Conjunctival T-cell subpopulations in Sjögren's and non-Sjögren's patients with dry eye.

Publication Type
Journal Article
Year of Publication
Stern, Michael E; Gao, Jianping; Schwalb, Tammy A; Ngo, Mylinh; Tieu, David D; Chan, Chi-Chao; Reis, Brenda L; Whitcup, Scott M; Thompson, Darby; Smith, Janine A
Invest Ophthalmol Vis Sci
Date Published
2002 Aug
Adult; Aged; Aged, 80 and over; Biopsy; CD3 Complex; CD4 Antigens; CD8 Antigens; Conjunctiva; Female; Fluorescent Antibody Technique, Indirect; Histocompatibility Antigens Class II; Humans; Immunoenzyme Techniques; Immunophenotyping; Intercellular Adhesion Molecule-1; Keratoconjunctivitis Sicca; Male; Middle Aged; Sjogren's Syndrome; T-Lymphocyte Subsets; Up-Regulation

PURPOSE: To examine the conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca (SS-KCS) and non-Sjögren's keratoconjunctivitis sicca (NS-KCS) for evidence of immune-based inflammation.

METHODS: Conjunctival biopsy specimens were obtained from 15 patients with SS-KCS and 15 with NS-KCS. Immunohistochemistry was performed on frozen sections to characterize and quantify T-cell subtypes (CD3, CD4, and CD8) and markers of immune activation (major histocompatibility complex [MHC] class II: HLA-DR, HLA-DQ) and inflammation (intercellular adhesion molecule [ICAM]-1). The numbers of cells positive for each marker were counted by two masked observers and averaged.

RESULTS: Conjunctival biopsy specimens from patients with SS-KCS or NS-KCS revealed lymphocytic infiltration and increased immunoreactivity for the markers of inflammation and immune activation. The extent of cellular immunoreactivity did not differ significantly between SS-KCS and NS-KCS tissue samples.

CONCLUSIONS: The authors' findings indicate that patients with SS-KCS or NS-KCS have conjunctival inflammation manifested by inflammatory cell infiltrates and upregulation of expression in markers of immune activation. Clinical symptoms of KCS may be more dependent on T-cell activation and resultant inflammation than previously believed. In addition to tear substitutes, anti-inflammatory therapeutics should be investigated for the treatment of KCS.