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Reconstitution of self-tolerance after hematopoietic stem cell transplantation

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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.

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Acknowledgments

This work was supported by grants (CA 15396, CA 82583 and AI 24319) from the National Institutes of Health.

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  1. The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, 417 N. Caroline St., Baltimore, MD, 21231, USA

    Allan D. Hess

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  1. Allan D. Hess
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Correspondence to Allan D. Hess.

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Hess, A.D. Reconstitution of self-tolerance after hematopoietic stem cell transplantation. Immunol Res 47, 143–152 (2010). https://doi.org/10.1007/s12026-009-8145-2

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