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Klin Monbl Augenheilkd 2013; 230(8): 804-807
DOI: 10.1055/s-0032-1328410
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Immunoassay für Matrix-Metalloproteinase-9 in der Tränenflüssigkeit bei Patienten mit Pseudoexfoliationssyndrom – eine Pilotstudie

Immunoassay for Matrix Metalloproteinase-9 in the Tear Film of Patients with Pseudoexfoliation Syndrome – A Pilot Study
N. Zimmermann
Augenheilkunde, Augenklinik am Wittenbergplatz, Berlin
,
C. Erb
Augenheilkunde, Augenklinik am Wittenbergplatz, Berlin
› Author Affiliations
Further Information

Publication History

eingereicht 31 October 2012

akzeptiert 04 February 2013

Publication Date:
13 May 2013 (online)

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Zusammenfassung

Hintergrund: Matrix-Metalloproteinasen (MMPs) sind proteolytische Enzyme, die u. a. durch gereizte Epithelzellen der Augenoberfläche freigesetzt werden. Ein unspezifischer Entzündungsparameter im Tränenfilm ist die Unterform MMP-9, der auch ein Einfluss bei der PEX-Glaukomentstehung zugeschrieben wird. Neuerdings gibt es einen Schnell-Immunoassay zum Nachweis von MMP-9 in der Tränenflüssigkeit. Ziel dieser Studie war die Analyse der MMP-9-Konzentration im Tränenfilm beim PEX-Syndrom. Zusätzlich erfolgte eine Einschätzung der Durchführbarkeit, Auswertbarkeit und Zuverlässigkeit des Tests.

Methoden: Es wurden zufällig jeweils 10 Patienten mit PEX-Syndrom sowie allgemein- und augengesunde Kontrollpatienten ausgewählt. Es wurde der Schnell-Immunoassay RPS InflammaDry Detector™ von Rapid Pathogen Screening Inc. verwendet. Der Schnelltest wurde jeweils an einem Auge durchgeführt.

Ergebnis: Im Tränenfilm beim PEX-Syndrom sind erhöhte MMP-9-Konzentrationen nachweisbar. 80 % der PEX-Patienten und 20 % der Kontrollen zeigten ein positives Testergebnis (>/= 40 ng/ml MMP-9), woraus eine Test-Sensitivität und -Spezifität von jeweils 80 % resultiert. Dies entspricht ungefähr den publizierten Werten für das Trockene Auge (Sensitivität: 87 %, Spezifität: 92 %). Die Durchführung des Tests ist einfach und verständlich. Die Patienten tolerierten die Aufnahme des Tränenfilms mittels Teststreifen gut. Allerdings ist es trotz Färbeindikator schwierig einzuschätzen, ob genügend Tränenfilm gewonnen wurde. Beim Ablesen des Teststreifens ist die Färbung der Resultatlinie schwach.

Schlussfolgerung: Der MMP-9-Schnell-Immunoassay ist ein neuartiger, sinnvoller Ansatz zum Nachweis einer Entzündungsaktivität der Augenoberfläche. Wir zeigen eine Hochregulation des unspezifischen Entzündungsmarkers MMP-9 im Tränenfilm beim PEX-Syndrom und vermuten eine Assoziation mit einer Tränenfilmstörung. Allerdings ist eine Verbesserung der Einschätzung der gewonnenen Tränenmenge und Ablesbarkeit wünschenswert.

Abstract

Introduction: Matrix-metalloproteinases (MMPs) are proteolytic enzymes released by irritated epithelial cells of the ocular surface. It has been established that the subtype MMP-9 can serve as an inflammatory marker within the tear film. MMP-9 is also attributed to have an effect on the PEX-glaucoma development. Recently, a rapid immunoassay for detection of MMP-9 in the tear film was developed to estimate inflammatory extent during dry eye disease. The aim of this study was to analyse the MMP-9 concentration in tear film in PEX-syndrome. In addition, an assessment of the feasibility, reliability and readability of the test was done.

Methods: We randomly selected 10 patients with PEX-syndrome and 10 healthy control patients and measured tear film MMP-9 of one eye with the RPS InflammaDry Detector™ (Rapid Pathogen Screening Inc., USA).

Results: We detected increased levels of MMP-9 in tear film in PEX-syndrome. 80 % of the PEX-patients and 20 % of the controls showed a positive test result (>/= 40 ng/mL MMP-9) indicating a test specificity and sensitivity of 80 %. This corresponds approximately to the published values for the dry eye (sensitivity 87 %, specificity: 92 %). The performance of the test is simple. The patients tolerated the inclusion of the test strips well. However, it is difficult to estimate whether enough tear film was used and in many cases, the intensity of the “indicator line” was weak.

Conclusion: The rapid MMP-9-immunoassay is a novel, meaningful approach for the detection of inflammatory activity of the ocular surface. We have shown an up-regulation of the non-specific inflammatory marker MMP-9 in tear film in PEX-syndrome and suggest an association with a tear film disorder. However, an improvement in the estimation of the amount of collected tears and readability is desirable.

Schlüsselwörter

MMP-9 - PEX - Schnell-Immunoassay

Key words

MMP-9 - PEX - rapid immunoassay
 

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