title: Quantification of conjunctival TNF-α in aqueous-deficient dry eye.
abstract: OBJECTIVE
  This study aimed to quantify and compare conjunctival epithelial tumor necrosis factor (NF) α mRNA expression in Sjögren syndrome (SS), non-Sjögren syndrome aqueous-deficient dry eye (non-SS DE), and non-dry eye (NDE) control subjects.
  
  
  METHODS
  A total of 76 subjects were recruited for this study: 25 SS (confirmed via American-European Consensus Criteria 2002), 25 non-SS DE (confirmed by symptoms and Schirmer scores ≤ 10 mm), and 26 NDE. Superior and temporal bulbar conjunctival epithelial cells were collected via impression cytology. Epithelial RNA was extracted, and TNF-α mRNA expression was quantified by real-time quantitative polymerase chain reaction.
  
  
  RESULTS
  The expression of TNF-α mRNA was found to be significantly higher in the SS group (2.48 ± 1.79) compared to both non-SS DE (0.95 ± 1.18; p < 0.05) and NDE (0.84 ± 0.51; p < 0.05) groups. No difference in TNF-α mRNA expression was found between the non-SS DE and NDE groups (p = 0.67).
  
  
  CONCLUSIONS
  These results demonstrate that SS-associated aqueous-deficient dry eye is associated with a significant upregulation of conjunctival epithelial TNF-α mRNA relative to both non-SS DE and control groups. The degree to which TNF-α mRNA is upregulated in SS may contribute to the severe ocular surface damage observed in these patients.
authors.affiliation: *OD, PhD, FAAO †BSc ‡MSc §PhD ∥PhD, FAAO Center for Contact Lens Research, School of Optometry, University of Waterloo, Waterloo, Ontario, Canada (BC, EJ, MLH, LAJ); and Alcon Research Ltd. Fort Worth, Texas (RR, MS).
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Caffery
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Joyce
authors.forename: Miriam L
authors.initials: ML
authors.lastname: Heynen
authors.forename: Robert
authors.initials: R
authors.lastname: Ritter
authors.forename: Lyndon A
authors.initials: LA
authors.lastname: Jones
authors.forename: Michelle
authors.initials: M
authors.lastname: Senchyna
mesh_terms: D000328:Adult; D003228:Conjunctiva / Q000473:pathology; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D005786:Gene Expression Regulation / Q000502:physiology*; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012859:Sjogren's Syndrome / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha