A Journal of Postdoctoral Research.
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Kill the Messenger: T-cell/B-cell Interactions in cGVHD
Ethan Strattan, BS, and Yiming Zhong, PhD
The Ohio State University

Division of Hematology, Department of Internal Medicine, OSU, 320 W. 10th Avenue, Columbus, OH 43210, USA


Chronic graft-versus-host disease (cGVHD) is a common complication in patients after receiving an allogeneic tissue transplant, such as hematopoietic stem cell transplantation from unrelated donors.  cGVHD was viewed predominantly as a T-cell mediated disease but the emerging evidences indicate the crucial role of B-cell and other immune cells in its pathogenesis.  In their original paper in Blood [1], Flynn et al. show that increased frequency of T follicular helper (Tfh) cells and germinal center (GC) B-cells correlates with the development of cGVHD in a murine model and that blocking monoclonal antibodies (mAbs) for interleukin-21 (IL-21), inducble T-cell costimulator(ICOS) and CD40 ligand reverse cGVHD. These data demonstrate the importance of T follicular helper (Tfh) and germinal center (GC) B-cells in the pathogenesis of cGVHD and associated bronchiolitis obliterans syndrome (BOS) and suggest that new therapies using monoclonal antibodies (mAbs) targetingTfh cells, GC B cells, and their interactions could potentially reverse established pulmonary cGVHD. 


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