Am J Ophthalmol. 2020 Mar 21. pii: S0002-9394(20)30113-6. [Epub ahead of print]
PURPOSE: To compare tear protein markers between normal subjects and dry eye (DE) patients with high and low lymphotoxin (LT)-alpha levels.DESIGN: Prospective cross-sectional study.
METHODS: DE patients were divided into low (≤700 pg/ml) and high (>700 pg/ml) LT-alpha groups. Twelve protein markers were measured by microsphere-based immunoassay and ocular surface parameters were determined in right eyes (33 high LT-alpha DE, 27 low LT-alpha DE, 20 control) and left eyes (21 high LT-alpha DE, 39 low-LT-alpha DE, 20 control).
RESULTS: In both eyes, tumor necrosis factor-α (TNF-α), interleukin (IL)-10, IL-1beta, IL-1Ra, IL-17A, and IL-12/23 p40 levels in high LT-alpha DE were significantly higher (p<0.01) than in low LT-alpha DE. Significant correlations identified in high LT-alpha DE were: SPEED with IL-10 (R=0.43, P=0.013), IL-1beta (R=0.4 8, P=0.005), and IL-12/23 p40 (R=0.50, P=0.003); IL-12/23 p40 with ocular surface disease index (OSDI) (R=0.35, P =0.049); and epidermal growth factor (EGF) with corneal fluorescein staining (CFS) score (R=-0.36, P=0.038). Significant correlations in low LT-alpha DE were: SPEED with IL-10 (R=-0.39, P=0.046), TNF-α (R=-0.39, P=0.047), and IL-17A (R=-0.48, P=0.013); OSDI with TNF-α (R=-0.47, P=0.017) and IL-17A (R=-0.46, P=0.018); and IL-6 with tear breakup time (R=-0.40, P=0.044). Lastly, IL-1Ra levels significantly increased in DE patients, positively correlated with temporal conjunctival hyperemia index (TCHI) and negatively correlated with Schirmer I test (p<0.05).
CONCLUSIONS: Our study identified tear IL-1Ra level as a potential biomarker to replace Schirmer I test. Multiple tear protein marker levels increased in high LT-alpha DE, indicating that high LT-alpha DE might have a different pathogenesis.
Keywords: Dry Eye; LT-alpha; Pathogenesis; Tears Protein Markers