Aier School of Ophthalmology, Central South University, Changsha, China.
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Sci Rep. 2017 Sep 6;7(1):10720. doi: 10.1038/s41598-017-10237-w.
Dry eye disease (DED) is often elicited by graft-versus-host disease (GVHD), an extensive complication of hematopoietic stem cell transplantation (HSCT). To unravel the mechanism of this type of DED, in vivo confocal microscopy (IVCM) was used to investigate alterations in the state of the sub-basal nerves, dendritic cells (DCs) and globular immune cells (GICs) in the central cornea and limbal epithelia. In this study, we examined 12 HSCT recipients with GVHD-caused DED and 10 HSCT recipients without GVHD-associated DED and evaluated the clinical parameters in the 2 groups. Analysis of the central cornea and limbal epithelia using IVCM was conducted to investigate the density of the corneal sub-basal nerves, DCs and GICs as well as the tortuosity and branching of the sub-basal nerves. As suggested by our data, the clinical variables in the GVHD group were significantly different from those in the non-GVHD group. Additionally, GVHD-triggered DED conceivably increased the density of DCs and GICs in the central cornea and the density of DCs in limbal epithelia and altered the morphology of the sub-basal nerves. These phenomena are presumably correlated with the degree of inflammation. Thus, our findings may be translated into non-invasive diagnostic methods that indicate the severity of inflammation on the ocular surface in HSCT recipients.
干眼症（DED）通常由移植物抗宿主病（GVHD）引起，GVHD 是造血干细胞移植（HSCT）的一种广泛并发症。为了阐明这种类型的 DED 的机制，我们使用共聚焦显微镜（IVCM）研究了中央角膜和角膜缘上皮的基底下神经、树突状细胞（DC）和球状免疫细胞（GIC）状态的变化。在这项研究中，我们检查了 12 例因 GVHD 引起的 DED 的 HSCT 受者和 10 例无 GVHD 相关 DED 的 HSCT 受者，并评估了两组的临床参数。通过 IVCM 对中央角膜和角膜缘上皮进行分析，以研究角膜基底下神经、DC 和 GIC 的密度以及基底下神经的迂曲和分支。正如我们的数据所表明的，GVHD 组的临床变量与非 GVHD 组明显不同。此外，GVHD 引发的 DED 可能会增加中央角膜中 DC 和 GIC 的密度以及角膜缘上皮中 DC 的密度，并改变基底下神经的形态。这些现象可能与炎症程度有关。因此，我们的发现可以转化为非侵入性诊断方法，这些方法可以指示 HSCT 受者眼表面的炎症严重程度。
