Assessment of tear and blood cytokines in chronic ocular graft-versus-host disease

Abstract

Aims To assess cytokine levels in peripheral blood and tears of patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Methods We reviewed the data of patients who underwent allo-HSCT between October 2020 and August 2021. The patients were divided into chronic ocular graft-versus-host disease (coGVHD) and non-coGVHD groups. The corneal fluorescein staining (CFS) scores, fluorescein tear film break-up time (BUT), Schirmer I test (SIT) scores and Ocular Surface Disease Index (OSDI) scores were collected. The peripheral blood and tear were collected and the cytokine (IL-4, IL-6, IL-8, IL-10, IL-17, IL-2, TNF-α, TNF-β, IFN-γ, ICAM-1, Fas, Fas ligand, SOD1, SOD2 and MMP9) levels detected. The cytokine levels between the two groups and the relationship between blood and tear cytokine levels were analysed. Results Thirty-four patients were enrolled in the study, 19 of whom were diagnosed with coGVHD. The CFS scores of the coGVHD group were significantly higher than the non-coGVHD group, and the BUT and SIT in the coGVHD group were significantly lower than the non-coGVHD groups. No differences were found in the cytokines in the blood between the two groups, but the levels of cytokines in the tears of coGVHD patients were significantly higher than those in the tears of non-coGVHD patients. No significant linear correlation was detected between cytokines in blood and tears. Conclusion Cytokines related to inflammation, oxidative stress and apoptosis were highly expressed in the tears of coGVHD patients, but not in peripheral blood, which highlights the significance of regular ophthalmologic examination and local treatment in GVHD patients. Data are available upon reasonable request.