Immunological Impression Cytology of Conjunctival Epithelium in Thyroid Orbitopathy Combined with Dry Eye

• Main Authors: Shiuh-Liang Hsu, 徐旭亮
• Other Authors: Cheng-Hsien Chang
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/39812888783421232452

碩士 === 高雄醫學大學 === 醫學研究所 === 99 === Thyroid orbitopathy (TO), an autoimmune disease, is complicated with ocular surface disorder leading to discomforts of patients. Dry eye is highly prevalent in TO patients. Although previous studies have proposed factors of increased corneal exposure predisposing to dry eye disease in TO, inflammation in ocular surface may be another main contribution. Recent studies have focused on the inflammatory process to explain pathogenesis of dry eye and certain evidences have discovered. Since TO is a disorder of autoimmune origin, its association with dry eye is highly speculated to be inflammation-related. Inflammation of ocular surface has never been well studied in such cases of TO with dry eye. So far, no extensive study has been published in this aspect and hypothesis. In this study we will assay cellular inflammation in ocular surface and cytokines profiles in patients of TO combined with dry eye. Conjunctival impression cytology (CIC) will be studied with immunofluorescent assay (IFA). TO and dry eye patients were diagnosed with Schirmer test, tear break-up time, thyroid function and clinical signs. Conjunctival impression cytology (CIC) was combined with immunological stain of Interleukin-1???n?vIL-1???w, IL-1???nand IL-6?|?nThe grading of the immunological impression cytology (IC) was compared to clinical activity score of TO. All the markers of IL-1???z?nIL-1?? and IL-6 were highly positive in patients of TO with dry eyes. However, in normal control group, IL-1?? was similarly highly positive. A slight parallel trend was observed between clinical inflammatory score and grading of immunological IC. This study is the first to delineate the immunological IC of TO patients with dry eyes. The prospect of this study is to investigate the pathogenesis of dry eye occurring in TO. Our findings suggest that conjunctival cytokines IL-1α, IL-1β and IL-6 may play a role. This model of study is promising for further experiment of more inflammatory cytokines, and can be used as an outcome for investigation of treatment, such as anti-cytokine or immuno-suppression therapy, in such patients or other ocular surface inflammatory disorders.