过敏性结膜炎相关性干眼的发病机制

Pathogenesis of allergic conjunctivitis-associated dry eye

过敏性结膜炎是临床常见的眼表疾病,也是引发或加重干眼的重要危险因素之一。过敏性结膜炎和干眼相互促进,互为因果。前者可通过损害眼表上皮屏障、引起泪膜不稳定、睑板腺功能障碍及眼睑刷上皮病变等机制诱发或加重干眼。同时,干眼可因泪液量(相对)不足、眼表上皮屏障受损及神经源性炎性反应等促进并加重眼部过敏。此外,眼表菌群失调和焦虑抑郁等精神障碍也是两者并存或相互转化的桥梁。

Allergic conjunctivitis is a common ocular surface disease in clinics and one of the important risk factors for triggering or aggravating dry eye.Allergic conjunctivitis and dry eye are mutually reinforcing and causal.The former can induce or exacerbate dry eye through mechanisms such as damaging the epithelial barrier of the ocular surface,causing tear film instability,meibomian gland dysfunction,and lid-wiper epitheliopathy.Meanwhile,dry eye can promote and aggravate ocular allergy due to(relatively)insufficient tear volume,injury to the ocular surface epithelial barrier,and neurogenic inflammatory responses.In addition,dysbiosis of the ocular surface and mental disorders such as anxiety and depression also bridge the coexistence or interconversion of the two.