Alteration of mucin in human conjunctival epithelia in dry eye

PURPOSE. The objective of this study was to determine whether alteration in mucins could be detected in patients with dry eye symptoms by using the mo noclonal antibody H185, which recognizes carbohydrate epitopes on mucin mol ecules. METHODS. Immunohistochemistry and immunoelectron microscopy was used to exa mine binding of H185 antibody to conjunctival cells obtained by nitrocellul ose filter paper stripping (impression cytology). Two study populations wer e examined. Study I included 22 patients with dry eye symptoms and 13 norma l volunteers. Study II included 16 aqueous-deficient dry eye patients and 1 4 age-matched control subjects. RESULTS. Results of the studies demonstrated significant differences in bin ding patterns of H185 to conjunctival cells in normal eyes compared with th ose of patients with dry eye symptoms. In normal eyes, the antibody bound t o apical cells in a mosaic pattern, with cells exhibiting either light, med ium, or intense binding. A predominant pattern in patients with dry eye sym ptoms was loss of the mosaic pattern with replacement by a "starry sky" pat tern in which there was a lack of apical cell binding (hence, dark shy) but increased binding to goblet cells (hence, stars in the sky). The starry sk y pattern correlated with rose bengal staining. CONCLUSIONS. From these studies it is concluded that there is an alteration either in mucin distribution or mucin glycosylation on the surfaces of api cal conjunctival cells in dry eye and that glycosylation of goblet cell muc ins changes with the disease.