Department of Oncology/Hematology, Stem Cell Transplant Program, A.O.U. Città Della Salute E Della Scienza Di Torino, Presidio Molinette , Torino, Italy.
Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy.
Expert Rev Hematol. 2021 Jan;14(1):79-96. doi: 10.1080/17474086.2021.1860001. Epub 2020 Dec 24.
Despite significant advances in treatment and prevention, graft-versus-host disease (GVHD) still represents the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Thus, considerable research efforts have been made to find and validate reliable biomarkers for diagnosis, prognosis, and risk stratification of GVHD.
In this review the most recent evidences on different types of biomarkers studied for GVHD, such as genetic, plasmatic, cellular markers, and those associated with microbiome, were summarized. A comprehensive search of peer-review literature was performed in PubMed including meta-analysis, preclinical and clinical trials, using the terms: cellular and plasma biomarkers, graft-versus-host disease, cytokines, and allogeneic hematopoietic stem cell transplantation.
In the near future, several validated biomarkers will be available to help clinicians in the diagnosis of GVHD, the identification of patients at high risk of GVHD development and in patients' stratification according to its severity. Then, immunosuppressive treatment could be tailored to each patient's real needs. However, more efforts are needed to achieve this goal. Although most of the proposed biomarkers currently lack validation with large-scale clinical data, their study led to improved knowledge of the biological basis of GVHD, and ultimately to implementation of GHVD treatment.
尽管在治疗和预防方面取得了重大进展，但移植物抗宿主病（GVHD）仍然是异基因造血干细胞移植后发病率和死亡率的主要原因。因此，人们做出了相当大的努力来寻找和验证用于诊断、预后和 GVHD 风险分层的可靠生物标志物。
在这篇综述中，总结了用于 GVHD 研究的不同类型生物标志物的最新证据，如遗传、血浆、细胞标志物，以及与微生物组相关的标志物。在 PubMed 中使用术语：细胞和血浆生物标志物、移植物抗宿主病、细胞因子和异基因造血干细胞移植，对同行评审文献进行了全面搜索，包括荟萃分析、临床前和临床试验。
在不久的将来，将有几个经过验证的生物标志物可用于帮助临床医生诊断 GVHD，识别发生 GVHD 风险高的患者，并根据其严重程度对患者进行分层。然后，可以根据每个患者的实际需求来定制免疫抑制治疗。然而，需要付出更多的努力才能实现这一目标。尽管目前大多数提出的生物标志物缺乏与大规模临床数据的验证，但它们的研究提高了对 GVHD 生物学基础的认识，并最终实施了 GVHD 的治疗。
