Alteration of Meibum Lipidomics Profiling in Patients With Chronic Ocular Graft-Versus-Host Disease

PURPOSE: To investigate the characteristics of the lipid profiling in meibum of patients with chronic ocular graft-versus-host disease (coGVHD) and to detect the potential influence of anti-inflammatory therapy on these differential lipids. METHODS: This cross-sectional study included 25 coGVHD patients and 13 non-coGVHD after allogeneic hematopoietic stem cell transplantation. Among those with coGVHD, 14 had prior topical treatment (coGVHD((T))), and 11 did not (coGVHD((WT))). All participants completed ocular surface disease index questionnaire and received slit lamp examination, Schirmer's test without anesthesia, ocular surface interferometer, and meibography. Binocular meibum was collected and pooled for lipidomic analysis by liquid chromatography–mass spectrometry. RESULTS: One hundred and twenty differential lipid species were found among the three groups (96 of coGVHD((WT)) vs. non-coGVHD, 78 of coGVHD((WT)) vs. coGVHD((T)), and three of non-coGVHD vs. coGVHD((T))). Compared with non-coGVHD group, coGVHD((WT)) group had a significant abnormality of meibum composition, showing a significant decrease in glycerolipids, and an increase in glycerophospholipids and sphingolipids. Similar changes were also observed when coGVHD((WT)) versus coGVHD((T)). CoGVHD severity was negatively associated with mono-unsaturated triglycerides (TG), (β = −214.7; 95% CI, −363.9 to −65.5; P = 0.006) and poly-unsaturated TG (β = −4019.9; 95% CI, −7758.1 to −281.6; P = 0.036). Intensity of immunosuppression was negatively associated with mono-unsaturated TG (β = −162.4; 95% CI, −268.6 to −56.2; P = 0.004) and positively associated with phosphatidylcholine (β = 332.0; 95% CI, 19.2-644.8; P = 0.038). CONCLUSIONS: Altered meibum in coGVHD is characterized by a decrease of glycerolipids and an increase of glycerophospholipids and may be significantly reversed by topical anti-inflammatory therapy.