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Blood, 15 December 2007, Vol. 110, No. 13, pp. 4535-4542. Prepublished online as a Blood First Edition Paper on August 16, 2007; DOI 10.1182/blood-2006-10-049817. This Article Full Text (PDF) Supplemental Tables and Figure All Versions of this Article: blood-2006-10-049817v1 110/13/4535    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Luft, T. Articles by Dreger, P. Search for Related Content PubMed PubMed Citation Articles by Luft, T. Articles by Dreger, P. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 13, 2006 Accepted June 26, 2007 Serum cytokeratin-18 fragments as quantitative markers of epithelial apoptosis in liver and intestinal graft-versus-host disease Thomas Luft*, Michael Conzelmann, Axel Benner, Michael Rieger, Michael Hess, Ulrich Strohhaecker, Martin Gorner, Ute Hegenbart, Anthony D. Ho, and Peter Dreger Dept. Medicine V, University of Heidelberg, Heidelberg, Germany Unit Adaptive Immune Regulation, German Cancer Research Center, Heidelberg, Germany Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany * Corresponding author; email: t.luft{at}dkfz.de. Graft-versus-host disease (GvHD) is the main complication of allogeneic stem cell transplantation. However, diagnosis of GvHD and evaluation of response to immuno-suppressive treatment is sometimes difficult. Since apoptosis is the histopathological hallmark in GvHD, we investigated whether active GvHD-induced target organ destruction is mirrored by serum levels of the caspase-cleaved neo-epitope of cytokeratin 18 fragments (CK18F). Serum CK18F kinetics was monitored by M30 antibody-based ELISA in 50 patients who fulfilled histopathological and/or clinical criteria diagnostic for GvHD. Both intestinal and hepatic GvHD were consistently associated with significant elevations of CK18F levels over baseline. Responses of GvHD to immunosuppressive therapy were paralleled by CK18F decreases, whereas resistant GvHD was characterized by persistent CK18F rises. Clinical conditions that might represent relevant differential diagnoses, such as toxic mucositis, non-complicated, infection-related diarrhea and veno-occlusive disease were not associated with CK18F elevations. In conclusion, CK18F monitoring provides a serum marker for quantitative assessment of GvHD-associated apoptotic activity in intestinal and hepatic GvHD. Although apoptosis is not GvHD-specific, CK18F may help to distinguish active GvHD from GvHD-unrelated conditions with similar symptoms, and to monitor response to immunosuppressive treatment. Prospective studies are warranted to evaluate how CK18F may assist in diagnosis, grading, and treatment guidance of GvHD. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Cell biology comes to the bedside Paul J. Martin Blood 2007 110: 4135. [Full Text] [PDF] This article has been cited by other articles: S. Paczesny, O. I. Krijanovski, T. M. Braun, S. W. Choi, S. G. Clouthier, R. Kuick, D. E. Misek, K. R. Cooke, C. L. Kitko, A. Weyand, et al. A biomarker panel for acute graft-versus-host disease Blood, January 8, 2009; 113(2): 273 - 278. [Abstract] [Full Text] [PDF]

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