Biomarkers of Acute Graft-Versus-Host Disease

Acute Graft Versus Host Disease (aGVHD) is an important complicationafter allogeneic hematopoietic cell transplantation (Allo-HSCT). Despiteworthwhile investigation for finding biomarkers of aGvHD, the diagnosisis currently mainly based on clinical findings. An ideal biomarker isnoninvasive, rapid, simple, accurate, inexpensive, and standardized andcan demonstrate the state of the disease. The functions and numbers ofseveral immune cell populations are altered in aGVHD and cGVHDdisease states. Regulatory T cells, invariant natural killer T cells (iNKTs)are potential cellular biomarkers of aGVHD. In cGVHD, B cells and theirmodulators such as B cell-activating factor are important biomarkers.TIM-3 (T-cell Ig and mucin domain 3), ST2, REG3α (regenerating isletderived3-α) can be mentioned as the most valuable markers related tothe T-cell-mediated tissue damage of SCT. At day + 30 post-allo-HCT apanel of inflammatory cytokines and receptors including IL-2Rα, TNFR1,HGF, and IL-8 could predict aGvHD. Studies suggest that miRNAs, apost-transcriptional regulator of gene expressions, such as miR-155 andmiR-100 could not only be promising biomarkers, but also the potentialnew target for therapeutic agents of GVHD. Several single nucleotidepolymorphisms (SNPs) have been identified as risk factors for GVHDincluding tumor necrosis factor (TNFα), interleukin-6 (IL-6), interferon(IFNγ), IL-10, UDP-glucuronosyltransferase 2B17. But donor selectionaccording to SNP genotyping is still not performed clinically, although itmay be available in the near future. Overall, a scoring predictive systemincluding the most important member of these mentioned categoriesas an algorithm may be the best choice for utilizing in the clinicalsetting. GVHD biomarkers have predictive and prognostic value and theapproaches to distinguish them in therapeutic clinical trials are crucial toimprove outcomes post-allo-HCT.

Keywords:

Allogeneic hematopoietic cell transplantation , GvHD , Biomarker