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Abstract：
OBJECTIVE: To determine the association between systemic vitamin D (VD) and immunoglobulin E (IgE) levels with severity and ocular surface inflammatory profile in patients with epidemic keratoconjunctivitis (EKC).
METHODS: 210 eyes of 105 patients who were clinically diagnosed with EKC were included in the study. The levels of serum VD and serum IgE were measured. Schirmer\'s strip-based tear fluid (TF) was used to determine levels of IL-1β, IL-6, IL-10, IL-17A, TNFα, MMP9, sICAM1, and VEGF-A in a subset of patients.
RESULTS: Levels of VD were significantly ( P < 0.05) lower and levels of IgE were significantly higher in patients with severe forms of conjunctivitis compared to those with nonsevere forms. Majority of the patients with severe forms of the disease exhibited VD deficiency and/or abnormally high IgE. A negative correlation (r = -0.682; P < 0.0001) was observed between VD and IgE levels. TF levels of IL-1β, IL-6, TNFα, and sICAM1 were significantly higher in eyes with severe forms of conjunctivitis compared to those with nonsevere forms and controls. These factors showed a positive correlation ( P < 0.05) with IgE levels and a negative correlation ( P < 0.05) with VD levels.
CONCLUSIONS: Patients with severe forms of EKC exhibited VD deficiency and higher levels of IgE. Increased TF inflammatory factors demonstrated a disease causal relationship with VD and IgE. Hence, restoring the altered levels of VD and IgE to normal range would be pivotal in the prevention and management of severe conjunctivitis.
METHODS: 210 eyes of 105 patients who were clinically diagnosed with EKC were included in the study. The levels of serum VD and serum IgE were measured. Schirmer\'s strip-based tear fluid (TF) was used to determine levels of IL-1β, IL-6, IL-10, IL-17A, TNFα, MMP9, sICAM1, and VEGF-A in a subset of patients.
RESULTS: Levels of VD were significantly ( P < 0.05) lower and levels of IgE were significantly higher in patients with severe forms of conjunctivitis compared to those with nonsevere forms. Majority of the patients with severe forms of the disease exhibited VD deficiency and/or abnormally high IgE. A negative correlation (r = -0.682; P < 0.0001) was observed between VD and IgE levels. TF levels of IL-1β, IL-6, TNFα, and sICAM1 were significantly higher in eyes with severe forms of conjunctivitis compared to those with nonsevere forms and controls. These factors showed a positive correlation ( P < 0.05) with IgE levels and a negative correlation ( P < 0.05) with VD levels.
CONCLUSIONS: Patients with severe forms of EKC exhibited VD deficiency and higher levels of IgE. Increased TF inflammatory factors demonstrated a disease causal relationship with VD and IgE. Hence, restoring the altered levels of VD and IgE to normal range would be pivotal in the prevention and management of severe conjunctivitis.
摘要：
目的：确定全身性维生素D（VD）和免疫球蛋白E（IgE）水平与流行性角膜结膜炎（EKC）患者的严重程度和眼表炎症特征之间的关系。
方法：本研究纳入临床诊断为EKC的105例患者的210只眼。测定血清VD和血清IgE水平。Schirmer的条基泪液（TF）用于确定IL-1β的水平，IL-6,IL-10,IL-17A,TNFα,部分患者的MMP9、sICAM1和VEGF-A。
结果：重度结膜炎患者的VD水平显著降低（P<0.05），IgE水平显著高于非重度结膜炎患者。大多数患有严重疾病的患者表现出VD缺乏和/或异常高的IgE。在VD和IgE水平之间观察到负相关(r=-0.682;P<0.0001)。TF水平的IL-1β，IL-6,TNFα,与非严重型结膜炎和对照组相比,严重型结膜炎患者的sICAM1显著升高.这些因素与IgE水平呈正相关（P<0.05），与VD水平呈负相关（P<0.05）。
结论：重度EKC患者表现出VD缺乏和较高水平的IgE。增加的TF炎症因子显示与VD和IgE的疾病因果关系。因此，将改变的VD和IgE水平恢复至正常范围对于预防和治疗严重结膜炎至关重要.
方法：本研究纳入临床诊断为EKC的105例患者的210只眼。测定血清VD和血清IgE水平。Schirmer的条基泪液（TF）用于确定IL-1β的水平，IL-6,IL-10,IL-17A,TNFα,部分患者的MMP9、sICAM1和VEGF-A。
结果：重度结膜炎患者的VD水平显著降低（P<0.05），IgE水平显著高于非重度结膜炎患者。大多数患有严重疾病的患者表现出VD缺乏和/或异常高的IgE。在VD和IgE水平之间观察到负相关(r=-0.682;P<0.0001)。TF水平的IL-1β，IL-6,TNFα,与非严重型结膜炎和对照组相比,严重型结膜炎患者的sICAM1显著升高.这些因素与IgE水平呈正相关（P<0.05），与VD水平呈负相关（P<0.05）。
结论：重度EKC患者表现出VD缺乏和较高水平的IgE。增加的TF炎症因子显示与VD和IgE的疾病因果关系。因此，将改变的VD和IgE水平恢复至正常范围对于预防和治疗严重结膜炎至关重要.
