普拉洛芬在干眼中对Th1细胞趋化因子受体CXCR3和CCR5表达的影响

目的：观察普拉洛芬对Th1 细胞CXC趋化因子受体3（CXCR3）和CC趋化因子受体5（CCR5）表达的影响，并探讨其抑制干眼炎症免疫反应的机制。方法：随机对照试验。纳入干眼患者170例（170眼），均选取右眼为观察眼。采用随机数字表法分为试验组和对照组，各85 例（85 眼）。试验组予普拉洛芬联合玻璃酸钠点眼，均每日4次，每次1滴；对照组仅玻璃酸钠点眼，每日4次，每次1滴。于治疗前和治疗后30 d时进行随访，检测并比较2 组泪液分泌量（SIt）、泪膜破裂时间（BUT）、角膜荧光素染色（CFS）评分，CXCR3和CCR5 表达率，及两者与BUT和CFS关系。采用Pearson直线相关分析以及t 检验对数据进行分析。结果：治疗后2 组BUT均较治疗前延长（t =-13.27、-13.53，均P ＜0.05），且试验组长于对照组（t =10.11，P ＜0.05）；治疗后2组CFS评分均低于治疗前（t =7.34、5.27，均P ＜0.05），且试验组低于对照组（t =5.15，P ＜0.05）；治疗后试验组CXCR3、CCR5的表达率低于治疗前（t =6.74、9.27，均P ＜0.05），且试验组低于对照组（t =3.29、2.83，均P ＜0.05）；试验组CXCR3、CCR5表达率与BUT呈负相关（r =-0.22、-0.22，均P ＜0.05），与CFS评分呈正相关（r =0.28、0.23，均P ＜0.05）。结论：普拉洛芬可通过下调眼表Th1细胞CXCR3和CCR5的表达来发挥对干眼的治疗作用。

Effect of Pranoprofen on the Expression of Chemokine Receptors CXCR3 and CCR5 of Th1 Cells in Dry Eye Patients

Objective:To investigate the effect of pranoprofen on the expression of CXC chemokine receptor 3 (CXCR3) and CC chemokine receptor 5 (CCR5) of Thl cells in dry eye patients,and to explore the correlation of changes in receptor expression with clinical changes of dry eye signs.Methods:This study included 170 patients with dry eye in a randomized,controlled clinical trial.The right eyes of the patients (n=85) administered 0.1％ pranoprofen and 0.1％ sodium hyaluronate drops (4 times/day).The right eyes of the control dry eye patients (n=85) received 0.1％ sodium hyaluronate drops alone (4 times/day).The two groups were followed up before administration and 30 days later.The primary clinical indexes that were evaluated included Schirmer I test (SIt),tear film break-up time (BUT),and corneal fluorescein staining (CFS).Differences in the expression of CXCR3 and CCR5 were compared between the two groups.Changes in the expression levels of CXCR3 and CCR5 were correlated with changes in SIt,BUT,and FIS.The data were analyzed by t test and pearson correlation.Results:The tear BUT was significantly longer in both groups after treatment compared to the pretreatment values (t=-13.27,-13.53,both P＜0.05).Additionally,the tear BUT was significantly longer in the pranoprofen-treated test group compared to the control group (t=10.11,P＜0.05).The CFS scores in both groups were lower than before treatment (t=-7.34,5.27,both P＜0.05),and it was significantly lower in the test group compared with the control group (t=5.15,P＜0.05).Expression levels of both CXCR3 and CCR5 were significantly reduced in the test group than pretreatment (t=6.74,9.27,both P＜0.05),and it was significantly lower in the test group,compared with the pretreatment values (t=3.29,2.83,both P＜0.05).The expression levels of both CXCR3 and CCR5 were negatively correlated with BUT (r=-0.22,-0.22,both P＜0.05) and positively correlated with CFS (r=0.28,0.23,both P＜0.05).Conclusion:Pranoprofen inhibits the inflammatory immune response in dry eye by down-regulating the expression of the chemokine receptors CXCR3 and CCR5 on Th1 cells.