Aberrant HLA-DR expression in the conjunctival epithelium after autologous serum treatment in patients with graft-versus-host disease or Sjögren's syndrome.

Katerina Jirsova,Ivana Rybickova,Gabriela Mahelkova,Petra Seidler Stangova,Sarka Kalasova,Michalis Palos,Viera Vesela,Tor Paaske Utheim

doi:10.1371/journal.pone.0231473

Katerina Jirsova, Ivana Rybickova + Show 6 more

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https://doi.org/10.1371/journal.pone.0231473

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Abstract

The aim of this study was to determine the effect of autologous serum (AS) eye drops on the density of human leucocyte antigen (HLA)-DR-positive epithelial cells and Langerhans cells on the ocular surface of patients with bilateral severe dry eye disease (DED) due to graft-versus-host disease (GvHD) or Sjögren's syndrome (SS). The study was conducted on 24 patients (48 eyes). AS was applied 6-10 times daily for 3 months together with regular artificial tear therapy. HLA-DR-positive cells were detected by direct immunocytochemistry on upper bulbar conjunctiva imprints obtained before and after treatment. The application of AS drops led to a statistically significant increase in the mean density of aberrant HLA-DR-positive conjunctival epithelial cells (p < 0.05) and HLA-DR-positive Langerhans cells (p < 0.05) in the GvHD group. Aberrant HLA-DR-positive epithelial cells in the SS group were decreased non-significantly. All patients reported a significant decrease in the Ocular Surface Disease Index (p < 0.01), which indicates improvement of the patient's subjective feelings after therapy. There was an expected but non-significant decrease of aberrant HLA-DR-positive conjunctival epithelial cells in the SS group only. However, the increased density of HLA-DR-positive cells, indicating slight subclinical inflammation, does not outweigh the positive effect of AS in patients with DED from GvHD.

Highlights

Autologous serum (AS) or allogeneic serum eye drops can be profitably used in the treatment of dry eye of various etiologies, including graft-versus-host disease (GvHD) and Sjogren’s syndrome (SS), both frequent causes of dry eye disease (DED). [1,2,3,4,5]
Severe DED was defined by the following inclusion criteria: Schirmer test I (ST I) < 5 mm, tear film breakup time < 5 seconds, and subjective symptoms in the Dry Eye Severity Level adopted by the Dry Eye Workshop Committee
The overall difference for all patients was not statistically significant (p = 0.244); Autologous serum influences human leucocyte antigen (HLA)-DR expression the interaction between the phase of the study and the diagnosis group was statistically near significant (p = 0.056)

Summary

Introduction

Autologous serum (AS) or allogeneic serum eye drops can be profitably used in the treatment of dry eye of various etiologies, including graft-versus-host disease (GvHD) and Sjogren’s syndrome (SS), both frequent causes of dry eye disease (DED). Autologous serum (AS) or allogeneic serum eye drops can be profitably used in the treatment of dry eye of various etiologies, including graft-versus-host disease (GvHD) and Sjogren’s syndrome (SS), both frequent causes of dry eye disease (DED). [1,2,3,4,5]

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