The Research of Apoptosis in Conjunctiva Epithelial Cells with Connective Tissue Disease_Chinese Journal of Evidence-Based Medicine

Authors：

1. Department of Ophthalmology, The Second Hospital, Tianjin Medical University, Tianjin 300211, China;2. Deparment of Ophthalmology, The First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China;

Corresponding author：

Keywords：

Impression cytology; Apoptosis; Dry eye; Connective tissue disease

DOI：

10.7507/1672-2531.20090168

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Objective 　To investigate pathogenesis of dry eye and applied value in diagnosis of dry eye with connective tissue disease(CTD) by apoptosis detection, using impression cytology flow cytometry (ICFC) in conjunctiva epithelial cells.
Methods 　A total of 60 patients (120 eyes) with CTD, after asked case history and measured the basal Schirmer’s test (S-I-T), Break-Up Time (BUT), fluorescent Staining (FL), were divided into 4 groups: the first group without Sjögren syndrome or dry eye (NSS1), the second group without Sjögren syndrome but dry eye (NSS2), the third group with Sjögren syndrome and non-dry-eye (SS1) and the fourth group with Sjögren syndrome and dry eye (SS2). And apoptosis of conjunctiva epithelial cells was detected by ICFC.
Results 　The apoptosis rate of conjunctiva epithelial cells was statistically significant (P lt;0.001) between every two groups, except that between NSS1 group and SS1 group (P=0.998). And apoptosis rate was a positive correlation with FL (r=0.926, P lt;0.001), but negatively with S-I-T and BUT (r= –0.712, r= –0.818, P lt;0.001). Dye eye and Sjögren-syndrome both affected the apoptosis level of conjunctiva epithelial cell and there was an interaction between them.
Conclusion 　Apoptosis plays an important role of ocular damage and apoptosis detection helps with diagnosis of dry eye with CTD. Dye eye and Sjögren-syndrome increase apoptosis level. Apoptosis detection by ICFC in conjunctiva epithelial cells is a minimally invasive and effective way to detect ocular apoptosis.

Citation： HUANG Guannan,WANG Licong,ZHANG Hong. The Research of Apoptosis in Conjunctiva Epithelial Cells with Connective Tissue Disease. Chinese Journal of Evidence-Based Medicine, 2009, 09(9): 949-952. doi: 10.7507/1672-2531.20090168 Copy

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7.	Pflugfelder SC, Jones D, Ji Z, et a1. Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren’s syndrome keratoconjunctivitis sicca. Curr Eye Res, 1999, 19: 201-211.
8.	Gao J, Schwal TA, Addeo JV, et a1. The role of apoptosis in the pathogenesis of canine keratoconjunctivitis sicca: the effect of topical cyclosporin A therapy. Cornea, 1998, 17(6): 654-663.
9.	Tsubota K, Fujita H, Tadano K, et al. Abnormal expression and function of Fas ligand of lachrymal glands and peripheral blood in Sjögren’s syndrome patients with enlarged exocrine glands. Clin Exp Immunol, 2002, 129: 177-182.
10.	Brignole F, Pissella PJ, Goldschild M, et a1. Flow cytometric analysis of inflammatory markers in conjunctival epithelial cells of patients with dry eye. Invest Ophthalmol Vis Sci, 2000, 41: 1356-1363.
11.	肖启国, 刘祖国, 张梅. 多西环素对培养的人结膜上皮细胞炎性反应及凋亡的影响. 中华眼科杂志, 2005, 41(9): 842-845.
12.	Sahai A, Malik P. Dry eye: prevalence and attributable risk factors in a hospital-based population. Indian J Ophthalmol, 2005, 53(2): 87-91.
13.	Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis, 2002, 61(6): 554-558.

1. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf, 2007, 5(2): 75-92.
2. Steven Y, Song XJ, Farley W, et al. Apoptosis of Ocular Surface Cells in Experimentally Induced Dry Eye. Invest Ophthalmol Vis Sci, 2003, 44: 124-129.
3. Afonso AA, Monroy D, Stern ME, et al. Correlation of tear fluorescein clearance and Schirmer test scores with ocular irritation symptoms. Ophthalmology, 1999, 106: 803-810.
4. 刘祖国. 主编. 眼表疾病学. 第1版. 北京: 人民卫生出版社, 2003. 293.
5. 柯宁, 赵敏. 干眼的免疫学研究现状及进展. 中国实用眼科杂志, 2006, 24(10): 1009-1013.
6. Pflugfelder SC, Huang AJ, Feuer W, et al. Conjunctival cytologic features of primary Sjögren syndrome. Ophthalmology, 1990, 97(8): 985-991.
7. Pflugfelder SC, Jones D, Ji Z, et a1. Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren’s syndrome keratoconjunctivitis sicca. Curr Eye Res, 1999, 19: 201-211.
8. Gao J, Schwal TA, Addeo JV, et a1. The role of apoptosis in the pathogenesis of canine keratoconjunctivitis sicca: the effect of topical cyclosporin A therapy. Cornea, 1998, 17(6): 654-663.
9. Tsubota K, Fujita H, Tadano K, et al. Abnormal expression and function of Fas ligand of lachrymal glands and peripheral blood in Sjögren’s syndrome patients with enlarged exocrine glands. Clin Exp Immunol, 2002, 129: 177-182.
10. Brignole F, Pissella PJ, Goldschild M, et a1. Flow cytometric analysis of inflammatory markers in conjunctival epithelial cells of patients with dry eye. Invest Ophthalmol Vis Sci, 2000, 41: 1356-1363.
11. 肖启国, 刘祖国, 张梅. 多西环素对培养的人结膜上皮细胞炎性反应及凋亡的影响. 中华眼科杂志, 2005, 41(9): 842-845.
12. Sahai A, Malik P. Dry eye: prevalence and attributable risk factors in a hospital-based population. Indian J Ophthalmol, 2005, 53(2): 87-91.
13. Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis, 2002, 61(6): 554-558.

Chinese Journal of Evidence-Based Medicine

The Research of Apoptosis in Conjunctiva Epithelial Cells with Connective Tissue Disease

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