Cytokine Profiles of Tear Fluid From Patients With Pediatric Lacrimal Duct Obstruction

Abstract

PURPOSE. This study evaluated the cytokine levels in unilateral tear samples from both sides in patients with pediatric lacrimal duct obstruction.METHODS. Fifteen cases of unilateral lacrimal duct obstruction (mean, 26.9 6 28.7 months old) were enrolled in this study. Tear samples were collected separately from the obstructed side and the intact side in each case before surgery, which was performed under general anesthesia or sedation. The levels of IL-2, IL-4, IL-6, IL-10, TNF, IFN-c, and IL-17A then were measured in each tear sample. A receiver operating characteristic (ROC) curve was constructed for the IL-6 levels in the tears. We also measured the postoperative tear fluid levels of IL-6 in those cases from which tear fluid samples could be collected after the surgery. RESULTS.Only the IL-6 concentration was significantly higher on the lacrimal duct-obstructed sides, compared to the control sides (P < 0.001). An ROC curve analysis for the IL-6 levels in tears showed a high value for discriminating the lacrimal duct-obstructed side from the control side (area under the ROC curve [AUC], 0.99; 95% confidence interval [CI], 0.968-1). Significant decrease of the tear fluid IL-6 levels was observed in the seven cases from which tear fluid samples also could be collected after the surgery (P ¼ 0.016).CONCLUSIONS. The IL-6 level in tear fluid was significantly higher on the sides with lacrimal duct obstruction, compared to the control sides, and could be a biomarker for pediatric lacrimal duct obstruction.

Lacrimal duct diseases are the potential cause of corneal epitheliopathy

“…[7][8][9] Patients with lacrimal drainage pathway diseases exhibit elevated levels of various in ammatory cytokines in tear uid. [16][17][18] Recanalization of the lacrimal drainage pathway may reduce the levels of interleukins and matrix metalloproteinases. Therefore, treatment of the lacrimal drainage pathway is necessary for the treatment of corneal epitheliopathy in lacrimal duct obstruction.…”

Rebamipide promotes lacrimal duct epithelial cell survival via protecting barrier function

“…Inflammation is thought to be a pathology of NLDO, and it has been reported that several inflammatory cytokines, such as IL-2, IL-6, IL-10, vascular endothelial growth factor, and fibroblast growth factor 2, are increased in the tear fluid of patients with PANDO 2 , and that IL-6, specifically, is increased in the tear fluid of patients with CNLDO 3 . As the findings in several previous reports have suggested that IL-6 attenuates the barrier function between cells 7,8 , our results revealed that IL-6 induced barrier dysfunction of cultured LDECs.…”

“…It has recently been reported that various tear cytokines, such as interleukin (IL)-2, IL-6, and IL-10, are involved in the pathology of primary acquired nasolacrimal duct obstruction (PANDO) 2 , and that IL-6 is also involved in congenital NLDO (CNLDO) 3 . Thus, the suppression of the level of inflammatory cytokines in tears is considered to be a key factor in the development of new methods for the treatment of NLDO.…”

Authors’ response

“…Two main methods were employed to collect tears, capillary pipettes and Schirmer method 2 , 3 . Schirmer method was chosen as this is safe, convenient and is known to cause less irritation 4 . Tears remain in the conjunctival fornix, and we don’t think the strip which was put in the fornix would have caused any contamination.…”