TNFα, interleukin-10 and interleukin-18 expression in cells of the bronchoalveolar lavage in patients with pulmonary complications following bone marrow or peripheral stem cell transplantation:: a preliminary study
TNFα, interleukin-10 and interleukin-18 expression in cells of the bronchoalveolar lavage in patients with pulmonary complications following bone marrow or peripheral stem cell transplantation:: a preliminary study
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DOI：
10.1038/sj.bmt.1703722
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发表时间：
2002-10-01
影响因子：
4.8
通讯作者：
Pforte, A
中科院分区：
文献类型：
--
作者：
Hauber, HP;Mikkilä, A;Pforte, A
肺部并发症是骨髓移植（BMT）或外周血干细胞移植（PBSCT）后的主要临床问题。潜在的病理生理机制正在研究中。20例BMT或PBSCT后感染性或非感染性肺部并发症患者接受支气管肺泡灌洗（BAL），并与11例健康志愿者相比，测定BAL细胞中肿瘤坏死因子α（TNF α）、白细胞介素-10（IL-10）和白细胞介素-18（IL-18）mRNA的表达。患者分为两组（感染性肺炎，n = 14或特发性肺炎综合征（IPS）/闭塞性细支气管炎（130），n = 6）。与对照组相比，两个患者组中TNF α表达均显著增加（0.40 +/- 0.07和0.39 +/- 0.09对0.15 +/- 0.05; P < 0.05;半定量PCR分析;平均值+/- s.e.m.）。与正常对照组相比，感染性肺炎患者组IL-10表达显著升高（0.15 -t0.06 vs 0.01 +/- 0.01; P < 0.05），但IPS/BO患者组则无此差异（0.05 +/- 0.04; P > 0.05）。然而，IL-10在所有患者和对照个体的BAL细胞中不表达。与对照组（4.29 +/- 0.77; P < 0.05）相比，两个患者组（1.47 +/- 0.24和1.79 +/- 0.63）的IL-18表达均显着降低。生存分析显示TNFa升高与预后不良有显著相关性（P < 0.05）。这些结果突出了BMT/PBSCT后肺部的免疫调节紊乱。
Pulmonary complications pose a major clinical problem after bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT). The underlying pathophysiological mechanisms are under investigation. Twenty patients with infectious or non-infectious pulmonary complications after BMT or PBSCT underwent bronchoalveolar lavage (BAL) and tumor necrosis factor-a (TNFalpha), interleukin-10 (IL-10) and interleukin-18 (IL-18) mRNA expression was determined in BAL cells in comparison to 11 healthy volunteers. Patients were divided into two groups (infectious pneumonia, n = 14 or idiopathic pneumonia syndrome (IPS)/bronchiolitis obliterans (130), n = 6). TNFa expression was significantly increased in both patient groups compared to the control (0.40 +/- 0.07 and 0.39 +/- 0.09 vs 0.15 +/- 0.05; P < 0.05; semiquantitative PCR analysis; mean +/- s.e.m.). IL-10 expression was significantly elevated the group of patients with infectious pneumonia in comparison to normal controls (0.15 -t 0.06 vs 0.01 +/- 0.01; P < 0.05) but not in patients with IPS/BO (0.05 +/- 0.04; P > 0.05). However, IL-10 was not expressed in BAL cells of all patients and control individuals. IL-18 expression was significantly decreased in the both patient groups (1.47 +/- 0.24 and 1.79 +/- 0.63) in comparison to the control group (4.29 +/- 0.77; P < 0.05). Survival analysis showed a significant association between elevation of TNFa and poor prognosis (P < 0.05). These results highlight the immunoregulatory disturbances in the lungs after BMT/PBSCT.