原標題：淚液骨膜蛋白測定對眼部變態(tài)反應性疾病的診斷和治療價值
　?、俦尘?春季角膜結(jié)膜炎(VKC)、特應性角膜結(jié)膜炎(AKC)等慢性眼部變應性疾病均伴有嚴重的共病;然而，其潛在的發(fā)病機制仍不清楚。此外，對特應性皮炎患者結(jié)膜病變的診斷和AKC嚴重程度的估計對眼部變態(tài)反應性疾病的治療具有重要意義。②目的:探討骨膜蛋白作為一種新型的過敏性炎癥介質(zhì)和生物標志物，是否參與眼部過敏性疾病的發(fā)病過程，骨膜蛋白能否作為這些疾病的生物標志物。③方法:對季節(jié)性變應性結(jié)膜炎(SAC)、VKC、AKC患者及無結(jié)膜炎的過敏性疾病患者淚液骨膜蛋白進行研究，并與淚液IL-13、血清骨膜蛋白進行比較。此外，在AKC患者中，我們檢測了外用他克莫司治療前后的淚液骨膜蛋白。④結(jié)果:眼源性變應性疾病患者的淚液中骨膜蛋白含量明顯高于無結(jié)膜炎的變應性疾病患者，AKC、VKC、SAC患者的淚液中骨膜蛋白含量依次下降。淚液骨膜蛋白與AKC中嚴重的乳頭形成和角膜損傷等并發(fā)癥有關(guān)，但淚液IL-13和血清骨膜蛋白幾乎沒有這種能力。此外，局部他克莫司治療后，隨著AKC患者臨床癥狀的改善，大部分患者的淚液骨膜蛋白呈下降趨勢。⑤結(jié)論:IL-13刺激結(jié)膜組織產(chǎn)生的骨膜蛋白可能是眼部變態(tài)反應性疾病的發(fā)病機制之一。此外，淚液骨膜蛋白可作為一種生物標志物，用于診斷變應性結(jié)膜炎的患者和評估疾病的嚴重程度以及AKC治療的療效。(J Allergy Clin Immunol 2016;nnn:nnn-nnn.)
延伸閱讀
JACI
The usefulness  of  measuring  tear  periostin  for the diagnosis and management of ocular allergic diseases
Dio.org/10.1016/j.jaci.2015.11.039
Abstract:
Background: Chronic ocular allergic diseases such as vernal kerato conjunctivitis (VKC) and atopic kerato conjunctivitis (AKC) are accompanied by serious comorbidities; however, the underlying pathogenesis remains obscure. Furthermore, diagnosing conjunctival lesions in patients with atopic dermatitis and estimating the severity in AKC are important for the treatment of ocular allergic diseases.
Objective: We addressed whether periostin, a novel mediator and biomarker in allergic inflammation, is involved in the pathogenesis of ocular allergic diseases and whether periostin can be a biomarker for these diseases.
Methods: We investigated tear periostin in patients with seasonal allergic conjunctivitis (SAC), VKC, and AKC and allergic patients without conjunctivitis and compared it with tear IL-13 and serum periostin. Furthermore, in patients with AKC, we measured tear periostin before and after topical treatment with tacrolimus.
Results: Tears from patients with ocular allergic disease showed significantly high periostin levels than did tears from allergic patients without conjunctivitis and from patients with AKC, VKC, and SAC in descending order. Tear  periostin was associated with serious comorbidities such as large papilla formation and corneal damage in AKC, although both tear IL-13 and serum periostin had little to no such abilities. Furthermore, after topical tacrolimus treatment, tear periostin tended to decrease in most patients with AKC along with their clinical improvement.
Conclusions: Periostin produced in conjunctival tissues stimulated by IL-13 may contribute to the pathogenesis of ocular allergic diseases. Furthermore, tear periostin can be potentially applied as a biomarker to diagnose conjunctivitis in allergic patients and to evaluate disease severity as well as the efficacy of treatments in AKC. (J Allergy Clin Immunol 2016;nnn:nnn-nnn.)
All Author:
Hiroshi Fujishima, MD,a* Naoko Okada, PhD,b* Kenji Matsumoto, MD, PhD,b Kazumi Fukagawa, MD, PhD,c,d Ayako Igarashi, BS,e Akio Matsuda, PhD,b Junya Ono, BS,f Shoichiro Ohta, MD, PhD,g Hideki Mukai, MD, PhD,h
Mamoru Yoshikawa, MD, PhD,i and Kenji Izuhara, MD, PhD
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預防的共享平臺。