Advances in the treatment of graft-versus-host disease with immunomodulatory cells

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been widely used to treat hematological malignancies and genetic diseases. Graft-versus-host disease (GVHD) induced by donor immune system is the most common complication, contributing to severe morbidity and mortality after allo-HSCT. Currently, in terms of the prevention and treatment of GVHD, the major first-line therapeutic drugs are corticosteroids. However, most patients with systemic corticosteroid treatment are prone to steroid-refractory and poor prognosis. The use of several immune cells including Tregs, Bregs and mesenchymal stromal cells (MSCs) as an alternative on prevention or therapy of GVHD has been demonstrated to be beneficial. However, there are still many defects to a certain degree. Based on immune cells, it is promising to develop new and better approaches to improve GVHD. In this article, we will review the current advance of immune cells (Tregs, Bregs, MSCs) with negative regulation in the treatment of GVHD and present emerging strategies for the prevention and treatment of GVHD by other immune regulatory cells and chimeric antigen receptor (CAR) Tregs. In addition, these new therapeutic options need to be further evaluated in well-designed prospective multicenter trials to determine the optimal treatment for GVHD patients and improve their prognosis.

Automated summary

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is commonly used to treat hematological malignancies and genetic diseases, with graft-versus-host disease (GVHD) being a common complication leading to severe morbidity and mortality. Current first-line therapeutic drugs for GVHD prevention and treatment are corticosteroids, but a significant number of patients develop steroid-refractory GVHD with poor prognosis. Various immune cells, such as Tregs, Bregs, and mesenchymal stromal cells (MSCs), have shown benefit in GVHD prevention and therapy, but further research is needed to optimize treatment strategies and improve patient prognosis.