Purpose: To compare concentrations of tear cytokines in 3 groups composed of Sjögren syndrome (SS) dry eye, non-Sjögren syndrome (non-SS) dry eye, and normal subjects. Correlations between ocular surface parameters and tear cytokines were also investigated. Design: Prospective cross-sectional study. Methods: SS dry eye patients (n = 24; 40 eyes) were diagnosed with primary SS according to the criteria set by the American-European Consensus Group. Non-SS dry eye patients (n = 25; 40 eyes) and normal subjects (n = 21; 35 eyes) were also enrolled. Tear concentrations of interleukin (IL)-17, IL-6, IL-10, IL-4, IL-2, interferon γ (IFN-γ), and tumor necrosis factor α (TNF-α) were measured by a multiplex immunobead assay. Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), Schirmer I test, and fluorescein staining scores were obtained from dry eye patients. Results: All cytokine levels except for IL-2 were highest in the SS group, followed by non-SS dry eye group and control subjects. Concentrations of IL-17, TNF-α, and IL-6 were significantly different among the 3 groups (IL-17: SS > control P <.001, non-SS > control P =.042, SS > non-SS P <.001; TNF-α: SS > control P =.006, non-SS > control P =.034, SS > non-SS P =.029; IL-6: SS > control P =.002, non-SS > control P =.032, SS > non-SS P =.002). IL-17 was significantly correlated with TBUT (R = -0.22, P =.012) and Schirmer I test (R = -0.36, P =.027) scores in the SS group. IL-6 was significantly correlated only with TBUT (R = -0.38, P =.02) in the non-SS group. Conclusions: Differences in tear cytokine levels and correlation patterns between SS dry eye and non-SS dry eye patients suggest the involvement of different inflammatory processes as causes of dry eye syndrome.
Bibliographical noteFunding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Publication of this article was supported by funding provided Grant A103001 from the South Korea Healthcare technology R&D Project‚ Ministry of Health & Welfare‚ South Korea and an unrestricted faculty research grant from Yonsei University College of Medicine . The funding organization had no role in the design or conduct of this research. The authors indicate no financial disclosures. Contributions of authors: involved in design of the study (S.Y.L., K.Y.S.) and conduct of the study (S.Y.L., S.J.H., K.Y.S.); data collection (S.Y.L., K.Y.S.), data analysis (S.Y.L., S.J.H., K.Y.S.), and interpretation of the data (S.Y.L., S.M.N., S.C.Y., T.I.K., E.K.K., K.Y.S.); and preparation, review, and approval of the manuscript (S.Y.L., S.M.N., S.C.Y., J.M.A., T.I.K., E.K.K., K.Y.S.).
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