Method: A prospective study was carried out with patients undergoing allogeneic hematopoietic stem cell transplantation. Unstimulated saliva was collected over 5 minutes at three time points (before transplant, 8-10 days after transplant and 80-100 days after transplant) and clinical data was collected from medical records. BPIFA2 expression was analyzed by western blotting and quantified by densitometry. The results were statistically analyzed (ANOVA, Tukey’s, p<0.05).
Result: Thirty-six patients were included in this study, (mean age 42.6 years). Prior to transplant salivary flow rate was normal in 16 patients (44.4%) and 20 patients (55.6%) had at least one clinical sign of hyposalivation. At 8-10 days post-HSCT salivary flow rate was normal in 22 patients (61.1%), and 14 patients (38.9%) had clinical signs of hyposalivation. At the final collection point the salivary flow rate was similar to that at pre-transplant with 16 patients having (44.4%) normal flow rate and 20 patients (55.6%) having clinical signs of hyposalivation. Seventeen (47.2%) patients were diagnosed with cGVHD. Post-transplant BPIFA2 expression was reduced in patients presenting with mucositis (p=0.16) but this reduction was not significant when compared with that of GVHD patients (p=0.29).
Conclusion: The present study suggests that changes in BPIFA2 expression in patients undergoing HSCT are associated with the development of potentially debilitating oral side effects. BPIFA2 could therefore proof to be a useful biomarker enabling earlier intervention and the prevention of severe mucosal disease.