The kinetics of immune reconstitution after human marrow transplantation.
The kinetics of immune reconstitution after human marrow transplantation.
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DOI：
10.1182/blood.v69.2.369.bloodjournal692369
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发表时间：
1987-02
期刊：
影响因子：
20.3
通讯作者：
L. Lum
中科院分区：
文献类型：
--
作者：
L. Lum
用于治疗恶性和非恶性疾病的人骨髓移植正在成为一种既定的治疗方式。与任何积极的治疗方式一样，治疗的益处必须与风险相平衡。用于为患者进行骨髓移植做准备的积极化放疗会在移植后产生短暂的免疫缺陷疾病，直到转移的供体骨髓重新建立起有能力的免疫系统。移植后的免疫重建遵循从不成熟到成熟的免疫功能发展的一般模式。移植后第一个月的免疫反应性极低。细胞毒性和吞噬功能在移植后100天恢复，而T和B细胞的更专门和合作功能在移植后一年或更长时间内仍然受损。移植后第一年，大多数健康骨髓受体的免疫系统的各个组成部分开始同步工作，而慢性移植物抗宿主病（GVHD）受体的免疫系统仍然瘫痪。最近的证据表明，从骨髓供体到骨髓受体的特异性免疫转移在重建免疫能力中起作用。转移的抗原特异性免疫可以解释为什么更多的受体不会死于压倒性感染。
Human marrow transplantation for the treatment of malignant and nonmalignant disorders is becoming an established modality of therapy. As in any aggressive therapeutic modality, the benefits must be balanced with the risks of the therapy. The aggressive chemoradiotherapy used to prepare patients for marrow transplantation creates a transient immunodeficiency disorder postgrafting until the transferred donor marrow reestablishes a competent immune system. Immune reconstitution posttransplant follows a general pattern developing from immature to mature immune functions. Immune reactivity during the first month postgrafting is extremely low. Cytotoxic and phagocytic functions recover by day 100, while more specialized and cooperative functions of T and B cells remain impaired up to one year or more postgrafting. After the first year postgrafting, the various components of the immune systems of most healthy marrow recipients begin to work synchronously, whereas the immune systems of recipients with chronic graft-v-host disease (GVHD) remain crippled. Recent evidence shows that transfer of specific immunity from marrow donors to marrow recipients plays a role in reestablishing immunocompetence. Transferred antigen-specific immunity may explain why more recipients do not die from overwhelming infections.