Impact of Air Pollution on the Ocular Surface and Tear Cytokine Levels: A Multicenter Prospective Cohort Study

Frontiers in Medicine

Xiangyang Xin¹  Zhongping Luo²  Shuxuan Lv³  Mingzhou Zhang⁴  Xuemin Li⁴  Ran Hao⁴  Liming Zhao⁵  Yang Liu⁶  Feng Wu⁷  Yanhui Xu⁸  Min Sun⁹  Jinwen Wei^1,10  Jing Dong^1,12 

[1] 0Department of Ophthalmology, Inner Mongolia Baogang Hospital, Inner Mongolia, China;1Department of Ophthalmology, Tongliao City Ke’erqin Zuoyi Zhongqi People’s Hospital, Inner Mongolia, China;2Department of Ophthalmology, Yongqing People’s Hospital, Langfang, China;Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China;Department of Ophthalmology, Beijing Fengtai Hospital, Beijing, China;Department of Ophthalmology, Daqing Oilfield General Hospital, Daqing, China;Department of Ophthalmology, Fuyang Hospital Affiliated to Anhui Medical University, Fuyang, China;Department of Ophthalmology, Hebei Provincial Eye Hospital, Shijiazhuang, China;Department of Ophthalmology, Huabei Petroleum General Hospital, Cangzhou, China;Department of Ophthalmology, Inner Mongolia Autonomous Region Xilingol League Hospital, Inner Mongolia, China;Department of Ophthalmology, Peking University Third Hospital, Beijing, China;Department of Ophthalmology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia, China;

关键词: air pollution;    dry eye disease;    meibomian gland;    ocular surface;    tear cytokine;   

DOI  :  10.3389/fmed.2022.909330

来源: DOAJ

【 摘 要 】

PurposeTo assess air pollution-induced changes on ocular surface and tear cytokine levels.MethodsAs a prospective multicenter cohort study, 387 dry eye disease (DED) participants were recruited from five provinces in China and underwent measurements of ocular surface disease index (OSDI), Schirmer’s I test (ST), tear meniscus height (TMH), tear film break-up time (TBUT), corneal fluorescein staining (CFS), meibomian gland (MG) function, and tear cytokines. The associations between ocular surface parameters and exposure to particulate matter (PM), ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2) for 1 day, 1 week, and 1 month before the examination were analyzed in single- and multi-pollutant models adjusted for confounding factors.ResultsIn the multi-pollutant model, the OSDI score was positively correlated with PM with diameter ≤2.5 μm (PM2.5), O3, and SO2 exposure [PM2.5: β (1 week/month) = 0.229 (95% confidence interval (CI): 0.035–0.424)/0.211 (95% CI: 0.160–0.583); O3: β (1 day/week/month) = 0.403 (95% CI: 0.229–0.523)/0.471 (95% CI: 0.252–0.693)/0.468 (95% CI: 0.215–0.732); SO2: β (1 day/week) = 0.437 (95% CI: 0.193–0.680)/0.470 (95% CI: 0.040–0.901)]. Tear secretion was negatively correlated with O3 and NO2 exposures but positively correlated with PM2.5 levels. Air pollutants were negatively correlated with TBUT and positively related with CFS score. Besides SO2, all other pollutants were associated with aggravated MG dysfunction (MG expression, secretion, and loss) and tear cytokines increasement, such as PM2.5 and interleukin-8 (IL-8) [β (1 day) = 0.016 (95% CI: 0.003–0.029)], PM with diameter ≤10 μm (PM10) and IL-6 [β (1 day) = 0.019 (95% CI: 0.006–0.033)], NO2 and IL-6 [β (1 month) = 0.045 (95% CI: 0.018–0.072)], among others. The effects of air pollutants on DED symptoms/signs, MG functions and tear cytokines peaked within 1 week, 1 month, and 1 day, respectively.ConclusionIncreased PM2.5, O3, and SO2 exposures caused ocular discomfort and damage with tear film instability. PM10 exposure led to tear film instability and ocular injury. PM, O3, and NO2 exposures aggravated MG dysfunction and upregulated tear cytokine levels. Therefore, each air pollutant may influence DED via different mechanisms within different time windows.

【 授权许可】

Unknown