Abstract
Graft-versus-host disease (GVHD) is the most common complication after allogeneic hematopoietic stem cell transplantation, and also an important factor affecting the survival and quality of life in patients after transplantation. Currently, immunosuppressive therapy is commonly used for GVHD, but the curative effect is not ideal. How to effectively prevent and treat GVHD is one of the difficulties to be solved urgently in the field of transplantation. In this paper, we summarize the latest progress in pathogenesis, prevention and treatment of GVHD with Chinese medicine (CM). We hope it will provide ideas and methods for exploring the mechanism and establishing a new comprehensive therapy for GVHD with CM.
Similar content being viewed by others
References
Martin G, Theodore G, Mary EDF, et al. Morbidity and mortality of chronic GVHD after hematopoietic stem cell transplantation from HLA-identical siblings for patients with aplastic or refractory anemias. Biol Blood Marrow Transplant 2002;8:47–56.
Marie R, Raphaël P, Renato DCA, et al. Risk factors for late infections after allogeneic hematopoietic stem cell transplantation from a matched related donor. Biol Blood Marrow Transplant 2007;13:1304–1312.
Xu Y, Li L, Chen Y, et al. Role of HMGB1 in regulation of STAT3 expression in CD4+ T cells from patients with aGVHD after allogeneic hematopoietic stem cell transplantation. Clin Immunol 2015;161:278–283.
Jaebok C, Julie R, Julie LP, et al. In vivo administration of hypomethylating agents mitigate graft-versus-host disease without sacrificing graft-versus-leukemia. Blood 2010;116:129–139.
Anusara D, Supinya L, Paramita C, et al. Targeting Sirt-1 controls GVHD by inhibiting T-cell allo-response and promoting Treg stability in mice. Blood 2019;133:266–279.
Han LJ, Zhang HY, Chen S, et al. Intestinal microbiota can predict acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2019;25:1944–1955.
Lee SE, Lim JY, Ryu DB, et al. Alteration of the intestinal microbiota by broad-spectrum antibiotic use correlates with the occurrence of intestinal graft-versus-host disease. Biol Blood Marrow Transplant 2019;25:1933–1943.
Alyson S, Cynthia RG, Zachariah D, et al. Indoles derived from intestinal microbiota act via type I interferon signaling to limit graft-versus-host disease. Blood 2018;132:2506–2519.
Dirk SP, Allison J, Rob SS, et al. A donor-specific epigenetic classifier for acute graft-versus-host disease severity in hematopoietic stem cell transplantation. Genome Chin J Integr Med 2020 May;26(5):324–329 Med 2015;7:128.
Ramon MR, Beatriz SA, Rubén S, et al. DNA methylation dynamics in blood after hematopoietic cell transplant. PLoS One 2013;8:e56931.
Qaiser B, Basem MW, Guillermo GM, et al. Epigenetic therapy in allogeneic hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 2013;35:126–133.
Wang JN, Li L, Xu M, et al. Modulation of allogeneic CD8+ T-cell response by DZNep controls GVHD while preserving hematopoietic chimerism. Transplantation 2013;96:774.
Xiao B, Wang Y, Li W, et al. Plasma microRNA signature as a noninvasive biomarker for acute graft-versus-host disease. Blood 2013;122:3365–3375.
Sang W, Sun C, Zhang C, et al. MicroRNA-150 negatively regulates the function of CD4+ T cells through AKT3/Bim signaling pathway. Cell Immunol 2016;306:35–40.
Mukta A, Linda JB, Stella MD, et al. Chronic graft-versus-host disease: a prospective cohort study. Biol Blood Marrow Transplant 2003;9:38–45.
Li NN, Zhao DC, Mark K, et al. HDAC inhibitor reduces cytokine storm and facilitates induction of chimerism that reverses lupus in anti-CD3 conditioning regimen. Proc Natl Acad Sci 2008;105:4796–4801.
Pavan R. Targeting deacetylases to improve outcomes after allogeneic bone marrow transplantation. Trans Am Clin Climatol Assoc 2013;124:152.
Choi SW, Thomas B, Israel H, et al. Vorinostat plus tacrolimus/ methotrexate to prevent GVHD after myeloablative conditioning, unrelated donor HCT. Blood 2017;130:1760–1767.
Yukiko N, Murakami A, Murayama Y, et al. Adipose tissue-derived mesenchymal stem cells ameliorate bone marrow aplasia related with graft-versus-host disease in experimental murine models. Transpl Immunol 2019;55:101205.
Wang L, Gu ZY, Zhao XL, et al. Extracellular vesicles released from human umbilical cord-derived mesenchymal stromal cells prevent life-threatening acute graft-versus-host disease in a mouse model of allogeneic hematopoietic stem cell transplantation. Stem Cells Dev 2016;25:1874–1883.
Martin B, Andreas DH, Heiko B, et al. Mesenchymal stromal cells disrupt mTOR-signaling and aerobic glycolysis during T-cell activation. Stem Cells 2016;34:516–521.
Wu DJ, Ye BD, Shen YP, et al. Significance of TCM in the treatment of acute aplastic anemia with hematopoietic stem cell transplantation. Chin J Tradit Chin Med Pharmacy (Chin) 2016;31:3457–3460.
Li H, Li D. Exploration and experience of traditional Chinese medicine intervention in hematopoietic stem cell preitransplantation by LI Da. Chin J Tradit Chin Med Pharm (Chin) 2018;33:248–252.
Wu SJ. Analysis on Chinese medicine treatment of acute/chronic graft-versus-host disease. Liaoning J Tradit Chin Med (Chin) 2011;38:2165–2167.
Li HY, Feng SZ, Han MZ. Preliminary study on TCM syndrome differentiation of graft-versus-host disease after transplantation of the hemopoietic stem cell. J Tradit Chin Med 2005;16:617–618.
Tian M, Wang L, Liu JL, et al. Prevention and treatment of graft-versus-host disease with strengthening body resistance and supporting healthy energy after nonmyeloablative transplantation. Guangming J Chin Med (Chin) 2016;31:471–473.
Sun W, Yu J, Zhang FF, et al. Clinical experience of Professor YU Jian in treating graft-versus-host response after umbilical cord blood stem cell transplantation. Chin Pediatr Integr Tradit West Med (Chin) 2018;10:360–362.
Feng Y, Dou YQ. Treatment of chronic graft-versus-host response based on syndrome differentiation of Wei-Qi-Ying-Xue. Acad J PLA Postgrad Med Sch (Chin) 2005;26:106,115.
Ren WY, Chen XM, Qiu QY, et al. Inducement of chronic graft-versus-host disease (GVHD) model and observation of the effects of Bushen-Qingredu Formula. J Beijing Univ Tradit Chin Med (Chin) 2003;26:31–34.
Chen W, Fan HM, Zhang Q, et al. Experimental study of preventive effect of yin-nourishing and heat-clearing Chinese medicine on chronic graft-versus-host disease in mice with haploidentical bone marrow transplantation. J New Chin Med (Chin) 2012;44:162–164.
Zhang SJ, Wang LP, Wu KM, et al. Influence of Qingchang Decoction on intestinal flora and colonic expression of NLRP3-ASC-IL-l8 function axis in intestinal aGVHD mice. J Zhejiang Chin Med Univ (Chin) 2016;40:164–169.
Lyu M, Zhou ZC, Wang XM, et al. Network pharmacology-guided development of a novel integrative regimen to prevent acute graft-versus-host disease. Front Pharmacol 2018;9:1440.
Yan M, Wen BZ, Cao Y, et al. Influence of calcitriol and Salvia miltiorrhiza on acute graft-versus-host disease and cytokine after allogeneic bone marrow transplantation of rat. J Chin Pediatr Blood Cancer (Chin) 2009;14:211–215.
Yan M, Wen BZ, Cao Y, et al. Influences of 1,25-(OH)2D3 and Salvia miltiorrhiza on hematopoiesis reconstruction and T cell subsets after allogeneic bone marrow transplantation in rats. J Xian Jiaotong Univ (Med Sci) 2010;31:370–373.
Wu SJ, Luo T, Huang HD. Experimental study of Annao Tablets on preventing acute graft-versus-host disease in bone marrow transplanted mice. Immunol J 2012;28:475–479.
Wu SJ, Liang KW, Wu YB, et al. Effect of Guifurehmaniae bolus on preventing chronic graft-versus-host disease in major histocompatibilty complex halpo-identical bone marrow transplantation mice. Chin J Tissue Eng Res (Chin) 2012;16:5788–5792.
Niloufar K, Wioleta M, Amélie S, et al. Arsenic trioxide prevents murine sclerodermatous graft-versus-host disease. J Immunol 2012;188:5142–5149.
Hu XL, Li LW, Yan S, et al. Arsenic trioxide suppresses acute graft-versus-host disease by activating the Nrf2/HO-1 pathway in mice. Br J Haematol 2019;186:e145–e148.
Zhang Y, Wang YN, Feng CC, et al. Matrine combined with cyclosporin A alleviates acute graft-versus-host-disease after allogeneic bone marrow transplantation in a murine model. J Clin Rehabil Tissue Eng Res (Chin) 2011;15:8267–8271.
Pak MJ, Moon SJ, Lee SH, et al. Curcumin attenuates acute graft-versus-host disease severity via in vivo regulations on Th1, Th17 and regulatory T cells. Plos One 2013;8:e67171.
Wang BL, Su H, Chen Y, et al. A role for trichosanthin in the expansion of CD4+ CD25+ regulatory T cells. Scand J Immunol 2010;71:258–266.
Li ZY, Wu QY, Yan ZL, et al. Prevention of acute GVHD in mice by treatment with Tripterygium hypoglaucum Hutch combined with cyclosporin A. Hematology 2013;18:352–359.
Asano K, Yu Y, Kasahara T, et al. Inhibition of murine chronic graft-versus-host disease by the chloroform extract of Tripterygium wilfordii Hook F. Transpl Immunol 1997;5:315–319.
John MF, Geoffrey YK, Duane P, et al. Immunosuppressive activity of the Chinese medicinal plant Tripterygium wilfordii. III. Suppression of graft-versus-host disease in murine allogeneic bone marrow transplantation by the PG27 extract. Transplantation 2002;74:445–457.
Zhang XJ, Pan L, Wang FX, et al. An experimental study of the inhibitory effect of TWH on acute GVHD after allo-graft transplantation in mice. Chin J Immunol (Chin) 2005;21:612–616.
Xu XL, Chen ZW, Zou P. Triptolide regulates idiopathic pneumonia syndrome after allo-hematopoietic stem cell transplantation by down-regulation of IL-17/TNF-α. Chin J Immunol (Chin) 2019;35:1428–1432.
Doanh LH, Takashi M, Jin GH, et al. FTY720 ameliorates murine sclerodermatous chronic graft-versus-host disease by promoting expansion of splenic regulatory cells and inhibiting immune cell infiltration into skin. Arthritis Rheum 2013;65:1624–1635.
Daigo H, Shoji A, Ken IM, et al. FTY720 enhances the activation-induced apoptosis of donor T cells and modulates graft-versus-host disease. Eur J Immunol 2007;37:271–281.
Tadepally L, Frank H, SSV JRM, et al. In vivo engineering of mobilized stem cell grafts with the immunomodulatory drug FTY720 for allogeneic transplantation. Eur J Immunol 2016:46:1758–1769.
Patricia AT, Michael JE, Christopher JL, et al. Insights into the mechanism of FTY720 and compatibility with regulatory T cells for the inhibition of graft-versus-host disease (GVHD). Blood 2007;110:3480–3488.
Author information
Authors and Affiliations
Contributions
Gao RL and Wu XL conceived, designed, collected data and wrote the manuscript. Zhuang HF consulted relevant literature and clinical guidelines. Zhao YN, Yu XL and Dai TY participated in searching and reading the literatures.
Corresponding author
Ethics declarations
The authors declare that they have no conflict of interest.
Additional information
Supported by the National Natural Science Foundation of China (No. 81774068), the Natural Science Foundation of Zhejiang Province (Youth Project, No. LQ19H290002)
Rights and permissions
About this article
Cite this article
Wu, Xl., Zhuang, Hf., Zhao, Yn. et al. Chinese Medicine Treatment on Graft-Versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation. Chin. J. Integr. Med. 26, 324–329 (2020). https://doi.org/10.1007/s11655-020-3252-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11655-020-3252-y