Barrett Aaron, Gnehm Derek, Jones Jordan, Trask Barbara C
Medical Laboratory Sciences Department, Weber State University, Ogden, Utah, USA.
Clin Exp Optom. 2014 Jan;97(1):66-71. doi: 10.1111/cxo.12093. Epub 2013 Aug 1.
Corneal inflammation has long been associated with contact lens wear and the use of extended-wear lenses enhances the risk of corneal injury. Elucidation of the molecular mediators of contact lens-associated inflammation has the potential to provide injury-identifying markers early in the inflammatory process, as well as determine potential therapeutic targets.
This cross-over study investigated a potential correlation between overnight contact lens wear and the concentrations of two markers of inflammation, α1-antitrypsin and C-reactive protein, in tear fluid. To obtain baseline measurements, 17 subjects adapted to wearing silicone hydrogel contact lenses wore their prescribed eye glasses for one week, after which tears were collected and ocular health assessed by a licensed optometrist. Subjects then returned to wearing their prescribed silicone hydrogel lenses continuously for one week. A second tear sample was collected and ocular inflammation was again assessed. Enzyme-linked immunosorbent assays were performed on all tear samples for both α1-antitrypsin and C-reactive protein.
α1-antitrypsin was significantly (p = 0.01) elevated after continuous contact lens wear, with increases above baseline concentrations averaging 2.48-fold. Optometric assessment of inflammation loosely correlated with levels of this inflammatory marker. C-reactive protein was detected in the tears of subjects at both times and levels were also slightly elevated after extended lens wear, but not significantly (p > 0.5) and not consistently in all subjects.
The results of this study suggest that α1-antitrypsin in tear fluid may be useful as an early marker of contact lens-associated ocular irritation and inflammation. The presence of C-reactive protein in the tears of contact lens wearers is a novel finding which, while not correlative with either α1-antitrypsin concentrations or clinically observable inflammation, may warrant further study.
长期以来，角膜炎症一直与隐形眼镜佩戴有关，而使用长戴型隐形眼镜会增加角膜损伤的风险。阐明与隐形眼镜相关炎症的分子介质，有可能在炎症过程早期提供损伤识别标志物，并确定潜在的治疗靶点。
这项交叉研究调查了过夜佩戴隐形眼镜与泪液中两种炎症标志物α1-抗胰蛋白酶和C反应蛋白浓度之间的潜在相关性。为了获得基线测量值，17名适应佩戴硅水凝胶隐形眼镜的受试者佩戴他们的处方眼镜一周，之后收集眼泪，并由持牌验光师评估眼部健康状况。然后，受试者连续一周重新佩戴他们的处方硅水凝胶镜片。收集第二份泪液样本，并再次评估眼部炎症。对所有泪液样本进行α1-抗胰蛋白酶和C反应蛋白的酶联免疫吸附测定。
连续佩戴隐形眼镜后，α1-抗胰蛋白酶显著升高（p = 0.01），高于基线浓度的平均值增加了2.48倍。炎症的验光评估与这种炎症标志物的水平大致相关。在两个时间点均在受试者的眼泪中检测到C反应蛋白，长时间佩戴镜片后其水平也略有升高，但不显著（p > 0.5），且并非在所有受试者中都一致升高。
本研究结果表明，泪液中的α1-抗胰蛋白酶可能作为与隐形眼镜相关的眼部刺激和炎症的早期标志物。隐形眼镜佩戴者眼泪中存在C反应蛋白是一项新发现，虽然它与α1-抗胰蛋白酶浓度或临床可观察到的炎症均无相关性，但可能值得进一步研究。
