Histological features of the nasal mucosa in patients undergoing allogenetic hematopoietic hematopoetic stem cell transplantation with and without graft versus host disease / Caracterização histopatlologica da mucosa nasossinual em pacientes transplantados de celulas tronco hematopoieticas (TCTH) sem e com doença do enxerto contra o hospeiro (DECH)

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Immunosuppression is the leading cause of recurrent sinus infections following Hematopoietic Stem Cell Transplantation (HSCT) with increased incidence of sinusitis in patients with chronic graft versus host disease (GVHD) following HSCT. Histological descriptions of the oral mucosa, lung ciliary epithelium and intestinal mucosa related to HSCT and GVHD have been described. However, we sought to verify the histological and ultra structural aspects of nasal mucosa in patients following HSCT with and without GVHD in order to better understand the pathophysiology of the immune response. The uncinate processes from 24 HSCT (19 with GVHD, 5 without) patients were subjected to histological analyses via light and transmission electron microscopy (TEM). TEM revealed altered cilia structure, mitochondria quantity, microvilli, cytoplasm vacuolization. All HSCT patients with rhinosinusitis had significant loss or absence of cilia (P=0.018). Apoptotic bodies were increased and Goblet cells decreased in nasal epithelium from patients with chronic GVHD (P=0.04).This tissue destruction would facilitate the bacterial and viral penetration and may result in a recurrence or exacerbation of the infection.

ASSUNTO(S)

mucosa nasal sinusite anasal mucosa sinusitis graft vs host disease transplante de celulas-tronco hematopoeticas doença enxerto-hospedeiro hematopoietic stem cell transplantation

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