Liem L M, van Noort J T, Goulmy E
Department of Immunohematology and Blood Bank, Leiden University Hospital, The Netherlands.
Bone Marrow Transplant. 1996 Jul;18(1):73-8.
It is generally accepted that cytotoxic T cells (CTLs) play an important role in the pathogenesis of graft-versus-host disease (GVHD). Nonetheless, anti-host CTLs can be observed in the peripheral blood of patients both with and without clinical signs of GVHD following HLA genotypically identical bone marrow transplantation. Thus we questioned whether a qualitative difference, such as a differential in vitro sensitivity to cyclosporin A (CsA), may exist between the anti-host CTLs, generated from these groups of patients post-bone marrow transplantation (BMT). We analyzed anti-host CTL precursors (CTLp) of patients without clinical signs of GVHD, of patients suffering from acute GVHD (grade II-IV) and of patients suffering from acute GVHD followed by chronic GVHD for their in vitro sensitivity to the inhibitory effects of CsA. The results obtained in a total of 20 patients revealed anti-host CTLp frequencies (CTLpf) post-BMT in all three groups of patients and addition of CsA in the tests resulted in approximately 60% inhibition of the CTLpf independent of the GVHD status of the patients. Thus, in view of the in vitro CsA sensitivity, no difference exists between the anti-host CTLs in patients with or without GVHD.
普遍认为细胞毒性T细胞(CTLs)在移植物抗宿主病(GVHD)的发病机制中起重要作用。然而,在HLA基因型相同的骨髓移植后,无论有无GVHD临床症状的患者外周血中均可观察到抗宿主CTLs。因此,我们质疑这些骨髓移植(BMT)后患者组产生的抗宿主CTLs之间是否存在质的差异,例如对环孢素A(CsA)的体外敏感性差异。我们分析了无GVHD临床症状的患者、患有急性GVHD(II-IV级)的患者以及患有急性GVHD继之以慢性GVHD的患者的抗宿主CTL前体(CTLp)对CsA抑制作用的体外敏感性。在总共20例患者中获得的结果显示,三组患者BMT后的抗宿主CTLp频率(CTLpf),并且在试验中添加CsA导致CTLpf受到约60%的抑制,与患者的GVHD状态无关。因此,鉴于体外对CsA的敏感性,有或无GVHD患者的抗宿主CTLs之间不存在差异。