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Effect of green argon (514 nm) laser exposure on rose bengal-stained guinea pig cornea.

Our purpose was to study the effect of continuous wave (CW) green argon laser (514 nm) exposure on rose bengal-stained cornea. Following staining with rose bengal (1%), the corneas of 48 albino guinea pigs were exposed to different power levels of argon laser, ranging between 0.04 and 0.8 W. The beam diameter ranged between 50 and 200 microns, and exposure time was 0.1 sec. Histology revealed minimal tissue coagulation at 0.05 W and 50 microns. Moderate coagulation of the anterior stromal lamellae was found at power levels of 0.07-0.6 W and a beam diameter of 100-200 microns. At power levels of 0.7 and 0.8 W, lamellar disruption was also noted. Our data indicate that 1% rose bengal is a good photosensitizer for superficial corneal stromal photocoagulation.

Animals↗

Light-induced proteolysis of myosin heavy chain by Rose Bengal-conjugated antibody complexes.

The specific light-induced, non-enzymatic digestion of chicken skeletal muscle myosin heavy chain by xanthene dye-conjugated antibodies is reported. The xanthene dye Rose Bengal was conjugated to either a mouse monoclonal anti-myosin primary specific antibody or to goat anti-mouse IgG secondary antibodies. Under our experimental conditions, visible light induced the non-enzymatic breakdown of myosin heavy chains when chicken skeletal muscle myosin either directly formed a complex with Rose Bengal-conjugated anti-myosin antibodies or indirectly formed a complex with anti-myosin antibody-Rose Bengal-conjugated secondary antibodies. The rate of the photochemical reaction depended on irradiation time and temperature. Although SDS-PAGE and immunoblot analyses showed that fragments migrating below the myosin heavy chain polypeptide predominated, these analyses also showed higher molecular mass polypeptides were generated.

Animals↗

Rose bengal-induced photodamage to subcellular membranes and enzymes.

Studies were made of photodamage (photolysis) caused by Rose Bengal + light of peroxisomes, mitochondria, and lysosomes, as well as inhibition of the respective marker enzymes: catalase, sulfite oxidase, and acid phosphatase. The time-dependence of lipid peroxidation caused by the same system and measured by the increase of thiobarbituric acid-reactive substances was also examined. The most sensitive to photolysis were the peroxisomes and the least susceptible were lysosomes as the inhibition of their marker enzymes followed this order. The sensitivity of the subcellular membranes to digitonin (a sterol binding agent) showed the opposite dependence. The importance of the cholesterol content for the membrane stability to active oxygen species, as well as the role of lipid peroxidation in photodynamic damage of the systems studied, is discussed.

Acid Phosphatase↗

Factors affecting triple staining of human sperm.

We have previously described a triple stain for evaluating normal acrosome reactions of human sperm. This procedure uses trypan blue to distinguish live and dead sperm, Bismarck brown to stain the sperm's postacrosomal region, and rose Bengal to stain the sperm's acrosome. We have recently found that batches of rose Bengal vary significantly in their ability to produce good staining of the acrosome in this procedure. This appears to be due to variations in the intrinsic pH of rose Bengal solutions and the presence of nondye contaminants in the stain. In this study, we have evaluated acrosomal staining using 6 batches of rose Bengal and report a method for achieving uniform staining quality with each batch. Solutions of rose Bengal (0.8%) are made up in 0.1 M Tris HCl (pH 2.3) buffer and adjusted to pH 5.3 if necessary. For most batches of rose Bengal this promotes precipitation of some of the dye and an unidentified contaminating crystal. The precipitate is removed by centrifugation, and the supernatants have been found to give good to excellent staining of the acrosomes for all batches tested. Solutions of both rose Bengal and Bismarck brown are stable for at least 5 days but their pH values should be monitored daily and adjusted to 5.3 and 1.8 respectively if drifting occurs. We have also observed some variation in the intensity of rose Bengal staining of the acrosome from donor to donor and recommend that staining times in rose Bengal be adjusted for each donor.

Acrosome↗

Sjögren's syndrome: a stepwise approach to the use of diagnostic tests.

One hundred and forty two patients (62 with definite Sjögren's syndrome, 24 with probable Sjögren's syndrome, and 56 in whom Sjögren's syndrome was finally ruled out) were studied. Schirmer's test and rose bengal staining for the diagnosis of keratoconjunctivitis sicca and salivary scintigraphy and a labial biopsy sample for the diagnosis of xerostomaia were studied in all patients. Rose bengal staining showed high specificity (98%) but low sensitivity (55%). All patients with positive rose bengal staining results had associated xerostomia. In the rose bengal staining positive patients, scintigraphy had 100% specificity. A labial biopsy sample showed high sensitivity in the rose bengal staining, salivary scintigraphy positive group, and high specificity in the rose bengal staining positive, salivary scintigraphy negative group. In patients with negative rose bengal staining, salivary scintigraphy showed 96% specificity and 36% sensitivity. A labial biopsy sample had a sensitivity and specificity greater than 90% in rose bengal staining negative patients. Only 29 biopsy samples were needed to achieve a diagnosis of Sjögren's syndrome in 142 patients (20%). Hence the suggested approach may make it unnecessary to take biopsy samples in approximately 80% of patients with suspected Sjögren's syndrome. Using the stepwise approach of first rose bengal staining, then salivary scintigraphy, and eventually a labial biopsy sample in patients with suspected Sjögren's syndrome, the diagnosis is relatively simple.

Adult↗

Inhibition by singlet molecular oxygen of the vascular reactivity in rabbit mesenteric artery.

1. The effects of reactive oxygen intermediates derived from photoactivated rose bengal on the vascular reactivity have been evaluated in rabbit mesenteric artery ring preparations. The artery rings were exposed to xanthene dye rose bengal (50 nM) illuminated (6,000 lux) at 560 nm for 30 min. Spin trapping studies with 2,2,6,6-tetramethylpiperidine (TEMP) and 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) with electron spin resonance spectrometry were also conducted in solution (and not within tissues) to determine quantitatively the reactive oxygen species generated from photoactivated rose bengal. 2. Contraction of the ring preparations induced by noradrenaline (10(-8) to 10(-4) M) was attenuated by previous exposure to photolysed rose bengal; the observation that the pD2 decreased without a significant reduction in maximum tension generation is consistent with the view that receptor dysfunction may be involved in the effect of photolysed rose bengal. 3. Prior exposure to photolysed rose bengal of the ring preparations inhibited the endothelium-dependent relaxation evoked by acetylcholine (10(-6) M) and calcium ionophore A23187 (10(-7) M), but not the endothelium-independent relaxation evoked by nitroglycerin (10(-6) M). 4. A variety of scavengers, superoxide dismutase (33 units ml-1), catalase (32 units ml-1) and 1,3-dimethyl-2-thiourea (DMTU, 10 mM), which should eliminate the superoxide anion radical, H2O2 and the hydroxyl radical, had no effect on the attenuated responses to noradrenaline and acetylcholine induced by photolysed rose bengal. In contrast, the inhibition of the observed effect of photolysed rose bengal was obtained with addition of histidine (25 mM), a singlet molecular oxygen quencher. 5. It was found that photolysis of rose bengal from a 1:2:2:1 quartet, characteristic of the hydroxyl radical-DMPO spin adduct, which was effectively blunted by DMTU, superoxide dismutase and catalase whereas histidine was ineffective. The results of the electron spin resonance study also showed that a singlet molecular oxygen was produced by photoactivation of rose bengal; this was detected as singlet oxygen-TEMP product (TEMPO; 2,2,6,6-tetramethylpiperidine-N-oxyl). The formation of the TEMPO signal was strongly inhibited by histidine, but not by DMTU, superoxide dismutase and catalase. 6. It is suggested that the superoxide anion radical, H2O2 and hydroxyl radical are formed in addition to singlet molecular oxygen, and the data obtained from the present study indicate that singlet molecular oxygen is one of the most destructive oxygen species. Endothelium-dependent relaxation is quite vulnerable to singlet molecular oxygen. Singlet oxygen also depresses noradrenaline-induced contraction possibly via alpha-adrenoceptor dysfunction. This, in turn, may lead to vascular incompetence.

Acetylcholine↗

A wavelength dependent mechanism for rose bengal-sensitized photoinhibition of red cell acetylcholinesterase.

A 2-fold enhancement in the efficiency of rose bengal-photosensitized inhibition of red cell acetylcholinesterase activity was observed upon excitation of the dye in the ultraviolet (UV) (313 nm) compared to irradiation in the visible (514 or 550 nm). The measurements of efficiency of photosensitized enzyme inhibition were based on the effect produced when the same number of photons are absorbed by rose bengal (RB) at each wavelength. The mechanism for this unexpected enhancement of RB photosensitization upon UV excitation was investigated. The yield of singlet oxygen (O2(1 delta g], detected by time-resolved luminescence at 1270 nm, was independent of excitation wavelength for RB. Radicals were produced upon irradiation of RB at 313 nm but not at 514 nm as detected by bleaching of N,N-dimethylnitrosoaniline (RNO). Irradiation of RB at 313 nm but not at 514 nm appeared to cause homolytic cleavage of carbon-iodine bonds in the dye because iodine radicals, I, detected as I2 were produced with a quantum yield of 0.0041 +/- 0.0005 upon excitation in the UV. Photolysis of I2 in the presence of RNO caused bleaching of the RNO absorption at 440 nm, apparently resulting from reaction of I with RNO. Thus, the enhanced photosensitization upon UV excitation of RB is attributed to formation of I and/or RB. These results indicate that radicals, produced with low relative yield but having high reactivity compared to O2(1 delta g), can contribute to photosensitized enzyme inhibition and may represent an alternative mechanism for photodynamic therapy.

Acetylcholinesterase↗

Application of a user-friendly Brucella-specific IgM and IgG antibody assay for the rapid confirmation of Rose Bengal-positive patients in a hospital in Iran.

The Brucella IgM/IgG flow assay was used for the confirmation of brucellosis in patients from an area endemic for brucellosis and who had a Rose Bengal (RB)-positive serum sample collected at the time of first presentation for diagnosis. The flow assay confirmed the result of the RB test in 46.6% of the positive admission sera, with the majority (62.5%) of the flow assay-positive samples staining moderately strong to very strong (> or =2+). In comparison, Wright and 2-ME at the routinely used cut-off titre values of 1:320 for Wright and 1:160 for 2-ME tested positive in 37.7% of the RB-positive samples. A relatively large number of RB-positive samples agglutinated at or around the cut-off value in the Wright and 2-ME tests and 66.7% of the RB-positive samples tested positive in these confirmatory tests when using one titre step lower threshold values. The relatively high number of samples with low antibody levels supports the argument for testing follow-up samples from patients with an RB-positive sample in order to confirm the diagnosis by showing seroconversion or a rise in antibody levels.

Brucella↗

Rose bengal-sensitized photooxidation of rat kidney gamma-glutamyltransferase.

Rose bengal-sensitized photooxidation of rat kidney gamma- glutamyltransferase (EC 2.3.2.2) resulted in irreversible inactivation of the enzyme. Inactivation revealed two distinct phases, the faster phase followed by the slower phase. During photooxidation, the enzyme lost its transpeptidation activity much faster than its hydrolysis activity. The rate of inactivation was markedly reduced by S- benzylglutathione , a substrate for the enzyme. Inactivation was also prevented by hippuric acid or by 3- benzylpropionate , acceptor site- directed ligands of the transferase. In contrast, D-glutamine, a donor site-specific substrate, had no effect on the inactivation process. Photooxidation of the enzyme affected neither the affinity for D-glutamine (apparent Km of 5.3-5.6 mmol/l) nor the reactivity with 6-diazo-5-oxo-D-(6-14C)norleucine, a donor site- specific affinity labeling reagent of the enzyme, suggesting preferential impairment of catalytic function of the acceptor site rather than that of the donor site. Amino acid analysis revealed that the photooxidative modulation of the catalytic activity represents a complex process accompanied by loss of multiple amino acid residues.

Animals↗

EGF-genistein inhibits neointimal hyperplasia after vascular injury in an experimental restenosis model.

A murine model of vascular injury-induced neointimal hyperplasia was developed by using a photoactive dye, rose bengal. Photoactivation of rose bengal induced vascular injury to the femoral arteries of C57B1/6 mice and resulted in an occlusive neointimal hyperplasia after 4 weeks. The cellular elements of the hyperplastic neointima were found to be alpha-actin-positive vascular smooth muscle cells expressing epidermal growth factor (EGF) receptor at high levels. EGF-Gen, an EGF-R-specific inhibitor with potent anticancer activity, suppressed the formation of hyperplastic neointima. Morphometric analysis of serial tissue sections at 4 weeks after vascular injury showed that in 75% of the EGF-Gen-treated mice, the maximal stenosis index was only 0.44 +/- 0.13, whereas in 75% of phosphate-buffered saline (PBS)-treated mice, the maximal stenosis index was 1.20 +/- 0.25. The mean neointima/media ratios for areas of maximum neointimal hyperplasia were 0.59 +/- 0.16 (n = 24) for the EGF-Gen-treated group, 0.99 +/- 16 (n = 45) for the PBS group (EGF-Gen vs. PBS, p = 0.0017), and 1.03 +/- 18 (n = 8) for group treated with unconjugated genistein (EGF-Gen vs. Gen, p = 0.0088). EGF-Gen treatment of mice with vascular injury to the left femoral artery was not associated with any clinical signs of toxicity or histopathologic lesions in any of the organs, including the uninjured right femoral artery. EGF-Gen also inhibited VSMC migration in vitro, without affecting VSMC proliferation and viability, suggesting that EGF-Gen is blocking neointima formation by inhibiting cellular migration to vascular injury sites. In conclusion, EGF-Gen may be useful as a nontoxic prophylactic agent for prevention of restenosis in clinical settings.

Animals↗

[Comparative study of the Brucellacapt test versus the Coombs test for Brucella].

BACKGROUND: To compare the results obtained by Brucella Coombs' test with those obtained by Brucellacapt. MATERIAL AND METHODS: 145 serum samples from 112 patients with brucellosis or with brucellar infection suspected on clinical grounds and a history of occupational exposure were analyzed. All serum samples were tested for Rose Bengal, agglutinations whenever Rose Bengal was positive, Brucella Coombs' test and Brucellacapt. RESULTS: There was a direct correlation between both methods (p < 0.01). Negative serum samples and most serum samples with titers between 1/40 and 1/2,560 as tested by Brucella Coombs' test showed similar results into a range of one to two dilutions by Brucellacapt. However, serum samples with titres between 1/5,120 and 1/40,960 by Brucella Combs' test yielded also higher titres by Brucellacapt and for this reason we were unable to define a titre. CONCLUSIONS: Brucellacapt is a rapid assay to exclude infection and yield results comparable to Brucella Coombs' test in range 1/40 to 1/2,560. Significantly higher and more rapid titres were obtained in acute brucellosis by Brucellacapt as compared with those obtained by Brucella Coombs' test. Titre's evolutions by Brucellacapt is similar to Brucella Coombs' test. Unfortunately it was difficult the titres definition of Brucellacapt at high titres.

Brucellosis↗

Photooxidation of skeletal muscle sarcoplasmic reticulum induces rapid calcium release.

The photooxidizing xanthene dye rose bengal is shown to induce rapid Ca2+ release from skeletal muscle sarcoplasmic reticulum (SR) vesicles. In the presence of light, nanomolar concentrations of rose bengal increase the Ca2+ permeability of the SR and stimulate the production of singlet oxygen (1O2). In the absence of light, no 1O2 production is measured. Under these conditions, higher concentrations of rose bengal (micromolar) are required to stimulate Ca2+ release. Furthermore, removal of oxygen from the release medium results in marked inhibition of the light-dependent reaction rate. Rose bengal-induced Ca2+ release is relatively insensitive to Mg2+. At nanomolar concentrations, rose bengal inhibits [3H]ryanodine binding to its receptor. beta,gamma-Methyleneadenosine 5'-triphosphate, a nonhydrolyzable analog of ATP, inhibits rose bengal-induced Ca2+ release and prevents rose bengal inhibition of [3H]ryanodine binding. Ethoxyformic anhydride, a histidine modifying reagent, at millimolar concentrations induces Ca2+ release from SR vesicles in a manner similar to that of rose bengal. The molecular mechanism underlying rose bengal modification of the Ca2+ release system of the SR appears to involve a modification of a histidyl residue associated with the Ca2+ release protein from SR. The light-dependent reaction appears to be mediated by singlet oxygen.

Adenosine Triphosphatases↗

Relation between signs and symptoms of dry eye in the elderly. A population-based perspective.

PURPOSE: To examine the distribution and association of dry eye symptoms, Schirmer test results, and rose bengal scores in a population-based sample of elderly Americans. DESIGN: Population-based prevalence survey. PARTICIPANTS: Involved were 2240 noninstitutionalized residents of Salisbury, Maryland, aged 65 years and older as of September 1993, and identified by the Health Care Financing Administration Medicare database. MAIN OUTCOME MEASURES: A standardized dry eye symptom questionnaire, rose bengal scoring of ocular surface staining, and Schirmer tests. RESULTS: Fourteen percent of participants reported one or more symptoms to be present often or all the time. The mean Schirmer score in the lower testing eye was 12.4 and 42% had a rose bengal score of 1 or greater. No significant differences by age, gender, or race were seen for symptoms, Schirmer, or rose bengal testing. No association was seen between lower Schirmer scores and presence of more frequent symptoms. Higher rose bengal scores were weakly associated with symptoms. The Schirmer and rose bengal test results, both individually and in combination, were insensitive in identifying individuals who had symptoms. CONCLUSIONS: Although symptoms of ocular irritation are common among the elderly, these population-based data indicate that there is minimal overlap between individuals identified by questionnaire, Schirmer tests, and rose bengal scoring.

Aged↗

Singlet oxygen interaction with Ca(2+)-ATPase of cardiac sarcoplasmic reticulum.

We investigated the role of singlet oxygen (generated from photoactivation of rose bengal) on the calcium transport and Ca(2+)-ATPase activity of cardiac sarcoplasmic reticulum (SR). Isolated cardiac SR exposed to rose bengal (10 nM) irradiated at 560 nm resulted in significant inhibition of Ca2+ uptake (from 2.27 +/- 0.05 to 0.62 +/- 0.05 mumol Ca2+/mg.min [mean +/- SEM], p less than 0.01) and Ca(2+)-ATPase activity (from 2.08 +/- 0.05 to 0.28 +/- 0.04 mumol Pi/min.mg [mean +/- SEM], p less than 0.01). The inhibition of calcium uptake and Ca(2+)-ATPase activity by rose bengal-derived activated oxygen (singlet oxygen) was dependent on the duration of exposure and intensity of light. Singlet oxygen scavengers ascorbic acid and histidine significantly protected SR Ca(2+)-ATPase against rose bengal-derived activated oxygen species, but superoxide dismutase and catalase did not attenuate the inhibition. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of SR exposed to photoactivated rose bengal for up to 14 minutes demonstrated complete loss of the Ca(2+)-ATPase monomer band, which was significantly protected by histidine. The addition of dithiothreitol (5 mM) had a slight protective effect, showing that new disulfide bond formation was not a major cause of aggregation. The results were also confirmed by high-performance liquid chromatography of the SR exposed to irradiated rose bengal. Irradiation of rose bengal also caused an 18% loss of total sulfhydryl groups of SR. On the other hand, superoxide radical (generated from xanthine oxidase action on xanthine) and hydroxyl radical (in the presence of Fe(3+)-EDTA or 0.5 mM H2O2 plus Fe(2+)-EDTA) as well as H2O2 (0.25-12 mM) were without any effect on the 97,000-d Ca(2+)-ATPase band of SR. Generation of radical species (superoxide and hydroxyl radical) from rose bengal was studied by electron paramagnetic resonance spectroscopy using the spin trap 5,5-dimethyl-1-pyrroline-N-oxide (DMPO). The results showed that irradiation of rose bengal formed a 1:2:2:1 quartet, characteristic of the DMPO-OH adduct, which was scavenged by ethanol but not by superoxide dismutase, catalase, or histidine. No radical species could be detected from irradiated rose bengal or irradiated DMPO under the assay conditions used. Peroxy adducts of DMPO might be produced but would be observed only at very low temperatures. Similarly, we could not detect any measurable.O2- anion from irradiation of rose bengal as indicated by either cytochrome c reduction at 550 nm or nitro blue tetrazolium reduction at 560 nm. These results show that SR is damaged most likely by singlet oxygen derived from rose bengal.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Use of hand held photopolymerizer to photoinactivate Streptococcus mutans.

OBJECTIVES: The main focus of this research was to investigate the photodynamic therapy (PDT), in vitro, acting on Streptococcus mutans and fibroblasts. A hand held photopolymerizer (HHP) and a classical photosensitizer (Rose Bengal) were used to induce photodynamic response. METHODS: S. mutans and fibroblast were treated with different concentrations of Rose Bengal (0-50 microM) irradiated with light (400-500 nm) for different time periods (0-40s) and then cell viability was evaluated. RESULTS: It was observed that the light (per se) is not toxic and in the dark Rose Bengal is toxic to the cells tested only at concentrations above 2.5 microM. Under light exposure concentrations of Rose Bengal above 0.5 microM all S. mutans were killed with no cytotoxic effects to fibroblasts. CONCLUSIONS: For the purpose of this work, the photoactivation of Rose Bengal, using the HHP, inactivated the bacteria without affecting the fibroblast viability.

Bacteriological Techniques↗

Effect of a transported ligand on the binding of albumin to rat liver cells.

Organic anions destined for hepatic uptake often bind to albumin in the circulation. Because albumin binds to liver cells but is not transported, we suggest that sites on the hepatocyte surface catalyze the dissociation of albumin-anion complexes, thus making more free anion available for transport than would otherwise occur. To learn whether liver cells distinguish between free albumin and albumin-anion complexes, we measured the binding of 125I-albumin to isolated rat hepatocytes in the presence and absence of rose bengal, a transported anion that binds extensively to albumin. Albumin binding to hepatocytes is reported as the albumin space corrected for extracellular fluid (14C-inulin space). Corrected albumin spaces are 2.95 and 2.83 microliter/mg cell protein with and without rose bengal, respectively. The mean difference and its 95% confidence interval computed from four comparisons in each of six rats is 0.12 +/- 0.67 microliter/mg cell protein. Inulin space is 32% of the uncorrected albumin space. Thus the affinities of albumin-rose bengal complexes and of free albumin for the hepatocyte surface differ by at most 28%. Accordingly, free albumin can compete with albumin-rose bengal complexes for cell surface sites, impairing the surface-mediated generation of free rose bengal for uptake. This finding explains the otherwise paradoxical observation that adding albumin to liver perfusate inhibits the uptake of rose bengal even when sufficient albumin is already present to bind 99.9% of this dye.

Animals↗

Singlet oxygen: a potential culprit in myocardial injury?

The purpose of this study was to explore the role of singlet oxygen in cardiovascular injury. To accomplish this objective, we investigated the effect of singlet oxygen [generated from photoactivation of rose-bengal] on the calcium transport and Ca(2+)-ATPase activity of cardiac sarcoplasmic reticulum and compared these results with those obtained by superoxide radical, hydrogen peroxide and hydroxyl radical. Isolated cardiac SR exposed to rose bengal (10 nM) irradiated at (560 nm) produced a significant inhibition of Ca2+ uptake; from 2.27 +/- 0.05 to 0.62 +/- 0.05 mumol Ca2+/mg.min (mean +/- SE) (P less than 0.01) and Ca(2+)-ATPase activity from 2.08 +/- 0.05 mumol Pi/min.mg to 0.28 +/- 0.04 mumol Pi/min.mg (mean +/- SE) (P less than 0.01). The inhibition of calcium uptake and Ca(2+)-ATPase activity by rose bengal derived activated oxygen (singlet oxygen) was dependent on the duration of exposure and intensity of light. The singlet oxygen scavengers ascorbic acid and histidine significantly protected SR Ca(2+)-ATPase against rose bengal derived activated oxygen species but superoxide dismutase and catalase did not attenuate the inhibition. SDS-polyacrylamide gel electrophoresis of SR exposed to photoactivated rose bengal up to 14 min, demonstrated complete loss of Ca(2+)-ATPase monomer band which was significantly protected by histidine. Irradiation of rose bengal also caused an 18% loss of total sulfhydryl groups of SR. On the other hand, superoxide (generated from xanthine oxidase action on xanthine) and hydroxyl radical (0.5 mM H2O2 + Fe(2+)-EDTA) as well as H2O2 (12 mM) were without any effect on the 97,000 dalton Ca(2+)-ATPase band of sarcoplasmic reticulum.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Oral and ocular manifestations in Sjögren's syndrome.

OBJECTIVE: Little is known about the relationship between lachrymal and salivary gland involvement in Sjögren's syndrome (SS). It is also of interest to know which eye test contributes most to the diagnosis of SS. We investigated the performance of different tear tests and how these tests relate to common serologic and salivary tests in SS. METHODS: In patients suspected of SS, the tear breakup time and the tear mucus score were evaluated in addition to the routine tests. Eighty consecutive patients were included, categorized into primary SS (pSS), secondary SS (sSS), and negative for SS. RESULTS: The tear breakup time and mucus score both performed insufficiently in diagnosing SS, in contrast to the Rose Bengal score. In pSS and sSS patients, a clear correlation was noted between tear and saliva quality and secretion rate, and between the Rose Bengal score and parotid sialography. Increased Rose Bengal scores also correlated significantly with hyperglobulinemia and presence of SSB antibodies in serum, with duration of subjective eye dryness, and with decreased tear gland function. CONCLUSION: The Rose Bengal score remains the eye test of choice having the highest specificity for SS. Hyperglobulinemia and especially positive SSB serology may warrant close monitoring of the eyes, since these serum findings appear to relate to the severity of ocular surface damage. Theoretically, a positive evaluation of either the ocular or oral component, in addition to positive serology or histopathology, could be sufficient to diagnose the syndrome for clinical purposes.

Adult↗