Bin Obaid, M.S. (2024) Myxovirus resistance protein-A as a potential diagnostic biomarker for cutaneous graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. thesis, Medicine.
Full text available on request.Abstract
Background: The incidence of graft-versus-host disease (GvHD) has risen with the increased use of allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially in elderly patients with hematological diseases. The clinical and histological complexity of cutaneous GvHD complicates diagnosis using current methods. Its similarity to other skin disorders, such as viral exanthema or cutaneous drug eruptions, makes it challenging to distinguish. This study aims to investigate the cutaneous myxovirus resistance protein-A (MxA) expression as a potential histological biomarker of GvHD. Since INF-I might play a role in the pathogenesis of cutaneous GvHD, upregulation of MxA in cells is a biomarker of increased INF-I expression, which can be used to distinguish cutaneous GvHD from its clinical imitators. Materials and methods: This is a retrospective cross-sectional study of fifty skin biopsies from patients with allo-HSCT who had cutaneous GvHD, ten with lichenoid drug eruption, and eight with viral exanthema. MxA expression was scored for various skin structures: epidermis, endothelium, adnexa, fibroblasts, and infiltrates. Kruskal-Wallis H and Mann- Whitney U tests were used to compare MxA expression between cutaneous GvHD, lichenoid drug eruption, and viral exanthema with a P value of (0.017) considered significant. Results: MxA expression was positive in all cutaneous GvHD skin structures; there was no significant difference between grades (P value= 0.157); however, a trend for MxA to be more expressed in higher grades was seen. MxA was also strongly expressed in lichenoid drug eruption biopsies, while viral exanthema had a lower MxA expression. Statistical analysis showed a significant difference in expression between GvHD and viral exanthema (p= 0.001). Conclusion: MxA is strongly expressed in cutaneous GvHD; however, it is not a useful biomarker since it is also expressed in lichenoid drug eruptions. Furthermore, MxA showed a trend in expression in higher grades of cutaneous GvHD, which implies that INF-I plays a substantial function in cutaneous GvHD. Although MxA can aid in diagnosing GvHD, it should be combined with other histological markers to ensure an accurate diagnosis. Therefore, further studies with a larger sample size could validate these results. Keywords: Allogeneic hematopoietic stem cell transplantation, Graft-versus-host disease, Differential diagnosis, Myxovirus resistance protein A (MxA) and Interferon -I
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Diercks, Gilles |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Sep 2024 11:03 |
| Last Modified: | 02 Sep 2024 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3748 |
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