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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 发生于移植物中的供者免疫细胞攻击受者器官时，常累及皮肤、肝脏及胃肠道。现代防控体系已从传统的化学<strong><a href="/免疫抑制剂" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">免疫抑制剂</a></strong>（如环孢素、甲氨蝶呤）演进为基于<strong><a href="/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="/免疫调节" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">免疫调节</a></strong>方案。利用 MSC 的<strong><a href="/免疫豁免" target="_blank" style="color: #1e40af; text-decoration: none; font-weight: bold;">免疫豁免</a></strong>特性及<strong><a href="/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 的标准二线策略。
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| − | <div class="medical-infobox mw-collapsible mw-collapsed" style="width: 100%; max-width: 380px; margin: 0 auto 35px auto; border: 1.2px solid #bae6fd; border-radius: 12px; background-color: #ffffff; box-shadow: 0 8px 20px rgba(0,0,0,0.05); overflow: hidden;">
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| − | <div style="padding: 18px; color: #1e40af; background: linear-gradient(135deg, #e0f2fe 0%, #bae6fd 100%); text-align: center; cursor: pointer;">
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| − | <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">GvHD防控 · 临床概要</div>
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| − | <div style="font-size: 0.75em; opacity: 0.85; margin-top: 4px;">GvHD Control Profile (点击展开)</div>
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| − | <div style="color: #64748b; font-size: 0.9em; font-weight: 500;">移植物抗宿主病干预逻辑模型</div>
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| − | <th style="text-align: left; padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #475569; background-color: #f8fafc; width: 40%;">预防一线方案</th>
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| − | <td style="padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #0f172a;">环孢素A + 甲氨蝶呤</td>
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| − | <th style="text-align: left; padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #475569; background-color: #f8fafc;">核心治疗载体</th>
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| − | <td style="padding: 10px 15px; border-bottom: 1px solid #f1f5f9; color: #0f172a;"><strong><a href="/MSC" target="_blank" style="color: #1e40af; text-decoration: none;">MSC</a></strong></td>
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| − | </tr>
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| − | <th style="text-align: left; padding: 10px 15px; color: #475569; background-color: #f8fafc;">关键干预靶点</th>
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| − | <td style="padding: 10px 15px; color: #1e40af; font-weight: 600;">效应 T 细胞 与 炎症因子</td>
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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;">病理基础与分级防控</h2>
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| − | <p style="margin: 15px 0; text-align: justify;">
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| − | 有效防控 GvHD 的逻辑在于抑制供者淋巴细胞对宿主器官的过度免疫识别与攻击，同时保留移植物抗肿瘤效应（GvL）。
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| − | <li style="margin-bottom: 12px;"><strong>预防阶段：</strong> 通过 HLA 精确配型及钙调磷酸酶抑制剂，阻断供者 <strong><a href="/T细胞" target="_blank" style="color: #1e40af; text-decoration: none;">T细胞</a></strong> 的初始激活。</li>
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| − | <li style="margin-bottom: 12px;"><strong>MSC 介入：</strong> 在难治型 aGvHD 中，<strong><a href="/MSC" target="_blank" style="color: #1e40af; text-decoration: none;">MSC</a></strong> 通过<strong><a href="/归巢机制" target="_blank" style="color: #1e40af; text-decoration: none;">归巢机制</a></strong>进入受损器官，释放 <strong>IDO</strong> 等因子诱导 <strong><a href="/Tregs" target="_blank" style="color: #1e40af; text-decoration: none;">Tregs</a></strong> 产生。</li>
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| − | <li style="margin-bottom: 12px;"><strong>无细胞方案：</strong> <strong><a href="/MSC外泌体" target="_blank" style="color: #1e40af; text-decoration: none;">MSC外泌体</a></strong> 能够作为更稳定的介质，下调局部的<strong><a href="/细胞因子风暴" target="_blank" style="color: #1e40af; text-decoration: none;">细胞因子风暴</a></strong>水平。</li>
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| − | </ul>
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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;">传统化学抑制 vs. 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>
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| − | <th style="padding: 12px; border: 1px solid #cbd5e1; color: #475569;">传统免疫抑制 (CsA/MTX)</th>
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| − | <th style="padding: 12px; border: 1px solid #cbd5e1; color: #16a34a;">MSC 细胞干预方案</th>
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| − | </tr>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">作用机制</td>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1;">全身性、非特异性抑制</td>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1;">局部炎症调节与组织修复</td>
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| − | </tr>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1; font-weight: 600;">长期益处</td>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1;">易伴随严重感染风险</td>
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| − | <td style="padding: 10px; border: 1px solid #cbd5e1;">诱导免疫耐受，副作用极低</td>
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| − | </tr>
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| − | </table>
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| − | </div>
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| − | <span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: block; margin-bottom: 2px;">参考文献与学术点评</span>
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| − | <div style="margin: 12px 0; border-bottom: 1px solid #e2e8f0; padding-bottom: 10px;">
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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>
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| − | <span style="color: #475569;">[点评]：确立了 MSC 作为激素耐药型 aGvHD 标准救治方案的里程碑研究。</span>
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| − | [2] <strong>Zeiser R, et al. (2021).</strong> <em>Ruxolitinib for Glucocorticoid-Refractory Acute GvHD.</em> <strong>NEJM</strong>. <br>
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| − | <span style="color: #475569;">[点评]：提供了基于 JAK 抑制剂防控 GvHD 的最新临床证据。</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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| − | <div style="padding: 15px; background: #ffffff; line-height: 2.2; text-align: center;">
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| − | <a href="/MSC" target="_blank" style="text-decoration: none; color: #1e293b;">[[MSC]]</a> •
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| − | <a href="/免疫调节" target="_blank" style="text-decoration: none; color: #1e293b;">[[免疫调节]]</a> •
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| − | <a href="/再生医学" target="_blank" style="text-decoration: none; color: #1e293b;">[[再生医学]]</a> •
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| − | <a href="/免疫豁免" target="_blank" style="text-decoration: none; color: #1e293b;">[[免疫豁免]]</a> •
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| − | <a href="/MSC外泌体" target="_blank" style="text-decoration: none; color: #1e293b;">[[MSC外泌体]]</a> •
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| − | <a href="/细胞因子风暴" target="_blank" style="text-decoration: none; color: #1e293b;">[[细胞因子风暴]]</a>
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