The Expression And Significance Of Inflammatory Cytokines And MMP-9 In The Tears Of The Infected Eye And Contralateral Uninfected Eye In Patients With Fungal Keratitis

Objective:To detect the levels of tear inflammatory cytokines and matrix metalloproteinase(MMP)-9 in patients with fungal keratitis(FK).To explore the relationship between the tear inflammatory cytokines and corneal perception or pain in affected eyes,tear film function in contralateral uninfected eyes.Method:A total of 60(20 FK,20 contralateral,20 healthy controls)tear samples was collected prospectively.Interleukin(IL)-1β,IL-17,IL-10,tumor necrosis factor(TNF)-α and MMP-9 in tears were analyzed by enzyme linked immunosorbent assay(ELISA).At the same time,the pain visual analogue score(VAS),tear breakup time(TBUT),basal tear secretion level(SIT)and corneal perception index were detected and the dates were statistically analyzed by SPSS22 statistical software.Kruskal-Wallis H and Mann-Whiney U tests were used for comparison between groups,and Spearman’s was used for correlation analysis among various indicators.Results:Compared with healthy controls,we found that the contents of IL-1β,IL-17 and IL-10 in tears of patients with FK increased(P < 0.05),and the level of IL-10 in tears of contralateral uninfected eyes was higher than that of infected eyes(P < 0.05),while the contents of TNF-α and MMP-9 in tears increased only in affected eyes(P <0.05).The corneal perception of the infected eyes of FK patients was significantly lower than that of the control eye(P < 0.05),and the corneal perception of the uninfected eyes of the contralateral side was slightly lower than that of the control group,but there was no significant difference between the two groups(P >0.05).The TBUT and SIT of the contralateral eyes were significantly lower than those of the healthy control eyes,and showed a negative correlation with the levels of IL-1 and IL-17(P < 0.05).SIT was also negatively correlated with MMP-9 levels(P < 0.05),while IL-1 β,IL-17,IL-10,TNF-α and MMP-9 in tears of healthy controls were not significantly correlated with TBUT and SIT(P > 0.05).Corneal perception and VAS score were positively correlated with IL-1 β,IL-17 and TNF-α protein levels,and negatively correlated with IL-10 protein levels(P < 0.05),but not correlated with MMP-9(P> 0.05).Conclusion:There were changes in inflammatory factors in bilateral tears in patients with unilateral FK,which were related to pain,corneal nerves and tear film changes.