Fig 1.
(a) Criteria for determination of the fluorescein staining score. All sub-scores for the nasal and temporal bulbar conjunctiva and the cornea were summed, and the value designated as the total score. (b) Impression cytology was performed to obtain the sample from the upper palpebral conjunctiva.
Table 1.
Demographic and clinical characteristics of participants in the control group.
Fig 2.
Correlation between SPDEF and MUC5AC mRNA expression levels in the control group.
SPDEF mRNA expression levels were significantly correlated with those of MUC5AC. ρ = 0.791, p < 0.001, Spearman’s correlation coefficient.
Table 2.
Partial correlation coefficient between age and mucin-related gene expression levels in the control group.
Table 3.
Comparison of mucin-related gene expression levels between male and female controls.
Table 4.
Demographic and clinical characteristics of patients with Sjögren’s syndrome.
Fig 3.
Change in fluorescein staining scores and tear breakup time (TBUT) at follow-up after rebamipide instillation treatment in SS-DE patients.
Least-square means (LS means ± 95% confidence interval) ware plotted for fluorescein staining scores and tear breakup times (TBUT) at each observation point. (a) Fluorescein staining scores at 4 and 8 weeks were significantly decreased compared with baseline values. (b) TBUT at 2 and 8 weeks were significantly increased compared with baseline levels. *, p < 0.05; **, p < 0.01, mixed-effects models.
Fig 4.
Change of SPDEF, MUC5AC, and MUC16 mRNA expression levels at follow-up points after rebamipide instillation treatment in SS-DE patients.
Least-square means (LS means ± 95% confidence interval) ware plotted for relative expression levels of SPDEF, MUC5AC, and MUC16 mRNA at each observation point. (a) SPDEF mRNA expression levels were significantly increased at 2, 4, and 8 weeks compared with baseline values. (b) MUC5AC mRNA expression levels were significantly increased at 8 weeks compared with those at baseline. (c) MUC16 mRNA expression levels were significantly decreased at 4 and 8 weeks compared with those at baseline. * p < 0.05, mixed-effects models.
Fig 5.
Mucin-related gene expression levels in the SS-DE and age- and sex-matched control groups at 4 weeks after the initiation of rebamipide instillation treatment.
Mucin-related gene expression levels in the SS-DE at 4 weeks after the initiation of rebamipide treatment were compared with those in age- and sex-matched control groups. MUC5AC mRNA expression levels in the SS-DE group were significantly higher than in the control group. (a) MUC5AC mRNA expression; (b) SPDEF mRNA expression; (c) MUC16 mRNA expression. * p < 0.05, Mann-Whitney U-test. SS-DE, Sjögren’s syndrome-associated dry eyes.
Fig 6.
A 77-year-old women with SS-DE disease.
Photographs of cornea with fluorescein staining at baseline (a), and 4 (b), 8 (c), and 12 (d) weeks. (e), expression levels of SPDEF, MUC5AC, and MUC16 mRNA in the right eye measured by reversed transcription-polymerase chain reaction.