Effects of tear hyperosmolarity on conjunctival cells in mild to moderate dry eye
Effects of tear hyperosmolarity on conjunctival cells in mild to moderate dry eye
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DOI：
10.1111/j.1475-1313.2012.00915.x
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发表时间：
2012-07-01
影响因子：
2.9
通讯作者：
Dolores Merindano, Maria
中科院分区：
文献类型：
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作者：
Julio, Gemma;Lluch, Sara;Dolores Merindano, Maria
引文信息：胡里奥·G，卢克·S，Pujol P&Merindano医学博士。泪液高渗对轻中度干眼症患者结膜细胞的影响。眼科生理学选项2012年，32,317323。摘要目的：分析轻、中度干眼症患者泪液高渗对结膜细胞的影响。方法：干眼症患者68例，女性35例，男性33例，平均年龄43岁，年龄20.3岁，年龄1887岁。有严重干眼或任何其他引起眼部炎症的患者被排除在外。根据测量的右眼泪液渗透压界值L 308mOmol-1，将样本分为两组。取颞侧眼睑结膜进行印迹细胞学检查，定量检测杯状细胞密度、胞核直径、胞浆直径和上皮细胞核浆比。还进行了一系列撕裂试验(羊肚菌试验、撕裂时间和Schirmer I试验)，以更全面地描述这些群体并了解这一过程。采用方差分析(ANOVA)建立高渗眼和正常眼的细胞学和泪液差异。计算细胞学变量与泪液渗透压之间的皮尔逊相关系数。结果：泪液渗透压正常组包括干眼症状、12级鳞状上皮化生、泪液阳性征象，范围为0~3级；高渗泪液组包括干眼症状、鳞状化生12级、核直径明显小于对照组(F1、66=4.3，P=0.040)，干眼泪液阳性征象在1~4级之间。两组泪液平均反射分泌量均正常，但高渗泪液组明显低于对照组(F1、66=7.2，P=0.009)。正常泪液渗透压与杯状细胞密度(R33=0.45，p=0.006)、核浆比(R33=-0.44，p=0.009)呈正相关，而高渗泪液组则无相关性。结论：轻度至中度高渗性撕裂可导致结膜细胞核缩小，胞浆直径未见明显增大趋势。泪液渗透压与结膜细胞特性之间的关系似乎只有在泪液渗透压正常组才呈线性关系。这些结果也提供了泪液反射性分泌减少和高渗透压之间的合理联系。
Citation information: Julio G, Lluch S, Pujol P & Merindano MD. Effects of tear hyperosmolarity on conjunctival cells in mild to moderate dry eye. Ophthalmic Physiol Opt 2012, 32, 317323. doi: 10.1111/j.1475-1313.2012.00915.x Abstract Purpose: To analyze the effects of tear hyperosmolarity on conjunctival cells in mild to moderate dry eye. Methods: Sixty-eight subjects (35 females and 33 males, mean age 43, S.D. 20.3, range 1887 years) with symptoms of dry eye were enrolled in the study. Patients with severe dry eye or any other condition that induces ocular inflammation were excluded. The sample was divided into two groups according to the tear osmolarity cut-off value of 308 mOsmol L-1 measured in the right eye of each patient. Impression cytology of the temporal interpalpebral conjunctiva was performed and goblet cell density, nucleus diameter, cytoplasm diameter and nucleus/cytoplasm ratio of epithelial cells quantitatively assessed. A battery of tear tests (ferning test, tear break-up time and Schirmer I test) was also carried out in order to more completely describe the groups and understand the process. Analysis of variance (anova) was applied to establish cytological and tear differences between hyperosmolar and normal tear osmolarity eyes. Pearsons correlation was calculated between the cytological variables and tear osmolarity. Results: The normal tear osmolarity group included patients with symptoms of dry eye, grade 12 of squamous metaplasia, and a number of positive tear signs of dry eye ranging between 0 and 3. The hyperosmolar tear group included patients with symptoms of dry eye, grade 12 of squamous metaplasia with significantly lower values of nucleus diameter (F1,66 = 4.3, p = 0.040), and a number of positive tear signs of dry eye ranging between 1 (hyperosmolar tear) and 4. Mean reflex secretion of tears was clearly normal in both groups but significantly lower (F1,66 = 7.2, p = 0.009) in the hyperosmolar tear group. Significant correlations were established for tear osmolarity and goblet cell density (r33 = 0.45, p = 0.006) and nucleus/cytoplasm ratio (r33 = -0.44, p = 0.009) in the normal tear osmolarity group but not in the hyperosmolar tear group. Conclusions: Mild to moderate hyperosmolar tear conditions seem to lead to an initial reduction of the conjunctival cell nucleus before the cytoplasm diameter showed a clear tendency to enlarge. The relationship between tear osmolarity and conjunctival cell characteristics seems to be linear only in the normal tear osmolarity group. These results also provide a plausible link between lower reflex secretion of tears and hyperosmolarity.