查看“GvHD防控”的源代码

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            <strong>GvHD防控</strong>（Prevention and Control of Graft-versus-Host Disease）是异基因造血干细胞移植（allo-HSCT）成功的核心关键。GvHD 发生于移植物中的免疫效应细胞攻击宿主器官时，常累及皮肤、肝脏及胃肠道。现代防控体系已从传统的化学免疫抑制剂（如环孢素、甲氨蝶呤）演进为基于<strong><a href="/wiki/MSC" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">MSC</a></strong>（间充质干细胞）的<strong><a href="/wiki/免疫调节" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">免疫调节</a></strong>及<strong><a href="/wiki/细胞治疗" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">细胞治疗</a></strong>。利用 MSC 的<strong><a href="/wiki/免疫豁免" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">免疫豁免</a></strong>特性及强大的<strong><a href="/wiki/旁分泌效应" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">旁分泌效应</a></strong>，已成为救治激素耐药型急性 GvHD 的前沿方案。
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            <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px; text-decoration: none;">GvHD防控 · 临床策略</div>
            <div style="font-size: 0.75em; opacity: 0.85; margin-top: 4px; white-space: nowrap;">GvHD Prevention Profile (点击展开)</div>
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                    临床核心：预防为主 + 梯次治疗
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                    <th style="text-align: left; padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #475569; background-color: #f8fafc; width: 40%;">一线药物</th>
                    <td style="padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #0f172a;">糖皮质激素, 环孢素A</td>
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                    <th style="text-align: left; padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #475569; background-color: #f8fafc;">二线/前沿方案</th>
                    <td style="padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #0f172a;"><strong>MSC</strong>, Ruxolitinib</td>
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                    <th style="text-align: left; padding: 10px 15px; color: #475569; background-color: #f8fafc;">核心靶点</th>
                    <td style="padding: 10px 15px; color: #1e40af; font-weight: 600;"><strong>T细胞</strong> 极化与活化</td>
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        有效的 GvHD 管理遵循梯次递进的逻辑，旨在平衡“移植物抗肿瘤效应”（GvL）与“移植物抗宿主病”（GvHD）：
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        <li style="margin-bottom: 12px;"><strong>一级预防：</strong> 通过 HLA 配型优化、使用钙调磷酸酶抑制剂及 <strong><a href="/wiki/T细胞" target="_blank" style="color: #1e40af; text-decoration: none;">T细胞</a></strong> 耗竭技术，降低初始免疫激活风险。</li>
        <li style="margin-bottom: 12px;"><strong>二线救治：</strong> 针对激素耐药型急性 GvHD（SR-aGvHD），利用 <strong><a href="/wiki/MSC" target="_blank" style="color: #1e40af; text-decoration: none;">MSC</a></strong> 释放 <strong>PGE2</strong> 和 <strong>IDO</strong>，通过抑制效应细胞增殖并诱导 <strong><a href="/wiki/Tregs" target="_blank" style="color: #1e40af; text-decoration: none;">Tregs</a></strong> 生成。</li>
        <li style="margin-bottom: 12px;"><strong>新型无细胞干预：</strong> 临床研究显示，<strong><a href="/wiki/MSC外泌体" target="_blank" style="color: #1e40af; text-decoration: none;">MSC外泌体</a></strong> 能够有效下调微环境中的促炎因子水平（如 <strong>TNF-alpha</strong>, <strong>IL-6</strong>），且安全性显著优于活细胞。</li>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold; text-decoration: none;">传统免疫抑制 vs. MSC 细胞免疫调控 对照表</h2>

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                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #0f172a; width: 25%;">对比维度</th>
                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">传统免疫抑制剂 (MTX/CsA)</th>
                <th style="padding: 12px; border: 1px solid #cbd5e1; color: #16a34a;">MSC 细胞干预方案</th>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">作用机制</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">全身性、非特异性抑制免疫</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;"><strong><a href="/wiki/归巢机制" target="_blank" style="color: #1e40af; text-decoration: none;">炎症趋化归巢</a></strong>，局部精准调节</td>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">副作用</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">骨髓抑制、严重感染风险高</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">极低，有助于造血功能恢复</td>
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                <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">长期结局</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">易复发，慢性 GvHD 发生率高</td>
                <td style="padding: 10px; border: 1px solid #cbd5e1;">诱导长期<strong><a href="/wiki/免疫豁免" target="_blank" style="color: #1e40af; text-decoration: none;">免疫耐受</a></strong></td>
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        <span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: inline-block; margin-bottom: 5px;">参考文献与学术点评</span>
        
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            [1] <strong>Le Blanc K, et al. (2008).</strong> <em>Mesenchymal stem cells for treatment of steroid-resistant...</em> <strong>The Lancet</strong>. <br>
            <span style="color: #475569;">[学术点评]：该项 II 期临床研究正式确立了 MSC 作为 SR-aGvHD 二线标准治疗方案的地位。</span>
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            [2] <strong>Zeiser R, et al. (2021).</strong> <em>Ruxolitinib for Glucocorticoid-Refractory Acute GvHD.</em> <strong>The New England Journal of Medicine</strong>. <br>
            <span style="color: #475569;">[学术点评]：解析了 JAK 抑制剂在 GvHD 防控中的最新机制，为联合治疗提供了依据。</span>
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            [3] <strong>Kordelas L, et al. (2014).</strong> <em>MSC-derived exosomes: a novel tool to treat GvHD.</em> <strong>Leukemia</strong>. <br>
            <span style="color: #475569;">[学术点评]：全球首个外泌体治疗 GvHD 的临床案例报告，展示了无细胞疗法的巨大潜力。</span>
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        <div style="background-color: #0f172a; color: #ffffff; text-align: center; font-weight: bold; padding: 10px; letter-spacing: 1px;">GvHD防控 · 知识图谱关联</div>
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            <a href="/wiki/MSC" target="_blank" style="text-decoration: none; color: #1e293b;">[[MSC]]</a> • 
            <a href="/wiki/免疫调节" target="_blank" style="text-decoration: none; color: #1e293b;">[[免疫调节]]</a> • 
            <a href="/wiki/MSC外泌体" target="_blank" style="text-decoration: none; color: #1e293b;">[[MSC外泌体]]</a> • 
            <a href="/wiki/细胞因子风暴" target="_blank" style="text-decoration: none; color: #1e293b;">[[细胞因子风暴]]</a> • 
            <a href="/wiki/再生医学" target="_blank" style="text-decoration: none; color: #1e293b;">[[再生医学]]</a> • 
            <a href="/wiki/免疫豁免" target="_blank" style="text-decoration: none; color: #1e293b;">[[免疫豁免]]</a>
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