实用医学杂志2025，Vol.41Issue(5)：628-633,6.DOI:10.3969/j.issn.1006-5725.2025.05.002
肠道菌群参与异基因造血干细胞移植免疫重建调控的研究进展
Gut microbiota modulates immune reconstitution in allogeneic hematopoietic stem cell transplantation
摘要
Abstract
As a symbiotic microbial community within the human body,the gut microbiota plays a crucial role in modulating various physiological processes,including metabolism,immunity,and endocrine function.During allogeneic hematopoietic stem cell transplantation(allo-HSCT),the hematopoietic and immune systems undergo significant changes,which are also influenced by the gut microbiota.Specifically,regarding hematopoietic function,the gut microbiota facilitates the multi-lineage differentiation of hematopoietic stem cells via NOD1-STATs and TLRs-MyD88 signaling pathways,and promotes rapid granulomonocytic lineage differentiation under infection stress.Consequently,early-stage primary graft dysfunction following transplantation may be associated with gut microbiota dysbiosis.In terms of immune function,the gut microbiota enhances the expression of antigen-presenting molecules on intestinal epithelial cells,thereby initiating acute graft-versus-host disease(aGVHD)in the gastrointestinal tract.Moreover,the gut microbiota regulates intestinal immune function through metabolites such as short-chain fatty acids,bile acids,and indole derivatives.Dysbiosis of the gut microbiota can lead to disrup-tion of the intestinal mucus barrier and immune barrier functions,further promoting the onset and progression of aGVHD in the gastrointestinal tract.Therefore,targeting the gut microbiota has emerged as an attractive therapeutic strategy and has been clinically applied.Notably,fecal microbiota transplantation combined with immunosuppressive therapy has shown significant efficacy in alleviating clinical severity and improving prognosis in steroid-refractory aGVHD,demonstrating high safety and manageable adverse reactions,representing a novel breakthrough in its treatment.关键词
肠道菌群/异基因造血干细胞移植/免疫重建/移植物抗宿主病/移植物抗白血病效应Key words
gut microbiota/allogeneic hematopoietic stem cell transplantation/immune reconstitu-tion/graft-versus-host disease/graft-versus-leukemia effect分类
临床医学引用本文复制引用
陆海洋,赵维莅,胡晓霞..肠道菌群参与异基因造血干细胞移植免疫重建调控的研究进展[J].实用医学杂志,2025,41(5):628-633,6.基金项目
国家重点研发计划(编号:2022YFC2502600) （编号:2022YFC2502600）
国家自然科学基金项目(编号:81710160,82170206) （编号:81710160,82170206）
上海市"医苑新星"杰出青年医学人才培养计划(编号:20224Z0022) （编号:20224Z0022）
