Back to Search
Start Over
Conjunctival Neutrophils Predict Progressive Scarring in Ocular Mucous Membrane Pemphigoid.
- Source :
-
Investigative ophthalmology & visual science [Invest Ophthalmol Vis Sci] 2016 Oct 01; Vol. 57 (13), pp. 5457-5469. - Publication Year :
- 2016
-
Abstract
- Purpose: Ocular mucous membrane pemphigoid (OcMMP) is a rare autoimmune disorder resulting in progressive conjunctival fibrosis and ocular surface failure leading to sight loss in up to 50%. This study was designed to optimize an ocular surface sampling technique for identification of novel biomarkers associated with disease activity and/or progressive fibrosis.<br />Methods: Fifty-seven patients with OcMMP underwent detailed examination of conjunctival inflammation and fibrosis using fornix depth measurement. Ocular surface impression cytology (OSIC) to sample superior bulbar conjunctiva combined with flow cytometry (OSIC-flow) profiled infiltrating leukocytes. Profiles were compared with healthy controls (HC) and disease controls (primary Sjögren's syndrome, pSS). Thirty-five OcMMP patients were followed every 3 months for 12 months.<br />Results: Overall neutrophils were elevated in OcMMP eyes when compared to pSS or HC (109 [18%] neutrophils/impression [NPI]; 2 [0.2%]; 6 [0.8%], respectively [P < 0.0001]) and in OcMMP patients with no visible inflammation when compared with HC (44.3 [7.9%]; 5.8 [0.8%]; P < 0.05). At 12 months follow-up, 53% of OcMMP eyes progressed, and this was associated with baseline conjunctival neutrophilia (P = 0.004). As a potential biomarker, a value of 44 NPI had sensitivity, specificity, and positive predictive values of 75%, 70%, and 73%, respectively. Notably, eyes with no visible inflammation and raised conjunctival neutrophils were more likely to progress and have a greater degree of conjunctival shrinkage compared to those without raised neutrophils.<br />Conclusions: These data suggest that OSIC-flow cytometric analyses may facilitate repeated patient sampling. Neutrophils may act as a biomarker for monitoring disease activity, progressive fibrosis, and response to therapy in OcMMP even when the eye appears clinically uninflamed.
- Subjects :
- Aged
Aged, 80 and over
Cicatrix etiology
Disease Progression
Female
Fibrosis pathology
Flow Cytometry
Follow-Up Studies
Humans
Male
Middle Aged
Pemphigoid, Benign Mucous Membrane complications
Time Factors
Cicatrix pathology
Conjunctiva pathology
Mucous Membrane pathology
Neutrophils pathology
Pemphigoid, Benign Mucous Membrane diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1552-5783
- Volume :
- 57
- Issue :
- 13
- Database :
- MEDLINE
- Journal :
- Investigative ophthalmology & visual science
- Publication Type :
- Academic Journal
- Accession number :
- 27760272
- Full Text :
- https://doi.org/10.1167/iovs.16-19247