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A. Peral, G. Carracedo, P. Loma, C. O. Dominguez, J. Pintor; Ap4A as Molecular Marker in the Severity of Systemic Pathologies Associated With Dry Eye. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5308.
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To analyse the level of diadenosine tetraphosphate Ap4A in tears of subjects with dry eye associated to systemic pathologies, such as Sjögren syndrome and congenital aniridia.
Nine subjects, diagnosed with Sjögren Syndrome, and fifteen subjects diagnosed with congenital aniridia, participating in the present study were invited to fill a Symptom Questionnaire. The tear secretion was measured and collected by Schirmer I test. The strips were placed in Eppendorf tubes containing 500 µL of ultrapure water and submitted to Sep-Pak Accell QMA chromatography. All the tear samples were then processed by High Pressure Liquid Chromatography (HPLC) . The system was equilibrated with a mobile phase consisting of 10 mM KH2PO4, 2mM tetrabutyl ammonium, 15 % acetonitrile, pH, 7.5. with a NovaPak C18 column. The control group were 37 subjects without symptoms and a normal values of Schirmer test and BUT
Sjögren Syndrome patients presented a values of Schirmer test of 4.12±3.90 mm. This patients were organised in two groups, those individuals presenting normal tear production and those presenting low tear production. The concentration of Ap4A in normal tear production patients were 0.42±0.01 µM. Those patients presenting Sjögren Syndrome and low tear production presented Ap4A concentration of 4.57 ± 1.20 µM. Patients with congenital aniridia were organised by age. The values of Schirmer I test for patients with congenital aniridia under 10 years old were 20.6 ± 9.4 mm, 12.6±9.3 mm for patients between 10 and 25 years old and 13.6±8.3 mm for the patients between 25 and 50 years of age. Only a patient was older than 50 years old, this patient presenting Schirmer values of 1.25 mm. The concentrations observed for Ap4A were 11.8±2.3 µM and 21.5±1.7µM, 29.5±1.8 µM and 196.1±3.3 µM, for each group. Control patients presented values of diadenosine tetraphosphate of 0.107 ± 0.048 µM.
Patients with this systemic pathologies, present abnormally elevated values of Ap4A indicating that this compound could be used as a marker for the dry eye severity.
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