Tear Cytokine Profiles in Dysfunctional Tear Syndrome

doi:10.1016/j.ajo.2008.08.032

American Journal of Ophthalmology

Volume 147, Issue 2, February 2009, Pages 198-205.e1

https://doi.org/10.1016/j.ajo.2008.08.032 Get rights and content

Purpose

To compare tear cytokine and chemokine concentrations in asymptomatic control and Dysfunctional Tear syndrome (DTS) patients and determine the correlations between tear inflammatory mediators and clinical severity.

Design

Prospective observational cohort study.

Methods

Concentrations of epidermal growth factor (EGF), interleukin (IL)-1 alpha (1α), 1 beta (1β), 6, 10, 12, and 13, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), and chemokines: IL-8 (CXC); macrophage inflammatory protein-1 alpha (MIP-1α) (CCL3); and regulated upon activation, normal T-cell expressed and secreted (RANTES CCL5) were measured by a multiplex immunobead assay in an asymptomatic control group and DTS patients with and without meibomian gland disease (MGD). Spearman correlations between tear cytokines and severity of irritation symptoms and ocular surface signs were calculated.

Results

Tear concentrations of IL-6, IL-8 and TNF-α were significantly higher in DTS with and without MGD and EGF was significantly reduced in the DTS without MGD group compared with the control group. MIP-1α was greater in entire DTS and DTS without MGD groups than the control group and RANTES was greater in DTS with MGD than the control and DTS without MGD groups. IL-12 was significantly higher in the DTS with MGD than the DTS without MGD subgroup. Significant correlations were observed between IL-6 and irritation symptoms and between a number of cytokines and chemokines and clinical parameters.

Conclusions

As predicted, patients with DTS have higher levels of inflammatory mediators in their tears that show correlation with clinical disease parameters. Furthermore, different tear cytokine/chemokine profiles were observed in DTS patients with and without MGD groups.

Section snippets

Patients

Thirty patients with DTS (22 females, eight males) meeting the inclusion and exclusion criteria were enrolled at the Ocular Surface Center of Baylor College of Medicine, Houston, Texas. Patients completed a 12 question symptom questionnaire and had an ocular surface and tear evaluation performed by one of the investigators (S.C.P.) that consisted (in the following order) of biomicroscopic examination of the face, lid margins and meibomian glands, fluorescein tear break-up time (TBUT), corneal

Results

The demographic and clinical findings in DTS patients and normal subjects are presented in Table 2.

There was no difference in mean age between groups. There was no significant difference between eyes for any clinical severity parameter; therefore, the mean value of the two eyes was used for statistical comparison. Compared with the no DTS control group, symptom severity scores were significantly greater and Schirmer test scores were significantly less in the DTS group as a whole, as well as the

Discussion

This study found significant differences in the concentrations of certain cytokines and chemokines in eyes with DTS compared with asymptomatic control eyes. Furthermore, differences were noted between the DTS groups with and without MGD. Clinical severity parameters of DTS, such as irritation symptoms, Schirmer test scores, and corneal and conjunctival dye staining scores showed a significant correlation with the concentration of certain cytokines in tears.

The DTS was proposed by the Delphi

Helene Y. Lam, MD, attended medical school at University of California, Los Angeles, California where she was elected to AOA. She did her Ophthalmology residency at Baylor College of Medicine, Houston, Texas, and completed a Cornea Fellowship at the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts where she served as Chief Fellow. Dr Lam currently works in Boston with Harvard Vanguard as a comprehensive ophthalmologist and cornea specialist. Her research interests include ocular

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Original articleTear Cytokine Profiles in Dysfunctional Tear Syndrome

Purpose

Design

Methods

Results

Conclusions

Section snippets

Patients

Results

Discussion

Am J Ophthalmol

J Allergy Clin Immunol

Ophthalmology

Am J Ophthalmol

Am J Ophthalmol

Exp Eye Res

Pain

Eur J Pharmacol

Dysfunctional tear syndromeA Delphi approach to treatment recommendations

Cornea

Dry eye, focal points

The Definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop (2007)

Ocul Surf

Stress-activated protein kinase signaling pathways in dry eye and ocular surface disease

Ocul Surf

Tear fluid gelatinase B activity correlates with IL-1α concentration and fluorescein tear clearance

Invest Ophthalmol Vis Sci

Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca

Current Eye Research

Original article
Tear Cytokine Profiles in Dysfunctional Tear Syndrome