Regenerating islet-derived 3-alpha is a biomarker of gastrointestinal graft-versus-host disease.

摘要

There are no plasma biomarkers specific for GVHD of the gastrointestinal (GI) tract, the GVHD target organ most associated with nonrelapse mortality (NRM) following hematopoietic cell transplantation (HCT). Using an unbiased, large-scale, quantitative proteomic discovery approach to identify candidate biomarkers that were increased in plasma from HCT patients with GI GVHD, 74 proteins were increased at least 2-fold; 5 were of GI origin. We validated the lead candidate, REG3alpha, by ELISA in samples from 1014 HCT patients from 3 transplantation centers. Plasma REG3alpha concentrations were 3-fold higher in patients at GI GVHD onset than in all other patients and correlated most closely with lower GI GVHD. REG3alpha concentrations at GVHD onset predicted response to therapy at 4 weeks, 1-year NRM, and 1-year survival (P