National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
The Emmes Company, LLC, Rockville, MD, USA.
Bone Marrow Transplant. 2021 Aug;56(8):1850-1858. doi: 10.1038/s41409-021-01254-5. Epub 2021 Mar 8.
This longitudinal cohort study compared ocular surface indicators in forty allogeneic hematopoietic stem cell transplant (HSCT) subjects with twenty healthy controls at baseline and identified changes in ocular graft-versus-host disease (oGVHD). Outcome measures included: Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's test, Oxford corneal staining score, tear break-up time (TBUT), and tear and serum biomarkers (IFN-γ, IL-10, MMP-9, IL-12, IL-13, IL-17α, IL-1β, IL-2, IL-4, IL-6, IL-8, CXCL10, MCP-1, MIP-1α, RANTES, TNF-α). At baseline the HSCT group had higher median Oxford corneal staining score (1.7 vs. 0.0; P < 0.0001), higher tear TNF-α (20.0 vs. 11.2 pg/mL; P < 0.0001), lower tear RANTES (70.4 vs. 190.2 pg/mL; P < 0.0001), higher serum IL-8 (10.2 vs. 4.5 pg/mL; P = 0.0008), and higher serum TNF-α (8.7 vs. 4.2 pg/mL; P < 0.0001). The incidence of oGVHD was 62% and associated changes included increased Oxford corneal staining score (4.6 vs. 1.8, P = 0.0001), decreased Schirmer's test (3.0 vs. 10.0; P < 0.0001), and decreased TBUT (4.7 vs. 9.0 s; P = 0.0004). Baseline differences in ocular surface indicators suggest a tendency toward ocular dryness in individuals with hematologic disorders preparing for HSCT. Individuals who developed oGVHD showed changes in corneal staining score, Schirmer's test, and TBUT.
这项纵向队列研究比较了四十名异基因造血干细胞移植（HSCT）受试者和二十名健康对照者的眼部表面指标，以确定眼部移植物抗宿主病（oGVHD）的变化。结果测量包括：眼表面疾病指数（OSDI）、泪液渗透压、泪液分泌试验、牛津角膜染色评分、泪膜破裂时间（TBUT）和泪液及血清生物标志物（IFN-γ、IL-10、MMP-9、IL-12、IL-13、IL-17α、IL-1β、IL-2、IL-4、IL-6、IL-8、CXCL10、MCP-1、MIP-1α、RANTES、TNF-α）。在基线时，HSCT 组的牛津角膜染色评分较高（1.7 比 0.0；P<0.0001），泪液 TNF-α较高（20.0 比 11.2 pg/mL；P<0.0001），泪液 RANTES 较低（70.4 比 190.2 pg/mL；P<0.0001），血清 IL-8 较高（10.2 比 4.5 pg/mL；P=0.0008），血清 TNF-α 较高（8.7 比 4.2 pg/mL；P<0.0001）。oGVHD 的发生率为 62%，相关变化包括牛津角膜染色评分增加（4.6 比 1.8，P=0.0001），泪液分泌试验减少（3.0 比 10.0；P<0.0001），TBUT 减少（4.7 比 9.0 s；P=0.0004）。眼部表面指标的基线差异表明，准备进行 HSCT 的血液系统疾病患者存在眼部干燥的倾向。发生 oGVHD 的患者角膜染色评分、泪液分泌试验和 TBUT 均发生变化。
