J Korean Med Sci.  2011 Jul;26(7):938-944. 10.3346/jkms.2011.26.7.938.

Interleukin-17 in Various Ocular Surface Inflammatory Diseases

• Kang MH
• Kim MK
• Lee HJ
• Lee HI
• Wee WR
• Lee JH

• KMID: 1094267
• DOI: http://doi.org/10.3346/jkms.2011.26.7.938

Abstract

Recently, the association of Th-17 cells or IL-17 with ocular inflammatory diseases such as uveitis, scleritis and dry eye syndrome was discovered. We assessed whether interleukin (IL)-17 was present in the tears of various ocular surface inflammatory diseases and the tear IL-17 concentrations were clinically correlated with various ocular surface inflammatory diseases. We measured concentrations of IL-17 in tears of normal subjects (n = 28) and patients (n = 141) with meibomian gland dysfunction (MGD), dry eye syndrome (DES), Sjogren syndrome (SS), Stevens-Johnson syndrome (SJS), graft-versus-host disease (GVHD), filamentary keratitis, and autoimmune keratitis associated with rheumatoid arthritis or systemic lupus erythematosus. Clinical epitheliopathy scores were based on the surface area of corneal and conjunctival fluorescein staining. The mean concentrations of IL-17 in tears of patients with filamentary keratitis, GVHD, autoimmune keratitis, SS, DES, MGD, SJS were significantly higher in order than that in normal subjects. Tear IL-17 concentration was significantly correlated with clinical epitheilopathy scores in the patients with systemic inflammatory disease, while tear IL-17 was not correlated with clinical severity of the cornea and conjunctiva in the dry eye patients without any systemic inflammatory disease. Tear IL-17 is likely to correlate clinically with corneal disease severity only in the patients with systemic inflammatory disease.

Keyword

Interluekin-17; Tears; Ocular Surface Inflammatory Diseases; Epitheliopathy Score

MeSH Terms

Adult
Aged
Dry Eye Syndromes/*metabolism
Eye Diseases/diagnosis/*metabolism
Eyelid Diseases/metabolism
Female
Graft vs Host Disease/metabolism
Humans
Interleukin-17/*analysis
Keratitis/metabolism
Male
Meibomian Glands/physiopathology
Middle Aged
Severity of Illness Index
Sjogren's Syndrome/metabolism
Stevens-Johnson Syndrome/metabolism
Tears/metabolism

Figure

• 

  Fig. 1 Photograph standards and diagram for clinical scoring of corneal and conjunctival staining, with fewer modifications. Corneal staining standards; (A, B) and (C) each are 1 point; (D) and (E) each are 2 points; (F) and (G) each are 3 points. (H) Diagram: fluorescein staining was recorded in upper, middle and lower corneal regions; and superior, inferior, nasal, and temporal conjunctival regions.

• 

  Fig. 2 Mean values of IL-17 concentrations in tears of each patient group compared to the normal control group. The patients were divided into two groups; subjects without systemic inflammatory disease (A, group A) and the others with systemic inflammatory disease (B, group B). In all groups, the mean concentrations of IL-17 were significantly higher than that of the normal group (Mann-Whitney U test). NL, normal control; MGD, meibomian gland dysfunction; Sjogren, Sjögren syndrome; GVHD, graft-versus host disease; Autoimmune, dry eye syndrome associated with rheumatoid arthritis or systemic lupus erythematosus; DES, dry eye syndrome without systemic disease; SJS, Stevens-Johnson syndrome; Keratitis, filamentary keratitis.

• 

  Fig. 3 Mean values of IL-17 concentrations in tears of each patient group compared to the Graft-versus-host disease patients. The mean IL-17 concentration of graft-versus-host disease patients was significantly higher than those of dry eye syndrome without systemic disease patients, Stevens-Johnson syndrome and Sjögren syndrome patients (Mann-Whitney U test). GVHD, graft-versus-host disease; DES, dry eye syndrome without systemic disease; SJS, Stevens-Johnson syndrome; Sjogren, Sjögren syndrome.

• 

  Fig. 4 Correlation of tear IL-17 concentrations with clinical scores. There was no correlation of tear IL-17 with clinical scores in subjects the dry eye patients without systemic disease (group A; (A) Pearson correlation coefficient [r] = 0.012, P = 0.901) while, tear IL-17 did correlate a statistically significantly positive correlation with clinical severity in the patients with systemic diseases (group B; (B) Pearson correlation coefficient [r] = 0.364, P = 0.002).

• 

  Fig. 5 Simple scatter graph of ages and IL-17 concentrations. There was no correlation between age and IL-17 concentrations (P = 0.637, r = Pearson correlation coefficient).

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