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Cytokine mediators of chronic graft-versus-host disease
Kelli P.A. MacDonald, … , Bruce R. Blazar, Geoffrey R. Hill
Kelli P.A. MacDonald, … , Bruce R. Blazar, Geoffrey R. Hill
Published June 30, 2017
Citation Information: J Clin Invest. 2017;127(7):2452-2463. https://doi.org/10.1172/JCI90593.
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Category: Review Series

Cytokine mediators of chronic graft-versus-host disease

Abstract

Substantial preclinical and clinical research into chronic graft-versus-host disease (cGVHD) has come to fruition in the last five years, generating a clear understanding of a complex cytokine-driven cellular network. cGVHD is mediated by naive T cells differentiating within IL-17–secreting T cell and follicular Th cell paradigms to generate IL-21 and IL-17A, which drive pathogenic germinal center (GC) B cell reactions and monocyte-macrophage differentiation, respectively. cGVHD pathogenesis includes thymic damage, impaired antigen presentation, and a failure in IL-2–dependent Treg homeostasis. Pathogenic GC B cell and macrophage reactions culminate in antibody formation and TGF-β secretion, respectively, leading to fibrosis. This new understanding permits the design of rational cytokine and intracellular signaling pathway–targeted therapeutics, reviewed herein.

Authors

Kelli P.A. MacDonald, Bruce R. Blazar, Geoffrey R. Hill

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