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Grading of minor salivary gland immuno-histopathology post-allogenic hematopoietic cell transplantation
Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden..
Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden..
Karolinska Inst, Dept Learning Informat Management & Ethics, Med Stat Unit, Stockholm, Sweden..
Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden..
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2023 (English)In: Heliyon, E-ISSN 2405-8440, Vol. 9, no 4, article id e15517Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Cell Press, 2023. Vol. 9, no 4, article id e15517
Keywords [en]
Oral cGVHD, Histopathology, Grading, Large cohort, Hematopoietic cell transplantation
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-61857DOI: 10.1016/j.heliyon.2023.e15517ISI: 000999086300001PubMedID: 37128306Scopus ID: 2-s2.0-85152651367OAI: oai:DiVA.org:mau-61857DiVA, id: diva2:1788090
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2025-06-04Bibliographically approved

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Warfvinge, Gunnar

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