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自身抗体作为异基因干细胞移植后慢性移植物抗宿主病生物标志物的潜在价值。

Potential value of autoantibodies as biomarkers of chronic graft-versus-host disease after allogeneic stem cell transplantation.

机构信息

National Health Commission (NHC) Key Laboratory of Combined Multi-organ Transplantation, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.

Department of Clinical Laboratory, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.

出版信息

J Zhejiang Univ Sci B. 2019;20(10):849-860. doi: 10.1631/jzus.B1900205.

Abstract

We investigated the value of autoantibodies as biomarkers of chronic graft-versus-host disease (cGVHD) by analyzing the autoantibody profiles of 65 patients (34 cGVHD and 31 non-cGVHD) surviving longer than three months after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Autoantibodies to at least one antigen were detected in 45 patients (70.8%), with multiple autoantibodies detected in 30 patients (46.2%). Antinuclear antibodies (ANAs) were the most frequently detected autoantibodies, with a significantly higher prevalence in non-cGVHD patients and cGVHD patients than that in healthy controls (HCs). ANA-nucleolar (ANA-N) was the main immunofluorescence pattern of ANA-positivity in both the non-cGVHD and cGVHD groups. There was a higher prevalence of anti-Ro52-positivity in non-cGVHD and cGVHD patients than in HC. Liver cGVHD was significantly associated with anti-Ro52-positivity. However, cGVHD activity and severity were not associated with the presence of autoantibodies. Similarly, there were no significant differences in overall survival or relapse among the four groups of patients expressing autoantibodies. Our results suggest that autoantibodies have limited value in predicting cGVHD.

摘要

我们通过分析 65 例(34 例 cGVHD 和 31 例非 cGVHD)在异基因造血干细胞移植(allo-HSCT)后存活时间超过三个月的患者的自身抗体谱,研究了自身抗体作为慢性移植物抗宿主病(cGVHD)生物标志物的价值。在 45 例患者(70.8%)中检测到至少一种抗原的自身抗体,在 30 例患者(46.2%)中检测到多种自身抗体。抗核抗体(ANA)是最常检测到的自身抗体,非 cGVHD 患者和 cGVHD 患者的阳性率明显高于健康对照者(HCs)。ANA-核仁(ANA-N)是非 cGVHD 和 cGVHD 两组 ANA 阳性的主要免疫荧光模式。非 cGVHD 和 cGVHD 患者抗 Ro52 阳性的患病率较高。肝 cGVHD 与抗 Ro52 阳性显著相关。然而,cGVHD 活动度和严重程度与自身抗体的存在无关。同样,在表达自身抗体的四组患者中,总生存率或复发率之间也没有显著差异。我们的研究结果表明,自身抗体预测 cGVHD 的价值有限。

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