春季角结膜炎（VKC）患者的血管内皮生长因子（VEGF）血清学和泪液信号传导
Vascular Endothelial Growth Factor (VEGF) Serological and Lacrimal Signaling in Patients Affected by Vernal Keratoconjunctivitis (VKC).
作者信息
Nebbioso Marcella, Iannaccone Andrea, Duse Marzia, Aventaggiato Michele, Bruscolini Alice, Zicari Anna Maria
机构信息
Department of Sense Organs, Sapienza University of Rome, p. le A. Moro 5, 00185 Rome, Italy.
Department of Pediatrics, Sapienza University of Rome, p. le A. Moro 5, 00185 Rome, Italy.
出版信息
J Ophthalmol. 2018 Sep 16;2018:3850172. doi: 10.1155/2018/3850172. eCollection 2018.
BACKGROUND
Vernal keratoconjunctivitis (VKC) is a rare inflammatory disease involving the ocular surface, with seasonally exacerbated symptoms. Both type-1 and type-4 hypersensitivity reactions play a role in the development of VKC.
PURPOSE
The aim of the present study was to assess the presence and evaluate the concentration of the vascular endothelial growth factor (VEGF) in tear and blood samples from patients with VKC, during the acute phase, based on the histopathological vasculostromal structure of the tarsal papillae.
METHODS
Two groups of children aged between 6 and 16 years of life were enrolled: 21 patients (16 males, 76%) affected by VKC, tarsal or mixed form, and 13 healthy children (5 males, 38%) used as controls. Blood and tear samples were obtained from all patients, in order to specifically assess the presence of VEGF. Statistical analyses were performed with one-way ANOVA, followed by post hoc comparisons with the Bonferroni tests. Pearson's correlation was chosen as statistical analysis to assess the relationship between the expression levels of VEGF in tears and blood and the clinical parameters measured.
RESULTS
Comparing the 2 groups for VEGF concentration, a statistically significant difference was found in tear samples: the mean value was 12.13 pg/mL (±5.54 SD) in the patient group and 7 pg/ml (±4.76 SD) in controls ( < 0.05). However, no statistically significant difference was found when comparing VEGF concentration in blood samples ( > 0.05), with a mean value of 45.17 pg/mL (±18.67 SD) in VKC patients and 38.08 pg/mL (±19.43 SD) in controls.
CONCLUSIONS
This pilot study highlights the importance of lacrimal and vascular inflammatory biomarkers that can be detected in VKC patients during the acute phase, but not in healthy children. The small group of patients warrants additional studies on a larger sample, not only to further investigate the role of VEGF but also to evaluate the angiogenic biomarkers before and after topical treatment.
背景
春季角结膜炎（VKC）是一种累及眼表的罕见炎症性疾病，症状有季节性加重。1型和4型超敏反应在VKC的发病过程中均起作用。
目的
本研究的目的是根据睑结膜乳头的组织病理学血管基质结构，评估急性期VKC患者泪液和血液样本中血管内皮生长因子（VEGF）的存在情况并测定其浓度。
方法
招募了两组6至16岁的儿童：21例（16例男性，76%）患有睑结膜型或混合型VKC的患者，以及13名健康儿童（5例男性，38%）作为对照。采集所有患者的血液和泪液样本，以专门评估VEGF的存在情况。采用单因素方差分析进行统计分析，随后用Bonferroni检验进行事后比较。选择Pearson相关性分析作为统计分析方法，以评估泪液和血液中VEGF表达水平与所测量的临床参数之间的关系。
结果
比较两组的VEGF浓度，泪液样本中发现有统计学显著差异：患者组的平均值为12.13 pg/mL（±5.54 SD），对照组为7 pg/ml（±4.76 SD）（P<0.05）。然而，比较血液样本中的VEGF浓度时未发现统计学显著差异（P>0.05），VKC患者的平均值为45.17 pg/mL（±18.67 SD），对照组为38.08 pg/mL（±19.43 SD）。
结论
这项初步研究强调了泪液和血管炎症生物标志物的重要性，这些生物标志物可在急性期的VKC患者中检测到，但在健康儿童中未检测到。由于患者样本量较小，需要对更大样本进行进一步研究，不仅要进一步研究VEGF的作用，还要评估局部治疗前后的血管生成生物标志物。
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