SALIVARY GLANDS INVOLVEMENT IN GRAFT VERSUS HOST DISEASE: Biochemical and proteomic analysis.

Abstract

The graft-versus-host disease (GVHD) is a complication that occurs after allogeneic bone marrow transplantation, T-cell mediated graft attacking the cells and tissues of the recipient, including the oral mucosa and salivary glands in a inflammatory process, and may trigger a restriction of mouth opening. Cytokines, such as interleukin 18 (IL-18) are involved in the activation of cytotoxic T cells and natural killer (NK) cells, causing the lesions in salivary glands and exhibit cell death with characteristics of lymphocyte infiltration leading to apoptosis by granzyme and perforin. Similar inflammatory process is found in patients with a previous diagnosis of oral lichen planus. It is known that salivary gland secretory units after being affected by the GVHD do not recover its functional status and the presence of inflammatory infiltrate can be an important factor in the fibrosis of salivary gland and other tissues. There is evidence of a significant reduction in salivary flow in patients with GVHD, major changes in salivary proteomics (IgA, lysozyme, lactoferrin, ²-2 microglobulin) and polymorphisms that modify the synthesis of proteins that must be considered for the evolution of the patient. Consequently patients have reduced salivary flow with variable loss of glandular secretory units, compromising the quality of life and the results of transplantation. The involvement of the salivary glands and oral GVHD will be investigated, contributing to the early diagnosis and management of these patients the clinical, biochemical and proteomic salivary glands are shown as an approach for better understanding of GVHD, in their interventions and therapy for these patients. (AU)