Distribution of conjunctival HLA-DR expression and the pathogenesis of damage in early dry eyes
Distribution of conjunctival HLA-DR expression and the pathogenesis of damage in early dry eyes
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DOI：
10.1097/01.ico.0000157421.93522.00
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发表时间：
2005-11-01
期刊：
影响因子：
2.8
通讯作者：
Calabria, G
中科院分区：
文献类型：
--
作者：
Rolando, M;Barabino, S;Calabria, G
目的：检查HLA-DR的表达，炎症的标志物，在干眼病的早期阶段，并找到这个标志物的外观上的特定区域的the bulbar conjunctiva.Methods：干眼症患者被确定和他们的条件分类为轻度（n = 16）或中度（n = 16）的基础上，Schirmer测试，活体染色，泪膜破裂时间，和症状问卷评分。采用刷式细胞学从患者和年龄匹配的对照组的鼻、颞和上级结膜收集上皮细胞。结果：中度干眼症患者结膜HLA-DR阳性细胞率最高，无论在哪个部位，均显著高于对照组（P < 0.01）;轻度干眼症组与对照组相比，上级结膜区域的HLA-DR阳性细胞比率相似。鼻、颞区HLA-DR阳性细胞率显著高于对照组（P < 0.01），鼻区与颞区比较差异有显著性（P < 0.01）。这些轻度干眼症的一些没有重要的staining.Conclusions：HLA-DR表达模式在轻度和中度干眼症似乎反映疾病的进展。轻度干眼症中HLA-DR的过度表达表明炎症可能是眼表损伤的主要原因。这些数据支持使用免疫调节药物治疗干眼症。
Purpose: To examine the expression of HLA-DR, a marker of inflammation, in the early stages of dry eye disease and to locate the appearance of this marker on specific areas of the bulbar conjunctiva.Methods: Dry eye patients were identified and their condition classified as mild (n = 16) or moderate (n = 16) based on Schirmer testing, vital staining, tear break-up time, and symptom questionnaire scores. Brush cytology was used to collect epithelial cells from the nasal, temporal, and superior conjunctivae of patients and age-matched controls. HLA-DR positive cells were detected by immunohistochemical staining and quantified.Results: Patients with moderate dry eye had the highest rate of conjunctival HLA-DR positive cells, with significantly higher rates than controls regardless of which region of the conjunctiva was sampled (P < 0.01). The mild dry eye group had similar rates of HLA-DR-positive cells in the superior conjunctival region compared with controls. However, in the nasal and temporal regions, they displayed a significantly higher rate of HLA-DR-positive cells than controls (P < 0.01) and the nasal region showed a significant difference (P < 0.01) when compared with the temporal one. Some of these mild dry eyes had no vital staining.Conclusions: The HLA-DR expression pattern in mild and moderate dry eyes appears to reflect disease progression. Overexpression of HLA-DR in mild dry eyes showing no vital staining suggests that inflammation may be a primary cause of ocular surface damage. These data support the use of immunomodulatory drugs in the treatment of dry eye disease.