Abstract
Purpose :
To date no biomarker exists to predict the development of ocular Graft versus Host Disease (GvHD) after allogenic hematopoietic stem cell transplantation. We evaluated the potential of tear proteins as biomarkers in ocular GvHD in a prospective observational clinical study.
Methods :
Tear fluid of 10 patients with ocular GvHD were compared to healthy individuals. Tryptic digests from Schirmer strips were analysed on an Orbitrap mass analyzer in triplicate. Clinical examinations included slit lamp examination, fluorescein staining, Schirmers test, break-up-time (BUT) and a quality of life questionnaire (OSDI). Outcome measures were the differences and consistency of proteins in human tear fluid between patients with ocular GvHD and healthy individuals.
Results :
306 different proteins with different cellular functions were found. 172 of these were significantly up- or downregulated in ocular GvHD. The main three significantly upregulated proteins were serum albumin (ratio 214.0), cluster of keratin (ratio 191.5) and cluster of pyruvate kinase (ratio 142.3). Top three downregulated proteins in ocular GvHD were lactotransferrin (ratio 0.007), proline-rich protein (ratio 0.01) and prolactin-inducible protein (ratio 0.014).
Conclusions :
Different groups of proteins were found to be up- or downregulated in ocular GvHD. Increased levels of albumin may indicate a disturbed integrity of ocular surface and leakage of conjunctival capillaries. Lacrimal proline-rich protein and prolactin-inducible protein have been known to be downregulated in dry eye disease. To evaluate the proteins found as potential biomarkers more detailed studies are now necessary with more participants, different subgroups and longitudinal analysis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.