研究概要
我们的结果表明,在选择相关供体阶段进行KIR/HLA I类分析可能对血液学移植的结果产生影响,并可能减少并发症。
研究思路结论见上方概要
背景
自然杀伤(NK)细胞表达杀伤细胞免疫球蛋白样受体(KIR),这些受体调控其功能。自身人类白细胞抗原(HLA)I类分子作为KIR的抑制性分子,阻断NK细胞的杀伤活性。由于正常NK活性可能影响来自HLA相合同胞供者的造血干细胞移植(HSCT)或骨髓移植(BMT)的结局,我们研究了NK细胞上呈现的KIR与I类HLA之间的相互作用。移植受者中I类HLA配体抑制物表达缺陷可能导致移植物抗宿主病(GvHD)或移植排斥等并发症。
方法
我们研究了缺失KIR配体(MSL)和KIR单倍型对HSCT患者GvHD发生、复发、死亡、感染和细胞恢复的影响。我们的研究组包括59例患者[n = 24例急性髓系白血病(AML),n = 12例慢性髓系白血病(CML),n = 12例骨髓增生异常综合征(MDS),n = 11例急性淋巴细胞白血病(ALL)],他们接受了来自同胞供者的HSCT/BMT。
结果
我们的结果显示,在MDS患者的供者中,单倍型AA比Bx更常见,并且与慢性(c)GvHD发生率较高相关(p = 0.003)。在该组中,我们还观察到AA供者单倍型与28天内中性粒细胞绝对计数重建至0.5 G/l (0.5 10 9 cells/L)之间存在统计学显著关系(p = 0.03)。我们的结果还显示,在AML患者中,KIR MSL值与cGvHD之间存在极好的相关性(r = 0.9932)。
展开英文摘要原文
BACKGROUND: Natural killer (NK) cells express killer immunoglobulin-like receptors (KIRs), which regulate their functions. Self-human leukocyte antigens (HLA) class I molecules act as inhibitory molecules for KIRs, blocking the killing activity of NK cells. Since normal NK activity may affect the outcomes of hematopoietic stem cell transplantation (HSCT) or bone marrow transplantation (BMT) from their HLA-matched sibling donors, we investigated the interaction between KIRs and class I HLA presented on NK cells. Complications such as graft-versus-host disease (GvHD) or transplant rejection may result because of deficient expression of class I HLA ligand inhibitors in the transplant recipient.
METHODS: We examined the effect of missing KIR ligands (MSL) and KIR haplotypes on GvHD development, relapses, death, infections, and cell recovery in HSCT patients. Our group included 59 patients [n = 24 with acute myeloid leukemia (AML), n = 12 with chronic myeloid leukemia (CML), n = 12 with myelodysplastic syndrome (MDS), and n = 11 with acute lymphoblastic leukemia (ALL)], who received HSCT/BMT from their sibling donors.
RESULTS: Our results showed that haplotype AA was more common than Bx in donors for patients with MDS and was associated with a higher incidence of chronic (c) GvHD (p = 0.003). In this group, we also observed a statistically significant relationship between the AA donor haplotype and absolute neutrophil count reconstruction of 0.5 G/l (0.5 10 9 cells/L) under 28 days (p = 0.03). Our results also showed an excellent correlation between KIR MSL values and cGvHD in AML patients (r = 0.9932).
CONCLUSION: Our results indicate that KIR/HLA class I analysis at the stage of selection of a related donor could have an impact on the results of hematological transplantation and possibly reduce complications.
论文信息
- 作者
- Dębska-Zielkowska J、Słomiński B、Zielińska H、Dukat-Mazurek A、Moszkowska G、Bieniaszewska M、Zaucha JM、Trzonkowski P
- 单位
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland.Poland
- 期刊
- Transplant immunology2025 Sep