Distribution of conjunctival HLA-DR expression and the pathogenesis of damage in early dry eyes

Maurizio Rolando, Stefano Barabino, Cristina Mingari, Sara Moretti, Sebastiano Giuffrida, Giovanni Calabria

Research output: Contribution to journalArticlepeer-review


Purpose: To examine the expression of HLA-DR, a marker of inflammation, in the early stages of dry eye disease and to locate the appearance of this marker on specific areas of the bulbar conjunctiva. Methods: Dry eye patients were identified and their condition classified as mild (n = 16) or moderate (n = 16) based on Schirmer testing, vital staining, tear break-up time, and symptom questionnaire scores. Brush cytology was used to collect epithelial cells from the nasal, temporal, and superior conjunctivae of patients and age-matched controls. HLA-DR positive cells were detected by immunohistochemical staining and quantified. Results: Patients with moderate dry eye had the highest rate of conjunctival HLA-DR-positive cells, with significantly higher rates than controls regardless of which region of the conjunctiva was sampled (P <0.01). The mild dry eye group had similar rates of HLA-DR-positive cells in the superior conjunctival region compared with controls. However, in the nasal and temporal regions, they displayed a significantly higher rate of HLA-DR-positive cells than controls (P <0.01) and the nasal region showed a significant difference (P <0.01) when compared with the temporal one. Some of these mild dry eyes had no vital staining. Conclusions: The HLA-DR expression pattern in mild and moderate dry eyes appears to reflect disease progression. Overexpression of HLA-DR in mild dry eyes showing no vital staining suggests that inflammation may be a primary cause of ocular surface damage. These data support the use of immunomodulatory drugs in the treatment of dry eye disease.

Original languageEnglish
Pages (from-to)951-954
Number of pages4
Issue number8
Publication statusPublished - Nov 2005


  • Dry eyes
  • HLA-DR
  • Ocular surface inflammation
  • Tears

ASJC Scopus subject areas

  • Ophthalmology


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