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Piera Versura, Alberto Bavelloni, Chiara Coslovi, William Blalock, Marco Grillini, giuseppe giannaccare, Emilio Campos; High levels of sIgA and exudated serum albumin in tears of contact lens related Dry Eye patients three months after discontinuation of lens use. Invest. Ophthalmol. Vis. Sci. 2013;54(15):503.
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To evaluate discontinued contact lens (CL) wearers with particular reference to secretory IgA (sIgA) and exudated serum albumin in tears as markers of local inflammation.
45 CL wearers diagnosed as having dry eye (DE) according to DEWS guidelines (DEWS grade 1-3) and 25 matched normal non-CL wearer volunteers were included in this study. Patients had discontinued the use of various types of CLs (12 RGP, 33 soft disposable or frequent replacement CL-average time from last use 60±30 days) because of associated discomfort. OSDI questionnaire score, Schirmer test I, Break Up Time (BUT), Lissamine green vital staining, corneal esthesiometry (Cochet-Bonnet), conjunctival scraping and imprint cytology were performed. Total tear protein content (TP), Lysozyme-C (LYS-C), Lactoferrin (LACTO) and exudated serum albumin (ALB) were evaluated (mg/ml) with the 2100 Bioanalyzer (Agilent Technology, CA, USA, P230 Lab-chip kit). Validation of kDa range for heavy chain IgA bands in each lane was carried out as previously described (Versura P et al, Mol Vis 2012). The sIgA/LYS-C ratio was calculated as an index of the increased activity of the IgA-producing cells in the lachrymal gland. Data were statistically evaluated and correlated with wear parameters (Pearson’s r) (significance p<0,05).
A statistically significant decrease was found in CL-related DE patients vs controls (media±S.D.) for BUT (respectively 8.6±4.9vs12.4±3.6 sec), corneal esthesiometry (50.2±2.3vs55.5±3.2 mm/lenght), TP (7.5±2.9vs9.3±4.3 mg/ml), LYS-C (2.08±0.9vs 2.9±0.9), LACTO (1.7±0.9vs 2.1±0.9), while an increase was found for OSDI score (22.4±14,4vs5.5±2.2), scraping cytology score (4.3±1.5vs2.1±0.3), imprint cytology score (1.8±0.8vs0.5±0.2), ALB (1.1±1.3 vs 0.3±0.5) heavy chain sIgA (0.51±0.41vs0.38±0.33, band validated in the range 48.0-51.0 kDa) and sIgA/LYS-C ratio (0.21±0.1vs0.12±0.1). sIgA/LYS-C was found to be positively correlated to DE severity grade, scraping cytology score and OSDI (r=0,52, 0,42 and 0,45 respectively, p<0.05). No significant correlation was found with CL type, wear regimen, discontinuation time.
Ocular surface parameters and tear proteins were significantly altered in CL-related DE patients, especially as regards local inflammation indexes. Data suggest that recovery of ocular surface homeostasis exceeds a three month CL use stop.
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