Intestinal IgA positive plasma cells are highly sensitive indicators of alloreaction early after allogeneic transplantation and associate with both, graft-<i>versus-</i>host disease and relapse related mortality

URN to cite this document:

urn:nbn:de:bvb:355-epub-546528 Copy

DOI to cite this document:

10.5283/epub.54652 Copy

Scheidler, Lucia ; Hippe, Katrin ; Ghimire, Sakhila ; Weber, Daniela ; Weber, Markus ; Meedt, Elisabeth ; Hoffmann, Petra ; Lehn, Petra ; Burkhardt, Ralph ; Mamilos, Andreas ; Edinger, Matthias ; Wolff, Daniel ; Poeck, Hendrik ; Evert, Matthias ; Gessner, André ; Herr, Wolfgang ; Holler, Ernst

License: Creative Commons Attribution Non-commercial 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 29 Aug 2023 15:04

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Details

Item type:	Article
Open Access Type:	Gold (with APC)
Journal or Publication Title:	Haematologica
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
Date:	1 June 2023
Institutions:	Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Medicine > Lehrstuhl für Pathologie Leibniz Institute for Immunotherapy (LIT)
Projects (Historical):	Wilhelm Sander Foundation Grant 2017.020.02, Jose Carreras Leukemia foundation (grant DJCLS 01/GvHD2020), DFG – Projektnummer 324392634, SFB TR221 GvH/GvL.
Identification Number:	Value Type 10.3324/haematol.2022.282188 DOI
Keywords:	MICROBIOME; RECIPIENTS;
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	54652

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Abstract

Intestinal immunoglobulin A (IgA) is strongly involved in microbiota homeostasis. Since microbiota disruption is a major risk factor of acute graft -versus-host disease (GvHD), we addressed the kinetics of intestinal IgA-positive (IgA+) plasma cells by immunohistology in a series of 430 intestinal biopsies obtained at a median of 1,5 months after allogeneic stem cell transplantation (allo-SCT) ...

Abstract

Intestinal immunoglobulin A (IgA) is strongly involved in microbiota homeostasis. Since microbiota disruption is a major risk factor of acute graft -versus-host disease (GvHD), we addressed the kinetics of intestinal IgA-positive (IgA+) plasma cells by immunohistology in a series of 430 intestinal biopsies obtained at a median of 1,5 months after allogeneic stem cell transplantation (allo-SCT) from 115 patients (pts) at our center. IgA+ plasma cells were located in the subepithelial lamina propria and suppressed in the presence of histological aGvHD (GvHD Lerner stage 0: 131+/-8 IgA+ plasma cells/mm2; stage 1-2: 108+/-8 IgA+ plasma cells/mm2; stage 3-4: 89+/-16 IgA+ plasma cells/mm2; P=0.004). Overall, pts with IgA+ plasma cells below median had an increased treatment related mortality (P=0.04). Time courses suggested a gradual recovery of IgA+ plasma cells after day 100 in the absence but not in the presence of GvHD. Vice versa IgA+ plasma cells above median early after allo-SCT were predictive of relapse and relapse-related mortality (RRM): pts with low IgA+ cells had a 15% RRM at 2 and at 5 years, while pts with high IgA+ cells had a 31% RRM at 2 years and more than 46% at 5 years; multivariate analysis indicated high IgA+ plasma cells in biopsies (hazard ratio =2.7; 95% confidence interval: 1.04-7.00) as independent predictors of RRM, whereas Lerner stage and disease stage themselves did not affect RRM. In contrast, IgA serum levels at the time of biopsy were not predictive for RRM. In summary, our data indicate that IgA+ cells are highly sensitive indicators of alloreaction early after allo-SCT showing association with TRM but also allowing prediction of relapse independently from the presence of overt GvHD.

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Metadata last modified: 20 Jan 2025 14:45

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