Comparative Evaluation of Matrix Metalloproteinase-9 Immunoassay and Tear Osmolarity Measurement for Diagnosing Severity of Dry Eye Disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To evaluate and compare the clinical efficacy of matrix metalloproteinase-9 (MMP-9) immunoassay and tear osmolarity measurement in diagnosing dry eye severity. Methods: Dry eye disease (DED) patients underwent diagnostic tests including MMP-9 assay, tear osmolarity measurement, fluorescein tear breakup time, ocular surface staining, anesthetized Schirmer test, Ocular Surface Disease Index questionnaire, and slit-lamp examination. The dry eye parameters were compared according to positive MMP-9 status and increased tear osmolarity. The correlation between dry eye profiles and MMP-9 positivity and high tear osmolarity was also analyzed. Results: Those who tested positive in MMP-9 immunoassay had significantly higher corneal fluorescein staining score and worse DED severity than those who tested negative. The intensity of MMP-9 positivity showed positive correlation with the corneal staining score and DED severity. However, DED patients with high tear osmolarity above 308 mOsm/L did not show significantly different dry eye signs and symptoms compared to those with lower tear osmolarity values. Tear osmolarity was associated with ocular surface staining score in severe DED patients. Conclusions: MMP-9 positivity was associated with ocular surface staining and worse dry eye severity. Therefore, it may be used as a useful indicator of disease severity in conjunction to other diagnostic tests.
Abstract
Purpose: To evaluate and compare the clinical efficacy of matrix metalloproteinase-9 (MMP-9) immunoassay and tear osmolarity measurement in diagnosing dry eye severity. Methods: Dry eye disease (DED) patients underwent diagnostic tests including MMP-9 assay, tear osmolarity measurement, fluorescein tear breakup time, ocular surface staining, anesthetized Schirmer test, Ocular Surface Disease Index questionnaire, and slit-lamp examination. The dry eye parameters were compared according to positive MMP-9 status and increased tear osmolarity. The correlation between dry eye profiles and MMP-9 positivity and high tear osmolarity was also analyzed. Results: Those who tested positive in MMP-9 immunoassay had significantly higher corneal fluorescein staining score and worse DED severity than those who tested negative. The intensity of MMP-9 positivity showed positive correlation with the corneal staining score and DED severity. However, DED patients with high tear osmolarity above 308 mOsm/L did not show significantly different dry eye signs and symptoms compared to those with lower tear osmolarity values. Tear osmolarity was associated with ocular surface staining score in severe DED patients. Conclusions: MMP-9 positivity was associated with ocular surface staining and worse dry eye severity. Therefore, it may be used as a useful indicator of disease severity in conjunction to other diagnostic tests.
참고문헌 (21)
- Craig JP, "TFOS DEWS II report executive summary", Ocul Surf, 15, pp.802~812 (2017)
- Pflugfelder SC, "The diagnosis and management of dry eye : a twenty-five-year review", Cornea, 19, pp.644~649 (2000)
- Luo L, "Experimental dry eye stimulates production of inflammatory cytokines and MMP-9and activates MAPK signaling pathways on the ocular surface", Invest Ophthalmol Vis Sci, 45, pp.4293~4301 (2004)
- Stevenson W, "Dry eye disease : an immune-mediated ocular surface disorder", Arch Ophthalmol, 130, pp.90~100 (2012)
- Corrales RM, "Desiccating stress stimulates expression of matrix metalloproteinases by the corneal epithelium", Invest Ophthalmol Vis Sci, 47, pp.3293~3302 (2006)
- Chotikavanich S, "Production and activity of matrix metalloproteinase-9 on the ocular surface increase in dysfunctional tear syndrome", Invest Ophthalmol Vis Sci, 50, pp.3203~3209 (2009)
- Baudouin C, "Role of hyperosmolarity in the pathogenesis and management of dry eye disease : proceedings of the OCEAN group meeting", Ocul Surf, 11, pp.246~258 (2013)
- Lemp MA, "Tear osmolarity in the diagnosis and management of dry eye disease", Am J Ophthalmol, 151, pp.792~798 (2011)
- 현준영, "Korean Guidelines for the Diagnosis and Management of Dry Eye: Development and Validation of Clinical Efficacy", Korean Journal of Ophthalmology, 28(3), pp.197~206 (2014), 대한안과학회
- Sambursky R, "Sensitivity and specificity of a point-of-care matrix metalloproteinase 9 immunoassay for diagnosing inflammation related to dry eye", JAMA Ophthalmol, 131, pp.24~28 (2013)
- Sambursky R, "Prospective, multicenter, clinical evaluation of point-of-care matrix metalloproteinase-9 test for confirming dry eye disease", Cornea, 33, pp.812~818 (2014)
- Messmer EM, "Matrix metalloproteinase 9 testing in dry eye disease using a commercially available point-of-care immunoassay", Ophthalmology, 123, pp.2300~2308 (2016)
- Lanza NL, "Dry eye profiles in patients with a positive elevated surface matrix metalloproteinase 9 point-of-care test versus negative patients", Ocul Surf, 14, pp.216~223 (2016)
- Huh J, "Changes in the matrix metalloproteinase 9 point-of-care test positivity according to MMP-9 concentration and loading volume", Cornea, 39, pp.234~236 (2020)
- Jun JH, "Importance of tear volume for positivity of tear matrix metalloproteinase-9 immunoassay", PLoS One, 15, pp.e0235408~ (2020)
- Suzuki M, "Tear osmolarity as a biomarker for dry eye disease severity", Invest Ophthalmol Vis Sci, 51, pp.4557~4561 (2010)
- Utine CA, "Tear osmolarity measurements in dry eye related to primary Sjogren’s syndrome", Curr Eye Res, 36, pp.683~690 (2011)
- Kyung Yun Kook, "Tear Osmolarity and Matrix Metallopeptidase-9 in Dry Eye Associated with Sjögren’s Syndrome", Korean Journal of Ophthalmology, 34(3), pp.179~186 (2020), 대한안과학회[DOI]
- Tashbayev B, "Utility of tear osmolarity measurement in diagnosis of dry eye disease", Sci Rep, 10, pp.5542~ (2020)
- Shimazaki J, "Tear film osmolarity measurement in Japanese dry eye patients using a handheld osmolarity system", Diagnostics(Basel), 10, pp.789~ (2020)
- Huet E, "EMMPRIN modulates epithelial barrier function through a MMP-mediated occludin cleavage : implications in dry eye disease", Am J Pathol, 179, pp.1278~1286 (2011)