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T. Inaba, Y. Ogawa, S. Shinmura, M. Tadaki, Y. Kawakami, K. Tsubota; A Role of Macrophages in the Lacrimal Gland Inflammation of Patient With Chronic Graft versus Host Disease. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2387.
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Activation of T cells and fibroblasts in the lacrimal gland of patients with chronic graft-versus-host disease (cGVHD) results in severe dry eye. Moreover, the inflammation in the lacrimal gland is due to the interaction among blood vessels, inflammatory cells and the lacrimal gland epithelia. This research focused on investigating the role of macrophages in the lacrimal gland pathology of patients with cGVHD.
Lacrimal gland specimens were obtained from 9 patients who had presented dry eye as part of their symptoms of cGVHD, and compared with 5 Sjogren’s Syndrome (SS) lacrimal gland as controls. To evaluate lacrimal gland pathology, we performed immunohistchemical and electron microscopic analyses. CD68 was used as a marker of macrophages. HLA-DR, CD40, CD80, and CD86 were used as a marker of antigen presentating cells. In addition, the interaction among blood vessels, inflammatory cells and the lacrimal gland epithelia was examined.
Many CD68 positive infiltrating cells were observed in the early phase of the inflammation of the GVHD lacrimal gland compared with the SS lacrimal gland. HLA-DR and CD86 positive cells were detected around the blood vessels and ducts from patients with cGVHD, whereas the expression of HLA-DR and CD86 was mainly on lacrimal gland epithelia in SS controls. Under electron microscopic observation, macrophages, fibroblasts, plasma cells, and lymphocytes interacted each other around the ducts and the capillaries in cGVHD lacrimal gland where T cells and fibroblasts activate.
The macrophages infiltrated around the ducts and the capillaries in the early stage GVHD lacrimal gland. The results suggest that the activation of the macrophage is the key role on the early phase of the inflammation in lacrimal gland from patients with cGVHD.
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