Novel regulatory therapies for prevention of Graft-versus-host disease

BMC Medicine

Review

Joseph Leventhal¹  Hong Xu²  Yiming Huang²  Idona Goode²  Suzanne T Ildstad² 

[1] Comprehensive Transplant Center, Northwestern Memorial Hospital, Chicago, IL, USA;Institute for Cellular Therapeutics, University of Louisville, Louisville, KY, USA;

关键词: Human Leukocyte Antigen;    Hematopoietic Stem Cell;    Hematopoietic Stem Cell Transplantation;    Acute GVHD;    Chronic GVHD;   

DOI  :  10.1186/1741-7015-10-48

 received in 2011-10-31, accepted in 2012-05-15,  发布年份 2012

来源: Springer

【 摘 要 】

Graft-versus-host disease is one of the major transplant-related complications in allogeneic hematopoietic stem cell transplantation. Continued efforts have been made to prevent the occurrence of severe graft-versus-host disease by eliminating or suppressing donor-derived effector T cells. Conventional immunosuppression does not adequately prevent graft-versus-host disease, especially in mismatched transplants. Unfortunately, elimination of donor-derived T cells impairs stem cell engraftment, and delays immunologic reconstitution, rendering the recipient susceptible to post-transplant infections and disease relapse, with potentially lethal consequences. In this review, we discuss the role of dynamic immune regulation in controlling graft-versus-host disease, and how cell-based therapies are being developed using regulatory T cells and other tolerogenic cells for the prevention and treatment of graft-versus-host disease. In addition, advances in the design of cytoreductive conditioning regimens to selectively target graft-versus-host disease-inducing donor-derived T cells that have improved the safety of allogeneic stem cell transplantation are reviewed. Finally, we discuss advances in our understanding of the tolerogenic facilitating cell population, a phenotypically and functionally distinct population of bone marrow-derived cells which promote hematopoietic stem cell engraftment while reducing the risk of graft-versus-host disease.

【 授权许可】

Unknown   
© Leventhal et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.