Graft-versus-host disease in the ovary potentially causes female infertility after allogeneic hematopoietic stem cell transplantation
Graft-versus-host disease in the ovary potentially causes female infertility after allogeneic hematopoietic stem cell transplantation
复制标题
卵巢移植物抗宿主病可能导致异基因造血干细胞移植后女性不孕
DOI：
10.11406/rinketsu.58.827
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Teshima T
中科院分区：
文献类型：
--
作者：
Shimoji S;Hashimoto D;Teshima T
卵巢功能衰竭相关不孕是女性异基因造血干细胞移植（SCT）后的严重晚期并发症。虽然移植前预处理方案的作用已得到很好的赞赏，越来越多的应用降低强度的预处理，使我们重新考虑其他因素可能影响异基因SCT后卵巢功能。我们最近报道了移植物抗宿主病（GVHD）靶向卵泡颗粒细胞，从而显著降低SCT后的卵巢储备和生育能力。我们还发现，卵巢GVHD损害生育能力独立的预处理方案的毒性，药物GVHD预防SCT后保留生育能力。这些结果第一次证明GVHD靶向卵巢并损害卵巢功能和生育能力，从而在患有非恶性疾病的年轻女性移植受者中具有重要的临床意义，对她们使用毒性最小的方案。本文就SCT后女性不孕症的临床和基础研究作一综述。
Ovarian failure-associated infertility is a serious late complication for female patients who have undergone allogeneic hematopoietic stem cell transplantation (SCT). Although the role of a pretransplant conditioning regimen has been well appreciated, the increasing application of reduced-intensity conditioning has led us to reconsider other factors possibly affecting ovarian function after allogeneic SCT. We recently reported that graft-versus-host disease (GVHD) targets granulosa cells of the ovarian follicles, thereby significantly reducing ovarian reserves and fertility after SCT. We also found that ovarian GVHD impairs fertility independently of the toxicities of the conditioning regimens, and pharmacological GVHD prophylaxis preserves fertility after SCT. For the first time, these results demonstrated that GVHD targets the ovary and impairs ovarian functions and fertility, thereby having important clinical implications in young female transplant recipients with nonmalignant diseases, for whom minimally toxic regimens are used. Here we review recently published articles regarding clinical and basic researches on female infertility after SCT.