Advances in the understanding of acute graft-versus-host disease.
Allogeneic stem cell transplantation (SCT) remains the definitive immunotherapy for malignancy. However, morbidity and mortality due to graft-vs.-host disease (GVHD) remains the major barrier to its advancement. Emerging experimental data highlights the immuno-modulatory roles of diverse cell populations in GVHD, including regulatory T cells, natural killer (NK) cells, NK T cells, gammadelta T cells, and antigen presenting cells (APC). Knowledge of the pathophysiology of GVHD has driven the investigation of new rational strategies to both prevent severe GVHD and treat steroid-refractory GVHD. Novel cytokine inhibitors, immune-suppressant agents known to preserve or even promote regulatory T-cell function and the depletion of specific alloreactive T-cell sub-populations all promise significant advances in the near future. As our knowledge and therapeutic options expand, the ability to limit GVHD whilst preserving anti-microbial and tumour responses becomes a realistic prospect.
Morris
Edward S
ES
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
Hill
Geoffrey R
GR
D000208:Acute Disease; D016207:Cytokines / Q000276:immunology; D051523:Fibroblast Growth Factor 7 / Q000008:administration & dosage; D005938:Glucocorticoids / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D008212:Lymphocyte Depletion; D010778:Photochemotherapy; D013601:T-Lymphocytes / Q000276:immunology
D016207:Cytokines; D005938:Glucocorticoids; D051523:Fibroblast Growth Factor 7