Morris Edward S, Hill Geoffrey R
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
Br J Haematol. 2007 Apr;137(1):3-19. doi: 10.1111/j.1365-2141.2007.06510.x.
Allogeneic stem cell transplantation (SCT) remains the definitive immunotherapy for malignancy. However, morbidity and mortality due to graft-vs.-host disease (GVHD) remains the major barrier to its advancement. Emerging experimental data highlights the immuno-modulatory roles of diverse cell populations in GVHD, including regulatory T cells, natural killer (NK) cells, NK T cells, gammadelta T cells, and antigen presenting cells (APC). Knowledge of the pathophysiology of GVHD has driven the investigation of new rational strategies to both prevent severe GVHD and treat steroid-refractory GVHD. Novel cytokine inhibitors, immune-suppressant agents known to preserve or even promote regulatory T-cell function and the depletion of specific alloreactive T-cell sub-populations all promise significant advances in the near future. As our knowledge and therapeutic options expand, the ability to limit GVHD whilst preserving anti-microbial and tumour responses becomes a realistic prospect.
异基因干细胞移植（SCT）仍然是治疗恶性肿瘤的决定性免疫疗法。然而，移植物抗宿主病（GVHD）导致的发病率和死亡率仍然是其发展的主要障碍。新出现的实验数据突出了多种细胞群体在GVHD中的免疫调节作用，包括调节性T细胞、自然杀伤（NK）细胞、NK T细胞、γδ T细胞和抗原呈递细胞（APC）。对GVHD病理生理学的了解推动了新的合理策略的研究，以预防严重GVHD和治疗类固醇难治性GVHD。新型细胞因子抑制剂、已知能保留甚至促进调节性T细胞功能的免疫抑制剂以及特定同种异体反应性T细胞亚群的清除都有望在不久的将来取得重大进展。随着我们的知识和治疗选择的扩展，在保留抗菌和抗肿瘤反应的同时限制GVHD的能力成为一个现实的前景。
