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目的探讨白血病患者造血干细胞移植后体内 Fas 配体(FasL)、穿孔素(Perforin)及颗粒酶 B(Granzyme B)基因转录水平的动态变化与急性移植物抗宿主病(aGVHD)发生及发展的关系。方法应用竞争性定量 RT-PCR 方法检测17例白血病患者造血干细胞移植后 Granzyme B、Perforin 及FasL 的基因表达水平。结合临床,分析 FasL、Perforin 及 Granzyme B 基因表达动态变化与 aGVHD 的相关关系。结果 14例发生 aGVHD 的患者,诊断前与诊断时 Granzyme B、Perforin 和 FasL 基因表达水平分别为4.6±0.2,4.5±0.1,1.4±0.1和98.7±2.5,91.8±3.4,61.5±2.2,诊断时均比诊断前明显升高(P<0.05);Granzyme B、Perforin 和 FasL 基因表达水平先于 aGVHD 临床症状出现升高的例数分别为13例、14例和12例,并可根据变化趋势提示 aGVHD 预后。结论 aGVHD 发生时 Perforin、FasL、Granzyme B 基因表达水平明显升高。Perforin、FasL、Gralnzyme B 基因表达水平在一定程度上能够预示 aGVHD 的发生,并可提示 aGVHD 严重程度及预后。
Objective To investigate the relationship between dynamic changes of gene transcription level of Fas ligand (Perforin) and granzyme B (Bcl-2) and the occurrence and development of acute graft versus host disease (aGVHD) in patients with leukemia after hematopoietic stem cell transplantation . Methods The gene expression levels of Granzyme B, Perforin and FasL in 17 leukemia patients after hematopoietic stem cell transplantation were assayed by competitive quantitative RT-PCR. Combined with clinical analysis of FasL, Perforin and Granzyme B gene expression changes associated with aGVHD. Results In 14 patients with aGVHD, the expression of Granzyme B, Perforin and FasL in pre-diagnosis and diagnosis were 4.6 ± 0.2, 4.5 ± 0.1, 1.4 ± 0.1 and 98.7 ± 2.5, 91.8 ± 3.4 and 61.5 ± 2.2, respectively (P <0.05). Granzyme B, Perforin and FasL gene expression levels before clinical symptoms of aGVHD were 13 cases, 14 cases and 12 cases, respectively, and could be prompted according to the change trend aGVHD prognosis. Conclusion The expression of Perforin, FasL and Granzyme B in aGVHD patients is significantly increased. Perforin, FasL, Gralnzyme B gene expression levels to a certain extent, can predict the occurrence of aGVHD, and can prompt aGVHD severity and prognosis.