Skip to main content

Advertisement

Log in

Chinese Medicine Treatment on Graft-Versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation

  • Feature Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. 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.

    PubMed  Google Scholar 

  2. 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.

    Google Scholar 

  3. 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.

    PubMed  CAS  Google Scholar 

  4. 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.

    Google Scholar 

  5. 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.

    Google Scholar 

  6. 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.

    PubMed  CAS  Google Scholar 

  7. 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.

    PubMed  Google Scholar 

  8. 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.

    Google Scholar 

  9. 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.

    Google Scholar 

  10. Ramon MR, Beatriz SA, Rubén S, et al. DNA methylation dynamics in blood after hematopoietic cell transplant. PLoS One 2013;8:e56931.

    Google Scholar 

  11. Qaiser B, Basem MW, Guillermo GM, et al. Epigenetic therapy in allogeneic hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 2013;35:126–133.

    Google Scholar 

  12. 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.

    PubMed  PubMed Central  CAS  Google Scholar 

  13. 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.

    PubMed  PubMed Central  CAS  Google Scholar 

  14. 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.

    PubMed  Google Scholar 

  15. 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.

    Google Scholar 

  16. 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.

    PubMed  CAS  Google Scholar 

  17. Pavan R. Targeting deacetylases to improve outcomes after allogeneic bone marrow transplantation. Trans Am Clin Climatol Assoc 2013;124:152.

    Google Scholar 

  18. 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.

    PubMed  PubMed Central  CAS  Google Scholar 

  19. 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.

    Google Scholar 

  20. 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.

    PubMed  CAS  Google Scholar 

  21. 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.

    Google Scholar 

  22. 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.

    Google Scholar 

  23. 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.

    Google Scholar 

  24. Wu SJ. Analysis on Chinese medicine treatment of acute/chronic graft-versus-host disease. Liaoning J Tradit Chin Med (Chin) 2011;38:2165–2167.

    Google Scholar 

  25. 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.

    Google Scholar 

  26. 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.

    Google Scholar 

  27. 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.

    Google Scholar 

  28. 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.

    Google Scholar 

  29. 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.

    Google Scholar 

  30. 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.

    Google Scholar 

  31. 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.

    Google Scholar 

  32. 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.

    PubMed  PubMed Central  Google Scholar 

  33. 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.

    Google Scholar 

  34. 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.

    Google Scholar 

  35. 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.

    Google Scholar 

  36. 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.

    Google Scholar 

  37. Niloufar K, Wioleta M, Amélie S, et al. Arsenic trioxide prevents murine sclerodermatous graft-versus-host disease. J Immunol 2012;188:5142–5149.

    Google Scholar 

  38. 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.

    PubMed  Google Scholar 

  39. 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.

    CAS  Google Scholar 

  40. 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.

    Google Scholar 

  41. 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.

    PubMed  CAS  Google Scholar 

  42. 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.

    PubMed  Google Scholar 

  43. 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.

    PubMed  CAS  Google Scholar 

  44. 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.

    Google Scholar 

  45. 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.

    Google Scholar 

  46. 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.

    Google Scholar 

  47. 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.

    Google Scholar 

  48. 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.

    Google Scholar 

  49. 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.

    Google Scholar 

  50. 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.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

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

Correspondence to Rui-lan Gao.

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

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

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

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-020-3252-y

Keywords

Navigation