title: Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine.
abstract: OBJECTIVE
  To compare conjunctival goblet cell numbers as well as epithelial turnover in patients with non-Sjögren syndrome--associated keratoconjunctivitis sicca (NSS-KCS) and those with SS-KCS before and after 6 months of treatment with topical cyclosporine A (CsA) ophthalmic emulsion.
  
  
  METHODS
  Conjunctival biopsy specimens from 16 patients with NSS-KCS and 12 with SS-KCS were obtained at baseline and after 6 months' therapy with CsA or vehicle alone. Conjunctival biopsy specimens were also obtained from 11 normal subjects. Periodic acid--Schiff staining determined the number of goblet cells present. Immunofluorescence microscopy for Ki-67 localization was used to evaluate the number of actively cycling cells.
  
  
  RESULTS
  Periodic acid--Schiff staining showed fewer goblet cells at baseline in both dry eye populations when compared with normal subjects (P<.001). After 6 months of CsA treatment, conjunctival biopsy specimens of both NSS-KCS and SS-KCS groups revealed an increase in goblet cells compared with baseline (P<.05). More Ki-67--positive cells were observed in NSS-KCS conjunctiva at baseline than in normal conjunctiva (P<.05) whereas numbers of these cells in SS-KCS conjunctiva were similar to normal at baseline. After 6 months of CsA treatment, conjunctival biopsy specimens of NSS-KCS revealed a decrease in Ki-67--labeled cells compared with baseline (P<.001). In contrast, no substantial change was observed for CsA treatment in patients with SS-KCS.
  
  
  CONCLUSIONS
  Treatment of dry eye syndrome for 6 months with topical CsA resulted in an increase in goblet cell numbers in patients with NSS-KCS and SS-KCS and a decrease in epithelial turnover in those with NSS-KCS. Reducing ocular surface inflammation might have an effect on the proliferative activity of the epithelium.
authors.affiliation: Schepens Eye Research Institute, Boston, MA 02114, USA.
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Kunert
authors.forename: Ann S
authors.initials: AS
authors.lastname: Tisdale
authors.forename: Ilene K
authors.initials: IK
authors.lastname: Gipson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D002455:Cell Division; D003228:Conjunctiva / Q000378:metabolism / Q000473:pathology*; D016572:Cyclosporine / Q000627:therapeutic use*; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology*; D019084:Fluorescent Antibody Technique, Indirect; D020397:Goblet Cells / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D008940:Mitotic Index; D010503:Periodic Acid-Schiff Reaction
chemical_list: D007166:Immunosuppressive Agents; D019394:Ki-67 Antigen; D016572:Cyclosporine