Nichols W C, Antin J H, Lunetta K L, Terry V H, Hertel C E, Wheatley M A, Arnold N D, Siemieniak D R, Boehnke M, Ginsburg D
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0650, USA.
Blood. 1996 Dec 15;88(12):4429-34.
Mismatch between bone marrow transplant (BMT) patient and donor for an amino acid polymorphism within the adhesion molecule CD31 has recently been reported to increase risk for the development of graft-versus-host disease (GVHD). We further examined this association in a larger series of 301 BMT patients (227 with grade III/IV GVHD and 74 with grade 0 GVHD) and their HLA-identical sibling donors. CD31 genotypes were determined by polymerase chain reaction and restriction endonuclease digestion. The role of mismatch at the CD31 locus in the development of GVHD was assessed by analyzing the extent of CD31 identity and CD31 compatibility among the grade 0 GVHD and grade III/IV GVHD sibling pairs. No significant association between CD31 mismatch and the development of severe GVHD was detected in our overall patient population. Sixty-three percent of grade III/IV GVHD sibling pairs and 69% of grade 0 GVHD sibling pairs had CD31 genotypes that were identical (P = .36, odds ratio = 1.30). In addition, neither the grade 0 GVHD group (P = .10) nor the grade III/IV GVHD group (P = .27) differed significantly from the expected probability of identity between sibling pairs. Mismatch at the CD31 polymorphism between recipients and donors showed no consistent association with the development of GVHD. Current evidence does not support the value of CD31 mismatch in the selection of BMT donors.
最近有报道称,骨髓移植(BMT)患者与供体在黏附分子CD31内的氨基酸多态性上不匹配会增加移植物抗宿主病(GVHD)的发生风险。我们在301例BMT患者(227例患有III/IV级GVHD,74例患有0级GVHD)及其人类白细胞抗原(HLA)相同的同胞供体的更大系列中进一步研究了这种关联。通过聚合酶链反应和限制性内切酶消化来确定CD31基因型。通过分析0级GVHD和III/IV级GVHD同胞对之间CD31的一致性程度和CD31兼容性,评估CD31基因座不匹配在GVHD发生中的作用。在我们的总体患者群体中,未检测到CD31不匹配与严重GVHD发生之间存在显著关联。III/IV级GVHD同胞对中有63%以及0级GVHD同胞对中有69%的CD31基因型相同(P = 0.36,优势比 = 1.30)。此外,0级GVHD组(P = 0.10)和III/IV级GVHD组(P = 0.27)与同胞对之间预期的相同概率相比,差异均无统计学意义。受体与供体之间CD31多态性的不匹配与GVHD的发生没有一致的关联。目前的证据不支持在选择BMT供体时考虑CD31不匹配的价值。