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Grading of minor salivary gland immuno-histopathology post-allogenic hematopoietic cell transplantation

Tollemar, V. (författare)
Karolinska Institutet
Arvidsson, H. (författare)
Karolinska Institutet
Häbel, H. (författare)
Karolinska Institutet
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Tudzarovski, N. (författare)
Karolinska Institutet
Legert, K. Garming (författare)
Karolinska Institutet
Le Blanc, K. (författare)
Karolinska Institutet
Warfvinge, Gunnar (författare)
Malmö universitet,Odontologiska fakulteten (OD)
Sugars, R. V. (författare)
Karolinska Institutet
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 (creator_code:org_t)
Cell Press, 2023
2023
Engelska.
Ingår i: Heliyon. - : Cell Press. - 2405-8440. ; 9:4
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Objectives: The oral cavity commonly displays mucosal lichenoid lesions and salivary gland dysfunction, which are considered different chronic Graft-versus-Host Disease (cGVHD) patho-physiology's. However, diagnostics of salivary gland (sg-)cGVHD are limited. The objectives of the current study are to evaluate the minor salivary gland (MSG) histo-immunopathological profiles post allogenic hematopoietic cell transplantation based on sg-cGVHD criteria. Design: Histopathology was characterized according to two published grading strategies. Firstly, the National Institute of Health (NIH) assessed peri-ductal/acinar infiltration, exocytosis, damage, and fibrosis, and a points-based grading scheme was established (0-16 points, Grade (G) 0 to IV). Second, a modified Sjo center dot gren's Syndrome focus-score with parenchymal damage was also adapted, (0-10 points, Score 0 to 2). 146 MSG biopsies from 79 patients were compared, using the his-topathological specific criteria for sg-cGVHD pathology. Quantitative immunohistochemistry for T-cells (CD4, CD8), B-cells (CD19, CD20), monocytic cells (CD68) and dendritic cells (CD1a) were also assessed. Results: The large-scale cohort validated the use of both grading schemes. GIII-GIV and score 2 signified a histopathological diagnosis of "likely" sg-cGVHD. Immunopathological severity was associated with increased T-cells (CD4 and CD8) and monocytic (CD68) infiltrate, with minimal involvement of B-cells (CD19 and CD20), and Langerhans cells (CD1a). Conclu-sions: Both schemes were verified as being suitable for histological grading to improve assess-ment and diagnosis of sg-cGVHD. The NIH cGVHD grading appears to be more beneficial for research purposes, including final diagnostics of "no/inactive", "possible" or "likely" cGVHD. The study highlights the intricacies of sg-cGVHD pathology; and the need for standardized assessment to improve patient management associated to sg-cGVHD.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

Nyckelord

Oral cGVHD
Histopathology
Grading
Large cohort
Hematopoietic cell transplantation

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