Biomarkers of immune activation to screen for severe, acute GVHD.

摘要

Severe acute GVHD (AGVHD) occurring after allogeneic hematopoietic SCT (AHSCT) is often unresponsive to glucocorticoids and, as a result, frequently fatal.1 A preemptive approach, similar to that used for CMV infection could be more effective.1-2 We conducted a prospective study of plasma markers of immune activation to assess whether the incipient immunologic graft-vs-host response can be detected in a diverse group of transplant recipients before the clinical manifestations of severe AGVHD emerge. Five markers were selected: four markers of T-cell activation, soluble CD8 (sCD8), soluble IL-2 receptor (sIL-2R), soluble CD40 ligand (sCD40L) and soluble CD28 (sCD"28) as well as soluble TNF receptor 1 (sTNFRl), an inflammatory marker. These markers are measurable in the blood and have been shown to be increased in clinical AGVHD or other immune-mediated processes