Intestinal trefoil factor maybe useful in prophylaxis of acute graft-versus-host disease

Abstract

Graft-versus-host disease (GVHD) is a major complication of hematopoietic cell transplantation, GVHD pathophysiology can be divided into three phases, damage to the gastrointestinal (GI) tract in phase 1, principally by inflammatory cytokines, amplifies LPS release and leads to the "cytokine storm" characteristic of severe acute GVHD. It has been proved that disruption of phase 1 of the GVHD cascade is effective in prophylaxis of acute GVHD. Intestinal trefoil factor (ITF), a member of trefoil factor family (TFF) domain peptides, was proved to be very effective in prevention and healing of acute dextran sodium sulfate-induced colitis, and was also involved in protection against and recovery from intestinal mucositis induced by radiation and chemotherapy. So we hypothesise that ITF protects the intestinal tract mucosa from lesions and that it maybe useful in prophylaxis of acute GVHD. ITF can block GI tract damage in phase 1, preventing the amplification of the cascade. ITF may represent a novel strategy for the separation of GVHD and graft-versus-leukemia (GVL), and may serve as an effective adjunct to clinical regimens of GVHD prophylaxis.