Department of Dermatology, Medical University of Vienna, Vienna, Austria.
CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.
Front Immunol. 2023 Jun 26;14:1199422. doi: 10.3389/fimmu.2023.1199422. eCollection 2023.
Chronic Graft-versus-Host Disease is a life-threatening inflammatory condition that affects many patients after allogeneic hematopoietic stem cell transplantation. Although we have made substantial progress in understanding disease pathogenesis and the role of specific immune cell subsets, treatment options are still limited. To date, we lack a global understanding of the interplay between the different cellular players involved, in the affected tissues and at different stages of disease development and progression. In this review we summarize our current knowledge on pathogenic and protective mechanisms elicited by the major involved immune subsets, being T cells, B cells, NK cells and antigen presenting cells, as well as the microbiome, with a special focus on intercellular communication of these cell types extracellular vesicles as up-and-coming fields in chronic Graft-versus-Host Disease research. Lastly, we discuss the importance of understanding systemic and local aberrant cell communication during disease for defining better biomarkers and therapeutic targets, eventually enabling the design of personalized treatment schemes.
慢性移植物抗宿主病是一种危及生命的炎症性疾病，影响异基因造血干细胞移植后的许多患者。尽管我们在了解疾病发病机制和特定免疫细胞亚群的作用方面取得了重大进展，但治疗选择仍然有限。迄今为止，我们缺乏对受影响组织中不同细胞参与者之间相互作用的全面了解，以及在疾病发展和进展的不同阶段。在这篇综述中，我们总结了我们目前对主要涉及的免疫亚群（即 T 细胞、B 细胞、NK 细胞和抗原呈递细胞）以及微生物组引发的致病和保护机制的了解，特别关注这些细胞类型的细胞间通讯，以及细胞外囊泡作为慢性移植物抗宿主病研究中的新兴领域。最后，我们讨论了了解疾病过程中全身和局部异常细胞通讯的重要性，以确定更好的生物标志物和治疗靶点，最终能够设计个性化的治疗方案。
