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Blood, 15 July 2007, Vol. 110, No. 2, pp. 776-782.
Prepublished online as a Blood First Edition Paper on March 15, 2007; DOI 10.1182/blood-2006-08-043612.


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Submitted August 25, 2006
Accepted March 9, 2007

Costimulatory molecule-targeted immunotherapy of cutaneous graft-versus-host disease

Juyang Kim, Hye J Kim, Keunhee Park, Jiyoung Kim, Hye-Jeong Choi, Hideo Yagita, Seok H Nam, Hong R Cho, and Byungsuk Kwon*

Department of Biological Science, University of Ulsan, Ulsan, Korea, Republic of
Department of Pathology, Ulsan University Hospital, Ulsan, Korea, Republic of
Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
Department of Biological Science, Ajou University, Suwon, Korea, Republic of
Department of Surgery & Biomedical Research Center, Ulsan University Hospital, Ulsan, Korea, Republic of

* Corresponding author; email: bkwon{at}mail.ulsan.ac.kr.

Chronic graft-versus-host disease (cGVHD) is an increasingly frequent complication of allogeneic stem cell transplantation. Current therapies for cGVHD reduce symptoms but are not cures. The B10.D2->Balb/c (H-2d) minor histocompatibility antigen-mismatched model, which reflects clinical and pathological symptoms of human cGVHD, was used in this study. We demonstrated that a single injection of an agonistic monoclonal antibody (mAb) against CD137, a member of the tumor necrosis factor receptor superfamily, reverses skin fibrosis, ulceration and alopecia, a dominant feature of cGVHD (cutaneous GVHD), ultimately improving general health conditions. The reversal is associated with markedly reduced CD4+ T cell cytokines and increased apoptosis of donor CD4+ T cells. The Fas pathway is required for ameliorating cutaneous GVHD by anti-CD137 mAb. Taken together, these data indicate that the anti-CD137 mAb has a therapeutic effect on cutaneous GVHD by removing donor CD4+ T cells that cause cutaneous GVHD. Thus, our study demonstrates an agonistic mAb, specific for a costimulatory molecule, as a possible target for therapeutic intervention in cutaneous GVHD.


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