Corticosteroids in gastrointestinal graft-versus-host disease

Corticosteroid failure is a poor prognostic factor in patients with gastrointestinal graft-versus-host disease (GVHD). In this study, researchers examined the mechanism of action of corticosteroids at the intestinal level. They found that they directly target the intestinal epithelium, potentially aggravating immune-mediated gastrointestinal damage. By administering corticoids to mice and intestinal organoid cultures ex vivo, the researchers observed a reduction in epithelial proliferation. In a mouse model of corticosteroid-refractory GVHD, corticosteroid treatment impaired epithelial regeneration and reduced the frequency of intestinal stem cells. These mechanisms were also observed in organoids.