Changes of chemokine receptors expression in the conjunctival epithelial cells and Th-17 cell number in tears of diabetic dry eye disease

Objective

To explore the expression of chemokine receptor 6 (CCR6) and T helper cell 17 (Th-17) in the epithelial cells and tears in diabetic patients with dry eye disease.

Methods

Prespective study was performed.Ninety-one type 2 diabetic patients with dry eye disease and 102 normal subjects were involved from January to July in 2017 in Affiliated Hospital of Yanbian University.Ocular Surface Disease Index (OSDI) questionnaire survey score, Break-up time of tear film (BUT), Schirmer Ⅰ test (SⅠt) and fluorescein corneal stainning (FLS) were performed on both groups.The conjunctival epithelial cells of both groups were obtained by impression cytology.The expression of the chemokine receptors (CCR) 4, CCR5 and CCR6 in conjunctival epithelial cells and the number of Th-17 cells in tears were detected by flow cytometry.This study was approved by the ethics committee of Affiliated Hospital of Yanbian University (2014053), and all the patients signed informed consent.

Results

The OSDI questionnaire scores, BUT, SⅠt and FLS were significantly different between diabetic dry eye group and normal control group (all at P<0.05). The ratio of CCR4⁺ CD4⁺ T cells, CCR5⁺ CD4⁺ T cells and CCR6⁺CD4⁺ T cells was (1.1±0.9)%, (2.1±1.7)% and (5.2±2.4)% in the normal control group, (1.2±0.8)%, (9.5±5.3)% and (19.2±5.7)% in the diabetic dry eye group, respectively.The ratios of CCR5⁺ CD4⁺ T cells and CCR6⁺ CD4⁺ T cells in the diabetic dry eye group were significantly higher than those in the normal control group (both at P<0.05). The proportion of Th-17 cell in tears of diabetic dry eye group was significantly higher than that in the normal control group (P<0.001).

Conclusions

CCR5, CCR6 and Th-17 cells may play a key role in the pathogenesis of diabetic patients with dry eye.