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同种异基因造血干细胞移植是急、慢性白血病及其他恶性血液病重要的治疗方法,但急慢性移植物抗宿主病(graft-versus-host disease,GVHD)作为异基因造血干细胞移植的主要并发症严重影响移植患者的存活率,阻碍移植的临床推广。很多研究发现,高表达Foxp3的CD4+CD25+调节性T细胞(regulatory T cells,Treg)不仅能控制急慢性GVHD的发生,而且不影响移植物抗白血病效应(graft-versus-leukemia,GVL),在急慢性GVHD发生发展及治疗方面有重要的作用。但Treg细胞在体内的数量很少,不能满足临床应用需求。目前应用外源的IL-2联合TCR、CD28信号通路共同刺激以及运用树突状细胞(dendritic cell,DC)刺激均能达到体外有效扩增Treg细胞的目的。这些扩增的Treg细胞在控制造血干细胞移植过程中急慢性GVHD的发生及防治自身免疫性疾病和移植排斥等方面具有明显作用,在疾病控制和临床应用中具有广阔前景。
Allogeneic hematopoietic stem cell transplantation is an important treatment for acute, chronic leukemia and other hematologic malignancies. However, graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation Seriously affect the survival rate of transplant patients, hinder the clinical promotion of transplantation. Many studies have found that CD4 + CD25 + regulatory T cells (Tregs) that overexpress Foxp3 not only control acute and chronic GVHD but also do not affect graft-versus-leukemia (GVL) Acute and chronic GVHD development and treatment has an important role. However, Treg cells in the body in small quantities, can not meet the needs of clinical applications. At present, exogenous IL-2 combined with TCR, CD28 signaling pathway co-stimulation and dendritic cell (DC) stimulation can achieve the purpose of effectively expanding Treg cells in vitro. These expanded Treg cells play a significant role in the control of acute and chronic GVHD in the process of hematopoietic stem cell transplantation and in the prevention and treatment of autoimmune diseases and transplant rejection and have broad prospects in disease control and clinical application.