Conjunctival T-cell subpopulations in Sjögren's and non-Sjögren's patients with dry eye.
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.
Stern
Michael E
ME
llergan, Inc., Irvine, California 92612, USA. stern_michael@allergan.com
Gao
Jianping
J
Schwalb
Tammy A
TA
Ngo
Mylinh
M
Tieu
David D
DD
Chan
Chi-Chao
CC
Reis
Brenda L
BL
Whitcup
Scott M
SM
Thompson
Darby
D
Smith
Janine A
JA
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
D017252:CD3 Complex; D015704:CD4 Antigens; D016827:CD8 Antigens; D000949:Histocompatibility Antigens Class II; D018799:Intercellular Adhesion Molecule-1