Abstract

Graft-versus-host disease (GVHD) remains one of the major complications after allogeneic bone marrow transplantation (allo-BMT). Acute GVHD (aGVHD) is distinguished by uncontrolled activation, migration, and proliferation of allogeneic donor T cells, as well as their production of pro-inflammatory cytokines in GVHD target organs. This study aimed to investigate the role of sirtuin-1 (sirt-1) in mediating GVHD and the relation between the activity of sirt-1 in T cells and the incidence of GVHD. This two-arm exploratory study was conducted at Ain Shams University over a period of six months. It included patients aged 18 to 65 years of both sexes who had undergone allogeneic stem cell transplantation and were admitted to the hospital with symptoms of acute or chronic GVHD. The study showed significantly elevated serum Sirt-1 levels in GVHD positive patients, supporting its role in GVHD pathogenesis. A cutoff >15.8 provided 73.3% sensitivity and 93.3% specificity for distinguishing GVHD. In conclusion, this study demonstrated that serum Sirt-1 levels are significantly elevated in patients with GVHD following allogeneic hematopoietic stem cell transplantation, highlighting its potential as a diagnostic biomarker with high specificity.

Keywords: Sirtuin-1, GVHD, HSCT.

Date received: 02 October 2025; accepted: 22 January 2026

PMID:
41966634