Division of Dry-Eye and Ocular GVHD, Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Cluster of Excellence in Aging Research, University of Cologne, Cologne, Germany.
Division of Dry-Eye and Ocular GVHD, Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; ImmunEyez LLC, Irvine, California.
Transplant Cell Ther. 2022 Nov;28(11):782.e1-782.e7. doi: 10.1016/j.jtct.2022.07.027. Epub 2022 Jul 31.
Desiccating stress (DS) is known to induce dry eye disease but has not been studied in the context of ocular graft-versus-host disease (oGVHD). Patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) are exposed to DS on transplantation wards, which are highly climate-regulated for hygienic purposes. Because oGVHD demonstrates features of dry eye disease, this retrospective study aimed to analyze DS as a risk factor for chronic oGVHD. A total of 444 patients undergoing allo-HSCT were investigated with a maximum follow-up of 5.8 years post-transplantation. Relative humidity (%rH) on the transplantation ward was monitored, and data were correlated with the occurrence, severity, and onset of chronic oGVHD, as well as the occurrence of acute skin GVHD. A logistic regression model was used to predict the development of oGVHD. One hundred three of 213 surviving patients developed oGVHD. oGVHD was significantly correlated with a lower %rH (r = .2; P = .03), and more patients (73%) developed oGVHD after transplantation under DS compared with patients after transplantation under high-humidity conditions (30%; P = .02). Reduced humidity increased the relative risk for oGVHD by 4% for each %rH, but it did not affect the severity or time of first diagnosis of oGVHD. In this study, we demonstrate that DS is an independent risk factor for oGVHD. Adjusting air humidity during allo-HSCT has the potential to serve as a preventive measure with clinical relevance.
干燥应激（DS）已知可引起干眼症，但尚未在眼移植物抗宿主病（oGVHD）的背景下进行研究。接受异基因造血干细胞移植（allo-HSCT）的患者在移植病房中接触 DS，这些病房为了卫生目的高度调节气候。由于 oGVHD 表现出干眼症的特征，因此这项回顾性研究旨在分析 DS 作为慢性 oGVHD 的危险因素。共调查了 444 名接受 allo-HSCT 的患者，随访时间最长为移植后 5.8 年。监测移植病房的相对湿度（%rH），并将数据与慢性 oGVHD 的发生、严重程度和发病时间以及急性皮肤 GVHD 的发生相关联。使用逻辑回归模型预测 oGVHD 的发展。在 213 名幸存患者中有 103 名发生了 oGVHD。oGVHD 与较低的 %rH 显著相关（r =.2；P =.03），在 DS 下接受移植的患者中，有 73%的患者发生了 oGVHD，而在高湿度条件下接受移植的患者中，只有 30%的患者发生了 oGVHD（P =.02）。相对湿度每降低 1%，oGVHD 的相对风险增加 4%，但不会影响 oGVHD 的严重程度或首次诊断时间。在这项研究中，我们证明 DS 是 oGVHD 的一个独立危险因素。调整 allo-HSCT 期间的空气湿度有可能成为一种具有临床意义的预防措施。
