Agrawal Rupesh, Balne Praveen Kumar, Veerappan Anuradha, Au Veonice Bijin, Lee Bernett, Loo Eileen, Ghosh Arkasubhra, Tong Louis, Teoh Stephen C, Connolly John, Tan Petrina
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Singapore Eye Research Institute, Singapore.
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
Cytokine. 2016 Dec;88:77-84. doi: 10.1016/j.cyto.2016.08.026. Epub 2016 Aug 29.
To investigate the tear cytokine profile in HIV patients with dry eye disease (DED) and study the association between the severity of ocular inflammatory complications and tear cytokines levels. We postulate that HIV-mediated inflammation may be the underlying pathogenic mechanism for HIV-associated DED.
The current prospective case-control study compared tear film cytokine profiles in DED patients with HIV infection (n=34) and age/gender-matched DED patients without HIV infection [controls (n=32)]. Participants were recruited from tertiary referral eye care centre and communicable disease clinics, Singapore. Ocular surface health was documented using tear film, Schirmer's test, corneal staining, and conjunctival injection measurements. Tear samples were collected using Schirmer's strips and analysed for the levels of 41 cytokines using Luminex bead assay. Logistic regression models were performed to determine correlation and significance.
Among the 41 cytokines analysed, statistically significant differences were observed in the mean values of epithelial growth factor (EGF), growth related oncogene (GRO) and interferon gamma-induced protein 10 (IP-10). EGF and IP-10 levels were higher and GRO levels were lower in the tears of DED patients with HIV infection compared to DED patients without HIV infection. No significant association was found between varying levels of ocular surface parameters and cytokine concentrations in HIV patients with DED (p>0.05).
EGF and IP-10 were significantly elevated and GRO levels were lower in the tear profile of HIV patients with DED compared to immunocompetent patients with DED. This study suggests a novel cytokine driven paradigm for ocular inflammatory complications of HIV infection. Additional studies in large organised cohorts can validate the results.
研究感染人类免疫缺陷病毒（HIV）的干眼症（DED）患者的泪液细胞因子谱，并探讨眼部炎症并发症严重程度与泪液细胞因子水平之间的关联。我们推测，HIV介导的炎症可能是HIV相关DED的潜在致病机制。
本前瞻性病例对照研究比较了HIV感染的DED患者（n = 34）和年龄/性别匹配的未感染HIV的DED患者[对照组（n = 32）]的泪膜细胞因子谱。研究对象来自新加坡的三级转诊眼科护理中心和传染病诊所。使用泪膜、泪液分泌试验、角膜染色和结膜充血测量来记录眼表健康状况。使用泪液分泌试纸收集泪液样本，并采用Luminex微球分析法分析41种细胞因子的水平。采用逻辑回归模型确定相关性和显著性。
在分析的41种细胞因子中，观察到上皮生长因子（EGF）、生长相关癌基因（GRO）和干扰素γ诱导蛋白10（IP-10）的平均值存在统计学显著差异。与未感染HIV的DED患者相比，感染HIV的DED患者泪液中EGF和IP-10水平较高，GRO水平较低。在感染HIV的DED患者中，不同水平的眼表参数与细胞因子浓度之间未发现显著关联（p>0.05）。
与具有免疫能力的DED患者相比，感染HIV的DED患者泪液中EGF和IP-10显著升高，GRO水平较低。本研究提示了一种由细胞因子驱动的HIV感染眼部炎症并发症的新范式。在大型有组织队列中的进一步研究可以验证这些结果。
