title: Chronic graft-versus-host disease: disease biology and novel therapeutic strategies.
abstract: Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation. Chronic GVHD often presents with clinical manifestations that resemble those observed in autoimmune diseases. Standard treatment is 1-2mg/kg/day of prednisone or an equivalent dose of methylprednisolone, with continued administration of a calcineurin inhibitor for steroid sparing. However, the prognosis of steroid-refractory chronic GVHD remains poor. Classically, chronic GVHD was said to involve predominantly Th2 responses. We are now faced with a more complex picture, involving possible roles for thymic dysfunction, transforming growth factor-β (TGF-β) and platelet-derived growth factor (PDGF), B cells and autoantibodies, and Th1/Th2/Th17 cytokines, as well as regulatory T cells (Tregs), in chronic GVHD. More detailed research on the pathophysiology of chronic GVHD may facilitate the establishment of novel strategies for its prevention and treatment.
authors: Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. n-mori@md.okayama-u.ac.jp
authors: Hisakazu
authors: H
authors: Nishimori
authors: Yoshinobu
authors: Y
authors: Maeda
authors: Mitsune
authors: M
authors: Tanimoto
mesh_terms: D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D006801:Humans; D010982:Platelet-Derived Growth Factor / Q000502:physiology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D058504:Th17 Cells / Q000276:immunology; D016212:Transforming Growth Factor beta / Q000502:physiology
chemical_list: D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta