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强脉冲光治疗睑板腺功能障碍后泪液细胞因子水平及临床相关性分析

Liu, R., Rong, B., Tu, P., et al.

期刊名称:American journal of ophthalmology

卷期:2017年第183卷

摘要

摘要:目的:旨在探讨强化脉冲光(IPL)治疗睑板腺功能障碍(MGD)引起的干眼病(DED)泪液中验证标记物较基线变化和睑板腺表达(MGE),并与假性治疗进行比较。设计:随机双盲,对照研究。方法:随机分为治疗组和对照组,治疗组接受3次连续治疗约4周(1416 J / cm2)),避开眶周围部分。对照眼以0J / cm2)相同的间隔接受3次治疗。收集所有眼泪液样品,并分析基线,12周和/4周的白细胞介素(IL-17AIL-6和前列腺素E2PGE2)。分析IPL治疗前后细胞因子与眼表参数的相关性。结果:与基线相比,所有炎症标志物均有下降。与每个测量时间点的假治疗相比,IL-17AIL-6下降具有出统计学显著性。结果显示,IL-17AIL-6的表达与IPL前下眼睑眼表参数具有良好的相关性。泪液中IL-6PGE2的变化值与研究眼IPL治疗后部分眼表面参数的变化值分别相关。结论:研究结果提示IPL能显着降低IPL治疗后MGD引起的DED患者泪液中炎性标志物。这些结果表明,IL-17AIL-6MGD所致的DED发病机制中发挥作用,炎症因子的减少与部分临床症状和体征的改善是一致的。

PURPOSE:To investigate the change from baseline of inflammatory markers in tears of dry eye disease (DED) subjects owing to meibomian gland dysfunction (MGD) after intense pulsed light (IPL) treatment and meibomian gland expression (MGE) compared to sham treatment, and the correlations with ocular surface parameters.DESIGN:Randomized, double-masked, controlled study.METHODS:Those randomized into the active treatment arm received 3 consecutive treatments (1416 J/cm(2)) approximately 4weeks apart in the periocular region. Control eyes received 3 treatments in the same intervals of 0 J/cm(2). Tear samples in all eyes were collected and analyzed at baseline, week 12, and/or week 4 for interleukin (IL)-17A, IL-6, and prostaglandin E2 (PGE2). The correlations between cytokines and ocular surface parameters were analyzed before and after IPL treatment.RESULTS:All of the inflammatory markers declined in value compared to baselines. IL-17A and IL-6 showed statistically significant decreases compared to sham treatment at each measured time point. PGE2 showed statistically significant decreases compared to sham at week 12. Results showed that the expressions of IL-17A and IL-6 correlated well with ocular surface parameters of the lower eyelid before IPL. The changed values of IL-6 and PGE2 in tears correlated with the changed values of partial ocular surface parameters after IPL treatment in study eyes, respectively.CONCLUSIONS:The study results suggest that IPL can significantly reduce inflammatory markers in tears of patients suffering with DED owing to MGD after IPL treatment. These findings indicate that IL-17A and IL-6 play roles in the pathogenesis of DED owing to MGD, and the reduction of the inflammatory factors is consistent with the improvement of partial clinical symptoms and signs.


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