Immunopathological findings in conjunctival cells using immunofluorescence staining of impression cytology specimens.

Abstract

The conventional technique of impression cytology provides a non-invasive method for the evaluation of conjunctival epithelium alterations. Using indirect immunofluorescence procedures two inflammatory markers, class I MHC antigens HLA DR and the receptor to IgE (CD23), were sought in impression cytology specimens obtained from 80 patients. In normal subjects conjunctival epithelial cells did not show any reactivity. Only scattered dendritic cells were found to express class U antigens but not the receptor to IgE. In contrast patients with chronic conjunctivitis of various aetiologies, mainly infectious or allergic, had 40-100% of brightly positive conjunctival cells for one or both antigens. In these cases epithelial cells and goblet cells reacted similarly. Twenty four eyes in 12 patients with idiopathic dry eye syndrome disclosed results similar to those from normal conjunctival specimens. However 18 other specimens from patients suffering from idiopathic tear deficiency but undergoing multiple substitutive treatments for dry eye had moderate to strong positivity for HLA DR and/or the receptor to IgE (20-100% of cells). As these results were independent of the degree of squamous metaplasia the expression of these membrane markers may reflect local inflammation in addition to tear deficiency, possibly due to sensitisation to the eye drops used. These immunocytological techniques thus provide useful methods of investigating conjunctival inflammation and allergy. They may constitute valuable aid in the diagnosis and appropriate treatment of ocular surface disorders. (BrJ7 Ophthalmol 1992; 76: 545-549)

Tearful relations: oxidative stress, inflammation and eye diseases

“…In addition, inflammation may finally influence tear film components other than those depending on the lacrimal gland, as interferon gamma, a major cytokine known to induce both HLA DR expression and apoptosis in conjunctival cells (13) , which has been shown to inhibit mucus production in the airways. Studies using immunological techniques have indeed shown the presence of conjunctival inflammation in more than 80% of patients with keratoconjunctivitis sicca (KCS) (17)(18) . The presence of inflammatory cell infiltrates in the lacrimal glands and the conjunctiva, the upregulation of immune-related antigens and inflammatory cytokines at the level of the conjunctival epithelium, impaired apoptotic regulation of lacrimal glands, and possible alterations in membrane trafficking of acinar cells, in association with squamous metaplasia and loss of globet cells, are common features of KCS (13,15,18) .…”

The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study

“…A new definition of this disease has been developed recently, due to evidence which supports that inflammation has a key role in the development of dry eye. [2][3][4][5] Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface.…”

Biomarkers of Ocular Surface Disease Using Impression Cytology

“…HLA-DR is thus considered a proinflammatory marker, and it is specifically upregulated in patients with severe DED. In 1992, Baudouin et al showed that IC could specifically detect HLA-DR expression in human conjunctival cells [11]. Then, in 1997 Baudouin demonstrated HLA-DR quantification via IC, using flow cytometry [25].…”

“…More recently, however, researchers have used IC to examine specific markers of inflammation, for example, HLA-DR, ICAM-1 and CD8 [10][11][12], and to examine novel biomarkers of dry eye disease (DED). The latter is performed in an attempt to understand the mechanisms underpinning DED pathophysiology and is now feasible, due to vast improvements in the assay sensitivities for gene and protein examination [13].…”