A 2-hit model for chronic GVHD.

摘要

Chronic GVHD continues to be a major cause of both morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT).2 Chronic GVHD has been assumed to be caused by the continuation of the pathogeneic mechanisms that cause acute GVHD, primarily donor-derived T lymphocytes specific for histocompatibility antigens uniquely expressed by recipient cells.3 As a consequence, therapy for chronic GVHD has traditionally been directed at suppressing the donor antirecipient immune response. However, during the last 25 years, a series of murine experiments have indicated that donor-derived, autoreactive T lymphocytes (ie, T lymphocytes specific for antigens expressed by both donor and recipient cells) are present in murine HSCT recipients with chronic GVHD and that the chronic GVHD could be transferred by the donor-derived T lymphocytes into both donor and recipient mice.