Pericapillary hemorrhage as criterion of severe human digestive graft-versus-host disease

In an experimental model we demonstrated that endothelial cells of all organs are targets of the alloimmune reaction. Here, in 68 digestive biopsies, we found endothelial lesions by immunohistochemistry and ultrastructure in patients with severe acute graft-versus-host disease (GVHD). In contrast, n...

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Bibliographic Details
Published in:Blood 2004-06, Vol.103 (12), p.4681-4684
Main Authors: Ertault-Daneshpouy, Marjan, Leboeuf, Christophe, Lemann, Marc, Bouhidel, Fatiha, Ades, Lionel, Gluckman, Eliane, Socié, Gérard, Janin, Anne
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Biopsy
Bone marrow, stem cells transplantation. Graft versus host reaction
Capillaries
Digestive System Diseases - blood
Digestive System Diseases - diagnosis
Digestive System Diseases - epidemiology
Endothelium, Vascular - pathology
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Hemorrhage - epidemiology
Gastrointestinal Hemorrhage - etiology
Graft vs Host Disease - diagnosis
Graft vs Host Disease - epidemiology
Graft vs Host Disease - pathology
Humans
Medical sciences
Retrospective Studies
Stem Cell Transplantation - adverse effects
Transfusions. Complications. Transfusion reactions. Cell and gene therapy
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Summary:In an experimental model we demonstrated that endothelial cells of all organs are targets of the alloimmune reaction. Here, in 68 digestive biopsies, we found endothelial lesions by immunohistochemistry and ultrastructure in patients with severe acute graft-versus-host disease (GVHD). In contrast, no such endothelial cell alterations were found either in patients without GVHD or in nongrafted controls. In the biopsies with severe GVHD lesions, ultrastructure showed rupture of the capillary basal membrane and extravased red blood cells. These pericapillary hemorrhages were highly correlated with GVHD severity. In a separate cohort of 39 patients who underwent an allogeneic transplantation after a nonmyeloablative conditioning, 8 patients had intestinal biopsies. Three of these latter patients had both severe pathologic lesions of GVHD and similar endothelial lesions, thus, strengthening the concept that endothelial lesions are linked to GVHD severity and not to the intensity of the conditioning regimen. (Blood. 2004;103:4681-4684)
ISSN:0006-4971
1528-0020
DOI:10.1182/blood-2003-05-1548