1. Immune Reconstitution after Allogeneic Hematopoietic Stem Cell Transplantation: Time To T Up the Thymus.
- Author
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Chaudhry, Mohammed S., Velardi, Enrico, Malard, Florent, and van den Brink, Marcel R. M.
- Subjects
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HEMATOPOIETIC stem cell transplantation , *T cells , *ADRENOCORTICAL hormones , *GRAFT versus host disease , *KERATINOCYTE growth factors , *INTERLEUKIN-7 , *INTERLEUKIN-22 , *THERAPEUTICS - Abstract
The success of allogeneic hematopoietic stem cell transplantation, a key treatment for many disorders, is intertwined with T cell immune reconstitution. The thymus plays a key role post allogeneic hematopoietic stem cell transplantation in the generation of a broad but selftolerant T cell repertoire, but it is exquisitely sensitive to a range of insults during the transplant period, including conditioning regimens, corticosteroids, infections, and graft-versus-host disease. Although endogenous thymic repair is possible it is often suboptimal, and there is a need to develop exogenous strategies to help regenerate the thymus. Therapies currently in clinical trials in the transplant setting include keratinocyte growth factor, cytokines (IL-7 and IL-22), and hormonal modulation including sex steroid inhibition and growth hormone administration. Such regenerative strategies may ultimately enable the thymus to play as prominent a role after transplant as it once did in early childhood, allowing a more complete restoration of the T cell compartment. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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