异基因造血干细胞移植(allo-HSCT)是彻底根治恶性血液病和遗传性疾病的主要手段,但其临床应用仍存在许多问题,其中急性移植物抗宿主病(aGVHD)是移植失败和患者死亡的主要原因之一。据欧洲骨髓移植登记中心统计资料,非亲缘allo-HSCT患者的aGVHD发生率为40%~60%,病死率为30%~50%。因此,深入研究aGVHD发病机制并探讨其防治新策略,对提高临床移植成功率和拓展allo-HSCT的临床应用具有重要意义。目前,aGVHD与内皮细胞损伤的相关性成为研究的热点。本文就aGVHD与内皮细胞损伤的相关性进展做一综述。
Many studies have proved that endothelial cell injury plays an important role in the initiation and development of acute graft-versus-host disease(aGVHD) and is an early event of tissue injury caused by aGVHD.Endothelial microparticles(EMPs) are cell-membrane vesicles that shed from peripheral-blood endothelial cells when subjected to stress conditions,such as activation,apoptosis and so on.Several studies have indicated that the rise of EMPs suggests severe endothelial damage in patients with aGVHD.EMPs may paticipate in the immune injury of aGVHD through the apoptosis induced by Fas / FasL.We will review the research progress of aGVHD after allogeneic hematopoietic stem cell transplantation and endothelial cell injury,and discusse EMPs and its possible mechanisms in endothelial cell injury during aGVHD.