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Corneal Langerhans cell and dry eye examinations in ankylosing spondylitis.

Abstract
APCs of the ocular surface, including corneal Langerhans cells (LCs), offer the opportunity to gain insight into the activity of innate immunity. We examined corneal LCs and dry eye parameters in ankylosing spondylitis (AS). Twenty-four AS patients with varying degrees of disease activity and 24 healthy participants were enrolled. Central and peripheral LC numbers, and Langerhans cell morphology (LCM) were assessed with in vivo laser confocal microscopy. In addition, ocular surface disease index, lid parallel conjunctival folds, tear break up time, and Schirmer test were evaluated. LC densities and central LCM were greater in AS patients than in the controls. Moreover, LCM was significantly greater in patients with higher systemic inflammation according to elevated C-reactive protein (CRP). Also, tear production was greatly suppressed in patients with more severe onset of the systemic inflammation according to the Bath Ankylosing Spondylitis Disease Activity Index and elevated CRP. Greater corneal LC density and LCM in AS may reflect an increased activation state of the innate immune system of the cornea in AS, which correlates with the systemic activity of AS even without ocular symptoms. Nonetheless, higher systemic inflammation might impair tear production, and it might partly explain the dry eye mechanism.
AuthorsLászló Marsovszky, János Németh, Miklós D Resch, Gergely Toldi, Nóra Legány, László Kovács, Attila Balog
JournalInnate immunity (Innate Immun) Vol. 20 Issue 5 Pg. 471-7 (Jul 2014) ISSN: 1753-4267 [Electronic] United States
PMID23960273 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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