The development of autoantibodies after allogeneic stem cell transplantation is related with chronic graft-vs-host disease and immune recovery
The development of autoantibodies after allogeneic stem cell transplantation is related with chronic graft-vs-host disease and immune recovery
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DOI：
10.1016/j.exphem.2005.12.011
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发表时间：
2006-03-01
影响因子：
2.6
通讯作者：
Fanin, R
中科院分区：
文献类型：
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作者：
Patriarca, F;Skert, C;Fanin, R
目标。慢性移植物抗宿主病(GVHD)与自身免疫性疾病有一定的相似性，并与某些患者各种自身抗体的产生有关。本研究分析了63例异基因造血干细胞移植(HSCT)后存活超过3个月的患者自身抗体的发生情况，旨在探讨自身抗体的发生与HSCT后慢性移植物抗宿主病(GVHD)和免疫功能恢复之间的关系。每3个月对患者进行一次自身抗体筛查：抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(ASMA)、抗心磷脂抗体(ACLA)、抗肝肾微粒体抗体(LKM)、抗DNA抗体、抗中性粒细胞胞浆抗体(ANCA)、抗甲状腺抗体。同时检测外周血中抗CD3、CD4、CD8、CD19、CD20、CD16和CD56抗体的免疫表型。18名患者(29%)未发现自身抗体，29名患者(46%)至少在一次筛查中未发现自身抗体，16名患者(25%)在所有筛查中未发现自身抗体。ANA阳性41例(65%)，AMA阳性4例(6%)，ASMA阳性4例(6%)，ANCA阳性7例(11%)，ACLA阳性1例(2%)，抗甲状腺抗体阳性3例(5%)，抗DNA阳性2例(31%)。63例阳性患者中有16例(25%)出现一种以上抗体。ANA在慢性GVHD患者中明显更常见，其中，在那些广泛性形式的患者中。ANA免疫荧光的核仁模式与慢性移植物抗宿主病的进展相关，而与其滴度无关。在第3个月(p=0.006)、第9个月(p=0.061)和第12个月(p 0.043)，发生自身抗体的患者的CD20(+)细胞计数高于阴性患者。我们的结论是，慢性GVHD患者，特别是那些广泛受累的患者，可能会产生自身抗体，并有更快的B细胞恢复，提示B细胞在慢性GVHD的发病机制中发挥了作用。(C)2006年国际实验血液学学会。由爱思唯尔公司出版。
Objective. Chronic graft-vs-host disease (GVHD) has certain similarities with autoimmune diseases and is associated with the development of various autoantibodies in some patients. In this study, we analyzed the occurrence of autoantibodies in 63 patients surviving longer than 3 months after an allogeneic haematopoietic stem cell transplantation (HSCT), with the aim of detecting a possible association between occurrence of autoantibodies and development of chronic GVHD and immune recovery after HSCT.Patients and Methods. The patients were screened every 3 months for the occurrence of the following autoantibodies: anti-nuclear (ANA), anti-mitochondrial (AMA), anti-smooth muscle (ASMA), anti-cardiolipin (ACLA), anti-liver-kidney microsomal (LKM), anti-DNA, anti-neutrophil cytoplasmatic (ANCA), and anti-thyroid antibodies. Peripheral blood immunophenotyping with anti-CD3, CD4, CD8, CD19, CD20, CD16, and CD56 antibodies was evaluated at the same intervals.Results. Autoantibodies were not found in 18 patients (29%), at least in one screening in 29 patients (46%), and in all screenings in 16 patients (25%). ANA were found in 41 patients (65%), AMA in 4 (6%), ASMA in 4 (6%), ANCA in 7 (11%), ACLA in 1 (2%), anti-thyroid antibodies in 3 (5%), and anti-DNA in 2 (31%). More than one antibody occurred in 16/63 (25%) positive patients. ANA was significantly more frequent in patients with chronic GVHD and, among these, in those with the extensive form. The nucleolar pattern of immunofluorescence of ANA but not its titer was correlated with the extension of chronic GVHD. Patients who developed autoantibodies had higher CD20(+) cell blood counts than negative patients in the third month (p = 0.006), ninth month (p = 0.061), and twelfth month (p 0.043).Conclusion. We conclude that patients with chronic GVHD, particularly those with an extensive involvement, were likely to develop autoantibodies and have a faster B-cell recovery, suggesting a role of B cells in the pathogenesis of chronic GVHD. (c) 2006 International Society for Experimental Hematology. Published by Elsevier Inc.