Biomarkers of immune activation to screen for severe, acute GVHD
Biomarkers of immune activation to screen for severe, acute GVHD
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DOI：
10.1038/bmt.2010.165
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发表时间：
2011-04-01
影响因子：
4.8
通讯作者：
Horan, J. T.
中科院分区：
文献类型：
--
作者：
August, K. J.;Chiang, K-Y;Horan, J. T.
异基因造血干细胞移植(AHSCT)后发生的严重急性移植物抗宿主病(AGVHD)通常对糖皮质激素无反应，因此常常是致命的。1类似于巨细胞病毒感染的先发制人方法可能更有效。1，2我们进行了一项前瞻性研究，以评估在出现严重的AGVHD临床表现之前，是否可以在不同的移植受者组中检测到早期免疫移植物抗宿主反应。选择T细胞活化的4个标志物：可溶性CD8(SCD8)、可溶性白介素2受体(sIL-2R)、可溶性CD40配体(SCD40L)和可溶性CD28(SCD28)，以及炎症标志物可溶性肿瘤坏死因子受体1(STNFR1)。这些标记物在血液中是可测量的，并已被证明在临床AGVHD或其他免疫介导过程中会增加。3-11本研究检验的主要假设是，通过使用这些标记物，临床前AGVHD可以在移植后第15天诊断出来，灵敏度和特异度至少为80%。
Severe acute GVHD (AGVHD) occurring after allogeneic hematopoietic SCT (AHSCT) is often unresponsive to glucocorticoids and, as a result, frequently fatal. 1 A preemptive approach, similar to that used for CMV infection could be more effective. 1, 2 We conducted a prospective study of plasma markers of immune activation to assess whether the incipient immunologic graft-vs-host response can be detected in a diverse group of transplant recipients before the clinical manifestations of severe AGVHD emerge. Five markers were selected: four markers of T-cell activation, soluble CD8 (sCD8), soluble IL-2 receptor (sIL-2R), soluble CD40 ligand (sCD40L) and soluble CD28 (sCD28) as well as soluble TNF receptor 1 (sTNFR1), an inflammatory marker. These markers are measurable in the blood and have been shown to be increased in clinical AGVHD or other immune-mediated processes. 3–11 The primary hypothesis tested in this study was that by using these markers, preclinical AGVHD can be diagnosed by transplant day 15 with a sensitivity and specificity of at least 80%.