Nagler A, Bishara A, Brautbar C, Barak V
Department of Bone Marrow Transplantation, Hebrew University-Hadassah Medical School and Hadassah University Hospital, Jerusalem, Israel.
Cytokines Cell Mol Ther. 1998 Sep;4(3):161-7.
The dysregulation of cytokines is thought to play a role in the inflammatory and allospecific components of graft-versus-host disease (GVHD) and graft rejection (GR) post allogeneic bone marrow transplantation (BMT). Both complications occur post unrelated BMT at significantly higher frequencies than post BMT from identical sibling donors. The levels of tumor necrosis factor alpha (TNF-alpha) and interleukin (IL)-1beta, IL-6, IL-10 and IL-12 following unrelated BMT were measured to examine cytokine dysregulation involvement in GVHD and GR. Of the 26 patients included in this study, 15 developed GVHD (14 acute; 1 acute and chronic), 5 had GR and 6 had uneventful BMT. TNF-alpha was markedly elevated in 13/15 of the patients with GVHD and in 3/5 patients with GR. IL-6 was elevated in patients with acute GVHD and with GR. IL-12 levels were similar in pre- and post-BMT sera. No correlation was found between HLA-C match and cytokine levels. In conclusion, a positive correlation was found between elevated levels of TNF-alpha, IL-6 and IL-10, and GVHD (p < 0.05, p < 0.005 and p < 0.002 respectively) and GR (p < 0.01).
细胞因子失调被认为在异基因骨髓移植（BMT）后的移植物抗宿主病（GVHD）和移植物排斥（GR）的炎症及同种特异性成分中起作用。这两种并发症在无关供体BMT后发生的频率明显高于同基因同胞供体BMT后。测量了无关供体BMT后肿瘤坏死因子α（TNF-α）、白细胞介素（IL）-1β、IL-6、IL-10和IL-12的水平，以检查细胞因子失调与GVHD和GR的关系。本研究纳入的26例患者中，15例发生GVHD（14例急性；1例急性和慢性），5例发生GR，6例BMT过程顺利。TNF-α在13/15例GVHD患者和3/5例GR患者中显著升高。IL-6在急性GVHD患者和GR患者中升高。BMT前后血清中IL-12水平相似。未发现HLA-C匹配与细胞因子水平之间存在相关性。总之，发现TNF-α、IL-6和IL-10水平升高与GVHD（分别为p < 0.05、p < 0.005和p < 0.002）和GR（p < 0.01）呈正相关。
