Correlation between tear IgE levels and HLA-DR expression by conjunctival cells in allergic and nonallergic chronic conjunctivitis
Correlation between tear IgE levels and HLA-DR expression by conjunctival cells in allergic and nonallergic chronic conjunctivitis
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DOI：
10.1007/s004170000179
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发表时间：
2000-11-01
影响因子：
2.7
通讯作者：
Goguel, A
中科院分区：
文献类型：
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作者：
Baudouin, C;Bourcier, T;Goguel, A
背景：慢性结膜炎症性疾病可能取决于多种机制。区分过敏和非特异性炎症对于诊断和治疗变得非常重要。我们通过比较两种客观的生物学工具——结膜上皮的泪液 IgE 和 HLA-DR 表达来研究结膜炎症反应。分别作为 Th2 和 Th1 子集激活的间接指标。方法：采用 ELISA 技术对 82 名慢性结膜炎患者进行泪液 IgE 检测，并定量印迹细胞学标本中 HLA-DR 的表达。 42 人有直接或间接的过敏机制临床症状，26 人患有慢性结膜炎，但没有任何过敏迹象，14 人患有孤立性非过敏性干眼症。结果：临床上认为过敏的患者仅在 84 只眼睛中的 47 只（56%）中显示出 IgE 阳性，而非特异性结膜炎和干眼症患者中分别有 21% 和 25% 的 IgE 呈阳性。过敏组的 IgE 水平显着高于其他两组。分别有 28.5%、48% 和 50% 的眼睛上皮细胞中 HLA-DR 呈阳性。上皮细胞的 HLA-DR 表达与泪液 IgE 呈负相关，因为大多数标本对一项标准呈阳性，而对另一项则呈阴性（49 只眼 DR+、IgE-；47 只眼 DR-、IgE+；只有 9 只眼对两项标准均呈阳性；卡方：P=0.0001）。结论：由于 IgE 合成和 HLA-DR 诱导可能代表 Th2 和 Th1 亚群激活的间接指标，因此这两个简单测试的关联对于炎症性眼表疾病机制的常规评估可能很有趣。
Background: Chronic conjunctival inflammatory diseases may depend upon various mechanisms. Discriminating allergy from nonspecific inflammation has become of striking importance for diagnosis and treatment. We investigated conjunctival inflammatory response by comparing two objective biological tools, tear IgE and HLA-DR expression by conjunctival epithelium. as indirect indicators of activation of the Th2 and Th1 subsets, respectively. Methods: Eighty-two patients with chronic conjunctivitis underwent tear IgE measurement by an ELISA technique and quantitation of HLA-DR expression in impression cytology specimens. Forty-two had direct or indirect clinical indications of allergic mechanisms, 26 had chronic conjunctivitis without any sign of allergy, and 14 suffered from isolated nonallergic dry eyes. Results: Patients clinically considered as allergic only showed positive IgE in 47 of 84 eyes (56%), whereas 21% and 25% of eyes with nonspecific conjunctivitis and dry eyes respectively were also positive. IgE levels were significantly higher in the allergic group than in the other two groups. HLA-DR positivity in epithelial cells was found in 28.5%, 48% and 50% of eyes, respectively. HLA-DR expression by epithelial cells was negatively correlated with tear IgE, as most specimens positive to one criterion were negative to the other one (49 eyes DR+, IgE-; 47 eyes DR-, IgE+; only 9 eyes positive to both criteria; chi-square: P=0.0001). Conclusion: As IgE synthesis and HLA-DR induction may represent indirect indicators of the activation of the Th2 and Th1 subsets, association of these two simple tests could be interesting for the routine assessment of the mechanisms of inflammatory ocular surface diseases.