title: A distinct cytokines profile in tear film of dry eye disease (DED) patients with HIV infection.
abstract: To investigate the tear cytokine profile in HIV patients with dry eye disease (DED) and study the association between the severity of ocular inflammatory complications and tear cytokines levels. We postulate that HIV-mediated inflammation may be the underlying pathogenic mechanism for HIV-associated DED.
  
  
  
  The current prospective case-control study compared tear film cytokine profiles in DED patients with HIV infection (n=34) and age/gender-matched DED patients without HIV infection [controls (n=32)]. Participants were recruited from tertiary referral eye care centre and communicable disease clinics, Singapore. Ocular surface health was documented using tear film, Schirmer's test, corneal staining, and conjunctival injection measurements. Tear samples were collected using Schirmer's strips and analysed for the levels of 41 cytokines using Luminex bead assay. Logistic regression models were performed to determine correlation and significance.
  
  
  
  Among the 41 cytokines analysed, statistically significant differences were observed in the mean values of epithelial growth factor (EGF), growth related oncogene (GRO) and interferon gamma-induced protein 10 (IP-10). EGF and IP-10 levels were higher and GRO levels were lower in the tears of DED patients with HIV infection compared to DED patients without HIV infection. No significant association was found between varying levels of ocular surface parameters and cytokine concentrations in HIV patients with DED (p>0.05).
  
  
  
  EGF and IP-10 were significantly elevated and GRO levels were lower in the tear profile of HIV patients with DED compared to immunocompetent patients with DED. This study suggests a novel cytokine driven paradigm for ocular inflammatory complications of HIV infection. Additional studies in large organised cohorts can validate the results.
authors: National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Singapore Eye Research Institute, Singapore. Electronic address: rupesh_agrawal@ttsh.com.sg.
authors: Rupesh
authors: R
authors: Agrawal
authors: National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
authors: Praveen Kumar
authors: PK
authors: Balne
authors: Singapore Eye Research Institute, Singapore.
authors: Anuradha
authors: A
authors: Veerappan
authors: Institute of Cell and Molecular Biology, Singapore; Singapore National Eye Centre, Singapore.
authors: Veonice Bijin
authors: VB
authors: Au
authors: Institute of Cell and Molecular Biology, Singapore; Singapore National Eye Centre, Singapore.
authors: Bernett
authors: B
authors: Lee
authors: National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.
authors: Eileen
authors: E
authors: Loo
authors: Singapore Eye Research Institute, Singapore; GROW Research Laboratory, Narayana Nethralaya Foundation, India.
authors: Arkasubhra
authors: A
authors: Ghosh
authors: Singapore Eye Research Institute, Singapore; Duke-NUS Medical School, Singapore; National University of Singapore, Singapore.
authors: Louis
authors: L
authors: Tong
authors: Eagle Eye Centre, Singapore.
authors: Stephen C
authors: SC
authors: Teoh
authors: Institute of Cell and Molecular Biology, Singapore; Singapore National Eye Centre, Singapore.
authors: John
authors: J
authors: Connolly
authors: Jurong General Hospital, Singapore.
authors: Petrina
authors: P
authors: Tan
mesh_terms: D000328:Adult; D016207:Cytokines / Q000378:metabolism*; D015352:Dry Eye Syndromes / Q000209:etiology / Q000378:metabolism*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000378:metabolism*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*
chemical_list: D016207:Cytokines
keywords: Cytokines; Dry eye; HIV; Inflammation; Luminex bead assay; Ocular surface; Tears