Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease
Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease
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DOI：
10.1038/sj.bmt.1705900
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发表时间：
2008-02-01
影响因子：
4.8
通讯作者：
Tsubota, K.
中科院分区：
文献类型：
--
作者：
Wang, Y.;Ogawa, Y.;Tsubota, K.
我们研究了0.05%外用环孢素（Cys）对慢性GVHD （cGVHD）干眼患者眼表和泪液功能的影响。招募基线治疗难治性患者15例30只眼，分别分为局部Cys治疗组（7例14只眼）和对照组（6例12只眼）。两名患者在使用局部Cys滴眼液时因无法忍受的刺激而退出。分别在基线和随访1个月时记录视觉模拟量表症状评分、角膜敏感性、Schirmer I试验值、泪膜破裂时间（TBUT）、泪液蒸发率和眼表生命染色评分。治疗前后分别行结膜印模和刷细胞学检查。局部Cys治疗后，症状评分、角膜敏感性、泪液蒸发率、TBUT、生命染色评分、杯状细胞密度、结膜鳞状化生分级、炎症细胞数量和MUC5AC表达均有显著改善。我们的研究表明，0.05%的局部Cys可能是治疗干眼症患者cGVHD的有效方法。眼表和泪液功能的改善可能是炎症减少、杯状细胞密度增加和MUC5AC mRNA表达增加所致。
We investigated the effect of 0.05% topical cyclosporine (Cys) on the ocular surface and tear functions in dry eye patients with chronic GVHD (cGVHD) in a prospective comparative study. Thirty eyes of 15 patients refractory to baseline treatment were recruited and the patients assigned for topical Cys treatment group (14 eyes of 7 patients) and control group (12 eyes of 6 patients) respectively. Two patients dropped out because of intolerable irritation while using topical Cys eye drops. Visual analog scale symptom scores, corneal sensitivity, Schirmer I test value, tear film break-up time (TBUT), tear evaporation rate and ocular surface vital staining scores were recorded at baseline and at the end of the following one month. Conjunctival impression and brush cytology were performed before and after the treatment. After topical Cys treatment, significant improvements were found in symptom scores, corneal sensitivity, tear evaporation rate, TBUT, vital staining scores, goblet cells density, conjunctival squamous metaplasia grade, inflammatory cell numbers and the MUC5AC expression. Our study suggests that 0.05% topical Cys may be an effective treatment for dry eye patients with cGVHD. The improvements in the ocular surface and tear functions resulted presumably from the decreased inflammation, increased goblet cell density and MUC5AC mRNA expression.