Activation of Conjunctiva-Associated Lymphoid Tissue in Diabetic Patients

ABSTRACT

Purpose

To evaluate changes in conjunctiva-associated lymphoid tissues (CALTs) in patients with type 2 diabetic mellitus (T2DM).

Methods

Thirty-two patients with T2DM and 32 healthy volunteers underwent comprehensive examinations. In vivo confocal microscopy and Image J were used to observe and evaluate the patients’ CALT-related parameters. Conjunctival impression cytology (CIC) samples of the tarsal conjunctiva were collected from the patients, and CD4+ and CD8+ cells were evaluated by immunofluorescence staining.

Results

The diabetes group showed higher diffuse lymphocyte density(p < .001), follicular density(p < .001) and parafollicular lymphocyte density(p < .001). The percentages of CD4+ cells (p < .001) and CD8+ cells (p < .001) in the diabetes group were higher than those in the control group. CALT-related parameters of the diabetic patients with diabetic retinopathy showed higher degrees of activation than those of the diabetic patients without diabetic retinopathy.

Conclusions

CALT activation is observed in patients with T2DM, and the activation is more obvious in patients with diabetic retinopathy.

Trial registration number

Retrospectively registered, ChiCTR2100046030.

KEYWORDS:

• Conjunctiva-associated lymphoid tissues
• diabetic mellitus
• in vivo confocal microscopy
• conjunctival impression cytology

Availability of data and material

The article’s data sharing is not applicable as no datasets were generated or analyzed.

Code availability

Image J(National Institutes of Health, Bethesda, MD, USA), Heidelberg in vivo confocal microscopy cell counting software (Heidelberg Engineering, Heidelberg, Germany).

Consent to participate

All subjects were informed and gave their consent prior to enrollment.

Consent for publication

All authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

Our study was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University (2020JS03).

SUPPLEMENTARY MATERIAL

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [Grant No. U20A20363, 81970776], supported by the Natural Science Foundation of Heilongjiang Province, China [Grant No. LH2020H039].