【摘要】：研究背景和目的 造血干細(xì)胞移植(HSCT)尤其是異基因HSCT(allo-HSCT)現(xiàn)廣泛應(yīng)用于血液腫瘤或非血液惡性腫瘤、再生障礙性貧血、某些遺傳性疾病等的治療。由于目前尚未解決的高移植物抗宿主病(GVHD)和高機(jī)會(huì)性感染率與致死率，致使allo-HSCT后患者的長(zhǎng)期生存率僅在50％左右，同時(shí)因移植后GVHD和機(jī)會(huì)性感染而影響患者的生存質(zhì)量。解決allo-HSCT后GVHD和降低機(jī)會(huì)性感染的發(fā)生率與致死率是提高allo-HSCT后長(zhǎng)期無(wú)病生存和生活質(zhì)量的關(guān)鍵。在allo-HSCT中，誘導(dǎo)供者T細(xì)胞對(duì)受者抗原產(chǎn)生免疫耐受及促進(jìn)移植后T細(xì)胞的重建，，是目前提高allo-HSCT后長(zhǎng)期無(wú)病生存和生活質(zhì)量的關(guān)鍵。 在個(gè)體發(fā)育過(guò)程中，T細(xì)胞獲得對(duì)自身抗原的免疫耐受和T細(xì)胞受體(TCR)庫(kù)的形成主要在胸腺完成，它依賴于胸腺上皮細(xì)胞及微環(huán)境。在不同年齡的allo-HSCT患者中觀察到，隨著受者年齡增長(zhǎng)，GVHD的發(fā)生率和機(jī)會(huì)性感染率均增高，免疫重建延遲越明顯。allo-HSCT后兒童患者可在移植后大約一年內(nèi)完成以T細(xì)胞為基礎(chǔ)的免疫重建，成人則需要數(shù)年甚至終生不能重建完整的T細(xì)胞庫(kù)，這些都與隨著年齡的增長(zhǎng)，胸腺逐漸萎縮，對(duì)供者T細(xì)胞的修飾作用(胸腺選擇)降低有關(guān)。allo-HSCT后供者T細(xì)胞的重建主要通過(guò)胸腺依賴途徑和胸腺非依賴途徑完成。allo-HSCT后受者體內(nèi)存在5類(lèi)不同類(lèi)型的T細(xì)胞群落，其
[Abstract]:Background and objective Hematopoietic stem cell transplantation (HSCT), especially allogeneic HSCT (allo-HSCT), has been widely used in hematopoietic neoplasms, non-hematological malignancies and aplastic anemia. The treatment of certain hereditary diseases, etc. Because of the unsolved high graft-versus-host disease (GVHD), high opportunistic infection rate and fatality rate, the long-term survival rate of patients with allo-HSCT was only about 50%, and the quality of life was affected by GVHD and opportunistic infection after transplantation. To solve the problem of GVHD after allo-HSCT and to reduce the incidence and mortality of opportunistic infection is the key to improve the long-term disease-free survival and quality of life after allo-HSCT. In allo-HSCT, the key to improve the long-term disease-free survival and quality of life after allo-HSCT is to induce donor T cells to develop immune tolerance to the recipient antigen and to promote the reconstruction of T cells after transplantation. The immune tolerance of T cells to autoantigen and the formation of T cell receptor (TCR) library are mainly completed in the thymus, which is dependent on thymoepithelial cells and microenvironment. It was observed that the incidence and opportunistic infection rate of allo-HSCT increased with the age of the recipient. The more significant the delay in immune reconstruction. Allo-HSCT in children can complete T cell-based immune reconstruction within about one year after transplantation, and in adults it takes years or even lifetime to reconstruct a complete T cell bank, which is associated with age. The thymus shrinks gradually, The modification of donor T cells (thymus selection) is related to the reduction of donor T cell remodeling after. Allo-HSCT. There are five different types of T cell communities in the recipient by thymus dependent pathway and thymus independent pathway.
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類(lèi)號(hào)】：R392.4

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相關(guān)期刊論文 前1條

1 邵傳森,朱康兒,郭漢身;同種異基因小鼠外周血干細(xì)胞移植的初步研究[J];中華血液學(xué)雜志;1997年05期

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