Recent advances in ocular graft-versus-host disease

Abstract

Ocular graft-versus-host-disease (GVHD) remains a significant clinical complication after allogeneic hematopoietic stem cell transplantation. Impaired visual function, pain, and other symptoms severely affect affected individuals’ quality of life. However, the diagnosis of and therapy for ocular GVHD involve a multidisciplinary approach and remain challenging for both hematologists and ophthalmologists, as there are no unified international criteria. Through an exploration of the complex pathogenesis of ocular GVHD, this review comprehensively summarizes the pathogenic mechanism, related tear biomarkers, and clinical characteristics of this disease. Novel therapies based on the mechanisms are also discussed to provide insights into the ocular GVHD treatment.

A Novel Murine Model for Lupus-Like Ocular Chronic Graft-Versus-Host Disease

“…Considering the susceptibility of the conjunctiva to inflammation caused by cGVHD, we also examined alterations in conjunctival tissues in our experimental model. 11 First, H&E staining of the conjunctiva revealed the presence of vacuolization in goblet cells and a decrease in cell count ( Fig. 5 A), which was further confirmed by PAS staining ( Figs.…”

“… 6 These ocular manifestations primarily include conjunctivitis, dry eye disease (DED), meibomian gland dysfunction, keratitis, corneal ulcers, and corneal vascularization. 7 Similar to the pathogenesis of cGVHD damaging other organ systems, T lymphocyte infiltration-derived immunoinflammatory cascade plays a vital role in damaging ocular tissues, including the lacrimal gland, 8 conjunctiva, 9 meibomian gland, 10 cornea, 11 , 12 retina, and optic nerve. 13 The current clinical treatments include artificial tears, corticosteroids, nonspecific immunosuppressants, or surgical interventions with unsatisfactory outcomes.…”

Ophthalmic Manifestations in Patients with Blood Malignancies

“…Recent evidence suggests that recruited fibroblasts may either derive from circulating donor-derived precursors or may arise from local epithelial to mesenchymal transition [ 73 , 74 ]. Regardless of their source, the accumulation of abnormal collagen fibers and extracellular matrix components by fibroblasts results in the fibrosis of the glandular interstitium [ 5 , 75 ]. These alterations ultimately result in lacrimal gland dysfunction, with consequent aqueous deficient dry eye.…”

Unlocking protein-based biomarker potential for graft-versus-host disease following allogenic hematopoietic stem cell transplants

“…Ocular symptoms of GVHD can include dry eyes, redness, and sensitivity to light. Oral symptoms of GVHD can manifest as painful mouth sores and difficulty in swallowing (80). Gastrointestinal GVHD may lead to diarrhea, abdominal pain, and even malabsorption.…”