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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2016; 6(4): 608-619
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.608
Biology of chronic graft-vs-host disease: Immune mechanisms and progress in biomarker discovery
Richard B Presland
Richard B Presland, Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA 98195, United States
Richard B Presland, Division of Dermatology, Department of Medicine, University of Washington, Seattle, WA 98195, United States
Author contributions: The author solely contributes to the manuscript.
Conflict-of-interest statement: The author declares no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Richard B Presland, PhD, Department of Oral Health Sciences, School of Dentistry, University of Washington, 1959 NE Pacific St, Box 357475, Seattle, WA 98195, United States. rp@uw.edu
Telephone: +1-206-6166706
Received: April 16, 2016
Peer-review started: April 19, 2016
First decision: June 7, 2016
Revised: August 15, 2016
Accepted: September 13, 2016
Article in press: September 18, 2016
Published online: December 24, 2016
Processing time: 242 Days and 9 Hours
Abstract

Chronic graft-vs-host disease (cGVHD) is the leading cause of long-term morbidity and mortality following allogeneic hematopoietic stem cell transplantation. It presents as a chronic inflammatory and sclerotic autoimmune-like condition that most frequently affects the skin, oral mucosa, liver, eyes and gastrointestinal tract. Both clinical and animal studies have shown that multiple T cell subsets including Th1, Th2, Th17, T follicular helper cells and regulatory T-cells play some role in cGVHD development and progression; B cells also play an important role in the disease including the production of antibodies to HY and nuclear antigens that can cause serious tissue damage. An array of cytokines and chemokines produced by different types of immune cells also mediate tissue inflammation and damage of cGVHD target tissues such as the skin and oral cavity. Many of these same immune regulators have been studied as candidate cGVHD biomarkers. Recent studies suggest that some of these biomarkers may be useful for determining disease prognosis and planning long-term clinical follow-up of cGVHD patients.

Keywords: Chronic graft-vs-host disease; Biomarker; Allogeneic hematopoietic stem cell transplantation; Cytokine

Core tip: Chronic graft-vs-host disease (cGVHD) is a frequent long-term medical complication of allogeneic hematopoietic stem cell transplantation which can have a devastating impact on overall health and quality of life. This immune-mediated disorder manifests as an inflammatory and autoimmune-like disorder that can affect multiple tissues in an individual patient. Both clinical and animal studies demonstrate that multiple T cell subsets, as well as B cells, and their secreted cytokines play important roles in cGVHD initiation and progression. In the last decade many molecular biomarkers have been identified that correlate with cGVHD onset and/or progression, and some might have applications clinically in the near future.