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目的研究异基因造血干细胞移植后合并慢性移植物抗宿主病(cGVHD)时的T细胞免疫状态。方法应用RT-PCR扩增14例白血病异基因造血干细胞移植后合并cGVHD患者及5名正常供者的外周血T细胞受体(TCR)BV24个家族的基因序列,并通过基因扫描的方法判断TCR BV家族的克隆表达情况、CDR3克隆性质,并计算BV家族的利用率。结果在移植后6~19个月,所有患者TCR BV家族的利用仍处于不均一状态,检测到部分BV家族缺失,部分家族出现寡克隆、单克隆T细胞增殖,在24个BV家族的表达为6/24~15/24,并且均出现1~5个单克隆家族表达。单克隆及双克隆表达分布在不同的BV家族,未发现共用的BV家族。结论异基因造血干细胞移植后合并cGVHD患者的T细胞免疫存在缺陷,在不同的TCR BV家族出现与cGVHD相关的克隆增殖的T细胞克隆。
Objective To study the T cell immune status after allogeneic hematopoietic stem cell transplantation combined with chronic graft versus host disease (cGVHD). Methods The gene sequences of 24 T-cell receptor (TCR) BV24 families in 14 patients with cGVHD and 5 normal donors after leukemia allogeneic hematopoietic stem cell transplantation were amplified by RT-PCR. The TCR BV family clone expression, CDR3 cloning properties, and calculate the BV family utilization. Results In 6 to 19 months after transplantation, the TCR BV family was still inhomogeneous in all patients. Some BV families were detected as missing. Some families showed oligoclonal and monoclonal T cell proliferation. The expression in 24 BV families was 6/24 ~ 15/24, and all appeared 1 ~ 5 monoclonal family expression. Monoclonal and diclonal expression were distributed in different BV families and no common BV family was found. Conclusions T-cell immunity in patients with cGVHD after allogeneic hematopoietic stem cell transplantation is deficient. T-cell clones that proliferate with clonality associated with cGVHD appear in different TCR BV families.