Host versus graft reaction ,HVGR

1
????
2
?. ????
????
???
???????
???????????
??
???????
(?? ?? ??)
?
?
??
????
?
?
3
?. ??????????????
???????????????,???????????
????????
Host versus graft reaction ,HVGR
????????
Graft versus host reaction ,GVHR
??? ????? ????
4
1. ???
????????? MHC??
Major histocompatibility complex
???????????
????????????,??????
????????? mH??
Minor histocompatibility system
???????????
? H-Y?Y?????
5
2.?? ??????
MHC I II
??????
????
MHC I
????(????)
MHC I II
??????APC
?????T????CD8T?CD4T
6
3. ??T?????MHC???????
????
??T?????????????MHC??
??????????,????????????
????
??MHC?????APC?????????MHC?????
(???MHC????????)
???????????
mH?????????????
7
??T
??MHC?????
???
??APC
??APC
????
????
8
?????????MHC??? ????????????????
??
MHC???aa??
TCR
??
????aa??
9
???X
???Y
??MHC??
??MHC??
TCR???MHC???????
10
???????
?????MHC?TCR????
??MHC???MHC??????aa,?????????TCR?????
??MHC?????????,????????TCR??
?????,??APC???????????MHC??????????(??????????????
,????TCR)???????MHC????TCR?????
11
?.???????????????????
???????
???????? ? ???
HVGR
??????
??? ???2?
??????
??? ?? ? ??
12
1. ???????
????
(ABO???????????????????)
??
(????????)
???????
????????????????????????
????
??????????????
??????????????
??????????????
13
2. ??????
?????
??????
CD8 CTL??????
CD4 Th?????????????
??????
?????
????
14
3. ??????
??????
?????????
CD4Th????????????
????????????????
????????????????(???????????????????????????)?????
????????
??????????????
15
Graft versus host reaction ,GVHR
??T?????????????????????
16
?. ??????????????
1. ?????
?????
2. ?????
(????????)
17
3. HLA??
??????HLA??,????????????
?HLA-A?B?C?DR?DQ?DP?????????? DR?A?B,??II???I?????
????
18
????3??6???????,????10?????62,5???47,4???45,3?
??40,?1????33,??HLA????????????????,????????????
???
19
(No Transcript)
20
100 90 80 70 60 50 40 30 20 10 0
?????(N12)
??????
HLA?????(N765)
HLA??????(N951)

?????(N3974)
1? 2?
21
4. ???????
????A(CsA)
??T???????IL-2?????
FK506?????
?????????
????
???
?????
??
?CD3?CD25?CD4?CD8??????TCR
22
5. ???????????
?????????MHC???????????,?????T????????
???????CTLA-4,???B7?CD28?????,??T????
????????????
6. ??????
23
?. ????
??????????,??????????
????????
???????????
24
?. ????
???? MHC ????