Graft vs Host Disease ; therapy ; Humans ; MicroRNAs ; Transplantation, Homologous

Chronic Disease ; Graft vs Host Disease ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans

Chronic graft-versus-host disease (cGVHD) continues to be a major complication in long-term survivors after allogeneic hematopoietic stem cell transplantation and is the principal cause of morbidity and non-relapse mortality. With the new approaches in the immune mechanisms of cGVHD, the diagnosis, prophylaxis and treatment of cGVHD are involved. This review summarises the current progress of research on cGVHD.
Chronic Disease ; Female ; Graft vs Host Disease ; diagnosis ; etiology ; therapy ; Humans ; Male ; Prognosis ; Risk Factors

China ; Chronic Disease ; Consensus ; Graft vs Host Disease/therapy* ; Hematopoietic Stem Cell Transplantation ; Humans

Graft vs Host Disease ; drug therapy ; Humans ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors ; therapeutic use

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an intensive therapy to cure high-risk haematological malignant disorders, congenital diseases, autoimmune disease and so on. The main complication of HSCT is graft-versus-host disease (GVHD), which can cause the death of recipients and affect the therapeutic effect. Many kinds of immune cells and inflammatory factors were involved in the occurrence of GVHD. Twenty years ago the mice and human interleukin-17 (IL-17) were found. A new kind of T cell-CD4(+) IL-17(+) T was found in recent years, named Th17 cells. Now IL-17 and Th17 cells have become the hot spot in the research field of infection immunity, autoimmune diseases, tumor immunity and GVHD. In this article, immunoregulatory effects of interleukin-17 and Th17 cells in GVHD are reviewed.
Animals ; Graft vs Host Disease ; immunology ; therapy ; Humans ; Immunomodulation ; Interleukin-17 ; immunology ; Mice ; Th17 Cells ; immunology

Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; classification ; therapy ; Phenotype

Mesenchymal stem cells (MSC) are the non-hematopoietic stem cells with a multi-differentiation potentials, which has a low immunogenicity and immune regulation ability. MSC immune regulation ability is particularly important, such as MSC can inhibit the activation and proliferation of T, B lymphocytes, NK cells and dendritic cells (DC). Meanwhile, MSC is able to reconstruct the human hematopoietic microenvironment, improving the successful rate of hematopoietic stem cell transplantation. Graft versus host disease (GVHD) is the main factor causing hematopoietic stem cell transplantation-related mortality. Based on the above mentioned properties, MSCs are used to treat autoimmune diseases and GVHD, recently. Therefore, deep exploration of the cellular immune mechanisms of MSC to treat GVHD is particularly important. This review focuses on progress of research related to treatment of GVHD by MSC immune mechanisms and briefly summarizes the status of the clinical studies.
Graft vs Host Disease ; immunology ; therapy ; Humans ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; immunology

OBJECTIVETo review the characteristics of regulatory T cells (Tregs) and ex vivo expansion of Tregs for treatment of graft-versus-host disease (GVHD).

DATA SOURCESThe data used in this review were retrieved from PubMed (1970-2013). The terms "ex vivo expansion", "regulatory T cell", and "graft-versus-host disease" were used for literature search.

STUDY SELECTIONThe publications about the characteristics of Tregs, ex vivo expansion of Tregs and clinical applications of Tregs against GVHD were identified, retrieved and reviewed.

RESULTSTregs can be classified as natural Tregs (nTregs) and induced Tregs (iTregs). Both subsets share most Treg features. Given their immunosuppressive property, Tregs have been tested for their capability of preventing GVHD. The bottleneck of Treg therapy is the limited numbers of naturally existing Tregs. To solve this problem, ex vivo expansion of nTregs or iTregs has been executed. The initial data indicate Treg therapy is effective in reducing GVHD without compromising graft-versus-leukemia (GVL).

CONCLUSIONEx vivo expansion of Tregs is a reliable way to prepare sufficient number of Tregs for management of GVHD.

Extracorporeal photochemotherapy, also called extracorporeal photopheresis, or ECP for short, is now an effective method to treat and prevent patients from graft-versus-host disease (GVHD). It is generally accepted that the mechanism of ECP is to induce immune tolerance. Further researches show that ECP acts on several stages of GVHD by means of many complex mechanisms. Firstly, ECP induces apoptosis of T lymphocytes, inhibiting T cells from differentiating and proliferating, and promoting regulatory T cells. Besides, it also adjusts the number and proportion of helper T cells. Secondly, ECP affects antigen presenting cells. It induces apoptosis and inhibits maturation of antigen presenting cells. At the same time it affects the ability to process and present antigens of antigen presenting cells. Thirdly, ECP adjusts the cytokine secretion, in order to inhibit inflammatory response. This review discusses why ECP can treat and prevent patients from GVHD via the three aspects mentioned above.
Apoptosis ; Graft vs Host Disease ; prevention & control ; therapy ; Humans ; Immune Tolerance ; Photopheresis ; methods