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Next generation treatment of acute graft-versus-host disease

Abstract

Despite rapid increase in the utilization of allogeneic hematopoietic stem cell transplantation, non-relapse mortality and sequela from acute graft-versus-host disease (GVHD) remain principle barriers. GVHD involves complex interactions between innate and adaptive immunity, culminating in tissue damage by inflammatory mediators and cellular effectors. Recently, our understanding of the molecular intricacies of GVHD has grown tremendously. New insights into the roles played by novel cytokines, chemokines, intracellular signaling pathways, epigenetics and post-translational modifications of proteins in GVHD biology provide numerous targets that might be therapeutically exploited. This review highlights recent advances and identifies opportunities for reshaping contemporary GVHD therapeutics.

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References

  1. Storb R, Gyurkocza B, Storer BE, Sorror ML, Blume K, Niederwieser D et al. Graft-versus-host disease and graft-versus-tumor effects after allogeneic hematopoietic cell transplantation. J Clin Oncol 2013; 31: 1530–1538.

    CAS  PubMed  Google Scholar 

  2. Pasquini MC WZ Current use and outcome of hematopoietic stem cell transplantation: CIBMTR Summary Slides. 2011. Available at http://www.cibmtrorg.

  3. Jagasia M, Arora M, Flowers ME, Chao NJ, McCarthy PL, Cutler CS et al. Risk factors for acute GVHD and survival after hematopoietic cell transplantation. Blood 2012; 119: 296–307.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Marr KA, Carter RA, Boeckh M, Martin P, Corey L . Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood 2002; 100: 4358–4366.

    CAS  PubMed  Google Scholar 

  5. Billingham RE . The biology of graft-versus-host reactions. Harvey Lect 1966; 62: 21–78.

    PubMed  Google Scholar 

  6. Korngold R, Sprent J . Lethal graft-versus-host disease after bone marrow transplantation across minor histocompatibility barriers in mice. Prevention by removing mature T cells from marrow. J Exp Med 1978; 148: 1687–1698.

    CAS  PubMed  Google Scholar 

  7. Paczesny S, Hanauer D, Sun Y, Reddy P . New perspectives on the biology of acute GVHD. Bone Marrow Transplant 2010; 45: 1–11.

    CAS  PubMed  Google Scholar 

  8. Ruutu T, van Biezen A, Hertenstein B, Henseler A, Garderet L, Passweg J et al. Prophylaxis and treatment of GVHD after allogeneic haematopoietic SCT: a survey of centre strategies by the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2012; 47: 1459–1464.

    CAS  PubMed  Google Scholar 

  9. Ram R, Storb R . Pharmacologic prophylaxis regimens for acute graft-versus-host disease: past, present and future. Leuk Lymphoma 2013; 54: 1591–1601.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 2010; 363: 2091–2101.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. MacMillan ML, DeFor TE, Weisdorf DJ . The best endpoint for acute GVHD treatment trials. Blood 2010; 115: 5412–5417.

    CAS  PubMed  Google Scholar 

  12. Antin JH, Weisdorf D, Neuberg D, Nicklow R, Clouthier S, Lee SJ et al. Interleukin-1 blockade does not prevent acute graft-versus-host disease: results of a randomized, double-blind, placebo-controlled trial of interleukin-1 receptor antagonist in allogeneic bone marrow transplantation. Blood 2002; 100: 3479–3482.

    CAS  PubMed  Google Scholar 

  13. Levine JE, Paczesny S, Mineishi S, Braun T, Choi SW, Hutchinson RJ et al. Etanercept plus methylprednisolone as initial therapy for acute graft-versus-host disease. Blood 2008; 111: 2470–2475.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Chen X, Das R, Komorowski R, Beres A, Hessner MJ, Mihara M et al. Blockade of interleukin-6 signaling augments regulatory T-cell reconstitution and attenuates the severity of graft-versus-host disease. Blood 2009; 114: 891–900.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Tawara I, Koyama M, Liu C, Toubai T, Thomas D, Evers R et al. Interleukin-6 modulates graft-versus-host responses after experimental allogeneic bone marrow transplantation. Clin Cancer Res 2011; 17: 77–88.

    CAS  PubMed  Google Scholar 

  16. Drobyski WR, Pasquini M, Kovatovic K, Palmer J, Douglas Rizzo J, Saad A et al. Tocilizumab for the treatment of steroid refractory graft-versus-host disease. Biol Blood Marrow Transplant 2011; 17: 1862–1868.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Kennedy GA, Varelias A, Vuckovic S, Zhang P, MacDonald K, Leach J et al. The addition of interleukin-6 inhibition to standard Gvhd prophylaxis prevents acute Gvhd: interim results of a phase I/II clinical study. ASH Ann Meet Absr 2013; 122: 908.

    Google Scholar 

  18. Bucher C, Koch L, Vogtenhuber C, Goren E, Munger M, Panoskaltsis-Mortari A et al. IL-21 blockade reduces graft-versus-host disease mortality by supporting inducible T regulatory cell generation. Blood 2009; 114: 5375–5384.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Hippen KL, Bucher C, Schirm DK, Bearl AM, Brender T, Mink KA et al. Blocking IL-21 signaling ameliorates xenogeneic GVHD induced by human lymphocytes. Blood 2012; 119: 619–628.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Das R, Chen X, Komorowski R, Hessner MJ, Drobyski WR . Interleukin-23 secretion by donor antigen-presenting cells is critical for organ-specific pathology in graft-versus-host disease. Blood 2009; 113: 2352–2362.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Murai M, Yoneyama H, Harada A, Yi Z, Vestergaard C, Guo B et al. Active participation of CCR5(+)CD8(+) T lymphocytes in the pathogenesis of liver injury in graft-versus-host disease. J Clin Invest 1999; 104: 49–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Bogunia-Kubik K, Duda D, Suchnicki K, Lange A . CCR5 deletion mutation and its association with the risk of developing acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Haematologica 2006; 91: 1628–1634.

    CAS  PubMed  Google Scholar 

  23. Wysocki CA, Burkett SB, Panoskaltsis-Mortari A, Kirby SL, Luster AD, McKinnon K et al. Differential roles for CCR5 expression on donor T cells during graft-versus-host disease based on pretransplant conditioning. J Immunol 2004; 173: 845–854.

    CAS  PubMed  Google Scholar 

  24. Reshef R, Luger SM, Hexner EO, Loren AW, Frey NV, Nasta SD et al. Blockade of lymphocyte chemotaxis in visceral graft-versus-host disease. N Engl J Med 2012; 367: 135–145.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Hanash AM, Dudakov JA, Hua G, O'Connor MH, Young LF, Singer NV et al. Interleukin-22 protects intestinal stem cells from immune-mediated tissue damage and regulates sensitivity to graft versus host disease. Immunity 2012; 37: 339–350.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Takashima S, Kadowaki M, Aoyama K, Koyama M, Oshima T, Tomizuka K et al. The Wnt agonist R-spondin1 regulates systemic graft-versus-host disease by protecting intestinal stem cells. J Exp Med 2011; 208: 285–294.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Silverman EK, Sandhaus RA . Clinical practice. Alpha1-antitrypsin deficiency. N Engl J Med 2009; 360: 2749–2757.

    CAS  PubMed  Google Scholar 

  28. Lewis EC, Shapiro L, Bowers OJ, Dinarello CA . Alpha1-antitrypsin monotherapy prolongs islet allograft survival in mice. Proc Natl Acad Sci USA 2005; 102: 12153–12158.

    CAS  PubMed  Google Scholar 

  29. Tawara I, Sun Y, Lewis EC, Toubai T, Evers R, Nieves E et al. Alpha-1-antitrypsin monotherapy reduces graft-versus-host disease after experimental allogeneic bone marrow transplantation. Proc Natl Acad Sci USA 2012; 109: 564–569.

    CAS  PubMed  Google Scholar 

  30. Marcondes AM, Li X, Tabellini L, Bartenstein M, Kabacka J, Sale GE et al. Inhibition of IL-32 activation by alpha-1 antitrypsin suppresses alloreactivity and increases survival in an allogeneic murine marrow transplantation model. Blood 2011; 118: 5031–5039.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Brennan TV, Lin L, Huang X, Cardona DM, Li Z, Dredge K et al. Heparan sulfate, an endogenous TLR4 agonist, promotes acute GVHD after allogeneic stem cell transplantation. Blood 2012; 120: 2899–2908.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Rodriguez-Otero P, Porcher R, Peffault de Latour R, Contreras M, Bouhnik Y, Xhaard A et al. Fecal calprotectin and alpha-1 antitrypsin predict severity and response to corticosteroids in gastrointestinal graft-versus-host disease. Blood 2012; 119: 5909–5917.

    CAS  PubMed  Google Scholar 

  33. Shibuya A, Campbell D, Hannum C, Yssel H, Franz-Bacon K, McClanahan T et al. DNAM-1, a novel adhesion molecule involved in the cytolytic function of T lymphocytes. Immunity 1996; 4: 573–581.

    CAS  PubMed  Google Scholar 

  34. Nabekura T, Shibuya K, Takenaka E, Kai H, Shibata K, Yamashita Y et al. Critical role of DNAX accessory molecule-1 (DNAM-1) in the development of acute graft-versus-host disease in mice. Proc Natl Acad Sci USA 2010; 107: 18593–18598.

    CAS  PubMed  Google Scholar 

  35. Koyama M, Kuns RD, Olver SD, Lineburg KE, Lor M, Teal BE et al. Promoting regulation via the inhibition of DNAM-1 after transplantation. Blood 2013; 121: 3511–3520.

    CAS  PubMed  Google Scholar 

  36. Zhang Y, Sandy AR, Wang J, Radojcic V, Shan GT, Tran IT et al. Notch signaling is a critical regulator of allogeneic CD4+ T-cell responses mediating graft-versus-host disease. Blood 2011; 117: 299–308.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Toubai T, Sun Y, Tawara I, Friedman A, Liu C, Evers R et al. Ikaros-Notch axis in host hematopoietic cells regulates experimental graft-versus-host disease. Blood 2011; 118: 192–204.

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Wilhelm K, Ganesan J, Muller T, Durr C, Grimm M, Beilhack A et al. Graft-versus-host disease is enhanced by extracellular ATP activating P2 × 7R. Nat Med 2010; 16: 1434–1438.

    CAS  PubMed  Google Scholar 

  39. Jankovic D, Ganesan J, Bscheider M, Stickel N, Weber FC, Guarda G et al. The Nlrp3 inflammasome regulates acute graft-versus-host disease. J Exp Med 2013; 210: 1899–1910.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Crocker PR, Paulson JC, Varki A . Siglecs and their roles in the immune system. Nat Rev Immunol 2007; 7: 255–266.

    CAS  PubMed  Google Scholar 

  41. Toubai T, Hou G, Mathewson N, Liu C, Wang Y, Oravecz-Wilson K et al. Siglec-G-CD24 axis controls the severity of graft-versus-host disease in mice. Blood 2014; 123: 3512–3523.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. van Bekkum DW . Bone marrow transplantation. Transplant Proc 1977; 9: 147–154.

    CAS  PubMed  Google Scholar 

  43. Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M et al. Diversity of the human intestinal microbial flora. Science 2005; 308: 1635–1638.

    PubMed  PubMed Central  Google Scholar 

  44. Eriguchi Y, Takashima S, Oka H, Shimoji S, Nakamura K, Uryu H et al. Graft-versus-host disease disrupts intestinal microbial ecology by inhibiting Paneth cell production of alpha-defensins. Blood 2012; 120: 223–231.

    CAS  PubMed  Google Scholar 

  45. Jenq RR, Ubeda C, Taur Y, Menezes CC, Khanin R, Dudakov JA et al. Regulation of intestinal inflammation by microbiota following allogeneic bone marrow transplantation. J Exp Med 2012; 209: 903–911.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Tawara I, Liu C, Tamaki H, Toubai T, Sun Y, Evers R et al. Influence of donor microbiota on the severity of experimental graft-versus-host-disease. Biol Blood Marrow Transplant 2013; 19: 164–168.

    PubMed  Google Scholar 

  47. Holler E, Butzhammer P, Schmid K, Hundsrucker C, Koestler J, Peter K et al. Metagenomic analysis of the stool microbiome in patients receiving allogeneic SCT: Loss of diversity is associated with use of systemic antibiotics and more pronounced in gastrointestinal GvHD. Biol Blood Marrow Transplant 2014; 20: 640–645.

    PubMed  PubMed Central  Google Scholar 

  48. Levine JE, Huber E, Hammer ST, Harris AC, Greenson JK, Braun TM et al. Low Paneth cell numbers at onset of gastrointestinal graft-versus-host disease identify patients at high risk for nonrelapse mortality. Blood 2013; 122: 1505–1509.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Edinger M, Hoffmann P, Ermann J, Drago K, Fathman CG, Strober S et al. CD4(+)CD25(+) regulatory T cells preserve graft-versus-tumor activity while inhibiting graft-versus-host disease after bone marrow transplantation. Nat Med 2003; 9: 1144–1150.

    CAS  PubMed  Google Scholar 

  50. Hoffmann P, Ermann J, Edinger M, Fathman CG, Strober S . Donor-type CD4(+)CD25(+) regulatory T cells suppress lethal acute graft-versus-host disease after allogeneic bone marrow transplantation. J Exp Med 2002; 196: 389–399.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Di Ianni M, Falzetti F, Carotti A, Terenzi A, Castellino F, Bonifacio E et al. Tregs prevent GVHD and promote immune reconstitution in HLA-haploidentical transplantation. Blood 2011; 117: 3921–3928.

    CAS  PubMed  Google Scholar 

  52. Brunstein CG, Miller JS, Cao Q, McKenna DH, Hippen KL, Curtsinger J et al. Infusion of ex vivo expanded T regulatory cells in adults transplanted with umbilical cord blood: safety profile and detection kinetics. Blood 2011; 117: 1061–1070.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Chaidos A, Patterson S, Szydlo R, Chaudhry MS, Dazzi F, Kanfer E et al. Graft invariant natural killer T-cell dose predicts risk of acute graft-versus-host disease in allogeneic hematopoietic stem cell transplantation. Blood 2012; 119: 5030–5036.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Juno JA, Keynan Y, Fowke KR . Invariant NKT cells: regulation and function during viral infection. PLoS Pathog 2012; 8: e1002838.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Rubio MT, Moreira-Teixeira L, Bachy E, Bouillie M, Milpied P, Coman T et al. Early posttransplantation donor-derived invariant natural killer T-cell recovery predicts the occurrence of acute graft-versus-host disease and overall survival. Blood 2012; 120: 2144–2154.

    CAS  PubMed  Google Scholar 

  56. Schneidawind D, Pierini A, Alvarez M, Pan Y, Baker J, Kim B et al. CD4+ invariant natural killer T cells protect from acute graft-versus-host disease lethality through a dramatic expansion of donor-derived CD4+FoxP3+ regulatory T cells. Biol Blood Marrow Transplant 2014; 20: S23.

    Google Scholar 

  57. Betts BC, Abdel-Wahab O, Curran SA St, Angelo ET, Koppikar P, Heller G et al. Janus kinase-2 inhibition induces durable tolerance to alloantigen by human dendritic cell-stimulated T cells yet preserves immunity to recall antigen. Blood 2011; 118: 5330–5339.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Spoerl S, Mathew NR, Bscheider M, Schmitt-Graeff A, Chen S, Mueller T et al. Activity of therapeutic JAK 1/2 blockade in graft-versus-host disease. Blood 2014; 123: 3832–3842.

    CAS  PubMed  Google Scholar 

  59. Park HB, Oh K, Garmaa N, Seo MW, Byoun OJ, Lee HY et al. CP-690550, a Janus kinase inhibitor, suppresses CD4+ T-cell-mediated acute graft-versus-host disease by inhibiting the interferon-gamma pathway. Transplantation 2010; 90: 825–835.

    CAS  PubMed  Google Scholar 

  60. Leonhardt F, Zirlik K, Buchner M, Prinz G, Hechinger AK, Gerlach UV et al. Spleen tyrosine kinase (Syk) is a potent target for GvHD prevention at different cellular levels. Leukemia 2012; 26: 1617–1629.

    CAS  PubMed  Google Scholar 

  61. Radojcic V, Pletneva MA, Yen HR, Ivcevic S, Panoskaltsis-Mortari A, Gilliam AC et al. STAT3 signaling in CD4+ T cells is critical for the pathogenesis of chronic sclerodermatous graft-versus-host disease in a murine model. J Immunol 2010; 184: 764–774.

    CAS  PubMed  Google Scholar 

  62. Lu SX, Alpdogan O, Lin J, Balderas R, Campos-Gonzalez R, Wang X et al. STAT-3 and ERK 1/2 phosphorylation are critical for T-cell alloactivation and graft-versus-host disease. Blood 2008; 112: 5254–5258.

    CAS  PubMed  PubMed Central  Google Scholar 

  63. Laurence A, Amarnath S, Mariotti J, Kim YC, Foley J, Eckhaus M et al. STAT3 transcription factor promotes instability of nTreg cells and limits generation of iTreg cells during acute murine graft-versus-host disease. Immunity 2012; 37: 209–222.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Sun Y, Chin YE, Weisiger E, Malter C, Tawara I, Toubai T et al. Cutting edge: Negative regulation of dendritic cells through acetylation of the nonhistone protein STAT-3. J Immunol 2009; 182: 5899–5903.

    CAS  PubMed  PubMed Central  Google Scholar 

  65. Lawrence T . The nuclear factor NF-kappaB pathway in inflammation. Cold Spring Harb Perspect Biol 2009; 1: a001651.

    PubMed  PubMed Central  Google Scholar 

  66. MacDonald KP, Kuns RD, Rowe V, Morris ES, Banovic T, Bofinger H et al. Effector and regulatory T-cell function is differentially regulated by RelB within antigen-presenting cells during GVHD. Blood 2007; 109: 5049–5057.

    CAS  PubMed  Google Scholar 

  67. Murray SE, Polesso F, Rowe AM, Basak S, Koguchi Y, Toren KG et al. NF-kappaB-inducing kinase plays an essential T cell-intrinsic role in graft-versus-host disease and lethal autoimmunity in mice. J Clin Invest 2011; 121: 4775–4786.

    CAS  PubMed  PubMed Central  Google Scholar 

  68. Shono YTA, Liou H, Atlan-Bonnet G, Tsai J, Smith O, West M et al. Inhibition of c-Rel signaling: A novel small molecule-based therapy diminishing T cell alloactivation while preserving anti-tumor activity. ASH Annual Meeting Abstracts 2012; 120: 454.

    Google Scholar 

  69. Gatza E, Wahl DR, Opipari AW, Sundberg TB, Reddy P, Liu C et al. Manipulating the bioenergetics of alloreactive T cells causes their selective apoptosis and arrests graft-versus-host disease. Sci Transl Med 2011; 3: 67ra8.

    PubMed  PubMed Central  Google Scholar 

  70. Byersdorfer CA, Tkachev V, Opipari AW, Goodell S, Swanson J, Sandquist S et al. Effector T cells require fatty acid metabolism during murine graft-versus-host disease. Blood 2013; 122: 3230–3237.

    CAS  PubMed  PubMed Central  Google Scholar 

  71. Wang M, Medeiros BC, Erba HP, DeAngelo DJ, Giles FJ, Swords RT . Targeting protein neddylation: a novel therapeutic strategy for the treatment of cancer. Expert Opin Ther Targets 2011; 15: 253–264.

    CAS  PubMed  Google Scholar 

  72. Mathewson N, Toubai T, Sun Y, Wang Y, Oravecz-Wilson K, Hou G . Targeting Sag in Donor T Cells As a Novel Strategy for Reducing GVHD. Biol Blood Marrow Transplant 2014; 20: S23.

    Google Scholar 

  73. Koreth J, Stevenson KE, Kim HT, McDonough SM, Bindra B, Armand P et al. Bortezomib-based graft-versus-host disease prophylaxis in HLA-mismatched unrelated donor transplantation. J Clin Oncol 2012; 30: 3202–3208.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Sun K, Welniak LA, Panoskaltsis-Mortari A, O'Shaughnessy MJ, Liu H, Barao I et al. Inhibition of acute graft-versus-host disease with retention of graft-versus-tumor effects by the proteasome inhibitor bortezomib. Proc Natl Acad Sci USA 2004; 101: 8120–8125.

    CAS  PubMed  Google Scholar 

  75. Choi J, Ritchey J, Prior JL, Holt M, Shannon WD, Deych E et al. In vivo administration of hypomethylating agents mitigate graft-versus-host disease without sacrificing graft-versus-leukemia. Blood 2010; 116: 129–139.

    CAS  PubMed  PubMed Central  Google Scholar 

  76. de Lima M, Giralt S, Thall PF, de Padua Silva L, Jones RB, Komanduri K et al. Maintenance therapy with low-dose azacitidine after allogeneic hematopoietic stem cell transplantation for recurrent acute myelogenous leukemia or myelodysplastic syndrome: a dose and schedule finding study. Cancer 2010; 116: 5420–5431.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. Goodyear OC, Dennis M, Jilani NY, Loke J, Siddique S, Ryan G et al. Azacitidine augments expansion of regulatory T cells after allogeneic stem cell transplantation in patients with acute myeloid leukemia (AML). Blood 2012; 119: 3361–3369.

    CAS  PubMed  Google Scholar 

  78. Reddy P, Sun Y, Toubai T, Duran-Struuck R, Clouthier SG, Weisiger E et al. Histone deacetylase inhibition modulates indoleamine 2,3-dioxygenase-dependent DC functions and regulates experimental graft-versus-host disease in mice. J Clin Invest 2008; 118: 2562–2573.

    CAS  PubMed  PubMed Central  Google Scholar 

  79. Jasperson LK, Bucher C, Panoskaltsis-Mortari A, Mellor AL, Munn DH, Blazar BR . Inducing the tryptophan catabolic pathway, indoleamine 2,3-dioxygenase (IDO), for suppression of graft-versus-host disease (GVHD) lethality. Blood 2009; 114: 5062–5070.

    PubMed  PubMed Central  Google Scholar 

  80. Wang D, Iclozan C, Liu C, Xia C, Anasetti C, Yu XZ . LBH589 enhances T cell activation in vivo and accelerates graft-versus-host disease in mice. Biol Blood Marrow Transplant 2012; 18: 1182–90 e1.

    CAS  PubMed  PubMed Central  Google Scholar 

  81. Choi SW, Braun T, Chang L, Ferrara JL, Pawarode A, Magenau JM et al. Vorinostat plus tacrolimus and mycophenolate to prevent graft-versus-host disease after related-donor reduced-intensity conditioning allogeneic haemopoietic stem-cell transplantation: a phase 1/2 trial. Lancet Oncol 2014; 15: 87–95.

    CAS  PubMed  Google Scholar 

  82. He S, Wang J, Kato K, Xie F, Varambally S, Mineishi S et al. Inhibition of histone methylation arrests ongoing graft-versus-host disease in mice by selectively inducing apoptosis of alloreactive effector T cells. Blood 2012; 119: 1274–1282.

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Ranganathan P, Heaphy CE, Costinean S, Stauffer N, Na C, Hamadani M et al. Regulation of acute graft-versus-host disease by microRNA-155. Blood 2012; 119: 4786–4797.

    CAS  PubMed  PubMed Central  Google Scholar 

  84. Sun Y, Varambally S, Maher CA, Cao Q, Chockley P, Toubai T et al. Targeting of microRNA-142-3p in dendritic cells regulates endotoxin-induced mortality. Blood 2011; 117: 6172–6183.

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Sun Y, Oravecz-Wilson K, Saunders T, Wang Y, Toubai T, Mathewson N . Atypical E2F Dependent Dysregulation Of Cell Cycling By Microrna-142 Regulates T-Cell Responses and Experimental Graft-Versus-Host Disease. ASH Annual Meeting Abstracts 2013; 122: 136.

    Google Scholar 

  86. Sun Y, Tawara I, Zhao M, Qin ZS, Toubai T, Mathewson N et al. Allogeneic T cell responses are regulated by a specific miRNA-mRNA network. J Clin Invest 2013; 123: 4739–4754.

    CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported by grants from the National Institutes of Health: AI-075284, HL-090775, and CA-173878 (PR); and ASBMT New Investigator Award (JM).

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Magenau, J., Reddy, P. Next generation treatment of acute graft-versus-host disease. Leukemia 28, 2283–2291 (2014). https://doi.org/10.1038/leu.2014.195

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