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December 2020

Longitudinal tracking of skin dynamic stiffness to quantify evolution of sclerosis in chronic graft-versus-host disease: a preliminary study

Authors: Laura X.Baker 1, 2, Fuyao Chen 1, 2, 3, 4, Yvette Ssempijja 1, 2, 5, Michael Byrne 6, Tae Kon Kim 6, Arved Vain 7, Madan Jagasia 8, & Eric R.Tkaczyk 1, 2, 3, 6

Affiliations:

Dermatology Service and Research Service, Department of Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
Vanderbilt Dermatology Translational Research Clinic, Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
Medical Scientist Training Program, Yale School of Medicine, New Haven, CT, USA
Meharry Medical College, Nashville, TN, USA
Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
University of Tartu Institute of Physics, Tartu, Estonia
Nashville, TN, USA

Journal: Nature - Bone Marrow Transplantation - December 2020, Volume 56, Pages 989-991 (DOI: 10.1038/s41409-020-01158-w)

Field & Applications:

Sclerotic chronic graft-versus-host disease (cGVHD) appears in 20% of cGVHD patients within 3 years of transplant [1]. Skin sclerosis severely impairs quality of life and responds slowly to therapy [1]. The current gold standard for grading cGVHD sclerosis, the NIH skin score, is coarse and subjective [2], motivating calls for more reproducible measures [3].

The Myoton is a handheld device (Fig. S1) that extracts soft tissue biomechanical parameters through a brief mechanical impulse [4]. Previously, we reported that sclerotic cGVHD patients and healthy controls have significant differences in dynamic stiffness measurements [5]. However, whether changes in dynamic stiffness correspond to clinical perception of skin cGVHD response to treatment has not been assessed.

In this study, we evaluated the Myoton’s ability to numerically monitor sclerosis over time and correlated these measurements with clinical disease progression and response.

We provide one of the largest longitudinal quantitative studies of sclerotic cGVHD to date.

Dynamic stiffness, measured longitudinally with the MyotonPRO, is able to identify clinically important changes in disease.

This preliminary study encourages the use of Myoton for tracking the clinical course of sclerotic cGVHD. A larger study with longer follow-up and standardized measurement protocol is necessary to assess the accuracy of skin biomechanical measurements as a longitudinal biomarker. Eventually, this method could complement the qualitative maneuvers that clinicians currently perform to assess sclerosis and enhance clinical disease management.

FULL ARTICLE

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