| ObjectivesTo perspectively study the clinical features, dynamic changes of lymphocyte subgroups and clonality of T cell receptor (TCR) before and after autologous hemopoietic stem cell transplantation (HSCT) in severe/refractory autoimmune disease , (AID), assess the post-transplantation immunological reconstitution which may yield important clues to our standing of the pathogenesis of AID.MethodsThirteen patients with severe/refractory AID registed for HSCT during April 2003-April 2005 in Peking Union Medical College Hospital, including 8 cases with systemic lupus erythematosus (SLE), 4 cases with rheumatoid arthritis(RA) , and 1 case with primary sjogren 's syndrome( pSS) , according to the disease criterias respectively. Granulocye colony-stimulating factor(G-CSF) was injected for 2-6 days in moblisation. The amount of selected CD34+ cell are 1.05-4.6X×106/kg. T cell depletion was about 103-4, and B cell depletion was about 102-6. the hematopoietic reconstitution was obeserved during 10-20 days after CD34+ cell enrichment. Median follow up 6 months (3-18 months). Data and blood samples were collected before/after mobilization, before conditioning, 2 weeks, 1 month, 3 months , 6 months 12 months 18 months post-transplantation. The overall study was carried out for three parts.PART 1 Clinical featursSigns and syptoms were recorded for SLE and RA patients. ANA, anti-dsDNA, anti-ENA, ACL, Complement 3 and Immunoglobulin were investigated for SLE/pSS patients, while ESR, CRP, RF and immunoglobulin for RA patients. SLE-DAI and DAS28/ACR score for RA were used to assess disease activities of SLE and RA respectively.PART 2 Investigation of lymphocyte subgroups by flow cytometry (FCM) are list as followingT cell (CD3+), B cell (CD19+), Natrual Killer (CD3-CD16+CD56+), Th (CD3+CD4+), Tc (CD3+CD8+), Naive T (CD4+CD45RA+), Memory T (CD4+CD45RO+), CD4/CD8 ratio and Regulatory T cell (CD4+CD25+, CD8+CD28-), Activated B cell (CD19+CD38+)... |
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