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

Frontiers in Medicine

article

Ran Hao¹  Mingzhou Zhang¹  Liming Zhao³  Yang Liu⁴  Min Sun⁵  Jing Dong⁶  Yanhui Xu⁷  Feng Wu⁸  Jinwen Wei⁹  Xiangyang Xin^1,10  Zhongping Luo^1,11  Shuxuan Lv^1,12  Xuemin Li¹ 

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

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

DOI  :  10.3389/fmed.2022.909330

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose To assess air pollution-induced changes on ocular surface and tear cytokine levels. Methods As 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 (O 3 ), nitrogen dioxide (NO 2 ), and sulfur dioxide (SO 2 ) for 1 day, 1 week, and 1 month before the examination were analyzed in single- and multi-pollutant models adjusted for confounding factors. Results In the multi-pollutant model, the OSDI score was positively correlated with PM with diameter ≤2.5 μm (PM 2.5 ), O 3 , and SO 2 exposure [PM 2.5 : β (1 week/month) = 0.229 (95% confidence interval (CI): 0.035–0.424)/0.211 (95% CI: 0.160–0.583); O 3 : 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); SO 2 : 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 O 3 and NO 2 exposures but positively correlated with PM 2.5 levels. Air pollutants were negatively correlated with TBUT and positively related with CFS score. Besides SO 2 , all other pollutants were associated with aggravated MG dysfunction (MG expression, secretion, and loss) and tear cytokines increasement, such as PM 2.5 and interleukin-8 (IL-8) [β (1 day) = 0.016 (95% CI: 0.003–0.029)], PM with diameter ≤10 μm (PM 10 ) and IL-6 [β (1 day) = 0.019 (95% CI: 0.006–0.033)], NO 2 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. Conclusion Increased PM 2.5 , O 3 , and SO 2 exposures caused ocular discomfort and damage with tear film instability. PM 10 exposure led to tear film instability and ocular injury. PM, O 3 , and NO 2 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】

CC BY