Abstract
BackgroundTo evaluate if conjunctival epithelial cells’ expression of HLA-DR and ICAM-1 could be helpful as early topical markers of inflammation in Graves’ orbitopathy (GO).MethodsThe ocular examination evaluated a clinical activity score (CAS) by assessment of clinical features, (e.g., eyelid or conjunctival inflammation, lid width, lid closure, proptosis, ocular motility). Conjunctival epithelial cell specimens for flow-cytometric evaluations of ICAM-I and HLADR expression were collected by impression cytology from ten eyes with active GO (CAS ≥ 4 and duration ≤ 12 months), from 15 eyes with Graves’ disease (GD) without active GO (CAS 0–2) and from 15 normal specimens without any ocular disorders.ResultsThe percentage of HLA-DR + conjunctival epithelial cells was significantly elevated in patients with active GO comparing to GD without active GO and healthy controls, 10.7 % (8.5–17.7) and 7.78 % (3.92–10.1) (p < 0.05) vs. control 4.89 % (3.5–5.5) (p < 0.005), respectively. The expression of ICAM − 1+ conjunctival epithelial cells was greater only in patients with GO vs. controls, 5.5 % (4.8–7.03) and 1.46 % (0.69–2.51) (p < 0.005), respectively.ConclusionThe percentage of HLA-DR+ and ICAM-1+ conjunctival epithelial cells in patients with the active GO may serve as a topical inflammation marker in Graves’ orbitopathy.
Highlights
Development of flow cytometric analysis of cytologic specimens provides a new, sensitive and objective tool for exploring conjunctival pathology [1]
The percentage of HLA-DR+conjunctival epithelial cells was significantly elevated in patients with active Graves’ orbitopathy (GO) comparing to Graves’ disease (GD) without active GO and healthy controls, 10.7 % (8.5–17.7) and 7.78 % (3.92–10.1) (p
The objective of this study was to evaluate the expression of ICAM-1 and HLA-DR in conjunctival epithelial cells by flow cytometry in patients with active GO and Graves disease (GD) without active GO, in order to estimate if the conjunctival expression of these molecules could serve as topical markers of ongoing inflammation in the active GO
Summary
Development of flow cytometric analysis of cytologic specimens provides a new, sensitive and objective tool for exploring conjunctival pathology [1]. Conjunctival epithelium expression of HLA-DR (human leukocyte antigen-DR) and ICAM-1 (intercellular adhesion molecule-1) have been shown to be correlated with some topical inflammatory processes like allergic conjunctivitis, pterygium, or keratoconjunctivitis sicca (KCS) in cystic fibrosis [2,3,4,5,6]. The expression of endothelial and epithelial ICAM-1 increases [7]. Detection of HLA-DR and ICAM-1 molecules on the conjunctiva may suggest activity of the immunopathological process underlying Graves' orbitopathy which should be considered as an indication of intensive systemic immunosuppression. To evaluate if conjunctival epithelial cells’ expression of HLA-DR and ICAM-1 could be helpful as early topical markers of inflammation in Graves’ orbitopathy (GO). Conjunctival epithelial cell specimens for flow-cytometric evaluations of ICAM-I and HLADR expression were collected by impression cytology from ten eyes with.
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