Comparable meibomian gland changes in patients with and without ocular graft-versus-host disease after hematopoietic stem cell transplantation

Zhao, Wenxin; Yang, Jing; Liao, Yinglin; Lao, Hubert Yuenhei; Huang, Quanbin; Jin, Ling; Sun, Jing; Huang, Fen; Liang, Lingyi

doi:10.1016/j.jtos.2022.04.002

Cited by 5 publications

(3 citation statements)

References 45 publications

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“…After full-text assessment, 15 studies were excluded from this review due to the use of subjective measurements and no quantifiable biomarkers. Of note, five of the papers excluded for this reason looked at Meibomian gland architecture [6][7][8][9][10][11]. While a promising area of research, Meibomian gland dysfunction had no objective means for quantification and was not included in this review.…”

Section: Resultsmentioning

confidence: 99%

Molecular Biomarkers in Ocular Graft-versus-Host Disease: A Systematic Review

Bohlen,

Gomez,

Zhou

et al. 2024

Biomolecules

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Ocular graft-versus-host disease (oGVHD) affects ~50% of post-stem cell transplant patients and is the only form of GVHD diagnosed without a biopsy. As it must be distinguished from other dry eye diseases, there is a need to identify oGVHD biomarkers to improve diagnosis and treatment. We conducted a systematic review of 19 scholarly articles published from 2018 to 2023 including articles focused on adult patients diagnosed with oGVHD following allogeneic hematopoietic stem cell transplant and used biomarkers as the outcome measure. Articles that were not original investigations or were not published in English were excluded. These clinical investigations explored different molecular oGVHD biomarkers and were identified on 3 October 2023 from the Scopus, PubMed, and Embase databases by using search terms including ocular graft-versus-host disease, biomarkers, cytokines, proteomics, genomics, immune response, imaging techniques, and dry-eye-related key terms. The Newcastle–Ottawa scale for case–control studies was used to assess bias. From the 19 articles included, cytokine, proteomic, lipid, and leukocyte profiles were studied in tear film, as well as ocular surface microbiota and fluorescein staining. Our findings suggest that cytokine profiling is the most studied oGVHD biomarker. Additionally, variations correlating these biomarkers with disease state may lead to a more targeted diagnosis and therapeutic approach. Limitations include language bias, publication bias, and sampling bias, as well as a lack of appropriate controls for included studies.

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Section: Resultsmentioning

confidence: 99%

Molecular Biomarkers in Ocular Graft-versus-Host Disease: A Systematic Review

Bohlen,

Gomez,

Zhou

et al. 2024

Biomolecules

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“…Besides, inflammatory cells infiltration and prominent fibrosis in meibomian glands in patients with coGVHD was another remarkable characteristic. 23 The coGVHD-related inflammatory cascade induces massive meibomian gland cell apoptosis, which may cause a reduction in lipid synthesis and TG content. 43 …”

Section: Discussionmentioning

confidence: 99%

“…22 Similarly, we previously reported that there was a dramatic inflammatory cell infiltration within MGs in patients with coGVHD. 23 Therefore, on the background of coGVHD-related chronic inflammation, whether and how meibum lipid metabolism changed remains a puzzle. If so, does anti-inflammatory treatment for coGVHD have any impact on such change?…”

mentioning

confidence: 99%

Alteration of Meibum Lipidomics Profiling in Patients With Chronic Ocular Graft-Versus-Host Disease

Zhao,

Yang,

Liao

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose To investigate the characteristics of the lipid profiling in meibum of patients with chronic ocular graft-versus-host disease (coGVHD) and to detect the potential influence of anti-inflammatory therapy on these differential lipids. Methods This cross-sectional study included 25 coGVHD patients and 13 non-coGVHD after allogeneic hematopoietic stem cell transplantation. Among those with coGVHD, 14 had prior topical treatment (coGVHD (T) ), and 11 did not (coGVHD (WT) ). All participants completed ocular surface disease index questionnaire and received slit lamp examination, Schirmer's test without anesthesia, ocular surface interferometer, and meibography. Binocular meibum was collected and pooled for lipidomic analysis by liquid chromatography–mass spectrometry. Results One hundred and twenty differential lipid species were found among the three groups (96 of coGVHD (WT) vs. non-coGVHD, 78 of coGVHD (WT) vs. coGVHD (T) , and three of non-coGVHD vs. coGVHD (T) ). Compared with non-coGVHD group, coGVHD (WT) group had a significant abnormality of meibum composition, showing a significant decrease in glycerolipids, and an increase in glycerophospholipids and sphingolipids. Similar changes were also observed when coGVHD (WT) versus coGVHD (T) . CoGVHD severity was negatively associated with mono-unsaturated triglycerides (TG), (β = −214.7; 95% CI, −363.9 to −65.5; P = 0.006) and poly-unsaturated TG (β = −4019.9; 95% CI, −7758.1 to −281.6; P = 0.036). Intensity of immunosuppression was negatively associated with mono-unsaturated TG (β = −162.4; 95% CI, −268.6 to −56.2; P = 0.004) and positively associated with phosphatidylcholine (β = 332.0; 95% CI, 19.2-644.8; P = 0.038). Conclusions Altered meibum in coGVHD is characterized by a decrease of glycerolipids and an increase of glycerophospholipids and may be significantly reversed by topical anti-inflammatory therapy.

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