异基因造血干细胞移植术后黏膜相关恒定 T (MAIT)细胞与发生常见病毒感染的差异及 危险因素分析

Analysis of the Differences and Risk Factors between Mucosa-Associated Invariant T (MAIT) Cells and Common Viral Infections after Allogeneic Hematopoietic Stem Cell Transplantation

摘要: 黏膜相关恒定T (MAIT)细胞作为一种先天样T细胞，在维持黏膜免疫稳态中起关键作用，但其在allo-HCT后的动态变化及其与移植后病毒感染的关联尚待深入探讨。本研究纳入42例首次接受allo-HCT的患者。在预处理前及移植后第30 (±3)天，通过流式细胞术检测外周血MAIT细胞(CD3 + TCRVα7.2 + CD161+)频率，通过受试者工作特征(ROC)曲线确定MAIT细胞计数的临界值，将患者分为高、低组，统计分析MAIT细胞水平与移植后常见病毒(CMV、EBV及BKV)感染及临床因素之间的相关性。本研究表明，allo-HCT后早期(第30天)的外周血MAIT细胞数量是预测BKV血症风险的潜在重要生物标志物。GVHD预防方案中的环磷酰胺(PTCy)可能会抑制MAIT细胞的早期重建，从而可能增加移植后感染等相关并发症风险。监测MAIT细胞动态变化有助于早期识别高危患者并进行干预。

Abstract: Mucosa-Associated Invariant T (MAIT) cells, as a type of innate T cells, play a key role in maintaining mucosal immune homeostasis. However, their dynamic changes after allo-HCT and their association with viral infections after transplantation remain to be further explored. This study included 42 patients who received allo-HCT for the first time. Before pretreatment and on the 30th (±3) day after transplantation, the frequency of MAIT cells (CD3 + TCRVα7.2 + CD161+) in peripheral blood was detected by flow cytometry. The critical value of MAIT cell count was determined by the Receiver Operating Characteristic (ROC) curve, and the patients were divided into high and low groups. Statistically analyze the correlation between MAIT cell levels and common viral (CMV, EBV and BKV) infections and clinical factors after transplantation. This study indicates that the number of MAIT cells in the peripheral blood in the early stage (day 30) after allo-HCT is a potentially important biomarker for predicting the risk of BKKV syndrome. Cyclophosphamide (PTCy) in the GVHD prevention protocol may inhibit the early reconstitution of MAIT cells, thereby potentially increasing the risk of related complications such as infection after transplantation. Monitoring the dynamic changes of MAIT cells is helpful for the early identification of high-risk patients and intervention.