FOXO3和IL-2在干眼患者结膜上皮细胞及泪液中表达及意义

Expression and significance of FOXO3 and IL-2 in conjunctival epithelial cells and tears of patients with dry eye

目的:探究叉头框蛋白O3(FOXO3)、白细胞介素-2(IL-2)在干眼(DE)患者结膜上皮细胞及泪液中的表达及意义。方法:前瞻性研究。选择2019-03/2021-03收治的DE患者106例,另选同期85位健康体检者为对照。利用实时荧光定量PCR(qRT-PCR)法检测结膜上皮细胞及泪液中FOXO3水平;酶联免疫吸附(ELISA)法检测样本中IL-2水平;分析DE患者治疗前后的泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)、角膜荧光素染色(CFS)等眼表临床指标变化;Pearson相关性分析DE患者结膜上皮细胞、泪液中FOXO3和IL-2水平的相关性以及二者与临床指标的关系。结果:与对照组相比,DE组患者结膜上皮细胞及泪液中FOXO3水平均明显降低,IL-2水平均明显升高(均P<0.01)。与治疗前相比,DE患者治疗后结膜上皮细胞及泪液中FOXO3水平明显上调,IL-2水平明显下调(均P<0.01)。Pearson相关性分析结果显示,结膜上皮细胞、泪液中FOXO3和IL-2水平均呈显著负相关(r=-0.531、-0.469,均P<0.01)。DE患者治疗后BUT、SⅠt指标较治疗前上升,CFS指标下降(均P<0.01)。DE患者结膜上皮细胞FOXO3水平与BUT、SⅠt均呈正相关(r=0.431、0.457,均P<0.01),与CFS呈负相(r=-0.469,P<0.01),IL-2水平与BUT、SⅠt均呈负相关(r=-0.416、-0.447,均P<0.01),与CFS呈正相关(r=0.424,P<0.01);泪液FOXO3与BUT、SⅠt呈正相关(r=0.421、0.443,均P<0.01),与CFS呈负相关(r=-0.474,P<0.01),IL-2与BUT、SⅠt呈负相关(r=-0.408、-0.429,均P<0.01),与CFS呈正相关(r=0.419,P<0.01)。结论:DE患者结膜上皮细胞及泪液中FOXO3水平降低,IL-2水平升高,二者与患者眼表指标存在密切的联系,有望成为DE临床监测和预后评估的实验室辅助指标。

·AIM:To explore the expression and significance of forkhead box class O3(FOXO3)and interleukin-2(IL-2)in conjunctival epithelial cells and tears of patients with dry eye(DE).·METHODS:A perspective study.A total of 106 DE patients who accepted from March 2019 to March 2021 were prospectively gathered,and 85 healthy subjects in the same period were selected as the control group.The level of FOXO3 in the conjunctival epithelial cells and tear fluid was measured by real-time fluorescent quantitative PCR(qRT-PCR)method;The level of IL-2 in the sample was measured by enzyme-linked immunosorbent(ELISA)method;The changes in clinical indicators of the ocular surface such as break-up time(BUT),SchirmerⅠtest(SⅠt),cornea fluorescein staining(CFS)in DE patients before and after treatment were analyzed;The correlation between the levels of FOXO3 and IL-2 in the conjunctival epithelial cells and tears of DE patients and the relationship between the two and clinical indicators were analyzed by Pearson correlation analysis.·RESULTS:Compared with the control group,the level of FOXO3 in conjunctival epithelial cells and tear fluid in the DE group was obviously reduced,and the level of IL-2 was obviously increased(all P<0.01).Compared with before treatment,the level of FOXO3 in conjunctival epithelial cells and tear fluid of DE patients was obviously up-regulated,and the level of IL-2 was obviously down-regulated(all P<0.05).Pearson correlation analysis showed that the levels of FOXO3 and IL-2 in conjunctival epithelial cells and tear fluid were obviously inversely correlated(r=-0.531,-0.469,all P<0.01).After treatment,BUT and SⅠt indexes of DE patients increased compared with before treatment,while CFS decreased(all P<0.01).The level of FOXO3 in conjunctival epithelial cells of DE patients was obviously directly correlated with BUT and SⅠt(r=0.431,0.457,all P<0.01),and it was obviously inversely correlated with CFS(r=-0.469,P<0.01),and the level of IL-2 was obviously inversely correlated with BUT and SⅠt(r=-0.416,-0.447,all P<0.01),and it was obviously directly correlated with CFS(r=0.424,P<0.01);tear FOXO3 was positively correlated with BUT and SⅠt(r=0.421,0.443,all P<0.01),and it was negatively correlated with CFS(r=-0.474,P<0.01),and IL-2 was negatively correlated with BUT and SⅠt(r=-0.408,-0.429,all P<0.01),and it was positively correlated with CFS(r=0.419,P<0.01).·CONCLUSION:the level of FOXO3 in conjunctival epithelial cells and tears of DE patients is decreased,and the level of IL-2 is increased.The two of which are closely related to the ocular surface indicators of patients.They are expected to become laboratory auxiliary indicators for clinical monitoring and prognostic evaluation of DE.