[Histopathological findings and biomarker analysis in cutaneous graft-versus-host disease ].

J V García Gutiérrez, C González García, B Fleta, I Sánchez-Ortega, P Herrera, A Chinea, J López, L Ramos, R P Ramos, R Duarte, J Odriozola
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Abstract

Graft-versus-host disease (GVHD) remains the greatest source of morbidity-mortality in allogenic transplant patients. Although in most cases the more easily obtainable clinical and laboratory test parameters suffice to confirm the diagnosis and establish the stage of the disease biopsies of the affected organ are sometimes needed. At present there is great Interest in the study of factors allowing a prognosis of the course and type of response to treatment in patients with CVHD. In this sense, It would be necessary to objectively Identify and validate biomarkers capable of predicting biological or pathological processes in patients with cVHD. To this effect we have performed serial analyses of skin tissue using peripheral blood and tissue biomarkers in a prospective observational study conducted in three transplant centers. The still preliminary results Indicate that certain histopathological findings classically attributed to CVHD ore also seen in patients not clinically affected by the disease--this probably being related to other physiopathological phenomena occurring during transplantation. The study of these findings, combined with biomarker analysis, will allow improved understanding of the underlying etiopathogenesis, as well as the definition of new diagnostic, prognostic and response-evaluating criteria.

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[皮肤移植物抗宿主病的组织病理学发现和生物标志物分析]。
移植物抗宿主病(GVHD)仍然是同种异体移植患者发病率和死亡率的最大来源。虽然在大多数情况下,更容易获得的临床和实验室测试参数足以确认诊断和确定疾病的阶段,但有时需要对受影响的器官进行活组织检查。目前有很大的兴趣在研究的因素,允许预后的过程和类型的反应,以治疗的CVHD患者。从这个意义上说,有必要客观地识别和验证能够预测cVHD患者生物学或病理过程的生物标志物。为此,我们在三个移植中心进行了一项前瞻性观察研究,使用外周血和组织生物标志物对皮肤组织进行了一系列分析。初步结果表明,某些通常归因于CVHD的组织病理学结果也见于临床未受该疾病影响的患者,这可能与移植过程中发生的其他生理病理现象有关。对这些发现的研究,结合生物标志物分析,将有助于提高对潜在发病机制的理解,以及对新的诊断、预后和反应评估标准的定义。
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