Br J Ophthalmol 1999;83:390-395 ( April )

Treatment of dry eye by autologous serum application in Sjögren's syndrome

Kazuo Tsubota,^{a b c} Eiki Goto,^{a b c} Hiromi Fujita,^{a c} Masafumi Ono,^{a d} Hiroko Inoue,^a Ichiro Saito,^e Shigeto Shimmura^{a b c}

^a Department of Ophthalmology, Tokyo Dental College, Chiba, Japan, ^b Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan, ^c Oral Research Center, Tokyo Dental College, Chiba, Japan, ^d Department of Ophthalmology, Tokai University School of Medicine, Kanagawa, Japan, ^e Department of Pathology, Tokushima University School of Dentistry, Tokushima, Japan

Correspondence to: Kazuo Tsubota, MD, Department of Ophthalmology, Tokyo Dental College, 11-13 Sugano 5 Chome, Ichikawa-shi, Chiba, Japan 272-8513.

Accepted for publication 26 August 1998

AIMTo evaluate the efficacy of autologous serum application for the treatment of dry eye in Sjögren's syndrome.
METHODSThe stability of essential components (EGF, vitamin A, and TGF-) in preserved serum were examined following preservation at 4°C and 20°C. In a primary clinical trial, 12 patients with Sjögren's syndrome were treated with autologous serum (diluted to 20% with sterile saline) for 4 weeks, and vital staining of the ocular surface was compared before and after treatment. The effects of serum on mucin (MUC-1) expression were observed in cultured conjunctival epithelial cells in vitro.
RESULTSEGF, vitamin A, and TGF- were well preserved for up to 1 month in the refrigerator at 4°C and up to 3 months in the freezer at 20°C. Rose bengal and fluorescein scores improved significantly from the initial scores of 5.3 and 5.6 to 1.7 and 2.5 after 4 weeks, respectively. The additive effect of human serum for cultured conjunctival epithelial cells showed significant MUC-1 upregulation on the cell surface.
CONCLUSIONAutologous serum application is a safe and efficient way to provide essential components to the ocular surface in the treatment of dry eye associated with Sjögren's syndrome.

Keywords: autologous serum; Sjögren's syndrome; tears ocular surface

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© 1999 by British Journal of Ophthalmology
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