title: Conjunctival T-cell subpopulations in Sjögren's and non-Sjögren's patients with dry eye.
abstract: OBJECTIVE
  To examine the conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca (SS-KCS) and non-Sjögren's keratoconjunctivitis sicca (NS-KCS) for evidence of immune-based inflammation.
  
  
  METHODS
  Conjunctival biopsy specimens were obtained from 15 patients with SS-KCS and 15 with NS-KCS. Immunohistochemistry was performed on frozen sections to characterize and quantify T-cell subtypes (CD3, CD4, and CD8) and markers of immune activation (major histocompatibility complex [MHC] class II: HLA-DR, HLA-DQ) and inflammation (intercellular adhesion molecule [ICAM]-1). The numbers of cells positive for each marker were counted by two masked observers and averaged.
  
  
  RESULTS
  Conjunctival biopsy specimens from patients with SS-KCS or NS-KCS revealed lymphocytic infiltration and increased immunoreactivity for the markers of inflammation and immune activation. The extent of cellular immunoreactivity did not differ significantly between SS-KCS and NS-KCS tissue samples.
  
  
  CONCLUSIONS
  The authors' findings indicate that patients with SS-KCS or NS-KCS have conjunctival inflammation manifested by inflammatory cell infiltrates and upregulation of expression in markers of immune activation. Clinical symptoms of KCS may be more dependent on T-cell activation and resultant inflammation than previously believed. In addition to tear substitutes, anti-inflammatory therapeutics should be investigated for the treatment of KCS.
authors.affiliation: llergan, Inc., Irvine, California 92612, USA. stern_michael@allergan.com
authors.forename: Michael E
authors.initials: ME
authors.lastname: Stern
authors.forename: Jianping
authors.initials: J
authors.lastname: Gao
authors.forename: Tammy A
authors.initials: TA
authors.lastname: Schwalb
authors.forename: Mylinh
authors.initials: M
authors.lastname: Ngo
authors.forename: David D
authors.initials: DD
authors.lastname: Tieu
authors.forename: Chi-Chao
authors.initials: CC
authors.lastname: Chan
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Reis
authors.forename: Scott M
authors.initials: SM
authors.lastname: Whitcup
authors.forename: Darby
authors.initials: D
authors.lastname: Thompson
authors.forename: Janine A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D017252:CD3 Complex / Q000378:metabolism; D015704:CD4 Antigens / Q000378:metabolism; D016827:CD8 Antigens / Q000378:metabolism; D003228:Conjunctiva / Q000276:immunology* / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D000949:Histocompatibility Antigens Class II / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D007638:Keratoconjunctivitis Sicca / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000276:immunology* / Q000473:pathology; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D015854:Up-Regulation
chemical_list: D017252:CD3 Complex; D015704:CD4 Antigens; D016827:CD8 Antigens; D000949:Histocompatibility Antigens Class II; D018799:Intercellular Adhesion Molecule-1