MHC和骨髓移植课件

MHC

&

marrowtransplantationMHCandMarrowTransplantationHistoryBasicdefinitionPrincipleandprocessesofMHCandmarrowtransplantationProblemswearefacingtodayThemethodweexcogitateHISTORYUptonow,thenumberoftransplantationforheart,liver,kidneyhasreached500,000allovertheworld.During2006,over9500patientsreceivedmarrowtransplantation.Transplantationbeganfrom1960sinChina,anditdevelopsrapidly.Definition

MHC：Alargeclusteroflinkedgeneslocatedinsomechromosomeinhumanorothermammalsrelatetoimmuneresponseandimmuneregulation.MHCmolecule:AgroupofproteinencodedbyMHCplayinganimportantroleinhumanimmunity,theycanbedividedintotwokinds——MHC-Ⅰ，MHC-ⅡPrincipleandProcesses

of

MarrowTransplantation

MHC-Ⅱmolecule※encodedentirelybythesixthchromosome※composedoftwochains:άchain,βchain※dividedintofourdomains:

ά1,ά2,β1,β2

tworegions:peptidebindingregion,immunoglobulin-likeregion※distribution:professionalantigen-presentingcells,thymusepithelialcells,activatedTcellsά1ά2β1β2Plasmamembrane※Polymorphism

differenceofindividual

inimmunology

difficultyofTissueTyping

FunctionofMHCmolecule※InducingmaturationofTcellspositiveselectionnegativeselection※PresentingantigensfortherecognitionofTCR

※Involvedintransplantationrejection

Early“BoneMarrowTransplantation”:Stemcellsonlyexistinredbloodmarrow,littlecandiffuseintoperipherialbloodWehavetogetthestemcellsbyBoneMarrowAspiration

ThismakeavastlostofredbloodcellsDonorwillfeeldizzy,weakandgothroughhugeriskMotivation:makethestemcellsreleaseintobloodSeparation:getenoughstemcellsfromtheperipheralblood,thentransplantthehealthystemcellsintothepatients’bodies(peripherialbloodstemcellstransplantation)Stemcellscancomebacktotheredbonemarrowandself-duplicatethedonorwillrecovertheoriginalnumberandwon’tfeeluncomfortable,soitismuchsaferModernstemcelltransplantationThediseasescommonlytreatedwithanautologoustransplantincludesolidtumors,suchasbreastcancerandovariancancer,non-Hodgkin'slymphoma,Hodgkin'sdisease,andsoon.Patientsareassessedbyatransplantteaminordertodetermineeligibility（适合）forastemcelltransplant.

FirstThestemcellswillbeprocessedandcryopreserved.

Thirdthepatientwillreceivetheirownstemscellsbackthroughacentralvenouscatheter.AfterreceivinghighdosechemotherapywithorwithouttotalbodyirradiationFourth(二)AllogeneicStemCellTransplants:

Adonorprovidesthestemcellsfortransplantationtoarecipient.

Itisusedtotreatpatientswithleukemia,aplasticanemia(再生障碍性贫血）,lymphoma（淋巴瘤）andimmunodeficiencysyndromes（免疫缺陷综合征）.First

Asuitabledonormustbefoundusinghumanleukocyteantigen(HLA)typing.Thesearchisstartedwithinthepatient‘sfamilyfirst,generallysiblings(同胞),andifnecessary,thesearchcontinuesthroughinternationaldonorregistries.Thestemcellscanbecryopreservedorcollected，therecipientisgiventhestemcellsfollowinghighdosechemotherapywithorwithouttotalbodyirradiationThirdPreventionof

TransplantationRejection※Tissuetyping一年存活率（%）错配数※Drugsusedininducingimmunitysuppression※InducingimmunetoleranceProblems

wearefacingtodayOrgansourceislimitedOver70%ofthepatientscannotgetsuitablebonemarrowdonor.QualityofdonororgansLegislation

Althoughtherearedifficulties,Thepatientsshouldnotgiveuphope.希望Themethodweexcogitate1.Thepatientsacceptchemotherapyorradiotherapytodestroythetumorandunhealthybonemarrow2.Collectedstemcellsfromtheperipheralbloodofdonor3.Imitateathymicmicroenvironmentofembryophase

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