Restoring T Cell Homeostasis After Allogeneic Stem Cell Transplantation; Principal Limitations and Future Challenges.

Restoring T Cell Homeostasis After Allogeneic Stem Cell Transplantation; Principal Limitations and Future Challenges.
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DOI:
10.3389/fimmu.2018.01237
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发表时间:
2018
影响因子:
7.3
通讯作者:
Guimond M
Guimond M
中科院分区:
医学2区
文献类型:
--
作者:
Moutuou MM;Pagé G;Zaid I;Lesage S;Guimond M

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对于一些白血病患者来说,同种异体干细胞移植(allogeneic- sct)是一种独特的治疗方式,有可能治愈他们的疾病。尽管同种异体sct的临床管理取得了重大进展,但急性移植物抗宿主病(aGVHD)和感染性并发症仍然是疾病复发后死亡的第二和第三大原因。同种异体sct后恢复免疫能力的临床选择非常有限,因为研究提高了对移植物抗宿主病(GVHD)安全性的认识。临床前工作现在集中在改善胸腺功能和恢复被同种异体反应性T细胞破坏的外周生态位的策略上。在这篇综述中,我们将简要介绍GVHD对胸腺和外周生态位的不良影响以及由此导致的外周T细胞稳态的负面结果。最后,我们将讨论协调我们在GVHD患者胸腺再生和外周血淋巴细胞生态位改善方面的研究以实现最佳T细胞再生的潜在相关性。
For several leukemia patients, allogeneic stem cell transplantation (allogeneic-SCT) is the unique therapeutic modality that could potentially cure their disease. Despite significant progress made in clinical management of allogeneic-SCT, acute graft-versus-host disease (aGVHD) and infectious complications remain the second and third cause of death after disease recurrence. Clinical options to restore immunocompetence after allogeneic-SCT are very limited as studies have raised awareness about the safety with regards to graft-versus-host disease (GVHD). Preclinical works are now focusing on strategies to improve thymic functions and to restore the peripheral niche that have been damaged by alloreactive T cells. In this mini review, we will provide a brief overview about the adverse effects of GVHD on the thymus and the peripheral niche and the resulting negative outcome on peripheral T cell homeostasis. Finally, we will discuss the potential relevance of coordinating our studies on thymic rejuvenation and improvement of the peripheral lymphoid niche to achieve optimal T cell regeneration in GVHD patients.
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