Bone Marrow Transplantation & Leukemia, Oncology Division, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Bone Marrow Transplantation & Leukemia, Oncology Division, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Methods Cell Biol. 2022;168:41-66. doi: 10.1016/bs.mcb.2021.12.008. Epub 2022 Jan 17.
Transplantation of allogeneic hematopoietic stem and progenitor cells (allo-HCT) allows for cure of life-limiting malignant and non-malignant hematologic diseases. Crossing the human leukocyte antigen (HLA) barrier, however, comes at the cost of graft-versus-host disease (GVHD), a life-threatening syndrome mediated in part by the same donor T-lymphocytes that eliminate malignant cells. Acute GVHD occurs in the skin, gut, and/or liver in 25-55% of patients with a mortality rate of 15-40%, while chronic GVHD develops in 30-65% of patients who survive at least 3 months following allo-HCT and is highly debilitating in its extensive form, with a 30-50% 5year mortality rate stemming in part from immune dysregulation and opportunistic infections. Knowledge gaps remain in understanding the pathogenesis and in developing novel and effective treatments for the acute and chronic GVHD, which have distinct biology and yet are both treated with front line systemic corticosteroids. Novel and informative mouse models remain the primary means by which these diseases are studied and drugs initially developed prior to testing in humans. In this chapter, we describe allo-HCT mouse models and protocols using these mouse models by which to study acute and chronic GVHD with the goal of improving prevention and therapy.
同种异体造血干细胞和祖细胞(allo-HCT)移植可治愈危及生命的恶性和非恶性血液系统疾病。然而,跨越人白细胞抗原(HLA)障碍需要付出移植物抗宿主病(GVHD)的代价,这种危及生命的综合征部分由消除恶性细胞的同种异体供体 T 淋巴细胞介导。急性 GVHD 发生在皮肤、肠道和/或肝脏,25-55%的患者死亡率为 15-40%,而慢性 GVHD 发生在至少在 allo-HCT 后 3 个月存活的 30-65%的患者中,其广泛形式高度致残,30-50%的 5 年死亡率部分源于免疫失调和机会性感染。在理解急性和慢性 GVHD 的发病机制和开发新的有效治疗方法方面仍存在知识空白,这两种疾病具有不同的生物学特性,但都用一线系统皮质类固醇治疗。新颖且信息丰富的小鼠模型仍然是研究这些疾病的主要手段,并且在人类测试之前首先在这些模型中开发药物。在本章中,我们描述了 allo-HCT 小鼠模型及其使用这些小鼠模型的方案,旨在改善急性和慢性 GVHD 的预防和治疗。