Current Concepts and Advances in Graft-Versus-Host Disease Immunology.

Current Concepts and Advances in Graft-Versus-Host Disease Immunology.
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DOI:
10.1146/annurev-immunol-102119-073227
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发表时间:
2021-04-26
影响因子:
29.7
通讯作者:
Blazar BR
Blazar BR
中科院分区:
医学1区
文献类型:
--
作者:
Hill GR;Betts BC;Tkachev V;Kean LS;Blazar BR

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在世界范围内,每年有超过30,000名患者接受同种异体造血干细胞移植,目的是治疗高危血液恶性肿瘤、免疫缺陷、代谢疾病或危及生命的骨髓衰竭综合征。尽管在供体选择和调节方案以及更大的同种异体移植来源方面取得了实质性进展,移植受者仍然忍受移植物抗宿主病(GVHD)的发病率和死亡率。在此,我们确定了急性和慢性GVHD病理生理的关键方面,包括宿主/供体细胞效应,肠道生态失调,免疫系统和细胞因子失衡,以及炎症和组织纤维化之间的界面。特别地,我们还总结了这种对免疫失调的高度理解在设计预防和治疗GVHD的新疗法中的转化应用。
Worldwide, each year over 30,000 patients undergo an allogeneic hematopoietic stem cell transplantation with the intent to cure high-risk hematologic malignancy, immunodeficiency, metabolic disease, or a life-threatening bone marrow failure syndrome. Despite substantial advances in donor selection and conditioning regimens and greater availability of allograft sources, transplant recipients still endure the morbidity and mortality of graft-versus-host disease (GVHD). Herein, we identify key aspects of acute and chronic GVHD pathophysiology, including host/donor cell effectors, gut dysbiosis, immune system and cytokine imbalance, and the interface between inflammation and tissue fibrosis. In particular, we also summarize the translational application of this heightened understanding of immune dysregulation in the design of novel therapies to prevent and treat GVHD.
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