PMID- 8888489
OWN - NLM
STAT- MEDLINE
DCOM- 19970131
LR  - 20220419
IS  - 1066-5099 (Print)
IS  - 1066-5099 (Linking)
VI  - 14
IP  - 5
DP  - 1996 Sep
TI  - The immunopathophysiology of acute graft-versus-host-disease.
PG  - 473-89
AB  - The major complication after allogeneic bone marrow transplantation (BMT) is the 
      development of graft-versus-host-disease (GVHD). This disease is initiated during 
      the conditioning of the recipient, when host tissues are damaged. During the 
      afferent phase of the disease, alloreactive donor T cells recognize foreign major 
      and minor histocompatibility antigens of host tissues. The efferent phase 
      includes activation of inflammatory effector cells as well as the secretion of 
      cytopathic molecules which induce pathology in skin, gastrointestinal tract, 
      liver, lung, and the immune system. Substantial experimental and clinical 
      evidence now indicates a central role of cytokines in the immunopathophysiology 
      of acute GVHD, which forms the basis of this review. The balance between 
      cytokines released by T helper 1 (Th1) cells (interleukin 2, interferon-gamma) or 
      by T helper 2 (Th2) cells (interleukin 4, interleukin 10) after allogeneic BMT is 
      hypothesized to govern the extent of the systemic inflammatory response. Because 
      Th2 cytokines can inhibit the production of proinflammatory cytokines such as 
      interleukin 1 and tumor necrosis factor-alpha, a Th1-->Th2 shift in the initial 
      response of donor T cells may interrupt the cytokine cascade and thus offer a new 
      approach to the prevention and treatment of acute GVHD. Successful interventions 
      to modify the response of donor T cells may obviate the need for T cell depletion 
      and thereby avoid the increased risk of relapse of malignancy and impairment of 
      donor cell engraftment.
FAU - Ferrara, J L
AU  - Ferrara JL
AD  - Division of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, 
      USA.
FAU - Cooke, K R
AU  - Cooke KR
FAU - Pan, L
AU  - Pan L
FAU - Krenger, W
AU  - Krenger W
LA  - eng
GR  - CA 39592/CA/NCI NIH HHS/United States
GR  - HL03565/HL/NHLBI NIH HHS/United States
GR  - HL55162/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - England
TA  - Stem Cells
JT  - Stem cells (Dayton, Ohio)
JID - 9304532
SB  - IM
MH  - Acute Disease
MH  - Graft vs Host Disease/*immunology/*physiopathology/therapy
MH  - Hematopoietic Stem Cells/*immunology
MH  - Humans
RF  - 139
EDAT- 1996/09/01 00:00
MHDA- 1996/09/01 00:01
CRDT- 1996/09/01 00:00
PHST- 1996/09/01 00:00 [pubmed]
PHST- 1996/09/01 00:01 [medline]
PHST- 1996/09/01 00:00 [entrez]
AID - 10.1002/stem.140473 [doi]
PST - ppublish
SO  - Stem Cells. 1996 Sep;14(5):473-89. doi: 10.1002/stem.140473.