白细胞介素-1β对视网膜色素上皮细胞产生白细胞介素-6的影响

目的观察重组人白细胞介素1β(interleukin1β,IL1β)对培养的视网膜色素上皮(retinalpigmentepithelial,RPE)细胞产生白细胞介素6(interleukin6,IL6)的影响。方法在人RPE细胞的培养液中分别加入终浓度为0μg·L-1、10μg·L-1、50μg·L-1、100μg·L-1、200μg·L-1的重组人IL1β,作用12h、24h、48h后,用酶联免疫吸附实验测定细胞上清液中IL6的质量浓度。结果50μg·L-1IL1β作用于RPE细胞48h内,RPE细胞产生IL6的量随时间延长而增加;在同一作用时间点,RPE细胞产生IL6的量随IL1β浓度的增高而增高。与对照组相比,当IL1β浓度达10μg·L-1时,二者之间即出现显著性差异(P<0.05),当IL1β浓度达100μg·L-1时,RPE细胞产生IL6的量呈平台高峰,不再升高,24h和48h组均有相同趋势。结论重组人IL1β促人RPE细胞分泌IL6在48h内具有时间和浓度依赖性。     

视网膜缺血再灌注损伤大鼠视网膜中白细胞介素-23和白细胞介素-17的表达及意义

目的　通过建立视网膜缺血再灌注损伤（ｒｅｔｉｎａｌｉｓｃｈｅｍｉａ-ｒｅｐｅｒｆｕｓｉｏｎｉｎｊｕｒｙ,ＲＩＲＩ）模型,观察白细胞介素-２３（ｉｎｔｅｒｌｅｕｋｉｎ-２３,ＩＬ-２３）和白细胞介素-１７（ｉｎｔｅｒｌｅｕｋｉｎ-１７,ＩＬ-１７）在Ｓｐｒａｇｕｅ-Ｄａｗｌｅｙ（ＳＤ）大鼠视网膜上的表达,探讨其在ＲＩＲＩ中的可能作用机制。方法　采用随机数字表法将７５只健康无眼疾ＳＤ大鼠随机分为正常对照组和模型组。正常对照组不作任何处理,模型组采用前房灌注生理盐水升高眼压法建立ＲＩＲＩ模型。分别在建模后１２ｈ、２４ｈ、７２ｈ、１４４ｈ处死ＳＤ大鼠,免疫组织化学染色法检测ＩＬ-２３和ＩＬ-１７蛋白在视网膜上的表达及分布情况;Ｗｅｓｔｅｒｎｂｌｏｔ和ＥＬＩＳＡ检测分析各时间点视网膜ＩＬ-２３和ＩＬ-１７的表达水平和变化规律。结果　免疫组织化学染色法显示ＩＬ-２３和ＩＬ-１７蛋白在正常对照组视网膜中表达极少,而在模型组表达明显增多。两者主要表达于视网膜神经节细胞层和内核层细胞的细胞浆。Ｗｅｓｔｅｒｎｂｌｏｔ法检测发现ＩＬ-２３和ＩＬ-１７蛋白在ＲＩＲＩ视网膜中的表达明显增强,ＩＬ-２３蛋白在建模后２４ｈ表达最强,而ＩＬ-１７蛋白在建模后７２ｈ表达达到最高峰。ＥＬＩＳＡ法结果显示建模后１２ｈ、２４ｈ、７２ｈ、１４４ｈ,模型组视网膜ＩＬ-２３和ＩＬ-１７蛋白的表达水平均较正常对照组明显升高,差异均有显著统计学意义（均为Ｐ＜０．０１）。结论　ＩＬ-２３和ＩＬ-１７在ＲＩＲＩ模型ＳＤ大鼠视网膜中表达明显增强,ＩＬ-２３／ＩＬ-１７通路作为致病因素,通过加重视网膜炎症反应参与ＲＩＲＩ的病理损伤。     

Vogt-Koyanagi-Harada综合征患者外周血中白细胞介素6及17的表达

白细胞介素6(IL-6)不仅通过直接与特异的受体结合发挥多种功能,而且可以诱导分泌IL-17的致病性辅助性Th17细胞的分化.它在类风湿性关节炎(RA)、系统性红斑狼疮(SLE)等自身免疫性疾病中发挥着重要作用[1].Vogt-KoyanagiHarada(VKH)综合征病因和发病机制尚不完全清楚,一般认为主要与自身免疫反应有关[2].而IL-6在VKH综合征中的作用目前尚不清楚.为了解IL-6在VKH综合征中的作用,我们应用酶联免疫吸附测定( ELISA)法检测了一组不同时期VKH综合征患者外周血中IL-6和IL-17的含量,并对其意义进行了探讨.现将结果报道如下.     

白细胞介素-33及其受体sST2在分泌性中耳炎中的表达及意义

目的 检测并分析分泌性中耳炎(SOM)患者中耳积液(MEE)中白细胞介素-33(IL-33)及其受体sST2的浓度.方法 采用双抗夹心酶联免疫吸附法检测患者中耳积液中IL-33和sST2的浓度.结果 慢性期组(病程≥3个月)MEE中IL-33含量明显高于急性期组(病程<3个月),差异具有统计学意义(P<0.05).慢性...     

FOXO3和IL-2在干眼患者结膜上皮细胞及泪液中表达及意义

目的:探究叉头框蛋白O3(FOXO3)、白细胞介素-2(IL-2)在干眼(DE)患者结膜上皮细胞及泪液中的表达及意义。方法:前瞻性研究。选择2019-03/2021-03收治的DE患者106例,另选同期85位健康体检者为对照。利用实时荧光定量PCR(qRT-PCR)法检测结膜上皮细胞及泪液中FOXO3水平;酶联免疫吸附(ELISA)法检测样本中IL-2水平;分析DE患者治疗前后的泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)、角膜荧光素染色(CFS)等眼表临床指标变化;Pearson相关性分析DE患者结膜上皮细胞、泪液中FOXO3和IL-2水平的相关性以及二者与临床指标的关系。结果:与对照组相比,DE组患者结膜上皮细胞及泪液中FOXO3水平均明显降低,IL-2水平均明显升高(均P<0.01)。与治疗前相比,DE患者治疗后结膜上皮细胞及泪液中FOXO3水平明显上调,IL-2水平明显下调(均P<0.01)。Pearson相关性分析结果显示,结膜上皮细胞、泪液中FOXO3和IL-2水平均呈显著负相关(r=-0.531、-0.469,均P<0.01)。DE患者治疗后BUT、S...     

LED光源对人视网膜色素上皮细胞分泌单核细胞趋化因子-1和白细胞介素-8的影响

目的　观察ＬＥＤ光源对人视网膜色素上皮（ｒｅｔｉｎａｌｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉａｌｃｅｌｌｓ,ＲＰＥ）细胞增生及分泌单核细胞趋化因子-１（ｍｏｎｏｃｙｔｅｃｈｅｍｏｔａｃｔｉｃｐｒｏｔｅｉｎ-１,ＭＣＰ-１）和白细胞介素-８（ｉｎｔｅｒｌｅｕｋｉｎ-８,ＩＬ-８）的影响。方法　传代培养的ＡＲＰＥ细胞分别置于５００ｌｕｘ、１０００ｌｕｘ的ＬＥＤ白光、蓝光、绿光中分别照射６ｈ、１２ｈ、２４ｈ,并分别设置对照组避光培养。采用ＭＴＴ法检测ＲＰＥ细胞的增生值（Ａ４６０）,分别使用Ｒｅａｌ-ｔｉｍｅＰＣＲ和ＥＬＩＳＡ法检测各组ＲＰＥ细胞ＭＣＰ-１和ＩＬ-８的表达水平。结果　ＭＴＴ法检测细胞增生值显示:蓝光、白光各组比较差异均有统计学意义（均为Ｐ＜０．０５）,白光５００ｌｕｘ２４ｈ和１０００ｌｕｘ１２ｈ、２４ｈ,蓝光各照度６ｈ、１２ｈ、２４ｈ,ＲＰＥ细胞增生值均较对照组低,差异均有统计学意义（均为Ｐ＜０．０５）,细胞增生值随着白光和蓝光光照强度及光照时间的增加逐渐下降。ＲＴ-ＰＣＲ结果显示,各组ＲＰＥ细胞中ＭＣＰ-１和ＩＬ-８的ｍＲＮＡ比较差异均有统计学意义（均为Ｐ＜０．０５）。其中白光５００ｌｕｘ２４ｈ和１０００ｌｕｘ２４ｈ,蓝光５００ｌｕｘ１２ｈ、２４ｈ和１０００ｌｕｘ１２ｈ、２４ｈ,绿光５００ｌｕｘ２４ｈ和１０００ｌｕｘ２４ｈ,各组ＲＰＥ细胞中ＭＣＰ-１和ＩＬ-８的ｍＲＮＡ表达水平较对照组高,差异均有统计学意义（均为Ｐ＜０．０５）。ＥＬＩＳＡ结果显示,白光５００ｌｕｘ２４ｈ和１０００ｌｕｘ１２ｈ、２４ｈ,蓝光５００ｌｕｘ１２ｈ、２４ｈ和１０００ｌｕｘ１２ｈ、２４ｈ,绿光５００ｌｕｘ２４ｈ、１０００ｌｕｘ２４ｈ,与对照组相比, ＲＰＥ细胞ＭＣＰ-１、ＩＬ-８分泌量增加,差异均有统计学意义（均为Ｐ＜０．０５）;蓝光在５００ｌｕｘ２４ｈ和１０００ｌｕｘ１２ｈ、２４ｈ,ＭＣＰ-１和ＩＬ-８分泌量较白光、绿光增加,差异均有统计学意义（均为Ｐ＜０．０５）。结论　ＬＥＤ白光、蓝光和绿光能以照度和时间依赖性影响ＡＲＰＥ细胞增生及分泌ＭＣＰ-１和ＩＬ-８,以蓝光更为显著。     

白细胞介素-1β诱导大鼠视网膜单核细胞趋化蛋白-1mRNA表达的研究

目的 探讨白细胞介素－１β（ＩＬ－１β）对大鼠视网膜单核细胞趋化蛋白（ＭＣＰ）－１ｍＲＮＡ表达的诱导作用。方法 ２４只ＳＤ大鼠,右眼为实验眼,左眼为对照眼。实验眼玻璃体内注入ＩＬ－１β ２５０ Ｕ／５μｌ,对照眼注入等量生理盐水（ＰＳＳ）。注射后４,２４ｈ取视网膜组织,提取总ＲＮＡ应用反转录－聚合酶链反应（ＲＴ－ＰＣＲ）检测视网膜ＭＣＰ－１ｍＲＮＡ表达。结果 眼内ＩＬ－１β注射后４ｈ实验眼视网膜ＭＣＰ－１ｍＲＮＡ表达水平较对照眼明显增加;２４ｈ实验眼视网膜ＭＣＰ－１ｍＲＮＡ水平与对照眼相近。结论 视网膜ＭＣＰ－１ｍＲＮＡ可被眼内ＩＬ－１β诱导表达,ＭＣＰ－１可能在ＩＬ－１β诱发的眼内炎症反应中发挥作用。     

植物凝集素诱导甲状腺相关眼病患者外周单核细胞与眼眶成纤维细胞共培养体系分泌IL-6、IL-17A的研究

背景 甲状腺相关眼病(TAO)的致病机制尚未明确,目前认为其是一种自身免疫性疾病,研究证实白细胞介素-17A(IL-17A)在多种自身免疫性疾病的发生和发展中起着重要作用,但其是否参与TAO的发病过程目前尚不明确. 目的 探讨培养外周血单个核细胞(PBMCs)与眼眶成纤维细胞(OFs)共培养体系中分泌的IL-17A是否参与TAO的发病过程及其可能的作用机制. 方法 采集2014年4-12月在中南大学湘雅医院确诊的12例TAO患者的外周血及眼眶结缔组织作为TAO组,并采集同期因先天性眼球萎缩行义眼台植入术的8例患者外周血及眼眶结缔组织作为对照组,采用密度梯度离心法提取所有受试者血中PBMCs,采用组织块培养法培养OFs.采用流式细胞仪检测PBMCs中T淋巴细胞纯度,分别用Giemsa染色法和免疫组织化学法鉴定培养的OFs.以1∶20的比例将OFs与PMBCs在U型96孔板中共培养以建立共培养体系,分别在各组共培养体系中加入0、1.0、2.5、5.0、10.0 μg/ml植物凝集素(PHA)刺激72 h,用ELISA法检测共培养体系上清液中IL-6、IL-17A质量浓度以及共培养体系细胞膜中总IL-17A受体(IL-17RA)的质量浓度.比较不同质量浓度PHA作用后各组共培养体系上清液中IL-6、IL-17A、IL-17RA质量浓度的差异. 结果 TAO组和对照组PBMCs中T淋巴细胞的纯度分别为(81.10±0.21)％和(80.05 ±0.38)％,组间差异无统计学意义(t=0.923,P＞0.05).体外培养的OFs对Vimentin呈阳性反应,Giemsa染色阳性,证实为成纤维细胞.1.0 μg/ml PHA作用后共培养体系中PBMCs和OFs增生能力最强,PHA质量浓度＞1.0μg/ml时,PBMCs出现凋亡,OFs增生明显减弱,相同质量浓度PHA作用下,TAO组的PBMCs和OFs增生均较对照组快.不同质量浓度PHA作用下TAO组与对照组共培养体系IL-6、IL-17A和IL-17RA质量浓度总体比较,差异均有统计学意义(IL-6:F分组=12.561,P=0.000;F质量浓度=23.356,P=0.001.IL-17A:F分组=12.037,P=0.000;F质量浓度=19.206,P=0.000.IL-17RA:F分组=16.216,P=0.000;F质量浓度=4.627,P=0.018).1.0μg/ml PHA作用后各组共培养体系上清液中IL-6、IL-17A和IL-17RA质量浓度均达峰值,随着PHA质量浓度的增加,IL-6、IL-17A和IL-17RA质量浓度均逐渐下降,差异均有统计学意义(均P＜0.05);相同质量浓度PHA作用下TAO组共培养体系上清液中IL-6、IL-17A、IL-17RA质量浓度明显高于对照组,差异均有统计学意义(均P＜0.05). 结论 1.0 μg/ml PHA刺激可增强共培养体系中PBMCs和OFs的增生及免疫炎性因子的分泌,IL-17A能够放大细胞免疫反应和炎症反应,从而参与TAO的发病过程.     

兔后发性白内障房水中白细胞介素-1β和白细胞介素-6的含量

目的:探讨白内障囊外摘除术后房水中白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的含量与后发性白内障的关系.方法:28只兔均行白内障晶状体囊外手术,分别于术后1、3、7、14、30 d和90 d对术眼进行裂隙灯和眼底检查,并抽取房水于-80 ℃中保存.用酶联免疫吸附试验对术后兔房水中的IL-1β和IL-6含量进行测定.结果:兔房水IL-1β和IL-6含量于术后3、7、14 d和30 d明显升高,术后7～14 d达最高值,且与后囊混浊程度呈正相关.结论:IL-1β和IL-6可能参与后发性白内障的形成.     

人工合成白细胞介素-1受体阻断剂CK-17对兔结膜下成纤维细胞的影响

目的研究非甾体类抗炎药物——人工合成白细胞介素-1受体阻断剂CK-17对体外培养的兔Tenon囊成纤维细胞(rabbit Tenon’s capsule fibroblast，RTCF)增生及细胞分泌功能的抑制作用。对CK-17在青光眼滤过术后抗瘢痕增生方面应用的可行性进行探讨。设计体外、对照干预实验研究。研究对象体外培养的兔RTCF。方法用细胞计数的方法检测RTCF增生的情况；用胶原检测试剂盒检测RTCF培养基中分泌的总胶原的含量。主要指标成纤维细胞记数，RTCF培养基中总胶原含量。结果(1)CK-17对RTCF的抑制呈浓度和时间依赖性；(2)CK-17对RTCF胶原分泌的抑制呈浓度和时间依赖性；(3)CK-17在实验浓度下对RTCF无细胞毒性。结论CK-17能够抑制体外培养的兔成纤维细胞增生及细胞总胶原的分泌。     

Characterization of tear production in subjects with dry eye disease during intranasal tear neurostimulation: Results from two pivotal clinical trials

PurposeThe intranasal tear neurostimulator (ITN) activates the nasolacrimal pathway, which is involved with basal and bolus tear secretion. These studies characterized the acute and long-term effectiveness of the ITN in stimulating tear production in subjects with dry eye disease (DED).MethodsStudy 1: Randomized, double-masked, dual-controlled, 1-day crossover. Study 2: Single-arm, open-label, 180-day prospective cohort. Eligible subjects had basal unstimulated Schirmer test (with anesthesia) ≤10 mm and intranasal cotton swab–stimulated Schirmer test at least 7 mm greater in the same eye, and Ocular Surface Disease Index^® ≥13 and ≥ 23, in Studies 1 and 2, respectively. Study 1: Subjects (n = 48) received three randomized test applications: active intranasal, extranasal (active control), and sham intranasal (inactive control) stimulation, 3 min/application with 1-hour minimum between applications. Primary outcome measure was the difference in Schirmer test scores during active intranasal and control applications. Study 2: Subjects (n = 97) performed intranasal neurostimulation for ≤3 min/application, 2–10 times/day. Primary outcome measure was the difference in Schirmer scores (stimulated minus unstimulated) at day 180. Both studies recorded device-related adverse events (AEs).ResultsStudy 1: Schirmer scores (mean ± SEM) were significantly greater (p < 0.0001) with active intranasal (25.3 ± 1.5 mm) vs extranasal (9.5 ± 1.2 mm) and sham (9.2 ± 1.1 mm) applications. Study 2: Schirmer scores were significantly greater (p < 0.0001) with ITN stimulation vs unstimulated at day 180 (17.3 ± 1.3 mm vs 7.9 ± 0.7 mm). No serious device-related AEs were reported in either study.ConclusionThe ITN was well-tolerated and effective in stimulating tear production with acute and long-term use in DED.Clinicaltrials.gov identifierNCT02680158 and NCT02526290.     

The evaluation of dry eye mobile apps for screening of dry eye disease and educational tear event in Japan

Purpose

To evaluate the usefulness of a dry eye mobile application (app) for screening dry eye disease (DED) at educational tear events in Japan.

Investigating the relationship between serum interleukin-17 levels and systemic immune-mediated disease in patients with dry eye syndrome

Purpose

To investigate the association between dry eye syndrome (DE) and serum levels of interleukin (IL)-17 in patients with systemic immune-mediated diseases.

Methods

IL-17 and IL-23 levels were measured in the sera of patients whose tear production was <5 mm on the Schirmer test. Subjects included patients with chronic graft-versus-host disease (GVHD), rheumatoid arthritis (RA), Sjogren''s syndrome (SS), systemic lupus erythematosus (SLE), and no systemic disease. Corneal/conjunctival fluorescein staining was scored and the correlation between the score and the IL-17 level was evaluated.

Results

A strong correlation existed between IL-17 level and the type of systemic disease. IL-17 was significantly elevated in patients with chronic GVHD compared to those with RA and SS. IL-17 was not detectable in patients with SLE or in those without systemic disease. IL-23 was not detected in any of the subjects. IL-17 was significantly increased in patients with high fluorescein staining scores.

Conclusions

Our data suggest that IL-17 is involved in the pathogenesis of DE in patients with systemic immune-mediated diseases.     

自体外周血淋巴细胞经泪腺注射与静脉回输两种方式诱导兔自身免疫性干眼模型的对比分析

目的 基于泪液学、眼表组织及Th17/Treg相关指标比较自体外周血淋巴细胞(PBLs)经泪腺注射与静脉回输两种方式诱导兔自身免疫性干眼模型的异同。方法 将雌性新西兰大白兔随机分为正常对照组(NC组)、生理盐水泪腺注射组(NSI组)、自体PBLs泪腺注射组(ALI组)、生理盐水静脉回输组(NST组)、自体PBLs静脉回输组(ALT组),每组8只;自体PBLs通过与泪腺上皮细胞共培养以激活;ALI组予泪腺注射激活的PBLs 200μL,ALT组予耳缘静脉回输同等细胞量的PBLs 1 mL,NSI组予泪腺注射生理盐水200μL,NST组予耳缘静脉回输生理盐水1 mL;造模前与造模后4周检测各组兔泪液分泌量(SIT)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、泪液中白细胞介素17(IL-17)和白细胞介素35(IL-35)浓度,泪腺HE染色观察组织形态学改变,免疫组织化染色检测ROR-γt、Foxp3蛋白表达。结果 造模后4周,ALI组、ALT组兔眼均观察到SIT降低、BUT缩短、FL评分增加、泪液IL-17浓度上升和IL-35浓度下降(均为P<0.05),泪腺组织HE染色见...     

Advances in the diagnosis and treatment of dry eye

The core mechanism of dry eye is the tear film instability. Tear film-oriented diagnosis (TFOD) is a concept to clarify the cause of tear film instability by tear film, and tear film-oriented treatment (TFOT) is a concept to treat dry eye disease by replacing the lacking components of the tear film layer based on the TFOD. In TFOD, the fluorescein breakup pattern of the tear film is important, and the subtype of dry eye can be judged to some extent from the breakup patterns. Current noninvasive devices related to the dynamic analysis of the tear film and visual acuity enabled the diagnosis of dry eye, subtype analysis, and the extent of severity. In Asian countries, secretagogues represent the main treatment in TFOT. Since meibomian gland dysfunction is a factor that greatly affects the tear breakup time, its treatment is also essential in the dry eye treatment strategy. A newly discovered dry eye subtype is the short breakup time-type (BUT) of dry eye. The only abnormal finding in this disease is the short BUT, suggesting a relationship with ocular neuropathic pain and eye strain. Recently, data from many studies have accumulated which show that dry eye is a life-style disease. In addition to the treatment of dry eyes, it is becoming possible to prevent the onset by intervening with the daily habits, diet, exercise and sleep, etc. It has been pointed out that oxidative stress is also involved in the pathology of dry eye, and intervention is being carried out by improving diet and taking supplements. Future research will be needed to link clinical findings to the molecular biological findings in the tear film.     

Th17相关细胞因子在干眼患者眼表的表达及其相关性研究

背景 干眼的发病机制尚未明确.越来越多的证据表明干眼是免疫介导的炎症过程,辅助性T细胞17（Th17）相关细胞因子可能在干眼中发挥重要作用,但这些炎性因子的具体作用尚有待证实. 目的 分析干眼患者眼表组织中Th17相关细胞因子表达的差异. 方法 采用前瞻性队列研究设计,纳入2011-2012年在北京大学第三医院确诊的Sjogren综合征（SS）患者20例（SS组）、非SS干眼患者20例（非SS干眼组）和正常志愿者20例（正常对照组）.所有患者均为50岁以上的绝经后妇女,在填写知情同意书后依次进入研究队列.所有患者填写眼表疾病指数（OSDI）评分问卷进行主观症状评分,并进行干眼相关检查,包括泪膜破裂时间（BUT）测定、角膜荧光素染色评分、泪液分泌试验Ⅰ（SⅠt）.采用PCR-Array法测定3个组患者眼表Th17相关细胞因子含量,包括眼表组织中白细胞介素-17A（IL-17A）、IL-6、IL-8、IL-22、IL-23 mRNA的表达,并分析结膜上皮细胞中IL-17A与OSDI、BUT、角膜荧光素染色和SⅠt结果的相关性. 结果 SS组、非SS干眼组和正常对照组受检者的OSDI评分分别为50.00（33.50,66.50）、45.00（35.50,55.00）和3.00（0.00,5.00）,SⅠt值分别为2.50（1.00,4.00）、5.00（2.00,5.00）和15.50（10.00,18.50）,BUT值分别为2.00（1.00,4.00）、4.00（3.00,5.00）和10.00 （10.00,12.00）,角膜荧光素染色评分分别为8.50 （6.00,12.00）、5.50（4.00,7.00）和0.00（0.00,0.00）.3个组间受检者的OSDI评分、SⅠt、BUT及荧光素染色评分的总体比较差异均有统计学意义（χ^2=34.11、28.13、93.66、92.25,P＜0.01）,其中SS组患者的OSDI评分、荧光素染色评分均高于非SS干眼组患者,差异均有统计学意义（χ^2=28.72、88.43,P＜0.01）,而SⅠt、BUT值均低于非SS干眼组,差异均有统计学意义（χ^2=25.91、87.46,P＜0.01）;非SS干眼组患者的OSDI评分、荧光素染色评分均明显高于正常对照?     

Sex and age differences in symptoms and signs of dry eye disease in a Norwegian cohort of patients

PurposeTo investigate sex and age differences in symptoms and signs in a Norwegian clinic-based cohort of patients with dry eye disease (DED).MethodsVisitors at the Norwegian Dry Eye Clinic were examined using Ocular Surface Disease Index (OSDI) questionnaire score, tear osmolarity, tear break-up time (TFBUT), ocular surface staining, corneal sensitivity, Schirmer I test, and meibum expressibility (ME) and quality (MQ). A diagnosis of DED was made by an ophthalmologist based on symptoms and signs, and only DED patients were enrolled in the study: 1823 patients (338 males; mean age 51.2 ± 16.2 years; 1485 females; mean age 52.5 ± 16.0 years). The patients were divided into age subgroups: 20–39 years, 40–59 years and ≥60 years. Sex differences in the aforementioned tests were analyzed. Values were reported as mean ± standard deviation (SD), and intergroup comparisons were performed using Mann-Whitney U test. Multiple regression was used to analyze sex and age influences on symptoms and signs.ResultsWhen patients of all ages were analyzed, females had increased osmolarity, shorter TFBUT, reduced MQ and ME and higher corneal sensitivity. OSDI, Schirmer I test, ocular surface staining and corneal staining were not significantly different between the sexes. Only with TFBUT and ME were the sex difference present in all age subgroups. Multiple regression showed that all parameters were influenced by either sex or age, but only TFBUT and ME were influenced by both sex and age. (all p < 0.05).ConclusionsSex and age differences in dry eye were most consistent in TFBUT and ME, that indicate differences in meibomian gland functionality. Sex and age subgroup stratification is important in future studies investigating DED in other populations.     

T细胞介导的炎症反应机制在干眼病中的研究现状

干眼病是眼科常见的眼表疾病,其发病机制复杂,目前尚无一种理想的动物模型能较好地模拟出干眼病发病缓慢、反复发生、逐渐恶化的特点。研究认为,炎症是干眼病发的主要因素。本文主要对Th1细胞和Th17细胞及其相关细胞因子在干眼病发病中作用做简要概述。     

Association of meibomian gland morphology with symptoms and signs of dry eye disease in the Dry Eye Assessment and Management (DREAM) study

PurposeTo describe associations between symptoms and signs of dry eye disease (DED) and meibomian gland (MG) morphology.MethodsCross-sectional study utilizing data from the Dry Eye Assessment and Management (DREAM) Study. Readers graded MG features in the middle third of upper and lower lids on infrared meibography images. Associations with signs and symptoms of DED were evaluated with adjustment for age and sex.ResultsAmong 268 patients, no MG features were associated with symptom scores (p > 0.08). Among 394 upper eyelids, better tear break-up times (<2, >2- <3.2and ≥ 3.2 s) were associated with more tortuous glands (mean (SD) 0.58(0.95), 0.83(1.2) and 1.14 (1.4), p = 0.01) and with higher scores on a composite score of MG features (21.90 (9.76), 23.29 (9.50), 26.26 (10.27); p = 0.02). Longer Schirmer test wetting lengths (0–5, >5–10, and >10 mm) were associated with increasing composite scores (22.02 (9.29), 23.80 (10.34), 24.96 (9.96), p = 0.03). Patients with Sjogren syndrome compared to other patients had fewer distorted MGs (mean 3.4 (2.3) vs 4.3 (2.3), p = 0.03) and fewer ghost glands (mean 0.33 (0.88) vs 0.89 (1.8), p = 0.006) in the upper lid.ConclusionIn the DREAM study, most MG morphologic features were not associated with the severity of DED symptoms or signs. Tortuous glands and a higher composite score for MG features were associated with longer tear break-up times and longer Schirmer test length in the upper eyelid only. Patients with Sjogren syndrome had fewer distorted and ghost glands.