Potential Novel Biomarkers in Chronic Graft-Versus-Host Disease

Area of Science:

• Hematology
• Immunology
• Biomarker Discovery

Background:

• Chronic graft-versus-host disease (cGvHD) is a significant risk following allogeneic hematopoietic stem cell transplantation.
• There is an urgent need for reliable prognostic, diagnostic, and predictive biomarkers for cGvHD.
• Current assessment relies on widely accepted molecular and cellular markers, necessitating exploration of novel avenues.

Purpose of the Study:

• To identify potential novel biomarkers for cGvHD beyond established markers.
• To review emerging areas including cellular biomarkers, alloantibodies, glycomics, endothelial particles, extracellular vesicles, microbiome, and epigenetic/neurologic changes.
• To assess their potential for diagnosis, prognosis, and prediction of outcomes in cGvHD.

Main Methods:

• Systematic review of literature on cGvHD biomarkers.
• Focus on non-traditional sources such as alloantibodies, glycomic profiles, microbiome alterations, and epigenetic modifications.
• Analysis of host-reactive antibodies, IgG glycans, microRNAs, DNA methylation, bacterial strains, and microbial metabolites.

Main Results:

• Alloantibodies and specific IgG glycan patterns show promise as predictive/stratification biomarkers for cGvHD.
• Epigenetic changes (microRNAs, DNA methylation) may serve as monitoring biomarkers and therapeutic targets.
• Microbiome alterations and metabolites are implicated in cGvHD pathophysiology and could indicate dysbiosis and risk.

Conclusions:

• While no validated biomarkers are currently available for clinical cGvHD assessment, several novel sources show significant promise.
• Further investigation in well-characterized, multi-center patient cohorts is warranted.
• These emerging biomarkers could improve the diagnosis, prognosis, and prediction of outcomes for cGvHD patients.