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Lower Vitamin D Level and Distinct Tear Cytokine Profile Were Observed in Patients with Mild Dry Eye Signs but Exaggerated Symptoms.

ABSTRACT: PURPOSE:Dry eye is associated with inflammation, pain, and discomfort. Vitamin D is known to modulate immune responses and pain. This study investigates the level of serum vitamin D and tear-inflammatory proteins with relation to exaggerated symptoms in patients with mild dry eye. METHODS:Patients with mild dry eye signs (Dry Eye Workshop [DEWS] severity grade 1) but with exaggerated symptoms and healthy controls (n = 19, each) were recruited for this cross-sectional study. Schirmer's Test I (mm), tear film break-up time (TBUT; secs), and ocular surface disease index (OSDI) score were recorded. Serum vitamin D level and tear cytokine levels were measured. RESULTS:The mean OSDI score in the patient cohort (46 ± 3) was significantly higher than controls (8.4 ± 1.6). TBUT was lower (7.6 ± 0.3 secs) in patients compared with controls (11.0 ± 0.9 secs). Mean Schirmer's Test I value in patients (19.3 ± 1.4 mm) was lower than in controls (30.6 ± 1.9 mm). An inverse correlation was observed between serum vitamin D levels and OSDI score (r = -0.569; P = 0.01). Significantly higher levels of interleukin (IL)-17A/F, interferon (IFN)-?, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1, IL-4, IL-10, and decreased IL-2 concentrations was observed in the tears of patients compared with controls (P < 0.05). CONCLUSION:Decreased serum vitamin D was associated with exaggerated symptoms in dry eye patients with mild dry eye signs. In addition, altered tear cytokine profile was also observed in these patients. TRANSLATIONAL RELEVANCE:Vitamin D measurements would aid in the diagnosis and management of dry eye.

SUBMITTER: Shetty R

PROVIDER: S-EPMC5156440 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Lower Vitamin D Level and Distinct Tear Cytokine Profile Were Observed in Patients with Mild Dry Eye Signs but Exaggerated Symptoms.

Shetty Rohit R Sethu Swaminathan S Chevour Priyanka P Deshpande Kalyani K Pahuja Natasha N Nagaraja Harsha H Pindipapanahalli Narendra N Ghosh Arkasubhra A

Translational vision science & technology 20161214 6

<h4>Purpose</h4>Dry eye is associated with inflammation, pain, and discomfort. Vitamin D is known to modulate immune responses and pain. This study investigates the level of serum vitamin D and tear-inflammatory proteins with relation to exaggerated symptoms in patients with mild dry eye.<h4>Methods</h4>Patients with mild dry eye signs (Dry Eye Workshop [DEWS] severity grade 1) but with exaggerated symptoms and healthy controls (<i>n</i> = 19, each) were recruited for this cross-sectional study. ...[more]

PMID: 27980879

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Project description:Knowledge about the variability of measurements using the TearLab Osmolarity System is necessary when evaluating the clinical utility of readings.To examine the variability of tear osmolarity measured by the TearLab Osmolarity System in patients with Sjögren syndrome (SS), patients with blepharitis, and control participants.Cross-sectional study at a tertiary care academic center from June 13, 2012, to March 21, 2013. Participants included 74 eyes of 37 patients from a volunteer sample (18 patients with SS, 11 patients with blepharitis, and 8 control participants) who were evaluated using the TearLab Osmolarity System, with 3 consecutive osmolarity measurements taken at 1-minute intervals in a session; 15 of these patients had the same measurements taken by the same examiner in 2 additional sessions on the same day (9 AM-10 AM, 12 PM-1 PM, or 3 PM-4 PM). Most patients with SS and patients with blepharitis were taking systemic or topical dry eye medications at the time of enrollment.Mean osmolarity and its variability calculated from a linear mixed model for each disease group that accounts for the variations attributable to different patients, eyes, and sessions and measurement error specific to each disease group.Mean tear osmolarity was 307 mOsm/L, 304 mOsm/L, and 301 mOsm/L in the SS, blepharitis, and control groups, respectively (P?=?.46). The error associated with repeated measurements within a session in the patients without dry eye (10.5 mOsm/L [95% CI, 9.0-12.4]) was significantly lower than in the patients with blepharitis (14.6 mOsm/L [95% CI, 12.5-17.5]; P?=?.006) and patients with SS (15.8 mOsm/L [95% CI, 14.2-17.8]; P?<?.001) but a difference in the error of repeated measurements between patients with blepharitis and patients with SS was not identified (P?=?.46).There was increased variability attributable to error in repeated measurements in patients with SS and patients with blepharitis compared with control participants. The high variability of TearLab osmolarity readings in all groups makes the clinical interpretation of measurements unclear.

Dataset Information

Lower Vitamin D Level and Distinct Tear Cytokine Profile Were Observed in Patients with Mild Dry Eye Signs but Exaggerated Symptoms.

Publications

Lower Vitamin D Level and Distinct Tear Cytokine Profile Were Observed in Patients with Mild Dry Eye Signs but Exaggerated Symptoms.

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