Hsu S L, Lee P Y, Chang C H, Chen C H
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Genet Mol Res. 2016 Aug 30;15(3):gmr9011. doi: 10.4238/gmr.15039011.
Thyroid orbitopathy (TO) is an autoimmune disease that is complicated by ocular surface disorders, leading to discomfort. Dry eye is very prevalent in patients with TO. Recent studies on the pathogenesis of dry eye have focused on the inflammatory process, and some supporting evidence has been discovered. Because TO is a disorder of autoimmune origin, we assumed that the association between TO and dry eye is related to inflammation. Inflammation of the ocular surface in TO-related dry eye has not been well studied. In this study, we assessed cellular inflammation of the ocular surface and the cytokine profiles in patients with TO-related dry eye. Conjunctival impression cytology (CIC) was assessed with an immunofluorescent assay. TO-related dry eye was diagnosed by using the Schirmer test, tear break-up time, thyroid function, and clinical signs. CIC was combined with immunological staining of interleukin-1a (IL-1a), IL-1b, and IL- 6. The immunological impression cytology (IC) grade was compared to the clinical activity score of TO. All TO patients with dry eye were positive for IL-1a, IL-1b, and IL-6. However, the normal controls were also positive for IL-1a. A trend was observed between the clinical inflammatory score and immunological IC grade. This study was the first to delineate the immunological IC of TO-related dry eye. Our study aimed to investigate the pathogenesis of dry eye in TO. Our findings suggest that the conjunctival cytokines IL-1a, IL-1b, and IL-6 may play a role. The results of this study will be useful for future studies of additional inflammatory cytokines, and the levels of these cytokines could be used as an outcome to assess the efficacy of treatment, such as anti-cytokine or immunosuppression therapy, in patients with TO-related dry eye or other ocular surface inflammatory disorders.
甲状腺眼病（TO）是一种自身免疫性疾病，常并发眼表疾病，导致不适。干眼症在TO患者中非常普遍。最近关于干眼症发病机制的研究集中在炎症过程，并已发现一些支持性证据。由于TO是一种自身免疫性起源的疾病，我们推测TO与干眼症之间的关联与炎症有关。TO相关性干眼症的眼表炎症尚未得到充分研究。在本研究中，我们评估了TO相关性干眼症患者眼表的细胞炎症和细胞因子谱。采用免疫荧光测定法评估结膜印迹细胞学（CIC）。通过使用泪液分泌试验、泪膜破裂时间、甲状腺功能和临床体征来诊断TO相关性干眼症。将CIC与白细胞介素-1α（IL-1α）、IL-1β和IL-6的免疫染色相结合。将免疫印迹细胞学（IC）分级与TO的临床活动评分进行比较。所有TO干眼症患者的IL-1α、IL-1β和IL-6均为阳性。然而，正常对照组的IL-1α也为阳性。在临床炎症评分与免疫IC分级之间观察到一种趋势。本研究首次描绘了TO相关性干眼症的免疫IC。我们的研究旨在探讨TO中干眼症的发病机制。我们的研究结果表明结膜细胞因子IL-1α、IL-1β和IL-6可能起作用。本研究结果将有助于未来对其他炎症细胞因子的研究，这些细胞因子的水平可作为评估TO相关性干眼症或其他眼表炎症性疾病患者抗细胞因子或免疫抑制治疗等治疗效果的指标。
