GVHD: biology matters

Blood Adv. 2018 Nov 27;2(22):3411-3417. doi: 10.1182/bloodadvances.2018020214.

Abstract

Acute graft-versus-host disease (GVHD) targets the crypts in the gastrointestinal (GI) tract that are responsible for the self-renewal of the intestinal mucosa. Recent advances in the identification and culture of intestinal stem cells have improved our understanding of the interactions between the microbiome and the immune system (both innate and adaptive) that are key to the pathophysiology of GVHD. The identification of serum biomarkers that best predict long-term GVHD outcomes derive from the GI tract and have focused attention on cellular elements that act as shields against GVHD as well as its targets. These biomarkers have illuminated new mechanisms of crypt biology and provided insights that should prove useful both in the design of clinical trials and as guides to GVHD prevention and treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antigen-Presenting Cells / immunology*
  • Antigen-Presenting Cells / metabolism
  • Biomarkers / blood
  • Gastrointestinal Tract / immunology
  • Gastrointestinal Tract / metabolism
  • Graft vs Host Disease / diagnosis*
  • Graft vs Host Disease / immunology
  • Graft vs Host Disease / pathology
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein / blood
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / metabolism
  • Pancreatitis-Associated Proteins / blood
  • Risk Factors
  • T-Lymphocytes / immunology

Substances

  • Biomarkers
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • Pancreatitis-Associated Proteins
  • REG3A protein, human