MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness

IntroductionApproximately 50% of allogeneic hematopoietic stem cell transplantation (HSCT) Q6 recipients develop graft versus host disease (GVHD). Glucocorticoids (GC) are the first line of treatment for both acute and chronic GVHD. Failure to respond to GC [steroid-refractory (SR)] encompasses a ve...

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Main Authors: Aviran Aharon, Batia Avni, Daniel Louzoun, Shlomo Elias, Polina Stepensky, Ron Ram, Tsila Zuckerman, Roberto Meza-Romero, Arthur A. Vandenbark, Sigal Grisariu, Gil Benedek
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Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1504976/full
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author Aviran Aharon
Batia Avni
Daniel Louzoun
Shlomo Elias
Polina Stepensky
Ron Ram
Tsila Zuckerman
Tsila Zuckerman
Roberto Meza-Romero
Roberto Meza-Romero
Arthur A. Vandenbark
Arthur A. Vandenbark
Arthur A. Vandenbark
Sigal Grisariu
Gil Benedek
Gil Benedek
author_facet Aviran Aharon
Batia Avni
Daniel Louzoun
Shlomo Elias
Polina Stepensky
Ron Ram
Tsila Zuckerman
Tsila Zuckerman
Roberto Meza-Romero
Roberto Meza-Romero
Arthur A. Vandenbark
Arthur A. Vandenbark
Arthur A. Vandenbark
Sigal Grisariu
Gil Benedek
Gil Benedek
author_sort Aviran Aharon
collection DOAJ
description IntroductionApproximately 50% of allogeneic hematopoietic stem cell transplantation (HSCT) Q6 recipients develop graft versus host disease (GVHD). Glucocorticoids (GC) are the first line of treatment for both acute and chronic GVHD. Failure to respond to GC [steroid-refractory (SR)] encompasses a very poor outcome with high mortality. Macrophage migration inhibitory factor (MIF) is released during transplantation and triggers enhanced and prolonged immune reactions. Persistently elevated levels of MIF have been shown to override both endogenous and exogenous antiinflammatory effects of GC.MethodsTwo functional polymorphisms in the MIF gene, a −794 CATT5–8 microsatellite repeat and a −173 G/C single-nucleotide polymorphism, were analyzed in 86 patients who underwent allogeneic HSCT. We also measured MIF serum levels at different time points before and after HSCT.ResultsFrequencies of MIF high-expression -794 CATT7 containing genotypes were increased in patients with grade III-IV acute GVHD (aGVHD) (36.8%) compared with patients that did not develop aGVHD (5.8%) and patients with grade II aGVHD (0%), (p=0.0019, 0.0080 respectively). We also demonstrated that the frequencies of the MIF-794 CATT7 and -173 C containing genotypes, were significantly associated with steroid-refractory aGVHD (46.6%, 60% respectively) compared to steroid-responsive aGVHD (0%, 5.3% respectively), (p=0.0011, P=0.0007 respectively). We further showed that MIF circulating levels preceded onset of severe aGVHD.DiscussionOur findings suggest that genetically controlled high expression MIF genotypes are associated with aGVHD worsening and could serve as a biomarker enhancing identification and treatment of steroid-refractory disease.
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spelling doaj-art-e851ad72d299403ea89a40ebe0b244d42025-08-20T03:52:47ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-04-011610.3389/fimmu.2025.15049761504976MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractorinessAviran Aharon0Batia Avni1Daniel Louzoun2Shlomo Elias3Polina Stepensky4Ron Ram5Tsila Zuckerman6Tsila Zuckerman7Roberto Meza-Romero8Roberto Meza-Romero9Arthur A. Vandenbark10Arthur A. Vandenbark11Arthur A. Vandenbark12Sigal Grisariu13Gil Benedek14Gil Benedek15Hebrew University-Hadassah Faculty of Medicine, Jerusalem, IsraelDepartment of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, IsraelHebrew University-Hadassah Faculty of Medicine, Jerusalem, IsraelDepartment of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, IsraelDepartment of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, IsraelBone Marrow Transplantation and Cellular Therapy Unit, Tel Aviv Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, IsraelThe Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, IsraelDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesNeuroimmunology Research, VA Portland Health Care System, Portland, OR, United StatesDepartment of Neurology, Oregon Health & Science University, Portland, OR, United StatesNeuroimmunology Research, VA Portland Health Care System, Portland, OR, United StatesDepartment of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, OR, United StatesDepartment of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, IsraelHebrew University-Hadassah Faculty of Medicine, Jerusalem, IsraelTissue Typing and Immunogenetics Unit, Department of Genetics, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelIntroductionApproximately 50% of allogeneic hematopoietic stem cell transplantation (HSCT) Q6 recipients develop graft versus host disease (GVHD). Glucocorticoids (GC) are the first line of treatment for both acute and chronic GVHD. Failure to respond to GC [steroid-refractory (SR)] encompasses a very poor outcome with high mortality. Macrophage migration inhibitory factor (MIF) is released during transplantation and triggers enhanced and prolonged immune reactions. Persistently elevated levels of MIF have been shown to override both endogenous and exogenous antiinflammatory effects of GC.MethodsTwo functional polymorphisms in the MIF gene, a −794 CATT5–8 microsatellite repeat and a −173 G/C single-nucleotide polymorphism, were analyzed in 86 patients who underwent allogeneic HSCT. We also measured MIF serum levels at different time points before and after HSCT.ResultsFrequencies of MIF high-expression -794 CATT7 containing genotypes were increased in patients with grade III-IV acute GVHD (aGVHD) (36.8%) compared with patients that did not develop aGVHD (5.8%) and patients with grade II aGVHD (0%), (p=0.0019, 0.0080 respectively). We also demonstrated that the frequencies of the MIF-794 CATT7 and -173 C containing genotypes, were significantly associated with steroid-refractory aGVHD (46.6%, 60% respectively) compared to steroid-responsive aGVHD (0%, 5.3% respectively), (p=0.0011, P=0.0007 respectively). We further showed that MIF circulating levels preceded onset of severe aGVHD.DiscussionOur findings suggest that genetically controlled high expression MIF genotypes are associated with aGVHD worsening and could serve as a biomarker enhancing identification and treatment of steroid-refractory disease. https://www.frontiersin.org/articles/10.3389/fimmu.2025.1504976/fullMIFacute GVHDsteroid-refractoryHSCTpolymorphism
spellingShingle Aviran Aharon
Batia Avni
Daniel Louzoun
Shlomo Elias
Polina Stepensky
Ron Ram
Tsila Zuckerman
Tsila Zuckerman
Roberto Meza-Romero
Roberto Meza-Romero
Arthur A. Vandenbark
Arthur A. Vandenbark
Arthur A. Vandenbark
Sigal Grisariu
Gil Benedek
Gil Benedek
MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
Frontiers in Immunology
MIF
acute GVHD
steroid-refractory
HSCT
polymorphism
title MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
title_full MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
title_fullStr MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
title_full_unstemmed MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
title_short MIF functional polymorphisms are associated with acute GVHD progression and steroid-refractoriness
title_sort mif functional polymorphisms are associated with acute gvhd progression and steroid refractoriness
topic MIF
acute GVHD
steroid-refractory
HSCT
polymorphism
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1504976/full
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