Milestones in acute GVHD pathophysiology

Abstract

In the past 65 years, over 25 000 referenced articles have been published on graft-versus-host disease (GVHD). Although this included clinically orientated papers or publications on chronic GVHD, the conservative estimate of scientific publications still contains several thousands of documents on the pathophysiology of acute GVHD. Thus, summarizing what we believe are prominent publications that can be considered milestones in our knowledge of this disease is a challenging and inherently biased task. Here we review from a historical perspective what can be regarded as publications that have made the field move forward. We also included several references of reviews on aspects we could not cover in detail.

Autophagy differentially regulates tissue tolerance of distinct target organs in graft-versus-host disease models

“…First, it does not address the impact of autophagy in various intestinal cell subsets, particularly those in the intestinal crypts, including the intestinal stem cells that are critical targets of GI GVHD. This remains a limitation that will need to be addressed by targeting of autophagy in specific GI cell subsets, including the intestinal stem cells, Paneth cells, and goblet cells, all of which are targets of alloreactive T cells and have been shown to regulate GI GVHD ( 53 ). Second, the microbiome is a critical regulator of GVHD; it also regulates IEC-specific autophagy and impacts GI infections ( 54 ).…”