Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2016.
Chronic graft-versus-host disease (cGVHD) is a common life threatening complication of allogeneic stem cell transplant (SCT). Although the pathophysiology of cGVHD is theorized to involve donor-derived adaptive T-cell responses, there has been limited translation of this understanding to biomarkers that aid in the diagnosis and management of cGVHD. Biomarkers will assist in diagnosis of cGVHD which is currently based on clinical symptoms and corroborated by histopathology. Biomarkers will also be instrumental in the early diagnosis of cGVHD and perhaps prior to the development of disease manifestations. Chronic GVHD can be described as an allo-mediated, autoimmune-like phenomenon involving cytokines and resultant cellular responses. Helper T-cells are known to play a role in some autoimmune diseases that share clinical features of cGVHD, specifically, Th1, Th2, Th17 and regulatory T-cells. The immune events that contribute to the development of cGVHD are presumed to occur early after SCT. The results of this study include that these four helper T-cell populations were rare at 60 days after SCT when measured by standard procedures for flow cytometry and single subtype surface markers, thus limiting our ability to explore related cytokine relative gene expression utilizing standard polymerase chain reaction technology. Our findings further highlight the need for research directed toward cGVHD pathophysiology and biomarker discovery.