系统性红斑狼疮患者自体外周血纯化造血干细胞移植后免疫功能的变化

Changs of immune function in patients with systemic lupus erythematosus after autologous peripheral blood purified stem cells transplantation

关键词:  造血干细胞  移植  系统性红斑狼疮

Key words:  stem cell  transplantation  lupus erythematosus, systemic

摘要:

［目的］研究自体外周血纯化造血干细胞移植对系统性红斑狼疮患者免疫功能的影响。［方法］16例接受自体外周血纯化造血干细胞移植的系统性红斑狼疮患者列入研究。应用四色荧光分析技术动态监测移植前及移植后3、6、12个月的CD₃⁺、CD₄₅RA⁺CD₄⁺、CD₄₅RA⁺CD₈⁺、CD₄₅RO⁺CD₄⁺表达的变化情况。［结果］移植后3个月CD₃⁺、CD₄₅RA⁺CD₄⁺、CD₄₅RA⁺CD₈⁺、CD₄₅RO⁺CD₄⁺的表达均低于移植前，其中CD₃⁺、CD₄₅RA⁺CD₈⁺、CD₄₅RO⁺CD₄⁺的表达水平差异具有显著性意义（P<0.05）。移植后6个月CD₃⁺、CD₄₅RA⁺CD₈⁺、CD₄₅RO⁺CD₄⁺的表达均低于移植前（P<0.05）。CD₄₅RA⁺CD₄⁺的表达水平高于移植前和移植治疗后3个月的，与移植后3个月的表达水平差异具有显著性意义（P<0.05）。移植后1年CD₄₅RO⁺CD₄⁺的表达水平低于移植前（P<0.05）。CD₄₅RA⁺CD₄⁺的表达水平高于移植前和移植后3个月和6个月，与移植后3个月的表达水平差异具有显著性意义（P<0.05）。［结论］自体外周血纯化造血干细胞移植后存在免疫功能缺陷，可持续1年之久。通过流式细胞仪检测患者外周血CD₃⁺、CD₄₅RA⁺CD₄⁺、CD₄₅RA⁺CD₈⁺、CD₄₅RO⁺CD₄⁺表达情况可相对定量地检测患者的胸腺再生输出功能，并通过测量新生T细胞的合成来监视胸腺功能在免疫重建中的作用，为临床干细胞移植提供有力的理论依据。

Abstract:

［Objective］To investigate the alteration of immune function in patients after autologous peripheral blood purified stem cells transplantation.［Methods］Sixteen patients with systemic lupus erythematosus had received autologous peripheral blood purified stem cells transplantation were enrolled in this study. Four-color flow cytometry was used to detect the express of CD⁺0₃,CD₄₅RA⁺CD₄,CD₄₅RA⁺CD₈⁺and CD₄₅RO⁺CD₄⁺ before transplantation and at 3,6,12 months after transplantation.［Results］Frequence of CD₃⁺,CD₄₅RA⁺CD₄⁺,CD₄₅RA⁺CD₈⁺ and CD₄₅RO⁺CD₄⁺ in peripheral blood at 3 months after transplantation were decreased compared with that of before transplantation. At the same time, the subset of CD₃⁺,CD₄₅RA⁺CD₈⁺ and CD₄₅RO⁺CD₄⁺ were lower than those of before transplantation (P<0.05). At 6 months after transplantation, theCD₃⁺,CD₄₅RA⁺CD₈⁺and CD₄₅RO⁺CD₄⁺ subsets were decreased compared with those of before transplantation (P<0.05). CD₄₅RA⁺CD₄⁺subset was higher than that of before transplantation and 3 months after transplantation.CD₄₅RA⁺CD₄⁺subset was increased significant at 6 months after transplantation than that of at 3 months(P<0.05). Frequence of CD₄₅RO⁺CD₄⁺ in peripheral blood at 12 months after transplantation were also decreased significant than that of before transplantation(P<0.05). Frequence of CD₄₅RA⁺CD₄⁺was higher than that of before transplantation, 3 and 6 months after transplantation, only increased significant than that of 3 months after transplantation (P<0.05).［Conclusion］Autologous peripheral blood purified stem cells transplantation can reduces the immune function. Measurement of the changes of CD₃⁺, CD₄₅RA⁺CD₄⁺, CD₄₅RA⁺CD₈⁺ and CD₄₅RO⁺CD₄⁺ cell ratio using flow cytometry may provide insights into the molecular picture of the thymus regeneration function in association with immune reconstruction process in SLE patients after stem cell transplantation. The number of newly generated T cells transported from the thymus can be a putative marker of immune reconstruction after transplantation.