Protein dysregulation in graft versus host disease

// Liren Qian 1 , Delia Dima 2 , Cristian Berce 3 , Yu Liu 1 , Ioana Rus 3 , Lajos-Zsolt Raduly 2 , Yi Liu 1 , Bobe Petrushev 3 , Ioana Berindan-Neagoe 3 , Alexandru Irimie 3 , Alina Tanase 4 , Ancuta Jurj 3 , Jianliang Shen 1 and Ciprian Tomuleasa 2, 3 1 Department of Hematology, Navy General Hospital, Beijing, PR China 2 Department of Hematology, Ion Chiricuta Oncology Institute, Cluj Napoca, Romania 3 Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania 4 Department of Stem Cell Transplantation, Fundeni Clinical Institute, Bucharest, Romania Correspondence to: Ciprian Tomuleasa, email: Ciprian.Tomuleasa@umfcluj.ro Liren Qian, email: qlr2007@126.com Keywords: allogeneic stem cell transplantation; biomarkers; proteins; graft versus host disease; exosomes Received: September 28, 2017     Accepted: December 05, 2017     Published: December 15, 2017 ABSTRACT Allogeneic hematopoietic stem cell transplantation is a well-established treatment for many malignant and non-malignant hematological disorders. As a frequent complication in up to 50% of all patients, graft-versus-host disease is still the main cause for morbidity and non-relapse mortality. Diagnosis is usually done clinically, even though confirmation by pathology is often used to support the clinical findings. Effective treatment requires intensified immunosuppression as early as possible. Although several promising biomarkers have been proposed for an early diagnosis, no internationally-recognized consensus has yet been established. Protein-based biomarkers represent an interesting tool since they have been recently reported to be an important regulator of various cells, including immune cells such as T cells. Therefore, we assume that protein dysregulation is important in the pathogenesis of acute graft versus host disease and their detection might be an possibility in the early diagnosis and monitoring. In this review, we aim to summarize the previous reports of protein biomarkers, focusing on the pathogenesis of the disease and possible implications in diagnostic approaches.