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　　原标题：泪液骨膜蛋白测定对眼部变态反应性疾病的诊断和治疗价值
　　①背景:春季角膜结膜炎(VKC)、特应性角膜结膜炎(AKC)等慢性眼部变应性疾病均伴有严重的共病;然而，其潜在的发病机制仍不清楚。此外，对特应性皮炎患者结膜病变的诊断和AKC严重程度的估计对眼部变态反应性疾病的治疗具有重要意义。②目的:探讨骨膜蛋白作为一种新型的过敏性炎症介质和生物标志物，是否参与眼部过敏性疾病的发病过程，骨膜蛋白能否作为这些疾病的生物标志物。③方法:对季节性变应性结膜炎(SAC)、VKC、AKC患者及无结膜炎的过敏性疾病患者泪液骨膜蛋白进行研究，并与泪液IL-13、血清骨膜蛋白进行比较。此外，在AKC患者中，我们检测了外用他克莫司治疗前后的泪液骨膜蛋白。④结果:眼源性变应性疾病患者的泪液中骨膜蛋白含量明显高于无结膜炎的变应性疾病患者，AKC、VKC、SAC患者的泪液中骨膜蛋白含量依次下降。泪液骨膜蛋白与AKC中严重的乳头形成和角膜损伤等并发症有关，但泪液IL-13和血清骨膜蛋白几乎没有这种能力。此外，局部他克莫司治疗后，随着AKC患者临床症状的改善，大部分患者的泪液骨膜蛋白呈下降趋势。⑤结论:IL-13刺激结膜组织产生的骨膜蛋白可能是眼部变态反应性疾病的发病机制之一。此外，泪液骨膜蛋白可作为一种生物标志物，用于诊断变应性结膜炎的患者和评估疾病的严重程度以及AKC治疗的疗效。(J Allergy Clin Immunol 2016;nnn:nnn-nnn.)
延伸阅读
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
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。