Understandig cGVHD
What is the Pathogenesis of cGVHD?
Chronic graft-versus-host disease is a complex multisystem disorder caused by an immune imbalance following an allogeneic HCT, which leads to serious and potentially life-threatening complications from both inflammatory and fibrotic processes. cGVHD is mediated by multiple immune pathways and is characterized by1
Early inflammation
due to tissue injury
Chronic inflammation and a dysregulated
adaptive immune system
Tissue repair with fibrosis
Chronic graft-versus-host disease presents multiple challenges for both clinicians and patients, specifically through manifestations of inflammation and fibrosis.
Although advances have been made in the understanding of cGVHD, many questions still remain.
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What roles do the inflammatory and fibrotic processes play in cGVHD?
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What is the full impact of cGVHD on patients' lives?
What is under clinical development?
cGVHD,chronicgraft-versus-hostdisease.
Although the understanding of the pathophysiology of cGVHD is improving, there is still much to be uncovered about the nature of the inflammatory cascade and the complex dynamics of the inflammatory and fibrotic processes.
Improving comprehension of these manifestations could help in the development of more targeted treatments.
What molecular pathways are implicated in cGVHD?
Abbreviations
BTK, Bruton’s tyrosine kinase; cGVHD, chronic graft-versus-host disease; HCT, hematopoietic cell transplant; IL-2, interleukin 2; JAK, Janus-associated kinase; ROCK, rho-associated coiled-coil–containing protein kinase.
Reference
- Zeiser R, Blazar BR. Pathophysiology of chronic graft-versus-host disease and therapeutic targets. N Engl J Med. 2017;377(26):2565-2579. doi:10.1056/NEJMra1703472