中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (29): 4679-4684.doi: 10.3969/j.issn.2095-4344.2017.29.015

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

人脐带间充质干细胞对急性淋巴细胞白血病患儿异基因干细胞移植后免疫重建的影响

向金峰   

  1. 南阳市中心医院小儿血液科,河南省南阳市 473000
  • 修回日期:2017-06-01 出版日期:2017-10-18 发布日期:2017-10-18
  • 作者简介:向金峰,女,1975年生,河南省社旗县人,汉族,2006年广东医学院毕业,硕士,主治医师,主要从事儿童血液学研究。
  • 基金资助:

    河南省南阳市科技成果(16058080)

Effect of human umbilical cord mesenchymal stem cells on immune reconstruction of acute lymphoblastic leukemia children undergoing allogeneic hematopoietic stem cell transplantation

Xiang Jin-feng   

  1. Pediatric Department of Hematology, Nanyang Central Hospital, Nanyang 473000, Henan Province, China
  • Revised:2017-06-01 Online:2017-10-18 Published:2017-10-18
  • About author:Xiang Jin-feng, Master, Attending physician, Pediatric Department of Hematology, Nanyang Central Hospital, Nanyang 473000, Henan Province, China
  • Supported by:

    the Scientific and Technological Achievements of Nanyang City, No. 16058080

摘要:

文章快速阅读:

文题释义:
异基因造血干细胞移植:
是目前治疗白血病等恶性血液病的最佳手段之一,但移植后造血重建缓解、免疫重建延迟及移植物抗宿主病的发生仍是影响治疗效果的重要因素。异基因造血干细胞移植后预防移植物抗宿主病应用大量免疫抑制剂或对移植物进行T细胞体外剔除,可导致患者免疫重建延迟,增加感染风险、移植后疾病复发及继发性恶性肿瘤的发生。异基因造血干细胞移植后尽早重建患者造血功能及免疫功能,对提高移植效果具有重要的意义。
T细胞亚群:可分为CD4+辅助T细胞及CD8+抑制T细胞亚群,CD4+T细胞为辅助/诱导性T淋巴细胞亚群,是免疫应答中主要的反应细胞,能影响抑制性T淋巴细胞的成熟与活化,影响B细胞抗体的产生,其活化释放的大量细胞因子能促进CD8+T细胞及吞噬细胞的活性,增强抗肿瘤效应。CD8+T细胞可分泌一些抑制因子,同时产生肿瘤源性免疫抑制因子,后者直接或通过诱导CD8+T细胞进一步抑制宿主的免疫系统,使宿主免疫力降低。CD4+/CD8+比值可反映机体细胞免疫功能状态,它们既相互促进又相互制约。

 

摘要
背景:人
脐带间充质干细胞可分泌多种支持造血的细胞因子和生长因子,可改变造血微环境,具有调节及改善机体免疫功能的作用。
目的:探讨人脐带间充质干细胞对儿童急性淋巴细胞白血病异基因造血干细胞移植后免疫重建的影响。
方法:选取64例接受异基因造血干细胞移植治疗的急性淋巴细胞白血病患儿,分为非血缘性供者异基因造血干细胞移植组(allo-HSCT组,n=32)及非血缘性供者异基因造血干细胞移植后输注人脐带间充质干细胞组(allo-HSCT+MSCs组,n=32),观察两组治疗效果及并发症发生情况,比较两组患儿预处理前、移植后1,3,6个月时外周血免疫球蛋白及淋巴细胞亚群水平。 
结果与结论:①allo-HSCT+MSCs组粒细胞植入时间短于allo-HSCT组(P < 0.05),慢性移植物抗宿主病、巨细胞病毒感染生率低于allo-HSCT组(P < 0.05);②两组移植后造血干细胞植入率、血小板重建、累计复发率、1年存活率比较差异无显著性意义(P > 0.05);③allo-HSCT+MSCs组移植后1,3,6个月血清免疫球蛋白IgA、IgG、IgM、IgE水平及外周血T淋巴细胞(CD4+、CD3+CD4+、CD4+CD8+)、B细胞(CD19+)水平均高于allo-HSCT组(P < 0.05);④结果表明,联合人脐带间充质干细胞输注能有效降低急性淋巴细胞白血病患儿异基因造血干细胞移植慢性抗宿主病发生率,有助于粒细胞造血重建及免疫功能重建。

中国组织工程研究杂志出版内容重点:干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程
ORCID:
0000-0001-8127-9573(向金峰)

关键词: 干细胞, 人脐带间充质干细胞, 儿童急性淋巴细胞白血病, 基因造血干细胞移植, 免疫重建

Abstract:

BACKGROUND: Human umbilical cord mesenchymal stem cells (hUC-MSCs) can secrete a variety of cytokines and growth factors to support hematopoiesis. They can change the hematopoietic microenvironment, and furthermore, regulate and improve the immune function of the organism.
OBJECTIVE: To investigate the effect of hUC-MSCs on immune reconstitution and prognosis in children with acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). 
METHODS: Sixty-four ALL children who had undergo allo-HSCT were enrolled and randomized into non-blood donor allo-HSCT group (n=32) and non-blood donor allo-HSCT+hUC-MSCs group (n=32). The therapeutic effect and complication were observed in the two groups. The changes of immunoglobulins and lymphocyte subpopulations in the two groups were compared before and 1, 3 and 6 months after transplantation. 
RESULTS AND CONCLUSION: Compared with the allo-HSCT group, the time of granulocyte implantation was shorter (P < 0.05), and the incidence of chronic graft versus host disease and cytomegalovirus was lower in the allo-HSCT+ hUC-MSCs group. There were no significant differences in hematopoietic stem cell implantation rate, platelet remodeling rate, cumulative recurrence rate and 1-year survival rate between the two groups (P > 0.05). The levels of serum immunoglobulins IgA, IgG, IgM, IgE and the levels of T lymphocytes (CD4+, CD3+CD4+, CD4+CD8+) and B cells in the peripheral blood of allo-HSCT+hUC-MSCs group were significantly higher than those in the allo-HSCT group at 1, 3 and 6 months after transplantation (P < 0.05). In conclusion, the combined use of hUC-MSCs infusion and allo-HSCT can effectively reduce the incidence of chronic graft-versus-host disease, and contribute to granulocyte hematopoietic reconstitution and immune function reconstruction.

中国组织工程研究杂志出版内容重点:干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程

Key words: Hematopoietic Stem Cell Transplantation, Umbilical Cord, Mesenchymal Stem Cell Transplantation, Leukemia, Tissue Engineering

中图分类号: