PURPOSE: To examine the expression of HLA-DR, a marker of inflammation, in the early stages of dry eye disease and to locate the appearance of this marker on specific areas of the bulbar conjunctiva. METHODS: Dry eye patients were identified and their condition classified as mild (n = 16) or moderate (n = 16) based on Schirmer testing, vital staining, tear break-up time, and symptom questionnaire scores. Brush cytology was used to collect epithelial cells from the nasal, temporal, and superior conjunctivae of patients and age-matched controls. HLA-DR positive cells were detected by immunohistochemical staining and quantified. RESULTS: Patients with moderate dry eye had the highest rate of conjunctival HLA-DR-positive cells, with significantly higher rates than controls regardless of which region of the conjunctiva was sampled (P < 0.01). The mild dry eye group had similar rates of HLA-DR-positive cells in the superior conjunctival region compared with controls. However, in the nasal and temporal regions, they displayed a significantly higher rate of HLA-DR-positive cells than controls (P < 0.01) and the nasal region showed a significant difference (P < 0.01) when compared with the temporal one. Some of these mild dry eyes had no vital staining. CONCLUSIONS: The HLA-DR expression pattern in mild and moderate dry eyes appears to reflect disease progression. Overexpression of HLA-DR in mild dry eyes showing no vital staining suggests that inflammation may be a primary cause of ocular surface damage. These data support the use of immunomodulatory drugs in the treatment of dry eye disease.
PURPOSE: To examine the expression of HLA-DR, a marker of inflammation, in the early stages of dry eye disease and to locate the appearance of this marker on specific areas of the bulbar conjunctiva. METHODS:Dry eyepatients were identified and their condition classified as mild (n = 16) or moderate (n = 16) based on Schirmer testing, vital staining, tear break-up time, and symptom questionnaire scores. Brush cytology was used to collect epithelial cells from the nasal, temporal, and superior conjunctivae of patients and age-matched controls. HLA-DR positive cells were detected by immunohistochemical staining and quantified. RESULTS:Patients with moderate dry eye had the highest rate of conjunctival HLA-DR-positive cells, with significantly higher rates than controls regardless of which region of the conjunctiva was sampled (P < 0.01). The mild dry eye group had similar rates of HLA-DR-positive cells in the superior conjunctival region compared with controls. However, in the nasal and temporal regions, they displayed a significantly higher rate of HLA-DR-positive cells than controls (P < 0.01) and the nasal region showed a significant difference (P < 0.01) when compared with the temporal one. Some of these mild dry eyes had no vital staining. CONCLUSIONS: The HLA-DR expression pattern in mild and moderate dry eyes appears to reflect disease progression. Overexpression of HLA-DR in mild dry eyes showing no vital staining suggests that inflammation may be a primary cause of ocular surface damage. These data support the use of immunomodulatory drugs in the treatment of dry eye disease.
Authors: Marjan Farid; Anshu Agrawal; Daniel Fremgen; Jeremiah Tao; He Chuyi; Anthony B Nesburn; Lbachir BenMohamed Journal: Ocul Immunol Inflamm Date: 2014-12-23 Impact factor: 3.070
Authors: Xiaofen Zheng; Cintia S de Paiva; De-Quan Li; William J Farley; Stephen C Pflugfelder Journal: Invest Ophthalmol Vis Sci Date: 2010-02-03 Impact factor: 4.799
Authors: Kyung-Chul Yoon; Cintia S De Paiva; Hong Qi; Zhuo Chen; William J Farley; De-Quan Li; Michael E Stern; Stephen C Pflugfelder Journal: J Autoimmun Date: 2007-11-07 Impact factor: 7.094
Authors: Helene Lam; Lauren Bleiden; Cintia S de Paiva; William Farley; Michael E Stern; Stephen C Pflugfelder Journal: Am J Ophthalmol Date: 2008-11-07 Impact factor: 5.258