with superior outcomes.
在过去10年中，关于跨越HLA屏障的不同机制的研究取得了进展。解决这一问题的总体框架已初见端倪，并且常被作为“单倍体相合造血干细胞移植”免疫学呈现出来。在本综述中，我们讨论了最近在体外和体内环境中所描述的几种机制，这些机制在单倍体相合环境中要么可以避免移植物抗宿主病（GVHD），要么可以促进造血重建。宿主和供体T细胞对同种异体HLA分子的反应是单倍体相合移植成功应用的一个基本障碍，这导致GVHD和移植物排斥反应的发生率高得令人无法接受。因此，T细胞反应是建立具有更好疗效的新型单倍体相合移植方案的核心因素。
