title: Apoptosis of conjunctival epithelial cells before and after the application of autologous serum eye drops in severe dry eye disease.
abstract: OBJECTIVE
  To assess the impact of autologous serum eye drops on the level of ocular surface apoptosis in patients with bilateral severe dry eye disease.
  
  
  METHODS
  This prospective study was conducted on 10 patients with severe dry eye due to graft versus host disease (group 1) and 6 patients with severe dry eye due to primary Sjögren's syndrome (group 2). Impression cytology specimens from the bulbar conjunctiva were obtained before and after a three-month treatment with 20% autologous serum eye drops applied a maximum of 12 times a day together with regular therapy with artificial tears. The percentage of apoptotic epithelial cells was evaluated immunochemically using anti-active caspase 3 antibody.
  
  
  RESULTS
  In group 1, the mean percentage of apoptotic cells was 3.6% before the treatment. The three-month treatment led to a significant decrease to a mean percentage of 1.8% (P = 0.028). The mean percentage of apoptotic conjunctival cells decreased from 5.4% before the treatment to 3.8% in group 2; however, these results did not reach the level of significance.
  
  
  CONCLUSIONS
  Three-month autologous serum treatment led to the improvement of ocular surface apoptosis, especially in the group of patients with severe dry eye due to graft versus host disease. This result supports the very positive effect of autologous serum on the ocular surface in patients suffering from severe dry eye.
authors.affiliation: Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.|Department of Ophthalmology, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Ivana
authors.initials: I
authors.lastname: Rybickova
authors.affiliation: Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Viera
authors.initials: V
authors.lastname: Vesela
authors.affiliation: Department of Cell Therapy and Cord Blood Bank Czech Republic, Institute of Haematology and Blood Transfusion, Prague, Czech Republic.
authors.forename: Ivan
authors.initials: I
authors.lastname: Fales
authors.affiliation: Department of Ophthalmology, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Pavlina
authors.initials: P
authors.lastname: Skalicka
authors.affiliation: Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Jirsova
mesh_terms: D017209:Apoptosis / Q000502:physiology*; D003228:Conjunctiva / Q000502:physiology*; D015352:Dry Eye Syndromes / Q000503:physiopathology / Q000628:therapy*; D004847:Epithelial Cells / Q000502:physiology; D006086:Graft vs Host Disease / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D011446:Prospective Studies; D044967:Serum
chemical_list: D009883:Ophthalmic Solutions
keywords: apoptosis; autologous serum; caspase 3; conjunctival epithelium; dry eye disease