Original articleIncreased regulatory T cells and eosinophils characterize atopic dermatitis–like graft-versus-host disease compared with lichen planus–like graft-versus-host disease
Section snippets
Study participants
The study enrolled 19 patients with AD-like GVHD, 8 with LP-like GVHD, 24 with AD, and 15 healthy controls. Peripheral blood samples were obtained from all participants for measurement of eosinophils and subpopulations of T cells. Sera were obtained after centrifugation and stored at −80°C before analysis. Skin biopsies were performed in 5 patients with AD-like GVHD, 5 with LP-like GVHD, 6 with AD, and 8 healthy controls. The Peking University People's Hospital Ethics Committee reviewed and
Patient characteristics
The characteristics of patients with cutaneous GVHD are summarized in Table I. Increased peripheral blood eosinophils were found in 36.8% of patients with AD-like GVHD, significantly higher than that of LP-like GVHD (P = .011, Fig 1). Eosinophils were also found in the infiltration of the skin lesions of AD and AD-like GVHD (Fig 1). Elevated total serum immunoglobulin E was found in 63.2% of patients with AD-like GVHD and in 50.0% of patients with LP-like GVHD (data not shown).
Th cells in cutaneous GVHD
Th1 cells were
Discussion
Chronic cutaneous GVHD represents a wide range of clinical manifestations reflecting a spectrum of superficial (lichenoid) and deep (scleroderma-like) cutaneous inflammations. We previously reported AD-like GVHD.5 The clinical features of patients with AD-like GVHD include eczematous lesions, dry skin, and itching. The histopathologic changes of AD-like GVHD include epidermal spongiosis, scattered keratinocyte necrosis, and a sparse perivascular infiltration of lymphocytes and eosinophils.
Conclusion
AD-like GVHD and LP-like GVHD are 2 forms of cutaneous GVHD. This study demonstrated that total serum immunoglobulin E level and Th2 cells were elevated in AD-like GVHD and LP-like GVHD. Although skin barrier functions were impaired in AD-like GVHD and LP-like GVHD, the filaggrin expression was increased in both diseases. Increased eosinophils and Treg cells were found in AD-like GVHD, which might be associated with the favorable outcome of the disease.
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Funding sources: Supported by the National Natural Science Foundation of China (No.81472879) and Peking University People's Hospital Scientific Research Development Funds (RDY2018-19).
Conflicts of interest: None.