Association of killer cell immunoglobulin-like receptor and human leukocyte antigen-C genotype with dry eye disease in a Chinese Han population.

Dry eye is one of the most prevalent eye diseases and dry eye disease (DED) is associated with ocular surface inflammation. The interaction between killer cell immunoglobulin-like receptors (KIRs) and human leukocyte antigens (HLAs) regulates the activation of natural killer (NK) cells and certain T cell subsets in response to inflammation. The objective of this study was to explore whether KIR gene and HLA-C allele polymorphisms were associated with DED in a Chinese Han population. Polymerase chain reaction with sequence-specific primers method was used to genotype KIR genes and HLA-C alleles in 106 DED patients and 220 healthy controls. Framework genes KIR2DL4, KIR3DL2, KIR3DL3, and KIR3DP1 were present in all individuals. There were no significant differences in the frequencies of inhibitory KIR genes between the two groups. However, the frequency of KIR2DS2 was significantly higher in severe DED patients than that in healthy controls (p=0.031, odds ratio [OR]=1.828, 95% confidence interval [CI]=1.05-3.17). Significantly different distributions of HLA-C allele groups were not observed in severe DED patients and controls. The frequency of the combination of HLA-C1 allele group with KIR2DS2 was significantly higher in severe DED patients compared with controls (p=0.013, OR=2.083, 95% CI=1.16-3.74). These data suggested that this genotype combination was associated with susceptibility to severe DED and that NK cells might have a role in the pathogenesis of DED. The results led to an interesting future research question of whether or not KIR and HLA-C genotypes were involved in the predisposition to or pathogenesis of DED.

Incidence of blinding vitamin A deficiency in North West Frontier Province and its adjoining Federally Administered Tribal Areas, Pakistan.

PURPOSE: To identify children aged 0-72 months with blinding xerophthalmia in the North West Frontier Province (NWFP) and its adjoining Federally Administered Tribal Areas (FATA) in Pakistan, using a new surveillance system, and to describe socio-economic and other characteristics of reported cases. METHODS: All ophthalmologists in district headquarter hospitals in NWFP and agency headquarter hospitals in FATA were requested to participate in a surveillance programme for the detection of blinding xerophthalmia (corneal xerosis, corneal ulcers, keratomalacia and corneal scars related to vitamin A deficiency) for children aged 0-72 months. The surveillance included reporting of each case of blinding xerophthalmia presenting to the participating eye units over a period of 12 months and recording their socio-economic and other related characteristics. RESULTS: Seventy six cases of blinding xerophthalmia were reported and there was almost no gender difference. Children came from 19 of 31 districts and agencies in NWFP and FATA with a working ophthalmologist. The commonest age at presentation was 25-48 months and almost half of them belonged to households with a monthly income of < Pak Rs. 1200 (US $ < 20). Precipitating systemic illnesses were diarrhea and fever with cough in 63.2% and 56.6% cases, respectively. Almost a third of children aged > 9 months had not been immunized against measles. A quarter of all children had not been adequately breast-fed, and 7 children (9%) had never been breastfed. Majority of the cases presented during summer and autumn months. CONCLUSIONS: Our surveillance data provide evidence that blinding xerophthalmia does occur in children in NWFP and its adjoining FATA. The surveillance system identified high risk age groups, systemic illnesses, seasons and community groups. The detection system detects minimal numbers of cases and it is likely that the problem is even more severe.

Ceguera nocturna y xeroftalmía tras cirugía de obesidad mórbida / Night blindness and xerophthalmia after surgery for morbid obesity

Caso clínico: Se describen los hallazgos oculares debidos a un déficit de vitamina A en un varón de 50 años. Fue sometido a una cirugía de bypass intestinal dos años antes. Después de tratamiento con vitamina A oral, los síntomas mejoraron. Discusión: La incidencia de obesidad mórbida sigue aumentando alarmantemente en todo el mundo, siendo actualmente el tratamiento mas adoptado en la mayoría de los pacientes la cirugía de bypass intestinal. Este tipo de cirugía puede provocar un déficit de vitamina A, con importantes consecuencias oftalmológicas, que podrían incluso llegar a la ceguera sin un correcto tratamiento. Por consiguiente, se debería considerar seriamente esta patología hasta ahora poco frecuente en países desarrollados

Case report: We describe ocular findings due to a vitamin A deficiency in a 50-year-old man. The patient had undergone intestinal bypass surgery two years before. After therapy with oral vitamin A the symptoms improved. Discussion: The incidence of morbid obesity is increasing throughout much of the developed world, with intestinal bypass surgery the treatment of choice for most people with the condition. This type of surgery can lead to a vitamin A deficiency, with remarkable ophthalmological consequences, which without correct treatment may ultimately cause blindness. For this reason, the pathology, even though rare at present, must considered seriously

[The natural course of primary Sjögren's syndrome (a clinical study)]. / Estestvennoe techenie pervichnogo sindroma Shegrena (klinicheskoe issledovanie).

In this work the authors analyzed the clinical course and diagnostic procedures of 104 patients with primary Sjogren's syndrome (pSS): 57 patients diagnosed and followed-up at Ioannina University and 47 similar patients treated at the National Institute of Health (USA). Both studies have shown that pSS is predominantly a female disease with a latent period of 6-8 yrs from the time of the first symptom to the time of final diagnosis. Although the syndrome begins almost exclusively with glandular manifestations (xerostomia, xerophthalmia or parotid gland enlargement), in a respectable percentage of patients it eventually progresses to extraglandular involvement. pSS can be potentially complicated by benign (pseudolymphoma) or malignant (lymphoma) lymphoproliferative disorders.

Breast-feeding, weaning patterns, and the risk of xerophthalmia in Southern Malawi.

A case-control study of breast-feeding and weaning patterns associated with xerophthalmia was conducted among children aged 24-71 mo in Southern Malawi in 1983. One hundred fifty-two children with active xerophthalmia were compared to 151 clinically normal children matched on age (+/- 12 mo), sex, and village of residence. All children were initially breast-fed; however, children with xerophthalmia began weaning onto porridge (p = 0.05) and ceased breast-feeding earlier (p less than 0.01 for 24-47 mo olds), had a shorter weaning interval (p less than 0.005), and were fully weaned from the breast for a longer duration (p less than 0.025) than the controls. The association between earlier cessation of breast-feeding and subsequent xerophthalmia was strongest during the immediate post-weaning years. These findings imply a protective role for breast-feeding against xerophthalmia in early childhood.

Age specific xerophthalmia rates among displaced Ethiopians.

The recent famine in Ethiopia has resulted in the dislocation of millions of people. Many of these individuals have moved to refugee camps in Sudan or to feeding centres within Ethiopia. A total of 1325 children up to the age of 15 years were examined by an ophthalmologist in January 1985 at several sites in these two countries. The rates of Bitot's spots were three times greater in those between the ages of 7 and 10 compared with those under 7. Rates of corneal xerosis were comparable for each group. Previously, xerophthalmia was considered predominantly to affect children aged under 6. These data document the presence of the disease in older children and raise questions regarding future modifications in the prevention and treatment of xerophthalmia.