Theobald M, Bunjes D, Nierle T, Arnold R, Heimpel H
Department of Immunology, Scripps Research Institute, La Jolla, CA.
Bone Marrow Transplant. 1993;12 Suppl 3:S18-23.
Acute graft-versus-host disease (GVHD) is a serious complication of allogeneic bone marrow transplantation (BMT) from an HLA-identical sibling. There is no practical test before transplantation that gives sufficient information to predict the degree of allogeneic reactivity between HLA-identical siblings. We determined the frequency with which host-specific interleukin-2 (IL-2) -secreting donor T lymphocyte precursors (Tl-p) occurred in 16 pairs of HLA-identical siblings before they underwent marrow grafting. The results were correlated with the development of acute GVHD after BMT. We further analyzed the responding host (and donor) -specific Tl-p with respect to the cell surface phenotype, the influence of previous in vivo priming, and the MHC class restriction of minor histocompatibility (mH) antigen recognition. To investigate whether host-reactive Tl-p are involved in the induction of acute GVHD, we also examined the frequency of host-specific Tl-p at various time intervals after BMT in 14 patients with and without acute GVHD. High frequencies of host-specific Tl-p were detectable before BMT in 8 donors whose siblings later had severe (grade II or III) acute GVHD. Among the donors to 8 patients with mild (grade 0 or I) acute GVHD, low frequencies were found. Various T-cell subsets contributed to the responding Tl-p. The presence of host-specific Tl-p after BMT was significantly correlated with the development of serious (grade II or III) acute GVHD. We conclude that host-specific IL-2-secreting T cells are critically involved in the induction and maintenance of acute GVHD.(ABSTRACT TRUNCATED AT 250 WORDS)
急性移植物抗宿主病（GVHD）是来自 HLA 相同同胞的异基因骨髓移植（BMT）的一种严重并发症。在移植前没有实际可行的检测方法能提供足够信息来预测 HLA 相同同胞之间的同种异体反应程度。我们测定了 16 对 HLA 相同同胞在进行骨髓移植前宿主特异性分泌白细胞介素 -2（IL-2）的供体 T 淋巴细胞前体（Tl-p）出现的频率。结果与 BMT 后急性 GVHD 的发生情况相关。我们进一步分析了反应性宿主（和供体）特异性 Tl-p 的细胞表面表型、先前体内致敏的影响以及次要组织相容性（mH）抗原识别的 MHC 类限制。为了研究宿主反应性 Tl-p 是否参与急性 GVHD 的诱导，我们还检测了 14 例有或无急性 GVHD 的患者在 BMT 后不同时间间隔的宿主特异性 Tl-p 频率。在 8 名供体中，其同胞后来发生严重（II 级或 III 级）急性 GVHD，在 BMT 前可检测到高频率的宿主特异性 Tl-p。在 8 例轻度（0 级或 I 级）急性 GVHD 患者的供体中，发现频率较低。各种 T 细胞亚群促成了反应性 Tl-p。BMT 后宿主特异性 Tl-p 的存在与严重（II 级或 III 级）急性 GVHD 的发生显著相关。我们得出结论，宿主特异性分泌 IL-2 的 T 细胞在急性 GVHD 的诱导和维持中起关键作用。（摘要截短于 250 字）
