Crosstalk between graft-versus-host disease and infection following allogeneic hematopoietic stem cell transplantation

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We discovered that Paneth cells are targeted by GVHD, resulting in marked reduction in the expression of α-defensins, which selectively kill non-commensals, while preserving commensals. Molecular profiling of intestinal microbial communities showed loss of physiological diversity among the microflora and the overwhelming expansion of otherwise rare bacteria, which caused septicemia. These results reveal the novel mechanism responsible for shift in the gut flora from commensals towards the widespread prevalence of pathogens and the previously unrecognized association between GVHD and infection following allogeneic stem cell transplantation.