Plasma Levels of Epinephrine and Norepinephrine Along with Expression Levels of 2-Adrenergic Receptor Gene as a ProbablePrognostic Factor of Acute GvHD

Background and Aim: Acute graft-versus-host disease (aGvHD) is themajor hindrance of allogeneic hematopoietic stem-cell transplantation(AHSCT). Epinephrine (E) and norepinephrine (NE) are adrenal glandsstress hormones which affect many cells include immune cells throughinteraction with adrenergic receptors mainly B2-adrenergic receptor (B2-AR). The immunomodulatory effects of E, NE and AR-signaling haveshown to decrease the probability of GvHD. The plasma levels of E andNE and the gene expression of B2-AR in leukocytes of patients who develop aGvHD with recipients without aGvHD have been comparedin this study.Method: The plasma samples were taken from 15 AHSCT candidatesAt days -7, 0, +7, and + 21 (day of transplantation was consideredas day 0) and the levels of E and NE were assayed by Enzyme-linkedimmunosorbent assay (ELISA). cDNA was reverse transcribed from buffycoats-extracted total RNA and the expression of B2-AR was measuredusing real-time PCR. The incidence of aGvHD was measured accordingto the patient s clinical manifestations and International criteria. Mann-Whitney U test was used to analyze data.Results: aGvHD were presented in 5 patients out of 15 patients during100 days post-AHSCT. The mean plasma levels of E and NE and also theexpression of B2-AR in leukocytes of aGvHD patients were significantlylower than non-aGvHD recipients. (P value <0.05).Conclusion: Regarding the lower levels of plasma E and NE and 2-ARexpression in aGvHD patients compared with recipients without aGvHD,we can conclude that the stress through hormones and their receptormight have a role in preventing aGvHD and could be a predictive markerfor aGvHD.

کلیدواژه ها:

Epinephrine ، Norepinephrine ، 2-adrenergic receptor ، aGvHD