GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, India; Manipal Academy of Higher Education, Manipal, India.
Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India.
Ocul Surf. 2021 Jul;21:96-106. doi: 10.1016/j.jtos.2021.04.002. Epub 2021 Apr 20.
Aberrant inflammation and immune dysregulation are known pathogenic contributors in dry eye disease (DED). Aim of the study was to determine the proportions of immune cell subsets on the ocular surface (OS) of DED patients.
15 healthy controls (22 eyes) and 48 DED subjects (36 eyes with evaporative DED - EDED; 60 eyes with aqueous deficient DED - ADED) were included in the study. Tear break up time (TBUT), Schirmer's test 1 (ST1), corneal staining (CS) and ocular surface disease index (OSDI) scoring were recorded. OS wash was used to collect immune cells on the OS of study subjects. The cells immunophenotyped using flow cytometry include leukocytes, neutrophils, macrophages, natural killer-NK cells and T cell subsets (CD4; CD8; double positive-DP; gamma delta-γδ and NK T cells).
Significantly higher proportions of leukocytes, neutrophils, CD4 T cells, CD8 T cells, DP T cells and CD4/CD8 T cells ratio were observed in EDED and/or ADED patients. Significantly higher proportions of neutrophils and lower proportions of NK cells were observed in ADED subjects with corneal staining compared to those without and controls. Neutrophils/NK cells ratio was significantly higher in EDED and ADED subjects compared to controls. Correlation analysis revealed pathological relationships between proportions of leukocytes, neutrophils, CD4 T cells and Neutrophil/NK cells ratio with DED clinical parameters.
OS immune cell subset proportion changes in DED patients were associated with DED types and severity. The data suggests the potential for a new generation of therapies targeting immune cells on the ocular surface.
已知异常炎症和免疫失调是干燥性眼病（DED）的致病因素。本研究旨在确定DED 患者眼表（OS）免疫细胞亚群的比例。
本研究纳入 15 名健康对照者（22 只眼）和 48 名 DED 患者（蒸发型 DED-EDED 患者 36 只眼；水液缺乏型 DED-ADED 患者 60 只眼）。记录泪膜破裂时间（TBUT）、Schirmer 试验 1（ST1）、角膜染色（CS）和眼表疾病指数（OSDI）评分。使用 OS 冲洗收集研究对象 OS 上的免疫细胞。使用流式细胞术对细胞进行免疫表型分析，包括白细胞、中性粒细胞、巨噬细胞、自然杀伤-NK 细胞和 T 细胞亚群（CD4；CD8；双阳性-DP；γδ-γδ 和 NK T 细胞）。
在 EDED 和/或 ADED 患者中，白细胞、中性粒细胞、CD4 T 细胞、CD8 T 细胞、DP T 细胞和 CD4/CD8 T 细胞比值明显较高。在 ADED 患者中，与无角膜染色者和对照组相比，角膜染色患者的中性粒细胞比例更高，NK 细胞比例更低。与对照组相比，EDED 和 ADED 患者的中性粒细胞/NK 细胞比值明显更高。相关性分析显示，白细胞、中性粒细胞、CD4 T 细胞和中性粒细胞/NK 细胞比值与 DED 临床参数之间存在病理性关系。
DED 患者 OS 免疫细胞亚群比例的变化与 DED 类型和严重程度有关。这些数据表明，针对眼表免疫细胞的新一代疗法具有潜力。
