Ocular surface cytokine profile in chronic Stevens-Johnson syndrome and its response to mucous membrane grafting for lid margin keratinisation

Abstract

background To study the tear cytokine and the conjunctival and oral mucosal marker profile in chronic ocular Stevens-Johnson syndrome (SJS) and their alteration following mucous membrane grafting (MMG) for lid margin keratinisation (LMK). Methods In a 1-year prospective study, SJS cases (n=25) and age-matched/sex-matched healthy controls (n=25) were recruited. Tear specimen (Schirmer's strip), conjunctival and oral mucosal imprints were collected from controls and SJS cases pre-MMG and post-MMG (at first follow-up, n=17). Tear cytokines were profiled using 27-bioplex array. Transforming growth factor-beta (TGF-β)-mediated extracellular matrix changes in conjunctival and oral mucosal cells were analysed by gene expression studies. 30

Evaluation of IL8 pathway on the ocular surface: new insights in patients with ocular mucous membrane pemphigoid

“…In line with this hypothesis, Gurumurthy et al. () reported that tear levels of IL‐8 is up‐regulated not exclusively in the acute inflammatory phase but also in the persistently chronic inflammatory phase of ocular SJS, a condition characterized by scarring features.…”

“…) and it is a pro‐fibrotic factor by inducing epithelial‐to‐mesenchymal transition changes (Gurumurthy et al. ).…”

“…In fact, IL-8 plays an important role in acute inflammation by recruiting inflammatory cells, including neutrophils, and inducing fibrotic processes (Williams et al 2016). In addition, IL-8 exerts angiogenic effect (Yoshida et al 1997;Li et al 2003) and it is a pro-fibrotic factor by inducing epithelial-to-mesenchymal transition changes (Gurumurthy et al 2018).…”

“…), Stevens–Johnson syndrome (SJS) (Gurumurthy et al. ), toxic epidermal necrolysis (TEN) (Paquet et al. ) and idiopathic pulmonary fibrosis (Southcott et al.…”

“…Several evidence demonstrated that ocular surface scarring occurring in ocular MMP is the result of the inflammatory response and the release of fibrogenic cytokines and mediators by inflammatory cells and fibroblasts which induce conjunctival fibrosis and extracellular matrix deposition (Razzaque et al 2001(Razzaque et al , 2003Dart 2017). Recently, it has been demonstrated that local and systemic levels of IL8 are increased in cicatrizing inflammatory conditions such as autoimmune glomerulonephritis (Tramma et al 2012), Stevens-Johnson syndrome (SJS) (Gurumurthy et al 2018), toxic epidermal necrolysis (TEN) (Paquet et al 2007) and idiopathic pulmonary fibrosis (Southcott et al 1995). It has been showed that IL8 plays a key role in stimulating fibrogenic inflammatory reaction through neutrophils recruitment (Murphy 1997;Yang et al 2018).…”