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B‐CELL‐MEDIATED GRAFT‐VERSUS‐HOST DISEASE IN TRANSPLANTATION

Acute and chronic graft-versus-host disease (GVHD) is mediated by donor T lymphocytes in blood transfusions and allogeneic bone marrow and organ transplants[l]. B lymphocyte function in GVHD is usually described as being impaired, with specific functional deficits against polysaccharide antigens and viral and bacterial agents. However, B lymphocytes are involved in several facets of the graft-versus-host immune response. This review will focus on three areas: (1) passenger-lymphocyte antibodies arising from solid organ grafts against the host’s blood cells; (2) the production of antibodies against blood cells by B cells in bone marrow transplants; and (3) B-cell dysfunction in GVHD, as manifested by high IgE levels in acute GVHD and autoantibodies in chronic GVHD. These are currently clinical problems in transplantation, but may also point the way toward therapeutic transfer of humoral immunity in transplantation.