Abstract
This study evaluated human papillomavirus’s (HPV) role in pterygium pathogenesis, its autoinoculation from genitalia to ocular surface, potential cytokines involved, and crosstalk cytokines between pterygium and dry eye (DE). This cross-sectional study enrolled 25 healthy controls (HCs) and 116 pterygium patients. Four subgroups of pterygium and DE were used in cytokine evaluations. Conjunctival and pterygium swabs and first-void urine samples (i.e., genitalia samples) were collected for HPV DNA detection using real-time polymerase chain reaction. Tear cytokines interleukin (IL)-6, IL-18, and vascular endothelial growth factor (VEGF) in tears were evaluated. No HPV DNA was detected in conjunctival or pterygium swabs. No association was found between HPV DNA in urine samples and that from conjunctival or pterygium swabs. Tear VEGF levels were significantly higher in pterygium patients than in HCs, with no markedly different levels between primary and recurrent pterygia. Tear IL-6, IL-18, and tear VEGF were significantly higher in participants with DE, regardless of pterygium status. In conclusion, HPV infection was not a pathogenic factor of pterygia. The hypothesis of HPV transmitting from the genitals to ocular surfaces was nullified. Tear VEGF was involved in both pterygia and DE, whereas tear IL-6 and IL-18 played roles only in DE.
Highlights
This study evaluated human papillomavirus’s (HPV) role in pterygium pathogenesis, its autoinoculation from genitalia to ocular surface, potential cytokines involved, and crosstalk cytokines between pterygium and dry eye (DE)
No HPV DNA was detected in the conjunctival swabs of either the healthy controls (HCs) or pterygium patients via real-time PCR
Binary logistic regression controlling for the Schirmer I test as a confounding factor, showed that the vascular endothelial growth factor (VEGF) covariate differed significantly between the HC and pterygium groups
Summary
This study included 141 participants: 25 healthy controls (HCs) and 116 pterygium patients. Subgroup analysis showed no statistically significant differences in tear IL-6, IL-18, or VEGF concentrations among the HCs, primary pterygium patients, and recurrent pterygium patients (p = 0.662, 0.938, and 0.081, respectively; Fig. 1). The geometric mean of the tear VEGF concentration in the pterygium group was 1.97 times higher (95% CI 1.07–3.60) than that in the HCs (p = 0.029; Fig. 2). Binary logistic regression controlling for the Schirmer I test as a confounding factor, showed that the VEGF covariate differed significantly between the HC and pterygium groups (adjusted OR = 1.89; 95% CI = 1.07–3.33; p = 0.028). The geometric mean of the tear IL-18 concentrations in the HCs with DE was 25.93 times higher (95% CI 5.62–119.76) than that of those without DE (p < 0.001) and 22.08 times higher (95% CI 8.64–56.43) than that of the pterygium groups without DE (p < 0.001).
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