HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Li, S. Articles by McNamara, N. A. Search for Related Content PubMed PubMed Citation Articles by Li, S. Articles by McNamara, N. A.

Small Proline-Rich Protein 1B (SPRR1B) Is a Biomarker for Squamous Metaplasia in Dry Eye Disease

¹From the Francis I. Proctor Foundation, the ²Department of Medicine, Diabetes Center, and the ³Departments of Oral Medicine, ⁴Ophthalmology, and ⁵Anatomy, University of California, San Francisco, San Francisco, California.

PURPOSE. Squamous metaplasia occurs in ocular surface diseases like Sjögren’s syndrome (SS). It is a phenotypic change whereby epithelial cells initiate synthesis of squamous cell-specific proteins such as small proline-rich protein 1B (SPRR1B) that result in pathologic keratin formation on the ocular surface. The authors hypothesized that inflammation is a key inducer of pathologic keratinization and that SPRR1B represents an analytical biomarker for the study of the molecular mechanisms.

METHODS. Real-time quantitative RT-PCR and immunohistochemistry were used to examine SPRR1B mRNA and protein in two different mouse models of dry eye and patients with SS. Adoptive transfer of mature lymphocytes from mice lacking the autoimmune regulator (aire) gene was performed to examine the role of inflammation as an inducer of squamous metaplasia. SPRR1B expression in response to several cytokines was examined in vitro, whereas the expression of cytokines IL1β and IFN was quantified in ocular tissues of aire-deficient mice and patients with SS.

RESULTS. SPRR1B was increased across the ocular surface of mice with both desiccating stress and autoimmune-mediated, aqueous-deficient dry eye and in patients with SS. Adoptive transfer of CD4⁺ T cells from aire-deficient mice to immunodeficient recipients caused advanced ocular surface keratinization. IL1, IL1β, IL6, IFN, and TNF induced SPRR1B expression in vitro and the local expression of IL1β and IFN was elevated in ocular tissues of patients with SS and aire-deficient mice.

CONCLUSIONS. SPRR1B is a valid biomarker for the study of the molecular mechanisms of squamous metaplasia. There is a definitive link between inflammation and squamous metaplasia in autoimmune-mediated dry eye disease, with IL1β and IFN likely acting as key participants.