Bile acid malabsorption in patients with graft-versus-host disease of the gastrointestinal tract

摘要

Graft-versus-host disease (GVHD) is a major complication of allogeneic bone marrow/granulocyte colony-stimulating factor mobilized blood transplantation. Acute GVHD requiring treatment is associated with substantial morbidity and mortality (Van Lint et al, 2006). Acute GVHD often involves the lower gastrointestinal (GI) tract, inducing diarrhoea, weight loss and abdominal pain. Allogeneic immune cells and the conditioning regimen combine to damage the GI tract leading to inflammation of the mucosa (Hill et al, 1997). Many patients, particularly those with lower GI GVHD, do not respond to intensive immunosuppression (MacMillan et al, 2002). This may be because the process of inflammation is not effectively suppressed by the agents used. Alternatively, additional mechanisms may be at play.