Pathophysiology of gastrointestinal acute graft-versus-host disease and the potential role of glucagon-like peptide 2
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Pathophysiology of gastrointestinal acute graft-versus-host disease and the potential role of glucagon-like peptide 2. / Zeiser, Robert; Chen, Yi-Bin; Youssef, Nader N; Ayuk, Francis.
In: BRIT J HAEMATOL, Vol. 201, No. 4, 05.2023, p. 620-627.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Pathophysiology of gastrointestinal acute graft-versus-host disease and the potential role of glucagon-like peptide 2
AU - Zeiser, Robert
AU - Chen, Yi-Bin
AU - Youssef, Nader N
AU - Ayuk, Francis
N1 - © 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
PY - 2023/5
Y1 - 2023/5
N2 - Acute graft-versus-host disease (aGVHD) is a life-threatening complication after allogeneic haematopoietic cell transplantation, with gastrointestinal (GI) tract involvement (GI aGVHD) being one of the leading causes of morbidity and mortality. Whilst systemic steroids are the standard first-line treatment for aGVHD, approximately 50% of patients become steroid refractory (SR), which is associated with poor outcomes. Existing options for SR-GVHD are limited, and there is a significant unmet need for new non-immunosuppressive treatment approaches in patients with GI aGVHD. Here, we review newer concepts in the pathogenesis of GI aGVHD and present the evidence for the role of glucagon-like peptide 2 (GLP-2) in maintaining and protecting GI epithelial cells, including the enterocytes, intestinal stem cells and Paneth cells, which are direct targets of aGVHD. Finally, we discuss the therapeutic rationale for GLP-2 treatment as a tissue regeneration approach and the potential use of the novel GLP-2 analogue apraglutide as an adjunctive treatment for GI aGVHD.
AB - Acute graft-versus-host disease (aGVHD) is a life-threatening complication after allogeneic haematopoietic cell transplantation, with gastrointestinal (GI) tract involvement (GI aGVHD) being one of the leading causes of morbidity and mortality. Whilst systemic steroids are the standard first-line treatment for aGVHD, approximately 50% of patients become steroid refractory (SR), which is associated with poor outcomes. Existing options for SR-GVHD are limited, and there is a significant unmet need for new non-immunosuppressive treatment approaches in patients with GI aGVHD. Here, we review newer concepts in the pathogenesis of GI aGVHD and present the evidence for the role of glucagon-like peptide 2 (GLP-2) in maintaining and protecting GI epithelial cells, including the enterocytes, intestinal stem cells and Paneth cells, which are direct targets of aGVHD. Finally, we discuss the therapeutic rationale for GLP-2 treatment as a tissue regeneration approach and the potential use of the novel GLP-2 analogue apraglutide as an adjunctive treatment for GI aGVHD.
KW - Humans
KW - Glucagon-Like Peptide 2/therapeutic use
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Steroids/therapeutic use
KW - Transplantation, Homologous/adverse effects
KW - Graft vs Host Disease/drug therapy
KW - Acute Disease
U2 - 10.1111/bjh.18778
DO - 10.1111/bjh.18778
M3 - SCORING: Review article
C2 - 36965050
VL - 201
SP - 620
EP - 627
JO - BRIT J HAEMATOL
JF - BRIT J HAEMATOL
SN - 0007-1048
IS - 4
ER -
