Reconstitution of self-tolerance after hematopoietic stem cell transplantation

Allan D. Hess

Research output: Contribution to journalReview article

Abstract

Graft-versus-host disease (GVHD) is a major complication of allogeneic bone marrow or hematopoietic stem cell transplantation. GVHD is thought to be primarily due to the response of mature T cells transferred along with the bone marrow graft to foreign histocompatibility antigens expressed on host tissues. Recent studies, however, have challenged this paradigm set forth in the 1960s and have suggested that self-MHC class II antigens can be recognized in GVHD. Many questions still remain unanswered particularly in regard to the role of immune reconstitution, the ability to recognize and discriminate self and the re-establishment of self-tolerance. In fact, the failure to re-establish tolerance to self can lead to systemic autoimmunity that may exacerbate or even mimic GVHD. The present review summarizes our studies in autologous GVHD characterizing the underlying immune mechanisms and their potential impact in allogeneic hematopoietic stem cell transplantation.

Original languageEnglish (US)
Pages (from-to)143-152
Number of pages10
JournalImmunologic Research
Volume47
Issue number1-3
DOIs
StatePublished - Jul 1 2010

Keywords

  • Allogeneic graft-versus-host disease
  • Autologous graft-versus-host disease
  • Hematopoietic stem cell transplantation
  • Regulatory T cells

ASJC Scopus subject areas

  • Immunology

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