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朱意.药物与调节性T细胞在异基因造血干细胞移植后急性移植物抗宿主病防治中的协同作用[J].内科急危重症杂志,2026,32(3):279-283
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| DOI：10.11768/nkjwzzzz20260315 |
| 中文关键词: 急性移植物抗宿主病 调节性T细胞 免疫抑制剂 协同作用 异基因造血干细胞移植 |
| 英文关键词:Acute graft- versus- host disease Regulatory T cells Immunosuppressive agents Synergistic role Allogeneic hematopoietic stem cell transplantation |
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| 摘要点击次数: 110 |
| 全文下载次数: 87 |
| 中文摘要: |
| 摘要 异基因造血干细胞移植是治疗血液系统疾病的有效手段之一，急性移植物抗宿主病（aGVHD）是其严重并发症。激素及传统免疫抑制剂虽能控制aGVHD，但缺乏特异性、存在感染和高复发风险。近年来，研究发现药物与调节性T细胞（Tregs）的协同作用，代表了aGVHD防治从“广泛免疫抑制”向“精准免疫调控”的转变。本文综述了药物对Tregs的影响及其在aGVHD防治中的协同作用，涵盖雷帕霉素、芦可替尼、地西他滨等药物的临床前和/或临床证据，探讨其如何通过调控Tregs/效应T细胞平衡，实现免疫耐受而不减弱抗白血病效应，并展望未来挑战与发展方向。 |
| 英文摘要: |
| Abstract Allogeneic hematopoietic stem cell transplantation is one of the effective approaches for the treatment of hematologic diseases, and acute graft-versus-host disease (aGVHD) is a serious complication thereof. Steroids and traditional immunosuppressive agents can control aGVHD. However, they lack specificity and are associated with increased risks of infection and relapse. In recent years, studies have shown that the synergistic role of pharmacological agents and regulatory T cells (Tregs) represents a shift in the prevention and treatment of aGVHD from "broad immunosuppression" to "precise immune regulation". This article reviews the effects of drugs on Tregs and their synergistic role in the prevention and treatment of aGVHD, covering the preclinical and/or clinical evidence of agents such as rapamycin, ruxolitinib, and decitabine, and discusses how these agents achieve immune tolerance without weakening the graft-versus-leukemia effect by regulating the balance between Tregs and effector T cells, as well as the future challenges and development directions in this field. |
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