Frequent expression of C4d in hepatic graft-versus-host disease: potential clue for diagnosis and distinguishing acute and chronic form.
BACKGROUND
Graft-versus-host disease (GVHD), a common complication of hematopoietic stem cell transplant, is generally regarded to develop through cell-mediated immune response following activation of helper T cells. Since production of antibodies is also mediated by helper T cells, the role of humoral immunity in GVHD is questioned and has not yet been explored in clinical practice. We conducted a pilot study to evaluate the role of antibody production in hepatic H-GVHD and whether it can distinguish acute and chronic forms.


RESULTS
C4d expression was increased in portal vessels and hepatic sinusoids of patients with histological proven evidence of GVHD 11/16 (P=0.007). Patients classified as chronic GVHD were statistically more likely to have C4d expression in the portal vasculature and liver sinusoids (P=0.011).


CONCLUSIONS
Humoral activation seems to play a role in pathophysiology of hepatic, especially chronic GVHD.
Department of Pathology and Laboratory Medicine, Detroit, MI 48202, United States. sali2@hfhs.org
Sharif A
SA
Ali
Veena
V
Shah
Rick
R
McKinnon
Meredith
M
Van Harn
Nalini
N
Janakiraman
D000208:Acute Disease; D000328:Adult; D000906:Antibodies / Q000097:blood; D002908:Chronic Disease; D015935:Complement C4b / Q000378:metabolism*; D005260:Female; D005786:Gene Expression Regulation; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism*
D000906:Antibodies; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d