Purpose

Aberrant inflammation and immune dysregulation are known pathogenic contributors in dry eye disease (DED). Aim of the study was to determine the proportions of immune cell subsets on the ocular surface (OS) of DED patients.

Methods

15 healthy controls (22 eyes) and 48 DED subjects (36 eyes with evaporative DED – EDED; 60 eyes with aqueous deficient DED – ADED) were included in the study. Tear break up time (TBUT), Schirmer's test 1 (ST1), corneal staining (CS) and ocular surface disease index (OSDI) scoring were recorded. OS wash was used to collect immune cells on the OS of study subjects. The cells immunophenotyped using flow cytometry include leukocytes, neutrophils, macrophages, natural killer–NK cells and T cell subsets (CD4; CD8; double positive–DP; gamma delta–γδ and NK T cells).

Results

Significantly higher proportions of leukocytes, neutrophils, CD4 T cells, CD8 T cells, DP T cells and CD4/CD8 T cells ratio were observed in EDED and/or ADED patients. Significantly higher proportions of neutrophils and lower proportions of NK cells were observed in ADED subjects with corneal staining compared to those without and controls. Neutrophils/NK cells ratio was significantly higher in EDED and ADED subjects compared to controls. Correlation analysis revealed pathological relationships between proportions of leukocytes, neutrophils, CD4 T cells and Neutrophil/NK cells ratio with DED clinical parameters.

Conclusion

OS immune cell subset proportion changes in DED patients were associated with DED types and severity. The data suggests the potential for a new generation of therapies targeting immune cells on the ocular surface.

中文翻译：

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干眼病患者眼表免疫细胞谱的改变

目的

异常炎症和免疫失调是干眼病 (DED) 的已知致病因素。该研究的目的是确定 DED 患者眼表 (OS) 上免疫细胞亚群的比例。

方法

研究包括 15 名健康对照者（22 只眼）和 48 名 DED 受试者（36 只眼有蒸发性 DED – EDED；60 只眼有水缺乏 DED – ADED）。记录泪液破裂时间 (TBUT)、Schirmer's test 1 (ST1)、角膜染色 (CS) 和眼表疾病指数 (OSDI) 评分。OS 清洗用于收集研究对象 OS 上的免疫细胞。使用流式细胞术进行免疫表型分析的细胞包括白细胞、中性粒细胞、巨噬细胞、自然杀伤-NK 细胞和 T 细胞亚群（CD4；CD8；双阳性-DP；γδ-γδ 和 NK T 细胞）。

结果

在 EDED 和/或 ADED 患者中观察到显着更高比例的白细胞、中性粒细胞、CD4 T 细胞、CD8 T 细胞、DP T 细胞和 CD4/CD8 T 细胞比率。与没有和对照组相比，在角膜染色的 ADED 受试者中观察到显着更高比例的中性粒细胞和更低比例的 NK 细胞。与对照组相比，EDED 和 ADED 受试者的中性粒细胞/NK 细胞比率显着更高。相关性分析揭示了白细胞、中性粒细胞、CD4 T 细胞和中性粒细胞/NK 细胞比例与 DED 临床参数之间的病理关系。

结论

DED 患者的 OS 免疫细胞亚群比例变化与 DED 类型和严重程度相关。数据表明，针对眼表免疫细胞的新一代疗法具有潜力。