Umbilical cord blood transplantation and the impact of the CTLA4 genotype on outcomes

Expert Rev Hematol. 2019 Dec;12(12):1089-1094. doi: 10.1080/17474086.2019.1680281. Epub 2019 Oct 30.

Abstract

Background: Umbilical cord blood transplantation is an effective method of curing multiple diseases when there is no donor available for allogeneic hematopoietic stem cell transplantation (AHSCT). It has been recently suggested that polymorphisms in genes affecting antigen presentation could potentially affect cord blood transplantation (CBT) outcomes.Areas covered: In this review, we present the results of the latest studies investigating the link between CTLA4 gene variability and umbilical cord blood transplantation outcomes.Expert opinion: The search for genetic variants that influence the immune response, both innate and adaptive immunity, may lead to more optimal therapies. Promising candidate genes are those that regulate the expression of proteins associated with T-cell activation. Many genetic variants could be therapeutically important, including those related to innate and adaptive immunity, cytokines, chemokines, drug-metabolizing enzymes, drug transporters, and inflammatory enzymes. The development of an algorithm that includes the determination of selected genetic variants could be helpful for an appropriate donor-recipient CBT matching.

Keywords: AHSCT; CBT; CTLA4; GVHD; blood.

Publication types

  • Review

MeSH terms

  • Allografts
  • Antigen Presentation / genetics*
  • CTLA-4 Antigen* / genetics
  • CTLA-4 Antigen* / immunology
  • Cord Blood Stem Cell Transplantation
  • Cytokines / genetics
  • Cytokines / immunology
  • Genotype*
  • Humans
  • Immunity, Innate / genetics*
  • Lymphocyte Activation / genetics*
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / pathology
  • Treatment Outcome

Substances

  • CTLA-4 Antigen
  • CTLA4 protein, human
  • Cytokines