泪膜和眼表 CCR5及其配体在干眼症中的表达和意义

摘要

ABSTRACT:Objective To investigate the expression and significance of chemokine receptor 5 (CCR5)and its ligands in tear film and ocular surface of patients with dry eye disease.Methods Forty-four patients with dry eye disease were divided into two groups:sicca syndrome group(17 cases)and non-sicca syndrome group(27 cases).In addition,20 healthy subjects were selected as the control group.The concentrations of CCL3,CCL4 and CCL5 were measured using enzyme-linked immunosorbent assay.The expression of CCL3,CCL4 and CCL5 and the density of CCR5 +cells were determined using immunohistochemistry.The percentages of CCR4 + CD4 + ,CCR5 +CD4+ and CCR6+CD4+ cells in conjunctival epithelium were detected using flow cytometry.Fur-thermore,the correlation between chemokine levels and tear film and ocular surface parameters was analyzed in sicca syndrome group.Results Compared with non-sicca syndrome group,the ex-pression of CCL3,CCL4 and CCL5 and the percentages of CCR5+CD4+ and CCR6+CD4 + cells in conjunctival epithelium significantly increased in sicca syndrome group(P <0.01).Compared with healthy subjects,the expression of CCL3,CCL4 and CCL5 and the percentages of CCR5 +CD4+ and CCR6 +CD4+ cells in conjunctival epithelium significantly increased in patients with dry eye disease(P <0.05 or P <0.01).The expression of CCL3,CCL4 and CCL5 was positively correlated with tear clearance rate(r=0.446,0.693 and 0.656,respectively,P <0.05)and corneal goblet cell density(r=0.712,0.768 and 0.780,respectively,P <0.05).Conclusion The expres-sion of CCR5 and its ligands increases in the tear film and ocular surface of patients with dry eye disease.CCL5 expression is correlated with the severity of dry eye disease.%目的：探讨泪膜和眼表趋化因子受体5（CCR5）及其配体在干眼症中的表达和临床意义。方法选择干眼症患者44例，其中干燥综合征患者（干燥综合征组）17例，非干燥综合征患者（非干燥综合征组）27例。以健康体检者20例作为对照组。对3组分别采用酶联免疫吸附法检测 CCL3、CCL4和 CCL5表达水平，免疫组织化学法检测结膜上皮 CCL3、CCL4、CCL5表达水平和 CCR5＋细胞密度，流式细胞术检测结膜上皮 CCR4＋CD4＋、CCR5＋CD4＋和 CCR6＋CD4＋细胞比例。对干燥综合征组 CCL3、CCL4、CCL5表达水平与检测指标的相关性进行分析。结果干燥综合征组结膜上皮 CCL3、CCL4和 CCL5表达水平均显著高于非干燥综合征组，非干燥综合征组、干燥综合征组结膜上皮 CCL3、CCL4和 CCL5表达水平则均显著高于对照组（均 P ＜0．01）。干燥综合征组 CCR5＋CD4＋、CCR6＋CD4＋细胞比例明显高于非干燥综合征组，非干燥综合征组、干燥综合征组 CCR5＋CD4＋、CCR6＋CD4＋细胞比例则均显著高于对照组（P ＜0．05或 P ＜0．01）。干燥综合征组 CCL3、CCL4、CCL5表达水平与泪液清除率、结膜杯状细胞密度均呈正相关（r ＝0．446、0．693、0．656、0．712、0．768和0．780，均 P ＜0．05）。结论CCR5及其配体在干眼症泪膜和眼表中的表达均显著增高，CCL5表达可能与干眼症严重程度有关。