Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan; and.
Technical Research Laboratory, Takanashi Milk Products Co., Ltd., Kanagawa, Japan.
Cornea. 2022 Oct 1;41(10):1232-1241. doi: 10.1097/ICO.0000000000002940. Epub 2021 Dec 7.
We investigated ocular surface microbiota dysbiosis in patients with refractory allergic conjunctival diseases (ACDs; stratified into mild and severe groups) treated with topical tacrolimus.
Patients (n = 21) with refractory ACDs (including vernal and atopic keratoconjunctivitis) actively treated with topical tacrolimus and 6 healthy controls were evaluated. Based on clinical scores and expression of specific cytokines on the ocular surface, patients with ACDs were divided into mild and severe groups using cluster analysis. The microbial composition of tear specimens collected from patients with mild and severe ACD and control subjects using the Schirmer test paper was determined through next-generation 16S rRNA sequencing analysis.
Compared with healthy controls, patients with ACDs exhibited significantly decreased ocular surface microbiota α-diversity. Ocular surface microbiota mainly comprised members of the phyla Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria in all groups. The relative abundance of ocular surface microbiota in patients with ACDs was increased for phylum Firmicutes and decreased for phylum Proteobacteria (compared with control subjects). The genera Blautia (vs. mild ACD group) and Morganella (vs. control group) exhibited significantly increased abundance only in the severe ACD group.
The ocular surface microbiota in patients with severe ACD exhibited decreased diversity and exacerbation of dysbiosis compared with that in patients with mild ACD and control subjects. Patients with mild refractory ACD also exhibited decreased diversity of these microbiota. These alterations in microbiota indicated a change in the ocular surface of patients with refractory ACD (be it because of disease pathogenesis or topical immunomodulatory treatment).
我们研究了接受局部他克莫司治疗的难治性过敏性结膜炎（ACD；分为轻度和重度组）患者的眼表微生物群落失调。
评估了 21 例（包括春季和特应性角结膜炎）接受局部他克莫司积极治疗的难治性 ACD 患者和 6 名健康对照者。根据眼表的临床评分和特定细胞因子的表达，使用聚类分析将 ACD 患者分为轻度和重度组。使用 Schirmer 试纸从轻度和重度 ACD 患者和对照组患者的泪液标本中采集微生物组成，通过下一代 16S rRNA 测序分析进行确定。
与健康对照组相比，ACD 患者的眼表微生物多样性显著降低。眼表微生物群落主要由放线菌门、拟杆菌门、厚壁菌门和变形菌门的成员组成。ACD 患者的眼表微生物群落相对丰度增加了厚壁菌门，减少了变形菌门（与对照组相比）。仅在重度 ACD 组中，布劳氏菌属（与轻度 ACD 组相比）和摩根菌属（与对照组相比）的丰度显著增加。
与轻度 ACD 患者和对照组相比，重度 ACD 患者的眼表微生物群落多样性降低，且失调加重。轻度难治性 ACD 患者的这些微生物群落多样性也降低。这些微生物群的变化表明难治性 ACD 患者的眼表发生了变化（无论是由于疾病发病机制还是局部免疫调节治疗所致）。
