[Bacteriological samples at the level of the eyes].
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Biomedical subjects
Publications and source records attributed to S Liotet.
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A biological study was conducted on tears from 20 subjects with a clinical sicca syndrome. Electrophoresis of lacrymal proteins, determination of lacrymal and salivary immunoglobulins G, and a human basophil degranulation test (HBDT) with a lacrymal gland extract as antigen were performed in each patient. Three different groups could be distinguished: a group with normal electrophoresis and normal HBDT corresponding to hyposecretion; a second group with abnormal electrophoresis and negative HBDT corresponding to an inflammatory state of the lacrymal gland; and a third group with abnormal electrophoresis and positive HBDT corresponding to a deficit in synthesis function of the lacrymal gland. These findings demonstrate that HBDT with lacrymal gland extract as antigen is a reliable means of diagnosis of the sicca syndrome.
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Electrophoresis of tears, a rapid and easy technique, shows several peaks of migration. Three main peaks correspond to the proteins synthesized by the lacrimal gland: rapid migrant proteins, lactoferrin migrating to the anode, and lysozyme migrating to the cathode. Secretory tissue injuries of the lacrimal gland show a more or less important decrease of one or several peaks. Any inflammatory reaction induces an increase in the serum albumin and immunoglobulin fractions. This exploration can be helpful in the diagnosis of the sicca syndrome or of drug poisoning thereby avoiding lacrimal biopsy.
Lactic deshydrogenase isoenzymes in different parts of the ocular tissues and humors were analyzed. An appreciation in crossing of the lactic deshydrogenase concentration was indicated. In the human eye, the largest quantities of lactic deshydrogenase were found in the cornea and in the vitreous and aqueous humors, where isoenzymes 3, 4, and 5 are the most numerous. Lactic deshydrogenase was found in small quantities only in the conjunctiva and in the lacrimal gland. In the bovine eye, the proportion of isoenzymes is different. The chemical constitution of human serum isoenzymes seems to differ from that of the tissues and liquids in the bovine eye (their mobility is different). Therefore, the results obtained with bovine eyes cannot be applied to human eyes. The largest quantity of lacrimal lactic deshydrogenase isoenzymes comes from the cornea, any recent corneal lesion causing an increase in isoenzyme 4.
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The search for immune complexes or immunoglobulin G aggregates in ocular liquids is often positive, particularly in tears. Immunoglobulin G titration is therefore as only free immunoglobulin are detected. Immunity load and Witmer ratio are also increased leading to inaccurate results. Systematic tests for immune complexes or immunoglobulin aggregates are necessary in order to obtain objective results.
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