Wang Y, Ogawa Y, Dogru M, Kawai M, Tatematsu Y, Uchino M, Okada N, Igarashi A, Kujira A, Fujishima H, Okamoto S, Shimazaki J, Tsubota K
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Bone Marrow Transplant. 2008 Feb;41(3):293-302. doi: 10.1038/sj.bmt.1705900. Epub 2007 Nov 5.
We investigated the effect of 0.05% topical cyclosporine (Cys) on the ocular surface and tear functions in dry eye patients with chronic GVHD (cGVHD) in a prospective comparative study. Thirty eyes of 15 patients refractory to baseline treatment were recruited and the patients assigned for topical Cys treatment group (14 eyes of 7 patients) and control group (12 eyes of 6 patients) respectively. Two patients dropped out because of intolerable irritation while using topical Cys eye drops. Visual analog scale symptom scores, corneal sensitivity, Schirmer I test value, tear film break-up time (TBUT), tear evaporation rate and ocular surface vital staining scores were recorded at baseline and at the end of the following one month. Conjunctival impression and brush cytology were performed before and after the treatment. After topical Cys treatment, significant improvements were found in symptom scores, corneal sensitivity, tear evaporation rate, TBUT, vital staining scores, goblet cells density, conjunctival squamous metaplasia grade, inflammatory cell numbers and the MUC5AC expression. Our study suggests that 0.05% topical Cys may be an effective treatment for dry eye patients with cGVHD. The improvements in the ocular surface and tear functions resulted presumably from the decreased inflammation, increased goblet cell density and MUC5AC mRNA expression. Bone Marrow Transplantation (2008) 41, 293-302; doi:10.1038/sj.bmt.1705900; published online 5 November 2007.
在一项前瞻性对照研究中，我们调查了0.05%的局部用环孢素（Cys）对慢性移植物抗宿主病（cGVHD）所致干眼症患者眼表及泪液功能的影响。招募了15例对基线治疗无效的患者的30只眼，将患者分别分配至局部用Cys治疗组（7例患者的14只眼）和对照组（6例患者的12只眼）。2例患者因使用局部用Cys滴眼液时出现无法耐受的刺激而退出。在基线时以及接下来一个月结束时记录视觉模拟量表症状评分、角膜敏感性、泪液分泌试验I值、泪膜破裂时间（TBUT）、泪液蒸发率及眼表活性染色评分。在治疗前后进行结膜印片和刷片细胞学检查。局部用Cys治疗后，症状评分、角膜敏感性、泪液蒸发率、TBUT、活性染色评分、杯状细胞密度、结膜鳞状化生分级、炎性细胞数量及MUC5AC表达均有显著改善。我们的研究表明，0.05%的局部用Cys可能是治疗cGVHD所致干眼症患者的有效方法。眼表及泪液功能的改善可能是由于炎症减轻、杯状细胞密度增加及MUC5AC mRNA表达增加所致。《骨髓移植》（2008年）41卷，293 - 302页；doi:10.1038/sj.bmt.1705900；2007年11月5日在线发表。
