Shared biology of GVHD and GVT effects: potential methods of separation.

摘要: The difficult separation of clinical graft-versus-tumor (GVT) effects from graft-versus-host disease (GVHD) reflects their shared biology. Experimental approaches to mediate GVT while limiting GVHD include: (1) allograft T cell depletion followed by immune enhancement; (2) modulation dose or subset composition; (3) donor lymphocyte infusion; (4) reduced-intensity host preparation; (5) Th1/Th2 and Tc1/Tc2 balance; (6) cytokine therapy neutralization; (7) regulatory therapy; (8) co-stimulatory pathway modulation; (9) chemokine (10) induction antigen-specific cells; (11) alloreactive NK (12) targeted pharmaceutical inhibition proteosome, mammalian target rapamycin, histone deacetylase pathways. Clearly, a multitude exist that hold promise for separating GVHD. Future success in this endeavor will require strong commitment towards translational research continued advances cell, vaccine, cytokine, monoclonal antibody, molecular therapy.