Immune reconstitution after allogeneic hematopoietic stem cell transplantation: Time to T up the thymus Review uri icon

Overview

MeSH Major

  • Hematopoietic Stem Cell Transplantation
  • Regeneration
  • Thymus Gland

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 self-tolerant 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.

publication date

  • January 2017

Research

keywords

  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.4049/jimmunol.1601100

PubMed ID

  • 27994167

Additional Document Info

start page

  • 40

end page

  • 46

volume

  • 198

number

  • 1