Huang Ken, Yang Mengxin, Huang Jinfang, Cao Yaxuan, Zhou Yuhang, Pang Guanxiu, Zhao Jie, Luo Jianming
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.
Clin Transplant. 2025 Mar;39(3):e70108. doi: 10.1111/ctr.70108.
Acute graft-versus-host disease (aGVHD) remains a major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Identifying reliable biomarkers for early prediction of aGVHD could enable timely interventions and improve patient outcomes.
This study aims to assess whether levels of specific cytokines can serve as predictive markers for the onset and severity of aGVHD.
Plasma levels of IL-6, IFN-γ, TNF-α, sST2, CD25, and REG3α were measured via ELISA in 50 allo-HSCT patients (20 with aGVHD and 30 without aGVHD) on Days +7, +14, and +21 post - transplantation. Receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses were used to assess the predictive performance of these biomarkers.
Among the six biomarkers analyzed, sST2 demonstrated the highest predictive accuracy for aGVHD. Elevated sST2 levels at Days +14 and +21 posttransplantation significantly correlated with aGVHD occurrence (AUC = 0.7092 at Day +21) and gastrointestinal aGVHD (AUC = 0.8007 at Day +14). sST2 also showed strong predictive performance for severe aGVHD (Grade II-IV), with AUC values of 0.8125 at Day +7 and 0.8021 at Day +14. Other biomarkers, including IL-6, REG3α, CD25, and TNF-α, exhibited dynamic changes but lacked robust predictive value for aGVHD onset or severity. These findings support sST2 as a promising biomarker for early risk stratification of aGVHD.
SST2 is a promising biomarker for the early prediction of aGVHD, offering potential for guiding proactive therapeutic strategies in allo-HSCT patients.
急性移植物抗宿主病（aGVHD）仍然是异基因造血干细胞移植（allo-HSCT）的主要并发症。识别可靠的生物标志物以早期预测aGVHD能够实现及时干预并改善患者预后。
本研究旨在评估特定细胞因子水平是否可作为aGVHD发生及严重程度的预测标志物。
通过酶联免疫吸附测定法（ELISA）检测50例allo-HSCT患者（20例发生aGVHD，30例未发生aGVHD）移植后第7天、第14天和第21天血浆中白细胞介素-6（IL-6）、干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）、可溶性ST2（sST2）、CD25和再生胰岛衍生蛋白3α（REG3α）的水平。采用受试者工作特征（ROC）曲线和曲线下面积（AUC）分析评估这些生物标志物的预测性能。
在分析的六种生物标志物中，sST2对aGVHD的预测准确性最高。移植后第14天和第21天sST2水平升高与aGVHD发生显著相关（第21天时AUC = 0.7092）以及与胃肠道aGVHD相关（第14天时AUC = 0.8007）。sST2对重度aGVHD（II-IV级）也显示出较强的预测性能，第7天时AUC值为0.8125，第14天时AUC值为0.8021。其他生物标志物，包括IL-6、REG3α、CD25和TNF-α，呈现动态变化，但对aGVHD的发生或严重程度缺乏可靠的预测价值。这些发现支持sST2作为aGVHD早期风险分层的有前景的生物标志物。
SST2是早期预测aGVHD的有前景的生物标志物，为指导allo-HSCT患者的积极治疗策略提供了潜力。
