摘要
目的研究谷氨酰胺双肽对造血干细胞移植患者血清Th1/Th2细胞因子水平的影响,及对移植后急性移植物抗宿主病(GVHD)的预防作用。方法将20例接受异基因造血干细胞移植患者随机分为两组,谷氨酰胺组10例,对照组10例。从移植后当天至第20天,谷氨酰胺组患者除接受标准胃肠外营养支持外,每天给予N(2)-L-丙氨酰-L-谷氨酰胺200ml;对照组采用不含谷氨酰胺的标准化胃肠外营养支持。两组均采用改良白消安加环磷酰胺(BuCy2)预处理方案,采用环孢霉素加霉酚酸酯预防移植物抗宿主病(GVHD),分别于预处理当天,移植后第7、14、21、28和42天收集患者血清标本,采用酶联免疫吸附实验(ELISA)分别检测肿瘤坏死因子α(TNF-α)、干扰素γ(INF-γ)、白介素2(IL-2)、IL-4、IL-10的水平,同时监测两组GVHD发生率及严重程度。结果谷氨酰胺组TNF-α、INF-γ和IL-2水平较对照组低,其中TNF-α、INF-γ与对照组差异有显著意义(P<0.05);谷氨酰胺组IL-4和IL-10水平略高于对照组,但仅移植后第42天差异有显著意义(P<0.05)。GVHD发生两组无明显差异。结论谷氨酰胺能使造血干细胞移植患者的Th1/Th2细胞因子向有利于预防GVHD的方向偏移。
Objective To investigate the effects of glutamine （Gln） supplementation on Th1/Th2 cytokines in patients undergoing hematopoietic stem cell transplantation. Methods T hematopoietic stem cell transplantation （allo-HSCT） were enrolled into wen ty patients undergoing allogeneic study and divided into glutamine hematopoietic stem cell transplantation （allo-HSCT） were enrolled into the study and divided into glutamine group and control group randomly; glutamine-group received total parenteral nutrition （TPN） enriched by 200 ml/d N （2） -L-alanyl-L-glutamine injection （ containing 40 g alanyl-glutamine ： 16.40 g L-alanine and 26.92 g L-glutamine） and control group received glutamine-free TPN. All patients received BuCy2-based conditioning regimen and graft-versus-host-isease （GVHD） prophylaxis with cyclosporine and mycophenolate mofeil （MMF）. Serum samples of patients were collected on 0 days （0 d） , 7 d, 14 d, 21 d, 28 d, and 42 d after transplantation respectively. Enzyme-Linked Immunosorbent Assay （ELISA） was performed to detect TNF-α, INF-γ, 1L-2, IL-4, and IL-10 levels. The morbidity and severity of GVHD and mucositis of the two groups were monitored clinically. Results The cytokines levels of TNF-α, INF-γand IL-2 in glutamine-group are significantly higher than control group＇s at the corresponding period. There is no significantly difference in IL-4, IL- l0 levels except in 42 days posttransplantation between glutamine group and control group though with tendency of higher level of IL-4 and IL-10 in glutamine group. No significant difference was detected in morbidity and severity of GVHD. Conclusion Glutamine supplementation in patients undergoing hematopoietic stem cell transplantation will lead to a positive shift of Th1/Th2 cytokines for preventing GVHD.
出处
《中国临床营养杂志》
2006年第6期365-368,共4页
Chinese Journal of Clinical Nutrition
关键词
谷氨酰胺
造血于细胞移植
细胞因子
glutamine
hematopoietic stem cell transplantation
cytokine
