Serum Vitamin A Levels May Affect the Severity of Ocular Graft-versus-Host Disease.

Jiefeng Tong,Yingying Zhao,Xiuming Jin,Renjian Hu,Xiaoying Zhao,Yang Xu

doi:10.3389/fmed.2017.00067

Jiefeng Tong, Yingying Zhao + Show 4 more

Open Access

https://doi.org/10.3389/fmed.2017.00067

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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established therapeutic option for a range of inherited and acquired hematological disorders. However, graft-versus-host disease (GVHD) remains the leading cause of non-relapse mortality in allogeneic HSCT recipients. Ocular involvement occurs in up to 80% of chronic GVHD patients. In our cases, the diagnosis of vitamin A deficiency was suspected for GVHD patients. Serum vitamin A measurements were conducted to confirm clinical suspicions. Our study revealed significant decrease in serum levels of vitamin A in chronic liver GVHD patients. Although there have been many studies evaluating ocular manifestations in patients with GVHD, the present study is, to our knowledge, the first to study the relationship between vitamin A and ocular manifestations of GVHD in humans. Our data suggest that vitamin A deficiency affects the severity of ocular GVHD in adults.

Highlights

Graft-versus-host disease (GVHD) is one of the most devastating long-term complications of allogeneic hematopoietic stem cell transplantation (HSCT) [1]
Our results suggest that vitamin A deficiency may affect the severity of ocular GVHD
Innate immune cells and T cells from the donor have been identified in ocular specimens obtained from HSCT recipients, and alloreactive T cells were found predominantly in ocular lesions with Chronic GVHD (cGVHD) [15, 16]

Summary

Introduction

Graft-versus-host disease (GVHD) is one of the most devastating long-term complications of allogeneic hematopoietic stem cell transplantation (HSCT) [1]. Allogeneic HSCT can give rise to GVHD, either in acute or chronic form, which represents the major cause of morbidity and mortality after allogeneic HSCT [3]. Chronic GVHD (cGVHD) is a very common long-term complication that occurs in 25–70% of patients [4]. Unlike acute GVHD that affects mainly skin, liver, and gastrointestinal tract, cGVHD can occur in other sites including eyes, mouth, musculoskeletal system, and lungs [5]. Ocular GVHD may lead to sight-threatening ocular surface complications like corneal ulceration and perforation [7]

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