Tear Function Parameters in Keratoconjunctivitis sicca with and without the Association of Sjögren's Syndrome

Abstract

In a group of patients with keratoconjunctivitis sicca (KCS) associated with SjÖgren’s syndrome (SJ) a significant decrease in tear fluid lactoferrin concentration and tear film break-up time was demonstrated in comparison with a matched group in which KCS was not associated with any systemic disease. The Schirmer values were also lower in the SJ of patients and these differences almost reached statistical significance. None of these parameters in itself appeared to be of any clinical value to differentiate between KCS that was or was not associated with SJ. The combination of the tear fluid lactoferrin concentration, the Schirmer I test values and the tear film break-up time, however, provide a basis for differential diagnosis that is clinically of some value.

Fluorescence-based reagent and spectrum-based optical reader for lactoferrin detection in tears: differentiating Sjögren’s syndrome from non-Sjögren’s dry eye syndrome

“…This was achieved by using a fixed wavelength of emitted fluorescence light to decrease the interference of noise and a signal amplification wafer to increase device sensitivity. This improvement further expands the application of our method to patients with low levels of tear lactoferrin, such as those with SS-DED or GVHD-DED who have scarce amounts of tear fluid and reduced levels of lactoferrin 35 . Second, we employed a cost-effective and less invasive method for tear collection, the Schirmer strip paper.…”

Fluorescence-based reagent and spectrum-based optical reader for lactoferrin detection in tears: differentiating Sjögren’s syndrome from non-Sjögren’s dry eye syndrome

“…This was achieved by using a fixed wavelength of emitted fluorescence light to decrease the interference of noise and a signal amplification wafer to increase device sensitivity. This improvement further expands the application of our method to patients with low levels of tear lactoferrin, such as those with SS-DED or GVHD-DED who have scarce amounts of tear fluid and reduced levels of lactoferrin 35 . Second, we employed a cost-effective and less invasive method for tear collection, the Schirmer strip paper.…”

Predictive role of tear protein expression in the early diagnosis of Sjögren’s syndrome

“…30 DE syndrome in SS patients is associated with an altered proteomic profile with dysregulated expression of proteins involved in a variety of cellular processes: in particular, proteins involved in antibacterial action were found to be down-regulated, those involved in the inflammation, immunity and oxidative stress were up-regulated, and in addition, proteins uniquely present in the tear fluid of SS patients with DE were identified. 31 Other studies differentiated SS from DE and controls on the basis of changes in tear film-specific protein expression, 5,[32][33][34][35] leading to the suggestion that biomarker profiling may significantly contribute to patient characterization. 8,36 Both clinical tests and tear proteome analysis showed different trends in the two populations (SS and not-SS DE), at least for some of the analysed parameters in the present study.…”

Rose Bengal Staining of the Temporal Conjunctiva Differentiates Sjögren's Syndrome from Keratoconjunctivitis Sicca

“…There may be many physiological factors that cause increased amounts of staining and perhaps progression to the temporal conjunctiva in SS. These include the unique inflammatory status of the lacrimal gland, 31,32 lack of reflex tearing, 29 tear film protein composition, [33][34][35][36] inflammation of the ocular surface [37][38][39][40][41][42] and alterations in mucin expression. 37,43,44 It is the membrane-spanning mucins that have been most often linked to rose bengal staining.…”

Fluorescence-based reagent and spectrum-based optical reader for lactoferrin detection in tears: differentiating Sjögren’s syndrome from non-Sjögren’s dry eye syndrome

“…This was achieved by using a fixed wavelength of emitted fluorescence light to decrease the interference of noise and a signal amplification wafer to increase device sensitivity. This improvement further expands the application of our method to patients with low levels of tear lactoferrin, such as those with SS-DED or GVHD-DED who have scarce amounts of tear fluid and reduced levels of lactoferrin 35 . Second, we employed a cost-effective and less invasive method for tear collection, the Schirmer strip paper.…”

Predictive role of tear protein expression in the early diagnosis of Sjögren’s syndrome

“…30 DE syndrome in SS patients is associated with an altered proteomic profile with dysregulated expression of proteins involved in a variety of cellular processes: in particular, proteins involved in antibacterial action were found to be down-regulated, those involved in the inflammation, immunity and oxidative stress were up-regulated, and in addition, proteins uniquely present in the tear fluid of SS patients with DE were identified. 31 Other studies differentiated SS from DE and controls on the basis of changes in tear film-specific protein expression, 5,[32][33][34][35] leading to the suggestion that biomarker profiling may significantly contribute to patient characterization. 8,36 Both clinical tests and tear proteome analysis showed different trends in the two populations (SS and not-SS DE), at least for some of the analysed parameters in the present study.…”

Rose Bengal Staining of the Temporal Conjunctiva Differentiates Sjögren's Syndrome from Keratoconjunctivitis Sicca

“…There may be many physiological factors that cause increased amounts of staining and perhaps progression to the temporal conjunctiva in SS. These include the unique inflammatory status of the lacrimal gland, 31,32 lack of reflex tearing, 29 tear film protein composition, [33][34][35][36] inflammation of the ocular surface [37][38][39][40][41][42] and alterations in mucin expression. 37,43,44 It is the membrane-spanning mucins that have been most often linked to rose bengal staining.…”

Fluorescence-based reagent and spectrum-based optical reader for lactoferrin detection in tears: differentiating Sjögren’s syndrome from non-Sjögren’s dry eye syndrome

“…This was achieved by using a fixed wavelength of emitted fluorescence light to decrease the interference of noise and a signal amplification wafer to increase device sensitivity. This improvement further expands the application of our method to patients with low levels of tear lactoferrin, such as those with SS-DED or GVHD-DED who have scarce amounts of tear fluid and reduced levels of lactoferrin 35 . Second, we employed a cost-effective and less invasive method for tear collection, the Schirmer strip paper.…”

Predictive role of tear protein expression in the early diagnosis of Sjögren’s syndrome

“…30 DE syndrome in SS patients is associated with an altered proteomic profile with dysregulated expression of proteins involved in a variety of cellular processes: in particular, proteins involved in antibacterial action were found to be down-regulated, those involved in the inflammation, immunity and oxidative stress were up-regulated, and in addition, proteins uniquely present in the tear fluid of SS patients with DE were identified. 31 Other studies differentiated SS from DE and controls on the basis of changes in tear film-specific protein expression, 5,[32][33][34][35] leading to the suggestion that biomarker profiling may significantly contribute to patient characterization. 8,36 Both clinical tests and tear proteome analysis showed different trends in the two populations (SS and not-SS DE), at least for some of the analysed parameters in the present study.…”

Rose Bengal Staining of the Temporal Conjunctiva Differentiates Sjögren's Syndrome from Keratoconjunctivitis Sicca

“…There may be many physiological factors that cause increased amounts of staining and perhaps progression to the temporal conjunctiva in SS. These include the unique inflammatory status of the lacrimal gland, 31,32 lack of reflex tearing, 29 tear film protein composition, [33][34][35][36] inflammation of the ocular surface [37][38][39][40][41][42] and alterations in mucin expression. 37,43,44 It is the membrane-spanning mucins that have been most often linked to rose bengal staining.…”