Studies of human tear proteins--2. Analysis by crossed immunoelectrophoresis of tears from diseased eyes.

By filter paper strips, tears were collected from patients with diseases in the anterior ocular segment and analysed by crossed immunoelectrophoresis. Their crossed immunoelectrophoretic patterns were compared with those of normal subjects. Tear proteins from Sjögren's syndrome. Mikulicz's disease and tumor of the lacrimal gland showed abnormal patterns by crossed immunoelectrophoresis. Tears were collected from patients with lacrimal gland tumor after resection of the tumors. Ten tear-specific proteins were more decreased in these patients than in normal subjects. Serum proteins in the tears of these patients were increased, but secretory IgA (s-IgA) showed no change. A patient with symblepharon showed a marked decrease of both tear-specific proteins and s-IgA. Tears from patients wit epidemic keratoconjunctivitis (EKC), vernal conjunctivitis, herpes simplex keratitis (HSK) and adult inclusion conjunctivitis were analyzed. No remarkable change in tear-specific proteins could be noticed between tears from a case with an early stage of EKC or slight inflammation of the conjunctivitis and tears from the fellow unaffected eye. However, an increase was noted in serum proteins of the diseased eye. The tears collected from a case with severe EKC showed a decrease of tear-specific proteins, but an increase of serum proteins; especially s-IgA showed a significant increase. Tears from patients with EKC, HSK, vernal conjunctivitis and adult inclusion conjunctivitis showed differences in the immunoelectrophoretic patterns of tear proteins according to the severity and duration of the inflammation, as well as the amount of tears secreted. After due consideration of the analysis of tear proteins from some diseases of the anterior ocular segment, the following secretory sites of tear proteins under normal conditions were projected. The 10 tear-specific proteins reported in the previous paper are thought to be largely secreted from the main lacrimal gland. s-IgA is mainly secreted through the excretory ducts of the main lacrimal gland. Serum proteins in the tears are thought to come through the conjunctiva.