Abstract : PURPOSE Inflammatory molecules have been demonstrated in the tear film of patients with severe dry
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Abstract : PURPOSE Inflammatory molecules have been demonstrated in the tear film of patients with severe dry eye disease (DED). However little attention has been paid to the most frequent moderate forms of DED. This study analyzes tear cytokine levels and their clinical correlations in patients with moderate evaporative-type DED due to meibomian gland disease (MGD).|METHODS Twenty three evaporative-type DED patients (46 eyes) of mild-to-moderate intensity and nine healthy subjects (18 eyes) were recruited. Two symptom questionnaires were self-answered and multiple DED-related clinical tests were performed. Unstimulated tears from each eye were isolated and were not pooled. Levels of 15 cytokines and chemokines were measured by multiplex bead analysis compared with control levels and correlated with clinical tests.|RESULTS Fourteen out of the 15 molecules were reliably detected in 1 microl of unstimulated tears from DED patients. Epidermal growth factor (EGF) fractalkine/CX3CL1 interleukin (IL) 1-receptor antagonist (Ra) IL-8/CXCL8 interferon inducible protein (IP)-10/CXCL10 and vascular endothelial growth factor (VEGF) were found in 94-100 of samples IL-6 in 65 (significantly more detected in older patients) IL-1beta interferon gamma (IFN-gamma) and IL-10 in 30-48 IL-17 in 13 granulocyte macrophage colony stimulating factor (GM-CSF) IL-13 and tumor necrosis factor alpha (TNF-alpha) in 2-9 and IL-5 was never detected. EGF fractalkine/CX3CL1 IL-1Ra IP-10/CXCL10 and VEGF levels were significantly increased compared to normal controls. Pain was correlated with IL-6 and IL-8/CXCL8. Tear break-up time correlated inversely with IL1-Ra. Schirmer test and tear lysozyme levels negatively correlated with IL-1Ra IL-8/CXCL8 fracktalkine/CX3CL1 IL-6 IP-10/CXCL10 and VEGF had the same tendency. Conjunctival staining correlated negatively with EGF and positively with IL-6.|CONCLUSIONS: In this sample of moderate evaporative-type DED patients, five inflammatory molecules were elevated. Fracktalkine was demonstrated to be present and elevated in tears in human DED. IL-1Ra, IL-6, IL-8/CXCL8, and EGF levels correlated with pain and with clinical parameters measuring tear stability, tear production or ocular surface integrity. These results suggest that inflammation plays a role not only in severe DED but also in moderate evaporative DED.|
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