The Role Of Th Subset Cells And Some Cytokines In The Pathogenesis Of Acute Graft-versus-host Disease After The Allogeneic Hematopoietic Stem Cell Transplantation

BackgroundAcute graft-versus-host disease is the main complication in patients underwent allogeneic hematopoietic stem cell transplantation and the principal cause of mortality. Therefore, in recently, the immune mechanisms of acute graft-versus-host disease have become the highpoint in the immune-transplantation.PurposeTo explore the roles of Th subset cells and cytokines (IL-2, TNF-ot, IL-10, IL-8) in the pathogenesis of acute graft-versus-host disease in the patients after allogeneic hematopoietic stem cell transplantation. MethodThe incidence of aGVHD occuring was observed in 23 patients underwent allogeneic hematopoietic stem cell transplantation. The aGVHD was clinically diagnosed, Skin aGVHD was histologically confirmed in some patients by skin biopsy. Typically we derived serums from the 23 patients before and after allogeneic hematopoieticstem cell transplantation. Using radioimmuno-assay(RIA), the serum levels of IL- 2 ,TNF-α ,IL-8, IL-10 in 23 patients were measured serially. And using flow cytometry, the levels of Thl (INF- γ +/IL-4 ) and Th2 ( IFN- α /IL-4+ ) were examined,,Results1 .All of 23 patients were successfully engrafted and the median time to ANC >0.5 × 109/L and platelet > 20 × 109/L was 15 and 20 days post allo-PBSCT respectively.2. 13 out of 23 patients developed aGVHD, grade I in 8 patients, grade II ~ IV in 5 patients.3.We found that circulating levels of IL-2 , TNF- α were markedly elevated during aGVHD and strongly correlated with the severity of aGVHD comparing to patients without aGVHD. However the levels of the IL-10 in patients with aGVHD significantly was lower than those without aGVHD . The capicity of IL-8 had no sense of statistics.4.The levels of T h cell's cytokine IFN- Y in patients with aGVHD was much higher ( 29.5% + 6.88% ) than the patients without aGVHD (21.38% + 4.55% ) (P<0.05 ) . But the levels of the IL-4 in patients with aGVHD had little difference with the patients without aGVHD.Conclusions1.These findings suggest that IL-2 and TNF- a might play important roles in the pathogenesis of aGVHD , and that measurement of serum IL-2 and TNF- a levels after allo-HSCT could provide predictive marker for acute GVHD.2.Respectively, IL-10 play an important role in decreasing theclinical aGVHD.3.The imbalance of Thl/Th2 might correlate with the pathogenesis of aGVHD , Th cell's cytokine IFN-γ in the peripheral blood was found high in the patients with accelerating aGVHD clinically.