Zimmermann N, Erb C
Augenheilkunde, Augenklinik am Wittenbergplatz, Berlin.
Klin Monbl Augenheilkd. 2013 Aug;230(8):804-7. doi: 10.1055/s-0032-1328410. Epub 2013 May 13.
Matrix-metalloproteinases (MMPs) are proteolytic enzymes released by irritated epithelial cells of the ocular surface. It has been established that the subtype MMP-9 can serve as an inflammatory marker within the tear film. MMP-9 is also attributed to have an effect on the PEX-glaucoma development. Recently, a rapid immunoassay for detection of MMP-9 in the tear film was developed to estimate inflammatory extent during dry eye disease. The aim of this study was to analyse the MMP-9 concentration in tear film in PEX-syndrome. In addition, an assessment of the feasibility, reliability and readability of the test was done.
We randomly selected 10 patients with PEX-syndrome and 10 healthy control patients and measured tear film MMP-9 of one eye with the RPS InflammaDry Detector™ (Rapid Pathogen Screening Inc., USA).
We detected increased levels of MMP-9 in tear film in PEX-syndrome. 80 % of the PEX-patients and 20 % of the controls showed a positive test result (>or= 40 ng/mL MMP-9) indicating a test specificity and sensitivity of 80 %. This corresponds approximately to the published values for the dry eye (sensitivity 87 %, specificity: 92 %). The performance of the test is simple. The patients tolerated the inclusion of the test strips well. However, it is difficult to estimate whether enough tear film was used and in many cases, the intensity of the "indicator line" was weak.
The rapid MMP-9-immunoassay is a novel, meaningful approach for the detection of inflammatory activity of the ocular surface. We have shown an up-regulation of the non-specific inflammatory marker MMP-9 in tear film in PEX-syndrome and suggest an association with a tear film disorder. However, an improvement in the estimation of the amount of collected tears and readability is desirable.
基质金属蛋白酶（MMPs）是眼表受刺激的上皮细胞释放的蛋白水解酶。已证实MMP-9亚型可作为泪膜中的一种炎症标志物。MMP-9也被认为对假性剥脱性青光眼的发展有影响。最近，一种用于检测泪膜中MMP-9的快速免疫测定法被开发出来，以评估干眼病期间的炎症程度。本研究的目的是分析假性剥脱综合征患者泪膜中的MMP-9浓度。此外，还对该检测方法的可行性、可靠性和可读性进行了评估。
我们随机选择了10例假性剥脱综合征患者和10例健康对照患者，用RPS InflammaDry Detector™（美国快速病原体筛查公司）测量一只眼睛的泪膜MMP-9。
我们检测到假性剥脱综合征患者泪膜中MMP-9水平升高。80%的假性剥脱综合征患者和20%的对照者检测结果呈阳性（MMP-9≥40 ng/mL），表明检测的特异性和敏感性为80%。这与已发表的干眼病检测值大致相符（敏感性87%，特异性92%）。该检测方法操作简单。患者对使用试纸条的耐受性良好。然而，很难判断是否使用了足够的泪膜，而且在许多情况下，“指示线”的强度较弱。
快速MMP-9免疫测定法是检测眼表炎症活性的一种新的、有意义的方法。我们已证实在假性剥脱综合征患者泪膜中非特异性炎症标志物MMP-9上调，并提示其与泪膜紊乱有关。然而，需要改进对收集到的泪液量的估计和检测结果的可读性。
