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골수이식 후 사이토카인과 골교체 생화학적표지자의 변화 및 상관관계
민우성,강무일,한제호,강성구,오기원,이원영,김혜수,문성대,손현식,신완식,김춘추,윤건호,차봉연,이광우,손호영 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.1
Background : Loss of bone mass is usually detected after BMT. The causes of bone loss are related with gonadal dysfunction and immunosuppressants. Cytokines, especially IL-6, play an important role in the pathogenesis of postmenopausal osteoporosis. However, the pathogenetic role of cytokines in post-BMT bone loss is unknown and data on the changes of cytokines in accordance with bone turnover markers are scarce. The aim of this study is to assess the relationship of bone turnover markers and cytokines of peripheral blood and bone marrow before and after allogeneic BMT. Methods : This prospective study included two analyses. The first was a study of 46 BMT recipients, examining the relationship between bone turnover markers and cytokines of serum which were measured before and 1, 2, 3, 4 week and 3 months after BMT. The second was a study of 14 BMT patients, measuring bone marrow plasma cytokines such as IL-6 and TNF-? at post-BMT 3 week and bone turnover marker at the same time to assess the relationship beween two parameters. Results : Serum ICTP, bone resorption marker, increased progressively until 4 weeks (peak) after BMT and then decreased thereafter. Serum osteocalcin, bone formation marker, decreased progressively until 3 weeks after BMT and then increased thereafter. There was positive correlation between serum ICTP and bone marrow IL-6 levels at the post-BMT 3 week with a statistical significance, but the correlation between bone turnover markers and bone marrow TNF-? or peripheral blood cytokines was not found. Conclusion : Our data suggest that the progressive increase of bone resorption after BMT is related with the increase of bone marrow IL-6, which is a potent stimulator of bone resorption in vivo(J Kor Soc Endocrinol 15:85-96, 2000).
민우성 대한내과학회 2004 대한내과학회지 Vol.66 No.4
현재까지의 연구 결과에 따르면 동종 말초혈액조혈모 세포이식의 경우 재발 위험성과 이식관련 사망 위험율이 높은 진행된 백혈병 환자의 경우에서만 동종 골수조혈모세포이식에 비해 우월한 성적을 보였다. 동종 말초혈액조혈모세포이식의 경우 이식편대숙주병의 발생이 상대적으로 높으며 T-세포제거에 의해 발생율은 감소시킬 수 있으나 이에 따른 전체적인 이득은 아직 명확하지 않다. 공여자로부터의 동종 말초혈액조혈모세포이식의 역할과 모범적 임상치료 계획은 향후 더 많은 경험과 보완연구가 필요하다.