Sackstein R
Department of Internal Medicine, H. Lee Moffitt Cancer Center, University of South Florida College of Medicine, Tampa 33612.
Semin Oncol. 1993 Oct;20(5 Suppl 6):34-9.
The transplantation of bone marrow requires the recipient to create a new immune system as stem cells divide and differentiate into lymphocyte effector cells. The establishment of host immune capabilities posttransplant is critically dependent on the migration of immature and mature lymphocytes to lymph nodes, as these tissues function principally to promote lymphocyte maturation and differentiation into immunologic effectors. The first step in the directed migration of lymphocytes into lymph nodes is the attachment of the cells to lymph node high endothelial venules (HEVs), and the molecular basis of this interaction is well characterized. Experimental evidence indicates that bone marrow transplantation results in perturbations in the migration of lymphocytes to lymph nodes by affecting lymphocyte-HEV adherence: pretransplant conditioning regimens have toxic effects on HEV that decrease their capacity to support lymphocyte adherence, and the use of pharmacologic agents post-transplant may be associated with alterations in the level of expression of lymphocyte membrane adhesion proteins that mediate attachment to HEV. A greater understanding of these effects should lead to development of transplant regimens that preserve the physiologic trafficking of lymphocytes to lymph node, thereby accelerating the rate of immunologic recovery following transplant.
骨髓移植要求受体在干细胞分裂并分化为淋巴细胞效应细胞时创建一个新的免疫系统。移植后宿主免疫能力的建立严重依赖于未成熟和成熟淋巴细胞向淋巴结的迁移，因为这些组织的主要功能是促进淋巴细胞成熟并分化为免疫效应细胞。淋巴细胞定向迁移至淋巴结的第一步是细胞与淋巴结高内皮微静脉（HEV）的附着，这种相互作用的分子基础已得到充分表征。实验证据表明，骨髓移植通过影响淋巴细胞与HEV的黏附而导致淋巴细胞向淋巴结迁移受到干扰：移植前预处理方案对HEV有毒性作用，会降低其支持淋巴细胞黏附的能力，并且移植后使用药物可能与介导与HEV附着的淋巴细胞膜黏附蛋白表达水平的改变有关。对这些效应有更深入的了解应能促使开发出能保留淋巴细胞向淋巴结生理性迁移的移植方案，从而加快移植后免疫恢复的速度。
