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Review
. 2016 Dec 24;6(4):608-619.
doi: 10.5500/wjt.v6.i4.608.

Biology of chronic graft- vs-host disease: Immune mechanisms and progress in biomarker discovery

Affiliations
Review

Biology of chronic graft- vs-host disease: Immune mechanisms and progress in biomarker discovery

Richard B Presland. World J Transplant. .

Abstract

Chronic graft-vs-host disease (cGVHD) is the leading cause of long-term morbidity and mortality following allogeneic hematopoietic stem cell transplantation. It presents as a chronic inflammatory and sclerotic autoimmune-like condition that most frequently affects the skin, oral mucosa, liver, eyes and gastrointestinal tract. Both clinical and animal studies have shown that multiple T cell subsets including Th1, Th2, Th17, T follicular helper cells and regulatory T-cells play some role in cGVHD development and progression; B cells also play an important role in the disease including the production of antibodies to HY and nuclear antigens that can cause serious tissue damage. An array of cytokines and chemokines produced by different types of immune cells also mediate tissue inflammation and damage of cGVHD target tissues such as the skin and oral cavity. Many of these same immune regulators have been studied as candidate cGVHD biomarkers. Recent studies suggest that some of these biomarkers may be useful for determining disease prognosis and planning long-term clinical follow-up of cGVHD patients.

Keywords: Allogeneic hematopoietic stem cell transplantation; Biomarker; Chronic graft-vs-host disease; Cytokine.

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Conflict of interest statement

Conflict-of-interest statement: The author declares no conflict of interest.

Figures

Figure 1
Figure 1
Causes of death among allogeneic hematopoietic stem cell transplantation patients. Pie charts show causes of death among patients who received a cell graft from (A) an HLA-matched sibling or (B) an unrelated donor. Data is from the Center for International Blood and Marrow Transplant Research, for allogeneic hematopoietic stem cell transplants performed in 2012-13[88] (Available from: URL: http//www.cibmtr.org/Data/Resources/pages/index.aspx). GVHD: Graft-vs-host disease.

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