title: Corneal Langerhans cell and dry eye examinations in ankylosing spondylitis.
abstract: APCs of the ocular surface, including corneal Langerhans cells (LCs), offer the opportunity to gain insight into the activity of innate immunity. We examined corneal LCs and dry eye parameters in ankylosing spondylitis (AS). Twenty-four AS patients with varying degrees of disease activity and 24 healthy participants were enrolled. Central and peripheral LC numbers, and Langerhans cell morphology (LCM) were assessed with in vivo laser confocal microscopy. In addition, ocular surface disease index, lid parallel conjunctival folds, tear break up time, and Schirmer test were evaluated. LC densities and central LCM were greater in AS patients than in the controls. Moreover, LCM was significantly greater in patients with higher systemic inflammation according to elevated C-reactive protein (CRP). Also, tear production was greatly suppressed in patients with more severe onset of the systemic inflammation according to the Bath Ankylosing Spondylitis Disease Activity Index and elevated CRP. Greater corneal LC density and LCM in AS may reflect an increased activation state of the innate immune system of the cornea in AS, which correlates with the systemic activity of AS even without ocular symptoms. Nonetheless, higher systemic inflammation might impair tear production, and it might partly explain the dry eye mechanism.
authors: Department of Ophthalmology, Semmelweis University Budapest, Budapest, Hungary marsovsz@hotmail.com.
authors: László
authors: L
authors: Marsovszky
authors: Department of Ophthalmology, Semmelweis University Budapest, Budapest, Hungary.
authors: János
authors: J
authors: Németh
authors: Department of Ophthalmology, Semmelweis University Budapest, Budapest, Hungary.
authors: Miklós D
authors: MD
authors: Resch
authors: First Department of Pediatrics, Semmelweis University Budapest, Budapest, Hungary.
authors: Gergely
authors: G
authors: Toldi
authors: Department of Rheumatology, Faculty of Medicine, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary.
authors: Nóra
authors: N
authors: Legány
authors: Department of Rheumatology, Faculty of Medicine, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary.
authors: László
authors: L
authors: Kovács
authors: Department of Rheumatology, Faculty of Medicine, Albert Szent-Györgyi Health Center, University of Szeged, Szeged, Hungary.
authors: Attila
authors: A
authors: Balog
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000096:biosynthesis / Q000235:genetics; D003228:Conjunctiva / Q000473:pathology; D003315:Cornea / Q000473:pathology; D015352:Dry Eye Syndromes / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000473:pathology*; D013666:Tears / Q000378:metabolism
chemical_list: D002097:C-Reactive Protein
keywords: Corneal Langerhans cell; ankylosing spondylitis; dry eye; in vivo confocal microscopy