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. 2024 Nov 12;24(1):492.
doi: 10.1186/s12886-024-03760-8.

Evaluation of ocular surface inflammation and systemic conditions in patients with systemic lupus erythematosus: a cross-sectional study

Yuerong Ren  1   2 , Jing Tian  3 , Wen Shi  1   2 , Jianing Feng  4 , Yingyi Liu  1   2 , Huanmin Kang  1   2 , Yan He  5
Affiliations

Evaluation of ocular surface inflammation and systemic conditions in patients with systemic lupus erythematosus: a cross-sectional study

Yuerong Ren et al. BMC Ophthalmol. .

Abstract

Objective: The cross-sectional study was designed to evaluate the association of ocular surface inflammation with systemic conditions in patients with systemic lupus erythematosus (SLE).

Methods: The study enrolled 30 SLE patients and 30 controls. Ocular symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Tear samples from all participants were collected for tear multi-cytokine and chemokine concentration analysis. All participants were assessed for dry eye disease (DED), including Schirmer I test, tear break-up time (TBUT), corneal fluorescein staining (CFS), meibomian gland secretion (MGS), lid-parallel conjunctival folds (LIPCOF), corneal clarity, and symblepharon. Besides, all participants were also examined for conjunctival impression cytology to measure the density of conjunctival goblet cells (CGCs). The peripheral blood indicators from SLE patients were also collected to measure the SLE-associated autoantibody specificities and systemic inflammatory indicators. Pearson and Spearman's analysis were uesd to examine the correlation between tear cytokines, CGCs, DED-related indicators, and systemic conditions.

Results: The two groups were matched for age and gender in this study. 36.67% of eyes (11 in 30) of SLE patients and 13.33% of eyes (4 in 30) of controls were diagnosed with DED. OSDI scores, abnormal TBUT percentages, CFS percentages, and DED grading were all higher in SLE patients than in control group, while density of CGCs was lower. There were no significant differences in Schirmer I test, MGS, LIPCOF, corneal clarity, and symblepharon between SLE patients and controls. The levels of tear chemokine (C-X-C motif) ligand 11 (CXCL11) and cytokine interleukin-7 (IL-7) in patients with SLE were significantly higher than those in control group. Moreover, among SLE patients, the severity of DED and the level of tear chemokine CXCL11 were significantly positively correlated with SLE-associated autoantibody specificities.

Conclusion: Dry eye and tear cytokines and chemokines-mediated ocular surface inflammation persist in SLE patients and are associated with systemic conditions. Therefore, it is necessary for patients with SLE to combine systemic and ocular assessments.

Keywords: Autoantibody; Dry eye disease; Ocular surface inflammation; Systemic lupus erythematosus.

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Conflict of interest statement

Declarations Ethics approval and consent to participate All subjects participated in the program voluntarily and signed informed consent forms. This study received approval from the clinical Research Ethics Committee of The Second Xiangya Hospital of Central South University (Ethics No.: Ocular Surface Observation in patients with systemic immune Diseases, LYF2021028). All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representative images of conjunctival impression cytology in SLE patientsand control group (× 200, PAS staining). The dark purple cells indicated by the white arrow represent goblet cells. Scale bar = 50 μm
Fig. 2
Fig. 2
Correlation analysis between the tear chemokine CXCL11 and anti-dsDNA antibody A, the level of tear chemokine CCL4 and AHA antibody B, the CD8.+ T cell count and tear cytokines IFN-γ, IL-1β, IL-2, IL-10, IL-17A, TNF-α, and chemokine CX3CL1 in SLE patients C
See this image and copyright information in PMC

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