细胞因子检测能否预测Allo-HCT后aGVHD的发生和结局?回顾性研究。

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Discovery medicine Pub Date : 2023-06-01 DOI:10.24976/Discov.Med.202335176.25
Qian Gao, Weijie Zhang, Di Zhang, Qi Hao, Yu An, Guowei Liang
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引用次数: 0

摘要

背景:许多细胞因子在急性移植物抗宿主病(aGVHD)的发生和发展中起重要作用。本研究旨在验证11种促炎和抗炎细胞因子是否可以作为aGVHD的候选生物标志物来预测其发生和预后。方法:在178例接受同种异体造血干细胞移植的患者中,我们回顾性地将32例纳入移植前队列,45例纳入移植后队列。用流式细胞术测定血清细胞因子浓度。对照组和实验组分别为非aGVHD组、I-II aGVHD组和III-IV aGVHD组。同时评估危险因素和总生存期(OS)。结果:在移植前队列中,白细胞介素(IL)-2在aGVHD患者中降低,IL-4仅在III-IV aGVHD患者中降低。在移植后队列中,III-IV aGVHD患者中只有IL-4比其他两组增加1.79倍。胃肠道(GI) aGVHD患者移植前IL-2、IL-4和IL-17F水平较低,移植后IL-2水平较低。其他细胞因子没有显著差异。Logistic回归分析显示,细胞因子不能预测aGVHD的发生及预后。移植后15天内腹泻是发生aGVHD的独立危险因素,也是致死性结局的危险因素。无腹泻患者的生存时间为672(586-757)天比444(229-548)天,2年OS(85.7%比46.4%)优于腹泻患者。与aGVHD患者相比,无aGVHD患者的生存时间更长,分别为618(530-706)天和449(353-545)天,2年OS更好(76.2%比47.1%)。结论:促炎和抗炎细胞因子对aGVHD的发生和发展有特定的指征。然而,为了真正指导诊断和预后,需要进一步研究样本量更大、检测时间点更多、诊断效果更准确的细胞因子。
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Can Cytokine Detection Predict the Occurrence and Outcome of aGVHD after Allo-HCT? A Retrospective Study.

Background: Many cytokines play essential roles in the occurrence and development of acute graft-versus-host-disease (aGVHD). This study aims to validate whether 11 proinflammatory and anti-inflammatory cytokines can be a candidate for aGVHD biomarkers to predict its occurrence and outcome.

Methods: Out of 178 patients who underwent allogeneic hematopoietic stem cell transplantation, we retrospectively enrolled 32 cases into the pre-transplant cohort and 45 cases into the post-transplant cohort. The serum cytokine concentrations were determined by flow cytometry. The control and experimental groups were non-aGVHD, I-II aGVHD and III-IV aGVHD groups, respectively. Risk factors and overall survival (OS) were also evaluated.

Results: In the pre-transplant cohort, interleukin (IL)-2 decreased in patients with aGVHD, and IL-4 only reduced in patients with III-IV aGVHD. In the post-transplant cohort, only IL-4 increased 1.79 times more in patients with III-IV aGVHD than in the other two groups. Patients with gastrointestinal (GI) aGVHD had lower IL-2, IL-4 and IL-17F levels pre-transplant and lower IL-2 post-transplant. None of the other cytokines was significantly different. Logistic regression analysis showed that no cytokine could predict the occurrence and outcome of aGVHD. Diarrhea within 15 days post-transplant is an independent risk factor for the occurrence of aGVHD and a risk factor for a fatal outcome. Patients without diarrhea had longer survival time of 672 (586-757) days vs 444 (229-548) days and better 2-year OS (85.7% vs 46.4%) than those with diarrhea. Compared to patients with aGVHD, patients without aGVHD had a longer survival time of 618 (530-706) days vs 449 (353-545) days and better 2-year OS (76.2% vs 47.1%).

Conclusions: Proinflammatory and anti-inflammatory cytokines can provide specific indications for the occurrence and progression of aGVHD. However, to truly guide the diagnosis and prognosis, cytokines with larger sample sizes, more detection time points and more accurate diagnostic efficacy need to be further studied.

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来源期刊
Discovery medicine
Discovery medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
5.40
自引率
0.00%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Discovery Medicine publishes novel, provocative ideas and research findings that challenge conventional notions about disease mechanisms, diagnosis, treatment, or any of the life sciences subjects. It publishes cutting-edge, reliable, and authoritative information in all branches of life sciences but primarily in the following areas: Novel therapies and diagnostics (approved or experimental); innovative ideas, research technologies, and translational research that will give rise to the next generation of new drugs and therapies; breakthrough understanding of mechanism of disease, biology, and physiology; and commercialization of biomedical discoveries pertaining to the development of new drugs, therapies, medical devices, and research technology.
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