Bidirectional Interactions: Microbiome and Immune System Function in Cutaneous Graft-Versus-Host Disease.
Chronic graft-versus-host disease (cGVHD) of the skin represents a complex immunopathologic process triggered by donor-derived immune cells following allogeneic hematopoietic stem cell transplantation (HSCT). While traditionally understood through the lens of alloimmune activation and fibrotic remodeling, emerging evidence highlights the role of microbial dysbiosis-particularly in the skin microbiome-as both a contributor to and a consequence of disease progression. This review explores the evolving understanding of the microbiome-immune interface in cutaneous GVHD, focusing on how shifts in microbial composition, such as the loss of Staphylococcus epidermidis and the overgrowth of S. aureus, may impair barrier function, promote local immune activation, and potentiate systemic inflammation. Disruption of commensal-derived signals leads to reduced antimicrobial peptide production, diminished regulatory T cell activity, and proinflammatory T cell polarization, all of which contribute to immune-mediated skin damage. A self-reinforcing cycle of barrier dysfunction and microbial imbalance emerges, suggesting new avenues for intervention. We discuss microbiome-targeted therapies including donor-derived skin allografting as potential strategies to restore microbial equilibrium and mitigate inflammation. Additionally, we highlight the diagnostic potential of skin microbiome profiling as a biomarker for disease activity and treatment response. Understanding the bidirectional interactions between the microbiome and immune system may offer novel therapeutic and prognostic tools for managing cutaneous cGVHD.
- # Donor-derived Immune Cells
- # Shifts In Microbial Composition
- # Biomarker For Disease Activity
- # Allogeneic Hematopoietic Stem Cell Transplantation
- # Cutaneous GVHD
- # Impair Barrier Function
- # Hematopoietic Stem Cell Transplantation
- # Fibrotic Remodeling
- # Immune System Function
- # Bidirectional Interactions
- Abstract
- 10.1182/blood.v118.21.2036.2036
- Nov 18, 2011
- Blood
Role of Hematopoietic Stem Cell Transplantation As Salvage Treatment of Acute Promyelocytic Leukemia Initially Treated with All-Trans-Retinoic Acid: A Retrospective Analysis of the Japan Adult Leukemia Study Group (JALSG) APL97 Study
- Discussion
16
- 10.1016/j.bbmt.2010.02.010
- Feb 16, 2010
- Biology of Blood and Marrow Transplantation
Preparing for Growth: Current Capacity and Challenges in Hematopoietic Stem Cell Transplantation Programs
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5
- 10.1016/j.bbmt.2010.11.025
- Dec 30, 2010
- Biology of Blood and Marrow Transplantation
Translational Research Efforts in Biomarkers and Biology of Early Transplant-Related Complications
- Discussion
5
- 10.1111/bjh.17637
- Jun 17, 2021
- British Journal of Haematology
Outcome of relapsed/refractory acute promyelocytic leukaemia in children, adolescents and young adult patients - a 25-year Italian experience.
- Research Article
2
- 10.1097/md.0000000000031786
- Nov 18, 2022
- Medicine
Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.
- Abstract
2
- 10.1182/blood-2021-147542
- Nov 23, 2021
- Blood
Serological Response Following BNT162b2 Anti-Sars-Cov-2 mRNA Vaccination in Hematopoietic Stem Cell Transplantation Patients
- Research Article
1
- 10.1038/s41598-024-65294-9
- Jul 22, 2024
- Scientific Reports
Hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for several malignant and non-malignant hematologic conditions. However, patients undergoing HSCT are at increased risk of developing serious cardiovascular events. Whether cardiovascular risks differ by the type of transplantation strategy used, allogeneic versus autologous HSCT, is unknown. Leveraging the National Inpatient Sample (2016–2019), we assessed the incidence of early cardiovascular events by HSCT mode (allogeneic vs autologous). The primary outcome was the incidence of atrial fibrillation (AF). The secondary outcome was the occurrence of any major adverse cardiac events (MACE), defined as acute heart failure, myocardial infarction (MI), symptomatic atrial or ventricular arrhythmia or heart block, and cardiovascular death. Outcomes were compared between those undergoing allogeneic versus autologous HSCT. Multivariable regression, adjusting for cardiovascular and cancer-related factors, was used to define the association between pre-HSCT factors and MACE. We further assessed the effect of acute cardiovascular events on in-patient mortality by calculating adjusted odds ratio (aOR) with corresponding 95% confidence intervals (CI) and p-values. Overall, 64,705 weighted hospitalizations for HSCT were identified, of which 22,655 (35.0%) were allogeneic HSCT and 42,050 (65.0%) were autologous HSCT. The prevalence of AF was 9.1%, and 12.1% for any arrhythmia. In multivariable regression, allogeneic HSCT was associated with higher adjusted odds of peri-HSCT acute heart failure (aOR 2.64; 1.86–3.76; p < 0.0001), QT prolongation (aOR 1.40; 1.04–1.88; p = 0.025), MI (aOR 2.87; 1.16–7.11; p = 0.023), any major cardiovascular complication (aOR 1.16; 1.03–1.32; p = 0.016), and inpatient mortality (aOR 4.87; 3.60–6.58; p < 0.0001). Following cerebrovascular events, AF was the strongest predictor of mortality. Allogeneic HSCT was associated with higher odds of in-hospital cardiovascular complications among patients undergoing HSCT.
- Abstract
1
- 10.1182/blood.v128.22.5755.5755
- Dec 2, 2016
- Blood
Prophylactic Use of a Combination of an Anticoagulant and Ursodeoxycholic Acid for Sinusoidal Obstruction Syndrome after Allogeneic Myeloablative Hematopoietic Stem Cell Transplantation
- Abstract
3
- 10.1182/blood.v126.23.265.265
- Dec 3, 2015
- Blood
The Impact of Pre-Transplant Depression on Outcomes of Allogeneic and Autologous Hematopoietic Stem Cell Transplantation
- Abstract
- 10.1182/blood.v130.suppl_1.4526.4526
- Jun 25, 2021
- Blood
Hematopoietic Stem Cell Transplantation for Children with Neurological Diseases Improves the Outcomes and Not Leads to Significant Late Effects — Report from Russian Group
- Abstract
5
- 10.1182/blood.v114.22.532.532
- Nov 20, 2009
- Blood
Autologous Hematopoietic Stem Cell Transplantation (HCT) is a Safe and Effective Treatment for Primary Plasma Cell Leukemia: The CIBMTR Experience.
- Research Article
28
- 10.1016/j.bbmt.2011.06.010
- Jun 30, 2011
- Biology of Blood and Marrow Transplantation
EBMT Risk Score Predicts Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Who Have Failed a Previous Transplantation Procedure
- Research Article
7
- 10.1111/j.1365-3148.2009.00927.x
- Sep 4, 2009
- Transfusion Medicine
Severe autoimmune diseases (ADs) are a major source of disability and reduced quality of life and may result in shortened life expectancy, particularly in treatment-resistant patients. For several decades, allogeneic and autologous haematopoietic stem cell transplantation (HSCT) has been the focus of scientific investigation as a potential means of delivering 'one-off' intensive treatment in severe ADs. Improvements in the clinical safety of HCST were followed by its increasing use in recent years as an experimental treatment for severe and resistant ADs. European and North American registries have accumulated between one and two thousand procedures. Retrospective analyses and prospective studies have demonstrated the feasibility, safety and initial efficacy data in various ADs. Profound cell biological changes induced by HSCT leading to stabilization or reversal of organ damage have been characterized. These have also shed light on basic disease mechanisms and support investigation of more specific cellular therapy in ADs. There is clear potential for harnessing a profound immunological effect through HSCT. However, there is a need for an ongoing balance against evolving non-transplant treatments for ADs. Ideally, these issues should be resolved in phase III studies, in which HSCT approaches are compared with the best comparator.
- Research Article
11962
- 008
- Sep 1, 2011
- Archives of Iranian medicine
Acute promyelocytic leukemia is a rare indication for hematopoietic stem cell transplantation. Usually it is indicated as consolidation of salvage regimens following relpase. Here we report our experience with stem cell transplantation in acute promyelocytic leukemia patients. Between 1989 and 2011, we performed 40 hematopoietic stem cell transplantation in first complete remission or relapsed acute promyelocytic leukemia patients. Median age of patients was 23.5 years. Patients received 11 autologous and 29 allogeneic hematopoietic stem cell transplantation from their HLA fully-matched sibling donors. Different conditioning regimens were applied. A total of 24 patients received hematopoietic stem cell transplantation who were in first complete remission and the remainder with a second or more complete remission. Hematopoietic stem cell engraftment was observed in all cases. There were no deaths prior to 100 days after hematopoietic stem cell transplantation. Acute graft versus host disease was mild to moderate in the majority of patients, whereas it was grade III in 4 patients. Chronic graft versus host disease was extensive in 2 cases. With a 4-year median follow up, the relapse rate was 25%. A total of 26 patients are alive. Five year overall survival was 65.5% and 46.8% for allogeneic and autologous hematopoietic stem cell transplantation, respectively. Hematopoietic stem cell transplantation is an acceptable treatment for acute promyelocytic leukemia. Although there is a statistical difference for overall survival between allogeneic or autologous hematopoietic stem cell transplantation, the choice between autologous or allogeneic transplantation needs to have reliable methods for the detection of molecular remission before hematopoietic stem cell transplantation as well as close, reliable follow up of patients with clinical and molecular parameters.
- Research Article
- 10.1182/blood-2025-7150
- Nov 3, 2025
- Blood
The role of hematopoietic stem cell transplantation in peripheral T-cell lymphoma not otherwise specified
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