Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine (Anhui Medical University), Ministry of Education, Anti-inflammatory Immune Drugs Collaborative Innovation Center, Anhui Province, Hefei 230032, China.
Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine (Anhui Medical University), Ministry of Education, Anti-inflammatory Immune Drugs Collaborative Innovation Center, Anhui Province, Hefei 230032, China.
Int Immunopharmacol. 2021 Mar;92:107349. doi: 10.1016/j.intimp.2020.107349. Epub 2021 Jan 21.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been widely used to treat hematological malignancies and genetic diseases. Graft-versus-host disease (GVHD) induced by donor immune system is the most common complication, contributing to severe morbidity and mortality after allo-HSCT. Currently, in terms of the prevention and treatment of GVHD, the major first-line therapeutic drugs are corticosteroids. However, most patients with systemic corticosteroid treatment are prone to steroid-refractory and poor prognosis. The use of several immune cells including Tregs, Bregs and mesenchymal stromal cells (MSCs) as an alternative on prevention or therapy of GVHD has been demonstrated to be beneficial. However, there are still many defects to a certain degree. Based on immune cells, it is promising to develop new and better approaches to improve GVHD. In this article, we will review the current advance of immune cells (Tregs, Bregs, MSCs) with negative regulation in the treatment of GVHD and present emerging strategies for the prevention and treatment of GVHD by other immune regulatory cells and chimeric antigen receptor (CAR) Tregs. In addition, these new therapeutic options need to be further evaluated in well-designed prospective multicenter trials to determine the optimal treatment for GVHD patients and improve their prognosis.
异基因造血干细胞移植（allo-HSCT）已广泛用于治疗血液系统恶性肿瘤和遗传疾病。供者免疫系统引起的移植物抗宿主病（GVHD）是最常见的并发症，导致 allo-HSCT 后严重发病率和死亡率。目前，在 GVHD 的预防和治疗方面，主要的一线治疗药物是皮质类固醇。然而，大多数接受全身皮质类固醇治疗的患者容易发生类固醇耐药和预后不良。已经证明，使用几种免疫细胞，包括调节性 T 细胞（Tregs）、调节性 B 细胞（Bregs）和间充质基质细胞（MSCs）作为替代物预防或治疗 GVHD 是有益的。然而，它们在某种程度上仍然存在许多缺陷。基于免疫细胞，开发新的、更好的方法来改善 GVHD 具有广阔的前景。本文将综述目前免疫细胞（Tregs、Bregs、MSCs）在治疗 GVHD 中的负调控作用的研究进展，并介绍其他免疫调节细胞和嵌合抗原受体（CAR）Tregs 预防和治疗 GVHD 的新策略。此外，这些新的治疗选择需要在精心设计的前瞻性多中心试验中进一步评估，以确定 GVHD 患者的最佳治疗方法并改善其预后。
