Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, School of Optometry and Ophthalmology, TMU, Tianjin, China.
BMJ Open. 2016 Aug 3;6(8):e010979. doi: 10.1136/bmjopen-2015-010979.
To compare expression of interleukin (IL)-1β and tumour necrosis factor (TNF)-α in the conjunctiva of diabetic and non-diabetic patients with symptomatic moderate dry eye.
Nineteen diabetic patients with dry eye, 15 non-diabetic patients with dry eye and 14 diabetic patients without dry eye were recruited. The relative expression of IL-1β and TNF-α in conjunctival impression cytology (CIC) specimens was evaluated using immunofluorescent staining and in conjunctival biopsy specimens using immunohistochemical staining.
The diabetic dry eye group showed significantly higher grades of metaplasia than the non-diabetic dry eye and diabetic without dry eye groups (both p<0.05). There was no significant difference in the concentration of IL-1β and TNF-α in CIC specimens between the three groups (p=0.504 and p=0.310, respectively). The mean levels of IL-1β and TNF-α in conjunctival biopsy specimens from the diabetic dry eye group was significantly increased compared with the non-diabetic dry eye and diabetic without dry eye groups (p=0.002, p<0.001; p=0.001, p<0.001, respectively). Interestingly, IL-1β- and TNF-α-positive cells were mainly located in the basal layer of the conjunctival epithelium, and rarely seen in the apical conjunctival epithelium in the three groups. The levels of both IL-1β and TNF-α did not correlate with conjunctival squamous metaplasia grades.
Levels of IL-1β and TNF-α in conjunctival biopsy specimens were increased in diabetic patients with dry eye, while levels of IL-1β and TNF-α in apical conjunctival epithelium were similar in the CIC specimens. These findings suggest that the inflammatory response is not limited to the surface of conjunctival epithelial cells, and is more serious in the basal layer of the epithelium, which may play an important role in the pathogenesis of dry eye in diabetic patients.
比较有症状的中重度干眼的糖尿病患者和非糖尿病患者的结膜中白细胞介素 (IL)-1β 和肿瘤坏死因子 (TNF)-α 的表达。
招募了 19 例糖尿病干眼症患者、15 例非糖尿病干眼症患者和 14 例无干眼症的糖尿病患者。使用免疫荧光染色评估结膜印迹细胞学 (CIC) 标本中 IL-1β 和 TNF-α 的相对表达，并使用免疫组织化学染色评估结膜活检标本中 IL-1β 和 TNF-α 的相对表达。
糖尿病干眼症组的化生程度明显高于非糖尿病干眼症组和无干眼症的糖尿病组（均 p<0.05）。三组 CIC 标本中 IL-1β 和 TNF-α 的浓度无显著差异（p=0.504 和 p=0.310）。与非糖尿病干眼症组和无干眼症的糖尿病组相比，糖尿病干眼症组结膜活检标本中 IL-1β 和 TNF-α 的平均水平明显升高（p=0.002，p<0.001；p=0.001，p<0.001）。有趣的是，IL-1β 和 TNF-α 阳性细胞主要位于结膜上皮的基底层，在三组的结膜上皮顶端很少见。两组 IL-1β 和 TNF-α 的水平与结膜鳞状化生程度均无相关性。
糖尿病干眼症患者结膜活检标本中 IL-1β 和 TNF-α 水平升高，而 CIC 标本中 IL-1β 和 TNF-α 水平在结膜上皮顶端相似。这些发现表明炎症反应不仅局限于结膜上皮细胞表面，而且在上皮基底层更为严重，这可能在糖尿病患者干眼症的发病机制中起重要作用。
