Abstract
Purpose To evaluate the presence of ocular surface mucin in patients with atopic and vernal keratoconjunctivitis (AKC/VKC), we investigated the mRNA expression levels of SAM-pointed domain-containing ETS-like factor (SPDEF) and mucin-related genes on the ocular surface. Methods Nineteen patients with AKC or VKC were divided into two groups based on the severity of the disease as determined by their clinical scores for AKC/VKC: the stable group and the active group. Impression cytology was performed in all patients using filter paper, and the expression levels of SPDEF, MUC1, MUC4, MUC5AC, MUC16, and eotaxin-2 mRNA were determined by real-time reverse-transcription polymerase chain reaction. Results The results showed that the expression levels of SPDEF and MUC5AC mRNA in the active group were significantly decreased compared with those in the stable group. Furthermore, clinical scores were significantly negatively correlated with the expression levels of SPDEF mRNA and significantly positively correlated with the expression levels of eotaxin-2, which is a biomarker for eosinophilic inflammation on the ocular surface. Cluster analysis classified the patients with AKC/VKC into three clusters, and the stable group was divided into two clusters according to the condition of ocular surface mucin. Conclusions Ocular surface mucin in patients with AKC/VKC is altered in accordance with the clinical severity of the disease.
Highlights
Allergic conjunctival diseases are allergic disorders characterized by eosinophilic inflammation on the ocular surface and by an immediate hypersensitivity reaction with or without allergen-specific IgE antibodies [1]
Apart from conjunctival proliferative lesions, the severe and chronic forms of atopic and vernal keratoconjunctivitis (AKC/VKC) are characterized by corneal epithelial damage similar to that clinically observed in dry eye disease [6]. erefore, maintaining a good tear film is an important aspect of a successful treatment in patients with chronic forms of atopic keratoconjunctivitis (AKC)/VKC
Cluster analysis based on the Euclidian distance and Ward linkage was used to identify the grouping of chronic allergic conjunctival diseases patients using similar characteristics in terms of clinical scores and expression levels of SAM-pointed domain-containing ETS-like factor (SPDEF), MUC16, and eotaxin-2 mRNA
Summary
Allergic conjunctival diseases are allergic disorders characterized by eosinophilic inflammation on the ocular surface (consisting of the tear film, conjunctiva, and cornea) and by an immediate hypersensitivity reaction with or without allergen-specific IgE antibodies [1]. We investigated the mRNA expression levels of goblet cell- and mucin-related genes, including SPDEF, MUC5AC, MUC1, MUC4, and MUC16, on the ocular surface in patients with VKC/AKC by impression cytology (i.e., the clinical ocular surface test). Expression levels of SPDEF, MUC1, MUC4, MUC5AC, and MUC16 mRNA were compared between the stable and active groups using the Mann–Whitney U test. Cluster analysis based on the Euclidian distance and Ward linkage was used to identify the grouping of chronic allergic conjunctival diseases patients using similar characteristics in terms of clinical scores and expression levels of SPDEF, MUC16, and eotaxin-2 mRNA. Cluster Analysis of Patients with ACDs. All patients with active and stable AKC/VKC were evaluated by cluster analysis and grouped into three clusters according to their clinical score and expression levels of SPDEF and MUC16 mRNA. No of patients (cases) Age (years) (mean ± SD) Sex (male : female) Clinical score (points, median) erapeutic use of immunosuppressants (yes/total)
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