Ebihara Nobuyuki, Funaki Toshinari, Takai Shinji, Miyazaki Mizuo, Fujiki Keiko, Murakami Akira
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
Curr Eye Res. 2004 Jun;28(6):417-20. doi: 10.1080/02713680490503750.
To determine the levels of mast cell chymase and tryptase activity in the tears of patients with vernal keratoconjunctivitis (VKC).
Subjects were 38 VKC patients and 18 healthy controls whose chymase and tryptase activity in tears was measured by enzyme assay. VKC severity was quantified based on the following clinical signs: papillary hypertrophy, conjunctival hyperemia, edema, punctate keratitis, Trantas dots, and mucus production. Of the 38 VKC patients, the degree of disease severity was mild in 13, moderate in 18, and severe in 7.
Mean chymase activity and standard deviation in tears was 0.23+/-0.07mU in mild VKC, 0.68+/-0.22mU in moderate VKC, 1.91+/-0.71 mU in severe VKC, and 0.11+/-0.05 mU in healthy controls. The increase in all VKC stages was statistically significant compared to that in healthy control. The degree of chymase activity in tears correlated significantly with VKC severity (r = 0.9245, p < 0.001). High tryptase activity was also detected in the tears of VKC patients, although increased tryptase activity in tears did not correlate with disease severity (r = 0.1999).
Chymase activity in tears may thus be a sensitive marker for determining the severity of VKC.
测定春季角结膜炎（VKC）患者泪液中肥大细胞糜蛋白酶和组织蛋白酶G的活性水平。
研究对象为38例VKC患者和18名健康对照者，通过酶测定法测量其泪液中糜蛋白酶和组织蛋白酶G的活性。根据以下临床体征对VKC严重程度进行量化：乳头肥大、结膜充血、水肿、点状角膜炎、Trantas点和黏液分泌。在38例VKC患者中，疾病严重程度为轻度的有13例，中度的有18例，重度的有7例。
轻度VKC患者泪液中糜蛋白酶的平均活性及标准差为0.23±0.07mU，中度VKC患者为0.68±0.22mU，重度VKC患者为1.91±0.71mU，健康对照者为0.11±0.05mU。与健康对照相比，所有VKC阶段的活性增加均具有统计学意义。泪液中糜蛋白酶活性程度与VKC严重程度显著相关（r = 0.9245，p < 0.001）。在VKC患者的泪液中也检测到高组织蛋白酶G活性，尽管泪液中组织蛋白酶G活性增加与疾病严重程度无关（r = 0.1999）。
因此，泪液中的糜蛋白酶活性可能是确定VKC严重程度的敏感标志物。
