Title:The Role of Intestinal Microbiota in Graft versus Host Disease
Volume: 16
Issue: 3
Author(s): Muna Qayed and John T. Horan
Affiliation:
Keywords:
Allogeneic hematopoietic stem cell transplantation, graft versus host disease, gut micriobiota, Lactobacillus,
Rifaximin.
Abstract: Graft versus host disease (GVHD) remains a major life threatening complication and one of the primary
barriers to successful allogeneic hematopoietic stem cell transplantation, limiting its application in nonmalignant
conditions. Immunosuppression is used for prevention and treatment of GVHD, dampening the graft versus leukemia
effect. Intestinal bacteria play a major role in inflammation and augmenting the GVHD cytokine response. Early studies in
murine models showed that manipulating the presence of intestinal flora or counteracting its byproducts could limit
GVHD. Thus multiple clinical trials targeting gut decontamination were conducted, with the aims of modulating
inflammation and protecting against GVHD, with mixed results. More recent work has improved our understanding of the
role of intestinal microbiota in the maintenance of innate immunity, mucosal integrity and limiting inflammation. This
review offers a summary of this data, with a discussion of potential therapeutic interventions manipulating the intestinal
microbiota.
