Protein dysregulation in graft versus host disease

Abstract

Allogeneic hematopoietic stem cell transplantation is a well-established treatment for many malignant and non-malignant hematological disorders. As a frequent complication in up to 50% of all patients, graft-versus-host disease is still the main cause for morbidity and non-relapse mortality. Diagnosis is usually done clinically, even though confirmation by pathology is often used to support the clinical findings. Effective treatment requires intensified immunosuppression as early as possible. Although several promising biomarkers have been proposed for an early diagnosis, no internationally-recognized consensus has yet been established. Protein-based biomarkers represent an interesting tool since they have been recently reported to be an important regulator of various cells, including immune cells such as T cells. Therefore, we assume that protein dysregulation is important in the pathogenesis of acute graft versus host disease and their detection might be an possibility in the early diagnosis and monitoring. In this review, we aim to summarize the previous reports of protein biomarkers, focusing on the pathogenesis of the disease and possible implications in diagnostic approaches.

Keywords: allogeneic stem cell transplantation; biomarkers; exosomes; graft versus host disease; proteins.

Figure 1

(A) Acute stage IV GVHD, following a myeloablative conditioning chemotherapy. (B) Chronic skin GVHD, following conditioning chemotherapy with TBI and cyclophosphamide. (C) Chronic GVHD, following reduced intensity conditioning chemotherapy.