Yang L, Wang Z, Wu S, Lu W J, Xiong H
Department of Hematology and oncology, Wuhan children's Hospital Affiliated to Tongji Medical College, Huazhong University of science and technology, Wuhan 430016, China.
Zhonghua Xue Ye Xue Za Zhi. 2021 Sep 14;42(9):757-762. doi: 10.3760/cma.j.issn.0253-2727.2021.09.008.
To explore the correlation between the affinity while donor's HLA type recognizing different cytomegalovirus (CMV) antigen peptide and the occurrence of CMV infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. To investigate the relationship between CMV reactivation, CMV infection or CMV related tissue/organ diseases and the different HLA-type recognition antigen peptide of the donors, we retrospectively analyzed the clinical data of 146 children with CMV infection for 6 months since from the time they underwent transplantation in Wuhan Children's Hospital. Among 146 patients, the HLA type of 82 (56.16%) cases had high affinity with PP65 alone, and 34 cases of CMV infection occurred after transplantation (41.46%) . None of 5 cases that had a high affinity with IE-1 alone got CMV infection. None of 2 cases with no clear high-affinity peptide had CMV infection. Three of 5 cases that had a high affinity with PP65 and PP50 had CMV infection. Thirteen of 52 cases that had a high affinity with PP65 and IE-1 had CMV infection (25.00%) . HLA with exclusive PP50 high affinity was not encountered. Donors with a high-affinity HLA locus associated with IE-1 showed a lower incidence of CMV infection after HSCT compared to those carrying only the PP65 high-affinity allele (22.81% 41.46%, =0.029) . HLA type with PP65 and IE-1 high-affinity covers approximately 99.8% of the donors. Stem cells generated from HLA donors with high affinity with the CMV antigen peptide IE-1 can reduce the risk of post-transplantation CMV-activated infection in children.
探讨儿童异基因造血干细胞移植(allo-HSCT)后供者人类白细胞抗原(HLA)类型识别不同巨细胞病毒(CMV)抗原肽的亲和力与CMV感染发生情况之间的相关性。为研究CMV再激活、CMV感染或CMV相关组织/器官疾病与供者不同HLA类型识别抗原肽之间的关系,我们回顾性分析了武汉市儿童医院146例自移植后6个月内发生CMV感染儿童的临床资料。146例患者中,82例(56.16%)的HLA类型仅与pp65具有高亲和力,移植后发生CMV感染34例(41.46%)。仅与IE-1具有高亲和力的5例患者均未发生CMV感染。2例无明确高亲和力肽的患者均未发生CMV感染。与pp65和PP50具有高亲和力的5例患者中有3例发生CMV感染。与pp65和IE-1具有高亲和力的52例患者中有13例发生CMV感染(25.00%)。未遇到仅与PP50具有高亲和力的HLA。与仅携带PP65高亲和力等位基因的供者相比,与IE-1相关的具有高亲和力HLA位点的供者在HSCT后CMV感染发生率较低(22.81%对41.46%,P=0.029)。具有pp65和IE-1高亲和力的HLA类型覆盖了约99.8%的供者。来自与CMV抗原肽IE-1具有高亲和力的HLA供者的干细胞可降低儿童移植后CMV激活感染的风险。