Purpose

To examine whether “activated” dendritic cells (aDCs) could serve as a biomarker of systemic immune disorders in individuals with dry eye (DE) symptoms. Secondarily, to examine the impact of a topical anti-inflammatory agent on aDC number.

Methods

Retrospective analysis was conducted to identify individuals with DE symptoms who had in-vivo confocal microscopy (IVCM) imaging between October 2018 and July 2020 at the Miami Veterans Hospital. aDCs were manually quantified based on morphology. Receiver operating curve (ROC) analysis examined relationships between aDC number and systemic immune disease status. Individuals were then grouped by aDC number (≥2 versus <2) and demographics and DE parameters were examined. Paired t-test was performed to evaluated aDC number pre-vs post-initiation of an anti-inflammatory agent.

Results

128 individuals were included. Their mean age was 57.1 ± 15.0 years; 71.1% were male, 53.1% self-identified as White and 24.2% as Hispanic. The mean number of aDCs in the central cornea was 1.28 ± 2.16 cells/image. The presence of ≥2 aDCs had a sensitivity of 60% and specificity of 77% for the diagnosis of a systemic immune disorder. Individuals with ≥2 aDCs were more likely to self-identify as Black, have Secondary Sjögren's, and have higher nerve fiber area and fractal dimension. In 12 individuals, aDC number decreased from 2.69 ± 2.36 to 0.58 ± 0.73 cells/image after initiation of an anti-inflammatory agent, p = 0.01.

Conclusions

The presence of ≥2 aDCs in the central cornea suggests a systemic immune disorder in individuals with DE symptoms. Topical anti-inflammatory therapy can reduce the number of aDCs in the central cornea.

中文翻译：

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活化的树突状细胞与干眼症状和体征之间的关系

 目的

研究“激活的”树突状细胞 (aDC) 是否可以作为干眼 (DE) 症状个体全身免疫疾病的生物标志物。其次，检查局部抗炎剂对 aDC 数量的影响。

 方法

进行回顾性分析，以确定 2018 年 10 月至 2020 年 7 月在迈阿密退伍军人医院进行体内共聚焦显微镜 (IVCM) 成像的具有 DE 症状的个体。根据形态学对 aDC 进行手动定量。受试者工作曲线 (ROC) 分析检查了 aDC 数量与全身免疫疾病状态之间的关系。然后根据 aDC 数量（≥2 与 <2）对个体进行分组，并检查人口统计和 DE 参数。进行配对t检验以评估抗炎剂启动前与启动后的DC数。

 结果

其中包括 128 人。他们的平均年龄为 57.1 ± 15.0 岁； 71.1% 是男性，53.1% 自认为是白人，24.2% 是西班牙裔。中央角膜中的 aDC 平均数量为 1.28 ± 2.16 个细胞/图像。 ≥2 个 aDC 的存在对于诊断全身性免疫疾病的敏感性为 60%，特异性为 77%。具有 ≥2 个 aDC 的个体更有可能自我认同为黑人，患有继发性干燥综合症，并且具有更高的神经纤维面积和分形维数。在 12 名个体中，在开始使用抗炎药后，aDC 数量从 2.69 ± 2.36 细胞/图像减少至 0.58 ± 0.73 个细胞/图像，p = 0.01。

 结论

中央角膜中存在 ≥2 个 aDC 表明患有 DE 症状的个体存在全身性免疫紊乱。局部抗炎治疗可以减少角膜中央的 aDC 数量。