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The role of the endothelium in the short-term complications of hematopoietic SCT

Bone Marrow Transplantation volume 46, pages 1495–1502 (2011)Cite this article

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Abstract

In this review, we analyse the role of the endothelium in the development of several complications that appear soon after haematopoietic SCT (HSCT). Once it had been demonstrated that sinusoidal damage is the initiating event of the sinusoidal obstruction syndrome, it was considered that other short-term complications with overlapping clinical manifestations, such as capillary leak syndrome, engraftment syndrome, transplant-associated microangiopathy, diffuse alveolar haemorrhage and idiopathic pneumonia syndrome, could have an endothelial origin. During HSCT, endothelial cells (ECs) are activated and damaged by several factors, including conditioning, cytokines released by damaged tissues, endotoxins translocated through damaged mucosa, drugs used in the procedure, the engraftment, and—in the allogeneic setting—immunological reactions. The different clinical syndromes that occur could be determined by the predominant phenotypic change in the ECs and the location of this change (organ dependant or systemic). Several translational studies have provided evidence of this endothelial dysfunction on the basis of analysis of soluble markers, soluble forms of adhesion molecules, the enumeration of circulating ECs and microparticles, and morphologic and functional changes induced in cultured ECs. This increased knowledge has opened up a wide range of potential pharmacologic interventions to prevent or treat endothelial damage and, consequently, to improve the outcome of patients receiving HSCT.

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Acknowledgements

This work has been partially supported by grants: FIS PI081056 (Fondo de Investigaciones de la Seguridad Social), German José Carreras Leukaemia Foundation (R 07/41v), SAF 2009-10365 (Ministerio de Ciencia y Tecnología), RD06/0009/1003 (Red HERACLES, Instituto de Salud Carlos III).

We thank Jordi Bozzo for providing the images included in Figures 1 and 3.

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Authors and Affiliations

  1. Hematology Department, Hospital Clinic, Institut d’Investigacions Biomèdiques Augustí Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

    E Carreras

  2. Hemotherapy-Hemostasis Department, Hospital Clinic, Institut d’Investigacions Biomèdiques Augustí Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

    M Diaz-Ricart

  3. Spanish Bone Marrow Donor Program (REDMO), Josep Carreras International Foundation, Barcelona, Spain

    E Carreras

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Correspondence to E Carreras.

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Carreras, E., Diaz-Ricart, M. The role of the endothelium in the short-term complications of hematopoietic SCT. Bone Marrow Transplant 46, 1495–1502 (2011). https://doi.org/10.1038/bmt.2011.65

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