Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Graft-versus-host disease, both acute and chronic, continues to be the major complication of human bone marrow transplantation. Improved posttransplant chemoprophylaxis has reduced the incidence of acute graft-versus-host disease, but the incidence of the chronic form of the disease remains unchanged. The use of donors that are not genotypically identical at the major histocompatibility complex increases the incidence of acute and chronic graft-versus-host disease. The clinical consequences of acute and chronic graft-versus-host disease are discussed.
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PMID:Graft-versus-host disease. 203 65

Graft rejection, mixed chimerism, graft-versus-host disease (GVHD), leukemia relapse, and tolerance are interrelated manifestations of immunologic reactivity between donor and host cells that significantly affect survival after allogeneic bone marrow transplantation (BMT). In this report, a mouse model of BMT, in which the donor and host were compatible at the major histocompatibility complex (MHC), was used (1) to examine the interrelationship of pretransplant conditioning and T-cell content of donor BM with regard to lymphoid chimerism and GVHD and (2) to determine how these factors affected graft-versus-leukemia (GVL) reactivity and donor-host-tolerance. AKR (H-2k) host mice were administered optimal or suboptimal total body irradiation (TBI) as pretransplant conditioning followed by administration of BM cells from B10.BR (H-2k) donor mice with or without added spleen cells as a source of T lymphocytes. Transplanted mice were injected with a supralethal dose of AKR leukemia cells 20 and 45 days post-BMT to assess GVL reactivity in vivo. The pretransplant conditioning of the host and T-cell content of the donor marrow affected the extent of donor T-cell chimerism and the severity of GVH disease. GVL reactivity was dependent on transplantation of mature donor T cells and occurred only in complete chimeras. Transplantation of T-cell-deficient BM resulted in the persistence of host T cells, ie, incomplete donor T-cell chimerism, even when lethal TBI was used. Mixed chimerism was associated with a lack of GVL reactivity, despite the fact that similar numbers of donor T cells were present in the spleens of mixed and complete chimeras. In this model, moderate numbers of donor T cells facilitated complete donor T-cell engraftment, caused only mild GVHD, and provided a significant GVL effect without preventing the subsequent development of tolerance after conditioning with suboptimal TBI. In contrast, severe, often lethal, GVHD developed when the dose of TBI was increased, whereas tolerance and no GVH/GVL reactivity developed when the T-cell content of the marrow was decreased.
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PMID:Impact of pretransplant conditioning and donor T cells on chimerism, graft-versus-host disease, graft-versus-leukemia reactivity, and tolerance after bone marrow transplantation. 203 33

Graft-versus-host reactions are mediated by subpopulations of donor T cells and can be attributed to host specific minor histocompatibility (mH) antigens. We isolated strong anti-host mH antigen proliferative T cell lines, LG2, PN2, and LH3, from three patients suffering from acute graft-versus-host disease (GVHD). To study the role of the different major histocompatibility complex (MHC) molecules in the anti-host mH antigen specific proliferative response, the reactivities of the three T cell lines were analysed in primed lymphocyte test (PLT) assays against panels of stimulator cells obtained from unrelated blood donors. LG2 and LH3 stimulating determinants were commonly detected in the unrelated panel, whereas the PN2 T cell line recognized a rare specificity. The responses were associated with the presence of self HLA-DR molecules on the stimulator cells, although not all DR sharing stimulator cells were recognized. The proliferative responses of LG2, LH3 and PN2 cells could be blocked by monoclonal antibodies (MoAbs) against HLA-DR, but not by MoAbs against HLA-A/B/Cw, HLA-DQ or -DP. At the responder cell level, depletion of CD4 cells as well as blocking with CD4 specific MoAbs abrogated the specific responses of the three T cell lines. Our findings suggest that anti-host Th cell responses activated in the acute phase of GVHD are directed against both frequent and rare mH antigens, are mediated by CD4 + ve class II restricted Th cells, and use the HLA-DR molecule as a common restriction element for mH antigen presentation.
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PMID:Graft-versus-host disease associated T helper cell responses specific for minor histocompatibility antigens are mainly restricted by HLA-DR molecules. 214 41

The process of graft-versus-host disease (GVHD) elicited by small bowel semi-syngeneic grafts in Lewis rats was studied by an immunohistochemical staining technique for analysis of MHC (major histocompatibility complex) class II antigen expression and of T-cell subpopulations in different organs. Specimens from the graft, native bowel, brain, testis, liver, kidney, and skin were taken on days 5, 10, and 15. All the investigated organs displayed strong class II antigen induction during the course of GVHD. In the native bowel of semi-syngeneically transplanted animals, only discrete morphological changes were noted, whereas the graft displayed a generalized serosal reaction with large infiltrates of rounded and polygonal cells expressing class II antigens. This was not observed in the graft of syngeneically transplanted animals. In the lamina propria of the semisyngeneic graft, 'free' lymphocyte-like cells were depleted and, at the same time, localized aggregates of these cells were observed. Crypt cell class II expression in the native bowel, and to some extent in the graft, was increased during GVHD. However, pronounced intraindividual variations in MHC class II antigen expression were noted, and class II expression was therefore not considered to be a good marker for GVHD.
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PMID:Immunomorphology of graft-versus-host disease after small bowel transplantation in the rat. 220 46

We studied the in vitro effects of lymphokine-activated killer (LAK) cells from the peripheral blood of chronic myeloid leukemia (CML) patients after allogeneic and syngeneic bone marrow transplantation (BMT). LAK cells were generated by incubating peripheral blood mononuclear cells from patients post-BMT with recombinant interleukin-2 (IL-2) (500 U/mL) in 10% AB serum for 7 days. They were phenotyped and tested for activity in a standard 4-hour 51Cr release assay (n = 37) and in a CFU-GM assay (n = 24). We found that the LAK cells were mainly activated natural killer cells, but some were CD3+ T cells. In the 51Cr release assay LAK cells from 20 of 33 (61%) allogeneic and 2 of 4 syngeneic recipients killed recipient CML cells and in 22 of 37 (60%) cases also killed the HLA disparate CML cells. In the CFU-GM assay the LAK cells incubated together with the CML cells in liquid culture before plating inhibited (P less than .05) colony growth in 16 of 22 allogeneic and 2 of 2 syngeneic recipients. Cell-cell contact was necessary for optimal effect. There was little or no inhibition of proliferation of donor marrow CFU-GM. This in vitro graft-versus-leukemia (GVL) effect could also be demonstrated after LAK effectors were depleted of CD3+ T cells. It was inducible in recipients of both T cell-depleted and T cell-replete donor marrow and in recipients with or without graft-versus-host disease. These results suggest that a major histocompatibility complex-unrestricted GVL effect is inducible following allogeneic and syngeneic BMT. The use of IL-2/LAK cells after BMT could reduce the risk of relapse.
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PMID:Induction of in vitro graft-versus-leukemia activity following bone marrow transplantation for chronic myeloid leukemia. 224 25

Gene products of the major histocompatibility complex (MHC) have been shown to elicit lethal graft-versus-host disease (GVHD) in experimental animals. Antibodies specific for MHC cell surface determinants might therefore be expected to overcome histocompatibility barriers and influence survival of marrow graft recipients. GVHD can be consistently induced in dogs by transplanting donor marrow cells into lethally irradiated, unrelated, mismatched recipients. Three anti-Ia monoclonal antibodies were administered to five canine recipients, each at a dose of 0.2 mg/kg body weight per day intravenously for 10 days, beginning on day 0, the day of transplantation. Eight canine recipients were treated with antidog alloantiserum 10 ml/kg body weight per day intravenously on days -2 to day +20, in addition to receiving postgrafting methotrexate. The antiserum was generated by immunizing a matched littermate of the donor with peripheral blood cells of the recipient before transplantation. Survival was no different in the two groups of dogs, compared with historical controls without antibody treatment. A possible explanation for the failure of anti-MHC antibodies to modify acute GVHD in the dog is the inability of antibody to reach critical tissue sites targeted in GVHD.
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PMID:Failure of anti-MHC antibodies to prevent GVHD in DLA mismatched unrelated canine marrow recipients. 229 89

The case described is that of an unrelated bone marrow transplantation in a 43-year-old man. Although the major histocompatibility complex met the criteria for a perfect genotypic match, de novo graft-versus-host disease developed with unusual manifestations involving structures of the oral cavity and associated areas. The loss of taste and smell, as well as profound xerostomia, was treated by stimulating salivary flow. Synergistic sialagogues were used with the hope that an increase in salivary production would mediate an improvement in taste and smell.
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PMID:An unusual presentation of chronic graft-versus-host disease in an unrelated bone marrow transplantation. 233 10

The lymphocyte cell surface molecule CD5 (T1, Leu 1, Tp67 in the human; Ly 1 in the mouse) is expressed on the majority of circulating T lymphocytes and a small population of B cells. We have analyzed CD5 expression on repopulating T cells in the peripheral blood of patients after allogeneic bone marrow transplantation (BMT). The frequency of CD3+ T cells that lack expression of CD5 is dramatically increased after BMT compared with the normal population. The percent of total CD3+ CD5- cells correlated with the presence of graft versus host disease and with time following transplant, but did not correlate with age, diagnosis, preparative regimen, T-cell depletion of the marrow, major histocompatibility complex compatibility, or the presence or absence of interstitial pneumonitis. Furthermore, the total number and percent of CD8+ CD5- cells was increased following BMT. CD3+ cells from BMT patients were sorted for the presence or absence of CD5 expression. CD3+ CD5- cells were capable of interleukin-2 production and of mediating cytolysis following lectin stimulation. We conclude that CD3+ CD5- T cells are functional and represent a significant proportion of circulating cells in patients after BMT.
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PMID:A large proportion of T lymphocytes lack CD5 expression after bone marrow transplantation. 246 8

Transplantation of cells from the bursa of Fabricius reconstitutes the B cell system of chemically bursectomized chickens. Even allogeneic bursa cells can restore the recipient's B cell system and induce tolerance to donor major histocompatibility complex antigens, but the chimeras cannot mount a T-dependent antibody response. In order to study the mechanisms of tolerance to class II MHC (B-L) antigens, we transplanted class II-incompatible bursa cells from 4-day-old donors into cyclophosphamide-treated recipients of the same age. Donor and host cells carried different allelic products of a genetically polymorphic B cell alloantigen (Bu-1), allowing us to detect cellular chimerism using monoclonal antibodies and immunofluorescence. The B cell-chimeric chickens were tested for tolerance by skin grafting, graft-versus-host splenomegaly assay, and mixed lymphocyte reaction. Specific unresponsiveness to donor MHC antigens was observed in all three tests. When spleen cells from chickens tolerant of donor class II antigens were transferred into irradiated secondary recipients of the same strain, several of the secondary recipients accepted primary donor-type skin grafts. Most secondary recipients were, however, reactive in the GVH assay and MLR. Depletion of chimeric B cells before spleen cell transfer impaired the transferability of tolerance to class II disparity. Altogether, our results indicate that tolerance to class II antigens can be induced with B cells. They suggest that at least two different mechanisms maintain the unresponsiveness in B cell-chimeric chickens.
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PMID:B cell-induced tolerance to class II MHC antigens in the chicken. 252 81

A double-determinant ELISA has been developed to measure class II major histocompatibility complex molecules in blood from healthy individuals and patients who received either an allogeneic or an autologous bone-marrow transplant. Levels were higher in pre-transplant patients than in healthy individuals, and in the majority of patients, these levels rose even higher at 4 weeks post-transplantation. At later times after transplantation, it was difficult to draw firm conclusions, because the number of values available were too limited. Nevertheless, in the autologous group with no graft-versus-host disease (GVHD), levels were consistently lower at 6 months and one year; in the allogeneic group these long-term levels varied. As class II antigens are expressed on skin and rectal epithelia in GVHD, this study suggests that serial measurement of serum class II levels may be useful for monitoring GVHD in bone-marrow transplantation.
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PMID:A preliminary study of serum class II levels in healthy individuals and bone-marrow transplant patients. 262 Apr 53


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