INFLAMMATORY CYTOKINES IN THE TEARS OF PATIENTS WITH OCULAR ROSACEA

Objective: The purpose of the study is to compare tear fluid concentra tions of interleukin-1 alpha (IL-1 alpha), tumor necrosis factor-alpha (TNF-alpha), and epidermal growth factor (EGF) in ocular rosacea with those in control subjects and to examine the relation between tear fu nctions, such as production and clearance rate, and the concentrations of cytokines in tear fluid. Participants and Intervention: Fourteen p atients with severe meibomian gland disease, facial rosacea, and sympt oms of ocular irritation were examined for ocular surface disease, tea r production, and tear clearance rate (TCR). Twelve control subjects, frequency-matched for age, and 15 ideal normal subjects with no ocular symptoms and normal tear function were assessed using the same parame ters. Minimally stimulated tear samples (20 mu l) were drawn from each subject and analyzed using a sandwich enzyme-linked immunosorbent ass ay to detect IL-1 alpha, TNF-alpha, and EGF. Results: Tear IL-1 alpha concentration was significantly higher in patients with rosacea than i n age-matched (P = 0.003) and ideal control subjects (P < 0.001). Tumo r necrosis factor-alpha was not detected in patients or control subjec ts, indicating levels of less than 10 pg/ml. Epidermal growth factor w as not significantly higher in patients with rosacea than in age-match ed control subjects, Tear turnover LN(TCR) was lower in patients with rosacea than in both age-matched (P = 0.048) and ideal control subject s (P = 0.002). Schirmer I scores were statistically lower in patients with rosacea than in ideal control subjects (P = 0.013), but not age-m atched control subjects. Interleukin-1 alpha was correlated inversely with LN(TCR) (r = -0.58, P < 0.0001) and Schirmer I (r = -0.39, P = 0. 012). Conclusions: Concentrations of IL-1 alpha are present in normal tears but are elevated in ocular rosacea, whereas TNF alpha is not pre sent in either case. The reduced tear turnover, LN(TCR), its inverse c orrelation with IL-1 alpha, and the absence of TNF-alpha in the tears of these patients suggest that the increased concentration of IL-1 alp ha observed may be largely because of clearance failure of cytokine no rmally produced at the ocular surface.