Natural killer cell HLA-C epitopes and killer cell immunoglobulin-like receptors both influence outcome of mismatched unrelated donor bone marrow transplants
Natural killer cell HLA-C epitopes and killer cell immunoglobulin-like receptors both influence outcome of mismatched unrelated donor bone marrow transplants
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DOI：
10.1111/j.1399-0039.2005.00396.x
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发表时间：
2005-06-01
期刊：
影响因子：
--
通讯作者：
Christiansen, FT
中科院分区：
文献类型：
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作者：
De Santis, D;Bishara, A;Christiansen, FT
据报道，ⅰ类人白细胞抗原-c （HLA-C）编码的自然杀伤（NK）表位的供体和受体的匹配会影响干细胞（SC）移植的结果，但一致的情况尚未出现。我们分析了104例不相关的SC移植物的移植结果与NK表位（C1和C2）匹配和供体杀伤细胞免疫球蛋白样受体（KIR）基因型的关系。排斥方向的NK表位错配与移植后排斥的可能性增加密切相关。当NK表位错配时，III-IV级急性移植物抗宿主病（GVHD）的患病率明显升高，发生时间明显提前。无论错配方向如何，较高的移植相关死亡率和较低的无病生存率都与表位错配有关。供体中更多的KIR受体（激活和抑制）可以预防III-IV级GVHD并提高生存率。
Matching of donor and recipient for the class I human leukocyte antigen-C (HLA-C)-encoded natural killer (NK) epitopes has been reported to influence stem-cell (SC) graft outcome, but a consistent picture has not yet emerged. We have analyzed transplant outcome in 104 unrelated SC grafts in relation to NK epitope (C1 and C2) matching and donor killer cell immunoglobulin-like receptor (KIR) genotype. NK epitope mismatching in the rejection direction was strongly associated with an increased probability of rejection subsequent to engraftment. The prevalence of grades III-IV acute graft-vs-host disease (GVHD) was significantly higher and occurred significantly earlier when there was NK epitope mismatching in the GVH direction. Higher transplant-related mortality and lower disease-free survival rates were associated with epitope mismatching regardless of the mismatch direction. A greater number of KIR receptors, both activating and inhibitory, in the donor protected against grades III-IV GVHD and improved survival.