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Heaven does not depend on what you do for Christ but on what He has done for you. Howeverdonor immune cells may also attack normal host tissue, particularly the skin, liver, and gastro-intestinal tract, resulting in the GVHD reaction [ 1 ]. Furthermore, a major barrier to GVHD research and treatment is that the diagnosis and prognosis rely almost entirely on the presence of clinical symptoms, which are sometimes confirmed by biopsy. Currently, no laboratory tests Mathis tx sex dating in corum to predict the risk of developing GVHD, responsiveness to treatment, or patient survival.
Despite these obstacles, considerable efforts have been made to develop GVHD biomarkers in a way that approaches used for GVHD biomarker discovery can now be consider as examples to follow. The ability to identify patients who will not respond to standard treatment and who are at particularly high risk for subsequent morbidity and mortality could result in personalized treatment plans, such as additional immunosuppressive treatments, that might be more effective if introduced early for high-risk patients. The identification of patients who will respond well to treatment could allow for more rapid tapering of steroid regimens, thereby reducing long-term toxicity and allowing a more robust GVL response in low-risk patients.
The current review provides an update on the different types of biomarkers in the age of omics, the types of samples to be collected with a focus on the pediatric population, omics approaches for the discovery of circulating biomarkers, as well as a summary of successful approaches used to obtain biomarkers for acute GVHD. Biomarkers have been evaluated in both hypothesis-driven and discovery-based testing for specific clinical outcomes. Initially, most biomarkers were identified from mechanistic studies and correlated with a particular outcome. Most recently, several groups have begun exploring omics biosignatures and biomarkers. Biomarkers can be classified into five types: Due to the absence, so far, of studies investigating pharmacodynamic and surrogate markers correlated to GVHD, this review focuses specifically on the first three types of biomarkers, which may have the most significant short-term translational impact Box 1.
Some profiling technologies, such as those involving microRNAs, require relatively large sample volumes that may be a limiting factor in the pediatric population. Noninvasive clinical tests are to be preferred because it allows for repetitive sample collection from the same patient over a short period of time.
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