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Antonio Di Zazzo, Alessandra Micera, Marco Coassin, Giuseppe Varacalli, William Foulsham, Maria De Piano, Stefano Bonini; InflammAging at Ocular Surface: Clinical and Biomolecular Analyses in Healthy Volunteers. Invest. Ophthalmol. Vis. Sci. 2019;60(5):1769-1775. doi: 10.1167/iovs.18-25822.
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To assess the ocular surface in volunteers who consider themselves as healthy, in order to evaluate how para-inflammatory mechanisms fail with age, and thus investigate the phenomenon of “InflammAging.”
In this observational prospective cohort study, volunteers were categorized into three groups according to age: young (19–40 years), middle-aged (41–60 years), and older adults (61–93 years). Clinical assessments included tear breakup time (T-BUT) and Schirmer test type I. Dry eye symptoms were evaluated by the Ocular Surface Disease Index (OSDI) questionnaire. Conjunctival mRNA and protein expression of intercellular adhesion molecule-1 (ICAM-1), MUC5AC, and IL-8 were measured by real-time PCR and immunofluorescence.
A total of 82 volunteers (38 males and 44 females) were enrolled. T-BUT decreased significantly with increasing age (young: 11.13 ± 0.18 seconds; middle-aged: 10.83 ± 0.56 seconds; older: 9.00 ± 1.00 seconds, P < 0.05). Schirmer test values decreased significantly with age (young: 20.6 ± 1.0 mm; middle-aged: 19.2 ± 1.2 mm; older: 16.0 ± 1.1 mm, P < 0.05). OSDI scores increased with age in both groups, but they were substantially higher in women. Conjunctival expression of inflammatory markers ICAM-1, IL-8, and MUC5AC increased with age.
Clinical signs, symptoms, and biomarkers of chronic inflammation increased with age in a cohort of volunteers who considered themselves healthy, indicating an age-related progressive impairment of ocular surface system function.
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