Analysis of Tear Cytokines and Clinical Correlations in Sjögren Syndrome Dry Eye Patients and Non–Sjögren Syndrome Dry Eye Patients

• Published in: American journal of ophthalmology 2013-08, Vol.156 (2), p.247-253.e1
• Main Authors: Lee, Sang Yeop, Han, Soo Jung, Nam, Sang Min, Yoon, Sang Chul, Ahn, Ji Min, Kim, Tae-Im, Kim, Eung Kweon, Seo, Kyoung Yul
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cross-Sectional Studies; Cytokines; Cytokines - metabolism; Eye care products; Eye Proteins - metabolism; Female; Humans; Immunoassay; Medical research; Middle Aged; Ophthalmology; Prospective Studies; Sjogren's Syndrome - diagnosis; Sjogren's Syndrome - metabolism; Studies; Tears - chemistry; Tears - metabolism
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2013.04.003

Purpose To compare concentrations of tear cytokines in 3 groups composed of Sjögren syndrome (SS) dry eye, non–Sjögren syndrome (non-SS) dry eye, and normal subjects. Correlations between ocular surface parameters and tear cytokines were also investigated. Design Prospective cross-sectional study. Methods SS dry eye patients (n = 24; 40 eyes) were diagnosed with primary SS according to the criteria set by the American-European Consensus Group. Non-SS dry eye patients (n = 25; 40 eyes) and normal subjects (n = 21; 35 eyes) were also enrolled. Tear concentrations of interleukin (IL)-17, IL-6, IL-10, IL-4, IL-2, interferon γ (IFN-γ), and tumor necrosis factor α (TNF-α) were measured by a multiplex immunobead assay. Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), Schirmer I test, and fluorescein staining scores were obtained from dry eye patients. Results All cytokine levels except for IL-2 were highest in the SS group, followed by non-SS dry eye group and control subjects. Concentrations of IL-17, TNF-α, and IL-6 were significantly different among the 3 groups (IL-17: SS > control P < .001, non-SS > control P  = .042, SS > non-SS P < .001; TNF-α: SS > control P  = .006, non-SS > control P  = .034, SS > non-SS P  = .029; IL-6: SS > control P  = .002, non-SS > control P  = .032, SS > non-SS P  = .002). IL-17 was significantly correlated with TBUT (R = −0.22, P  = .012) and Schirmer I test (R = −0.36, P  = .027) scores in the SS group. IL-6 was significantly correlated only with TBUT (R = −0.38, P  = .02) in the non-SS group. Conclusions Differences in tear cytokine levels and correlation patterns between SS dry eye and non-SS dry eye patients suggest the involvement of different inflammatory processes as causes of dry eye syndrome.