High Level of Inflammatory Cytokines in the Tears: A Bridge of Patients with Concomitant Exotropia and Dry Eye

Abstract

Concomitant exotropia have obvious symptoms of eye discomfort in adults, and the presence of ocular surface inflammation in patients may be important mediators between concomitant exotropia and dry eye. Oculus Keratograph eye comprehensive analyzer was performed to detect noninvasive tear break time, noninvasive tear height, and eye red index, while the ocular surface disease index and schirmer I testing were made. The levels of IL-6, IL-10, IL-17A, IL-12P70, INF-γ, and TNF-α were detected in tears in patients with concomitant exotropia and healthy controls matched by age and gender through the Simoa technology. IL-6 was significantly higher in patients with concomitant exotropia ( 4.683 ± 1.329 ) pg/mL than that in normal group ( 1.455 ± 0.391 ) pg/mL, p = 0.0304 . TNF-α was also significantly higher in patients ( 0.2095 ± 0.0703 ) pg/mL than normal group ( 0.0513 ± 0.0149 ) pg/mL, p = 0.0397 . The levels of inflammatory factors in strabismic patients vs. normal controls were as follows: IL-17A (0.1551 pg/mL︰0.0793 pg/mL), IL-10 (0.3358 pg/mL︰0.0513 pg/mL), IL-12p70 (0.0253 pg/mL︰0.0099 pg/mL), and INF-γ (0.0284 pg/mL︰0.009 pg/mL) were detected, and the median of them in concomitant strabismus was 1.96-6.55-fold as much as the control group. High levels of inflammatory cytokines in tears of patients with concomitant exotropia, which may be a potentially factor promoted the occurrence of dry eye in the patients with concomitant exotropia.

Calcitonin gene‐related peptide and persistent corneal pain: A trigeminal nerve sensitization perspective

“…Our previous study found that adult patients with concomitant exotropia had increased clinical indicators related to DED and increased expression of inflammatory molecules interleukin-6 and tumor necrosis factor-α in tears. [97] Long-term exotropia disrupts corneal stability, and repeated mechanical micro-damage may cause a sustained increase in the inflammation level by activating the corneal nerve and inducing trigeminal nerve sensitization. The 2021 Nobel Prize in Medicine emphasized that "Our ability to perceive hot, cold, and touch is essential for survival and fundamental to our interactions with the world around us."…”

The Incidence and Risk Factors for Dry Eye After Pediatric Strabismus Surgery

“…The mean age in our study was lower (7.21 years) than theirs (20.6 years). Gao and coworkers [ 32 ] found that inflammatory cytokines (interleukin-6 and tumor necrosis factor-α) in the tears of children with concomitant exotropia were significantly higher than those of normal subjects, but this difference was not observed in adults. Further studies are needed to clarify the mechanism of low BUT and the correlation with high inflammatory cytokines in children with strabismus.…”

Tear and Plasma Levels of Cytokines in Patients with Uveitis: Search for Active Disease Biomarkers

“…Our outcome is concordant with previous uveitis investigations in which the tear profile was analysed, emphasising that tear TNF-α levels do not reflect the concentrations within the eye [ 21 , 31 ]. However, we must consider that the TNF-α percentage of detection in tears is not constant in the literature, varying from 1% to 100% [ 32 , 33 , 34 , 35 , 36 ]. We have to consider that the TNF-α detection rate could be affected by different factors.…”