Ocular Graft-vs-Host Disease Treatment Affects Tear Cytokine Levels

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Topical treatments for the condition significantly alter tear interleukin levels.

Topical ocular graft-vs-host disease (oGVHD) treatment significantly alters tear interleukin (IL)-6 and IL-8 levels, according to results of a study published in Cornea.

Patients (N=80) with immunosuppressive treatment-naïve chronic oGVHD were recruited at 2 centers in China. At baseline and at 1 month after receiving topical treatment, patients were evaluated by the Ocular Surface Disease Index (OSDI) questionnaire, for tear break-up time (TBUT), tear cytokine concentrations, corneal fluorescein staining (CFS) score, and best-corrected visual acuity (BCVA). Treatment comprised immunosuppression, lubrication, and tear evaporation control strategies.

The study took into account 48 responders and 32 nonresponders (aged mean 29.04±15.75 and 25.69±13.97 years, 54.2% and 50.0% women, respectively). Within the 2 cohorts, 20.8% from the responder group and 37.5% from the nonresponder had acute myelogenous leukemia, 20.8% and 31.3% had acute lymphoblastic leukemia, 41.7% and 18.8% had myelodysplastic syndrome, 16.7% and 6.2% had aplastic anemia, 0% and 6.2% had plasma cell leukemia, 45.9% and 37.5% received stem cells from haploidentical donors, 41.6% and 56.2% had identical donors, and 12.5% and 6.3% had nonidentical donors, respectively.

At baseline, responders and nonresponders differed significantly for CFS scores (mean, 10.5 vs 5.0; P =.0002).

Compared with baseline, responders had significant improvements in CFS score (mean, 10.5 vs 2.5 points; P <.0001), National Institutes of Health eye score (mean, 2.0 vs 1.5; P =.0001), BCVA (mean, 0.40 vs 0.26 logMAR; P =.0005), TBUT (mean, 2.0 vs 3.0 s; P =.0044), and OSDI score (mean, 33.8 vs 24.3 points; P =.0116). Nonresponders did not have improvements to any measure (all P ≥.0781).

Similarly, responders had significant decreases in tear IL-6 (mean, 134.6 vs 42.1 pg/mL; P =.031) and IL-8 (mean, 4205 vs 1808 pg/mL; P =.037) concentrations after treatment. No changes were observed for the nonresponders (all P ≥.083). In nonresponders, the concentrations of IL-8 (mean, 1490 vs 1906 pg/mL) and intercellular cell adhesion molecule-1 (mean, 22,965 vs 23,179 pg/mL) increased numerically.

This study was likely limited by its modest sample size.

These data indicated that response to treatment for oGVHD, tear IL-6 and IL-8 levels may be important for successful treatment response. Additional study is needed to evaluate the importance of tear cytokine levels in oGVHD.


Ma J, Shen Z, Peng R, et al. Tear cytokines associated with therapeutic effects in chronic ocular graft-versus-host disease. Cornea. Published online July 5, 2022. doi:10.1097/ICO.0000000000003081