Graft-vs.-host reactions: mechanisms and contemporary theories

A graft-vs.-host (GvH) reaction can be initiated by injection of immunocompetent lymphocytes into a histoincompatible host that is unable to reject these cells. The reaction is characterized by splenomegaly, hepatomegaly, lymph node atrophy, body weight loss, dermatitis, and diarrhea, often leading to mortality. The onset and severity of the GvH reaction are determined by differences in histocompatibility antigens between the donor and the acceptor, and by the number and nature of the transplanted allogeneic cells. Many different in vivo and in vitro systems have been devised for experimental studies of the GvH reaction. In several of these models, however, different parameters are measured. Furthermore, the conclusions drawn from these investigations sometimes contradict each other. This paper reviews the experimental data, and discusses the mechanisms underlying the GvH reaction.