Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 1793-1805
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1793
Macrophage regulation of graft-vs-host disease
Ya-Qun Hong, Bo Wan, Xiao-Fan Li
Ya-Qun Hong, Xiao-Fan Li, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Department of Hematology, Fujian Medical University Union Hospital, Fuzhou 350000, Fujian Province, China
Bo Wan, Faculty of Life Sciences and Medicine, King’s College London, London WC1N 3BG, United Kingdom
Xiao-Fan Li, INSERM U1160, Hospital Saint Louis, Université Paris Diderot, Paris 94430, France
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Supported by Youth Project of National Natural Science Foundation, No. 81200400; National Social Science Foundation, No. 14CFX031; Top-Notch Innovative Talents Project and Fujian Project, No. 2016Y9025, No. 2016J06018 and No. 2017I0004; Fujian Medical University Teaching Reform Project, No. Y17005; and Fujian Provincial Health and Family Planning Commission Youth Research Project, No. 2017-1-6.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Xiao-Fan Li, MD, PhD, Doctor, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Department of Hematology, Fujian Medical University Union Hospital, No. 29 Xinquan Street, Gulou District, Fuzhou 350000, Fujian Province, China. morningshiplee@sina.com
Received: January 1, 2020
Peer-review started: January 1, 2020
First decision: February 20, 2020
Revised: April 8, 2020
Accepted: April 22, 2020
Article in press: April 22, 2020
Published online: May 26, 2020
Abstract

Hematopoietic stem cell transplantation has become a curative choice of many hematopoietic malignancy, but graft-vs-host disease (GVHD) has limited the survival quality and overall survival of hematopoietic stem cell transplantation. Understanding of the immune cells’ reaction in pathophysiology of GVHD has improved, but a review on the role of macrophages in GVHD is still absent. Studies have observed that macrophage infiltration is associated with GVHD occurrence and development. In this review, we summarize and analyze the role of macrophages in GVHD based on pathophysiology of acute and chronic GVHD, focusing on the macrophage recruitment and infiltration, macrophage polarization, macrophage secretion, and especially interaction of macrophages with other immune cells. We could conclude that macrophage recruitment and infiltration contribute to both acute and chronic GVHD. Based on distinguishing pathology of acute and chronic GVHD, macrophages tend to show a higher M1/M2 ratio in acute GVHD and a lower M1/M2 ratio in chronic GVHD. However, the influence of dominant cytokines in GVHD is controversial and inconsistent with macrophage polarization. In addition, interaction of macrophages with alloreactive T cells plays an important role in acute GVHD. Meanwhile, the interaction among macrophages, B cells, fibroblasts, and CD4+ T cells participates in chronic GVHD development.

Keywords: Macrophage, Graft-vs-host disease, Hematopoietic stem cell transplantation, Polarization, Cytokine, Regulation

Core tip: Macrophages tend to show a higher M1/M2 ratio in acute graft-vs-host disease (GVHD) and a lower M1/M2 ratio in chronic GVHD. Influence of cytokines on GVHD is controversial. Macrophages interact with alloreactive T cells in acute GVHD, and the interaction among macrophages, B cells, fibroblasts, and CD4+ T cells participates in chronic GVHD development.