Beschorner W E, Yardley J H, Tutschka P J, Santos G W
J Infect Dis. 1981 Jul;144(1):38-46. doi: 10.1093/infdis/144.1.38.
A possible deficiency of secretory immunity was investigated in 55 bone marrow recipients and nine control patients by evaluation of lamina propria plasma cells, Peyer's patch and mesenteric lymph node cellularity, and mucosal injury. All short-term survivors had marked depletion of Peyer's patch and mesenteric lymph node cellularity; long-term survivors demonstrated repopulation. In autologous or syngeneic marrow recipients and patients without engraftment, the intestines contained numerous IgA-bearing, IgM-bearing, and total plasma cells, compared with a marked decrease in these cells in patients with allogeneic engraftment. Patients with graft-vs.-host disease (GVHD) had even fewer IgA-bearing plasma cells and much greater mucosal injury. These results suggest that with allogeneic engraftment and GVHD, host intestinal plasma cells are depleted before repopulation and maturation of Peyer's patches and mesenteric lymph nodes with donor cells. These patients, therefore, are at increased risk for infection by intestinal organisms.
通过评估固有层浆细胞、派尔集合淋巴结和肠系膜淋巴结细胞数量以及黏膜损伤情况，对55例骨髓移植受者和9例对照患者的分泌性免疫可能存在的缺陷进行了研究。所有短期存活者的派尔集合淋巴结和肠系膜淋巴结细胞数量均显著减少；长期存活者则表现出细胞数量的重新增多。在自体或同基因骨髓移植受者以及未发生植入的患者中，肠道含有大量携带IgA、IgM的浆细胞以及总的浆细胞，而在同种异体植入患者中这些细胞数量明显减少。患有移植物抗宿主病（GVHD）的患者携带IgA的浆细胞更少，黏膜损伤也更严重。这些结果表明，在同种异体植入和GVHD的情况下，宿主肠道浆细胞在派尔集合淋巴结和肠系膜淋巴结被供体细胞重新填充和成熟之前就已耗尽。因此，这些患者受肠道微生物感染的风险增加。
