성형안과 질환과 눈물막 내 기질금속단백질분해효소 9와의 연관성 분석 = Matrix Metalloproteinases 9 Testing Using Immunoassay Kit in Oculoplastic Outpatient Clinic Patients

국문 초록 (Abstract)

목적: 성형안과 외래로 내원하는 다양한 환자에서 눈물막 matrix metalloproteinases 9 (MMP-9) 성분 분석을 통해 성형안과 질환의진단과의 연관성에 대해 알아보고자 하였다.
대상과 방법: 안구 불편감을 호소하며 성형안과 외래로 내원한 1,703명 환자의 1,703안에 대한 MMP-9 면역분석키트의 결과를 후향적으로 분석하였고 최종 성형안과 진단에 따른 MMP-9 결과의 양성률에 대해 분석하였다.
결과: 총 1,533안 중 1,126안에서 MMP-9 면역분석키트검사 양성을 보였다. 환자의 성별과 나이는 MMP-9 발현과 유의미한 상관관계를 보이지 않았다. 169안의 갑상샘눈병증 환자 중 120안, 161안의 비루관폐쇄 환자 중 145안, 375안의 비루관협착 환자 중 282안, 238안의 안검내반 환자 중 190안, 23안의 안검외반 환자 중 19안에서 MMP-9 양성 결과를 보였다.
결론: MMP-9 면역분석키트검사는 비침습적이고, 쉽고 빠른 검사 방법으로 다양한 성형안과 질환을 가진 환자들의 눈물막에서MMP-9 증가 소견을 보인다. 성형안과 외래로 내원하는 환자에서 MMP-9 검사 결과는 진단 및 치료 방향 결정에 도움을 줄 수 있다.

다국어 초록 (Multilingual Abstract)

Purpose: We assessed the association between the results of tear film-based matrix metalloproteinases 9 (MMP-9) immunoassay and the diagnosis of patients who visited an oculoplastic outpatient clinic.
Methods: We conducted a retrospective analysis of the MMP-9 immunoassay results in 1,703 eyes from 1,703 patients who presented with ocular discomfort at an oculoplastic outpatient clinic. The MMP-9 immunoassay results were analyzed in correlation with the final oculoplastic diagnosis of the patients.
Results: In total, 1,126 of 1,533 eyes demonstrated positive expression of MMP-9. No statistically significant differences were observed in MMP-9 expression based on sex (p = 0.107) and age (p = 0.510). Furthermore, 120 of 169 eyes with thyroid eye disease (71.0%, p < 0.001), 145 of 161 eyes with nasolacrimal duct obstruction (90.1%, p < 0.001), 282 of 375 eyes with nasolacrimal duct stenosis (75.2%, p < 0.001), 190 of 238 eyes with entropion (79.8%, p < 0.001), 19 of 23 eyes with ectropion (82.6%, p < 0.001), and 370 of 567 eyes with dry eye syndrome (65.3%, p < 0.001) exhibited positive MMP-9 expression.
Conclusions: The MMP-9 immunoassay is a noninvasive, convenient, and rapid test that evaluates ocular surface inflammation.
Most patients with oculoplastic diseases exhibit positive MMP-9 expression. These findings provide valuable information for guiding diagnostic and management decisions in patients with oculoplastic conditions.

참고문헌 (Reference)

• 1 Gürdal C, "Topical cyclosporine in thyroid orbitopathy-related dry eye : clinical findings, conjunctival epithelial apoptosis, and MMP-9 expression" 35 : 771-777, 2010
• 2 Weiler DL, "Thyroid eye disease : a review" 100 : 20-25, 2017
• 3 Lanza NL, "The matrix metalloproteinase 9 point-of-care test in dry eye" 14 : 189-195, 2016
• 4 Smith VA, "Tear film MMP accumulation and corneal disease" 85 : 147-153, 2001
• 5 Acera A, "Tear MMP-9 levels as a marker of ocular surface inflammation in conjunctivochalasis" 54 : 8285-8291, 2013
• 6 Li DQ, "Stimulation of matrix metalloproteinases by hyperosmolarity via a JNK pathway in human corneal epithelial cells" 45 : 4302-4311, 2004
• 7 Sambursky R, "Sensitivity and specificity of a point-of-care matrix metalloproteinase 9 immunoassay for diagnosing inflammation related to dry eye" 131 : 24-28, 2013
• 8 Li DQ, "Regulation of MMP-9production by human corneal epithelial cells" 73 : 449-459, 2001
• 9 Chotikavanich S, "Production and activity of matrix metalloproteinase-9 on the ocular surface increase in dysfunctional tear syndrome" 50 : 3203-3209, 2009
• 10 Pflugfelder SC, "Matrix metalloproteinase-9 in the pathophysiology and diagnosis of dry eye syndrome" 4 : 37-46, 2017
• 11 Messmer EM, "Matrix metalloproteinase 9 testing in dry eye disease using a commercially available point-of-care immunoassay" 123 : 2300-2308, 2016
• 12 Acera A, "Inflammatory markers in the tears of patients with ocular surface disease" 40 : 315-321, 2008
• 13 Stern ME, "Inflammation in dry eye" 2 : 124-130, 2004
• 14 Kapelko-Słowik K, "Elevated serum concentrations of metalloproteinases(MMP-2, MMP-9)and their inhibitors(TIMP-1, TIMP-2)in patients with Graves' orbitopathy" 27 : 99-103, 2018
• 15 Shetty R, "Elevated expression of matrix metalloproteinase-9 and inflammatory cytokines in keratoconus patients is inhibited by cyclosporine A" 56 : 738-750, 2015
• 16 Kishazi E, "Differential profiling of lacrimal cytokines in patients suffering from thyroid-associated orbitopathy" 8 : 10792-, 2018
• 17 Di Girolamo N, "Differential expression of matrix metalloproteinases and their tissue inhibitors at the advancing pterygium head" 41 : 4142-4149, 2000
• 18 Starr CE, "An algorithm for the preoperative diagnosis and treatment of ocular surface disorders" 45 : 669-684, 2019
• 19 Ali MJ, "Alteration of tear cytokine expressions in primary acquired nasolacrimal duct obstruction-potential insights into the etiopathogenesis" 45 : 435-439, 2020