摘要
背景 干眼的发病机制尚未明确.越来越多的证据表明干眼是免疫介导的炎症过程,辅助性T细胞17（Th17）相关细胞因子可能在干眼中发挥重要作用,但这些炎性因子的具体作用尚有待证实. 目的 分析干眼患者眼表组织中Th17相关细胞因子表达的差异. 方法 采用前瞻性队列研究设计,纳入2011-2012年在北京大学第三医院确诊的Sjogren综合征（SS）患者20例（SS组）、非SS干眼患者20例（非SS干眼组）和正常志愿者20例（正常对照组）.所有患者均为50岁以上的绝经后妇女,在填写知情同意书后依次进入研究队列.所有患者填写眼表疾病指数（OSDI）评分问卷进行主观症状评分,并进行干眼相关检查,包括泪膜破裂时间（BUT）测定、角膜荧光素染色评分、泪液分泌试验Ⅰ（SⅠt）.采用PCR-Array法测定3个组患者眼表Th17相关细胞因子含量,包括眼表组织中白细胞介素-17A（IL-17A）、IL-6、IL-8、IL-22、IL-23 mRNA的表达,并分析结膜上皮细胞中IL-17A与OSDI、BUT、角膜荧光素染色和SⅠt结果的相关性. 结果 SS组、非SS干眼组和正常对照组受检者的OSDI评分分别为50.00（33.50,66.50）、45.00（35.50,55.00）和3.00（0.00,5.00）,SⅠt值分别为2.50（1.00,4.00）、5.00（2.00,5.00）和15.50（10.00,18.50）,BUT值分别为2.00（1.00,4.00）、4.00（3.00,5.00）和10.00 （10.00,12.00）,角膜荧光素染色评分分别为8.50 （6.00,12.00）、5.50（4.00,7.00）和0.00（0.00,0.00）.3个组间受检者的OSDI评分、SⅠt、BUT及荧光素染色评分的总体比较差异均有统计学意义（χ^2=34.11、28.13、93.66、92.25,P＜0.01）,其中SS组患者的OSDI评分、荧光素染色评分均高于非SS干眼组患者,差异均有统计学意义（χ^2=28.72、88.43,P＜0.01）,而SⅠt、BUT值均低于非SS干眼组,差异均有统计学意义（χ^2=25.91、87.46,P＜0.01）;非SS干眼组患者的OSDI评分、荧光素染色评分均明显高于正常对照�
Background The pathogenesis of dry eye has not been clearly established.There are more and more evidences to suggest that it is associated with ocular surface inflammation mediated by immunity.But how T helper cell 17 （Th17） plays its role in dry eye remains unclear.Objective The aim of this study was to investigate the expressions of Th17 related cytokines in ocular surface with dry eye.Methods A prospective cohortl study was designed.This protocol was approved by Ethic Commission of Peking University Third Hospital,and written informed consent was obtained from each subject prior to entering this cohort.Twenty female patients with Sjigren syndrome （SS group）,20 patients with non-SS dry eyes and 20 normal volunteers were recruited in Peking University Third Hospital during 2011-2012 duration and all the subjects were menopausal female with the age 50 years old or more.The ocular surface disease index （OSDI）questionnaire designed by Schiffman was performed firstly,and then tear breakup time （BUT）,corneal fluorescein staining and Schirmer Ⅰ test （S Ⅰ t） were carried out in the subjects.Expression of Th17 related cytokines mRNA were measured using PCR-Array.The correlation between IL-17A and ocular surface parameters was analyzed.Results The OSDI scores of the SS dry eye group,non-SS dry eye group and normal control group were 50.00 （33.50,66.50）,45.00 （35.50,55.00） and 3.00 （0.00,5.00）,the S Ⅰ t values were 2.50 （1.00,4.00）,5.00 （2.00,5.00） and 15.50 （10.00,18.50）,the BUT were 2.00 （1.00,4.00）,4.00 （3.00,5.00） and 10.00 （10.00,12.00）,the corneal fluorescein staining score were 8.50 （6.00,12.00）,5.50 （4.00,7.00）and 0.00 （0.00,0.00）,respectively,and significant differences were seen among the SS group,non-SS dry eye group and normal control group （χ^2=34.11,28.13,93.66,92.25,all at P〈0.01）.The relative expression values of IL-17A mRNA,IL-6 mRNA,IL-8 mRNA,IL-22 mRNA and IL-23 mRNA in the ocular surface were 1.98±0.16,11.64±1.32,6.67±1
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2014年第7期641-646,共6页
Chinese Journal Of Experimental Ophthalmology
基金
国家自然科学基金资助项目（30872813）
