Bellow a few examples of autoimmune
diseases that may lead to dry eye states or dysfunctional tear
syndromes:
Rheumatoid
Arthritis
(or polyarthritis)
and other rheumatismal diseases
Rheumatoid polyarthritis is a
chronical autoimmune disease that causes pain, redness, swelling,
burning sensations and stiffness around the joints/articulations (particularly
the hands, feet and wrists). This disease may lead to the destruction
of the said articulations. As in every autoimmune disease the immunitary
system attacks some parts of the body provoking chronic inflammation of
tissues (notably conjuntival tissues), mucosa and other organs, such as
the eye, the lungs or even the heart. The disease usually strikes people
older than 15 years old. Before that age, joint tissue inflammation
exists under other forms such as juvenile arthritis. The symptoms vary
from one person to another: some persons suffer from mild forms of the disease, presenting occasional signs
of inflammation and pain in the joints and remission periods; but in other cases, the disease
remains active in permanence and gets progressively worse. The joints are
inflammed in a chronic way, particularly the hands and feet, leading to
the destruction of the cartilage and the adjacent bone in symetric
deformation processes. A dysfunctional tear syndrome may appear
affecting the lachrymal glands through chronic inflammation. There is
no cure for this disease currently altough it can be treated. Only the
ocular aspects of this disease enter the scope of action defined by
Keratos.
Lupus
The term «lupus»
actually designates several chronic autoimmune diseases. Systemic
erythematous Lupus is the most frequent form of this disease and
probably the most serious one. In such cases, the immunitary system is
disturbed and produces antibodies which attack healthy tissues in
various locations of the body. The main characteristic of this type of
lupus are caused by inflammation of such tissues and organs, notably the
skin, the muscles, the joints, the heart, the lungs, the kidneys, the
blood vessels and the nervous system. Lupus is characterised by the
alternation of severe episodes and remissions phases. Other forms of
lupus exist as well: erythematous discoid lupus and sub-acute cutaneous
erythemateous lupus. The main primary symptoms of both forms is
cutaneous eruptions and sensitivity to sunlight. At least 10% of the
persons suffering from these milder forms will have symptoms of the main
form of lupus. An induced form of Lupus also exists through the use of
medication (therefore it's an iatrogenic cause).
One of the possible symptoms of lupus is a dysfunctional tear syndrome.
Only the ocular aspects of this disease enter the scope of action
defined by Keratos.
Graft-Versus-Host-Disease
(GVHD)
GVDH is a severe autoimmune response
from the immune system of the graft cells agaisnt the organs of the
recipient. This occurs after bone marrow transplantation. Bone marrow
transplantation is sometimes necessary to treat leuchemia, some toxic
attacks and severe infections of the bone marrow. If
there is graft rejection, and althought GVHD's severity range varies considerably,
it may occcur in very severe forms where life prognostic is engaged.
After this acute phase (usually in the first 3 months) the disease may
become less severe but chronic. In this disease some immunitary cells of
the donor do not recognise the tissues of the receiver. In GVHD, Lymphocytes T
and cytokines immunitary response
may attack the skin and other mucosa of the patient (including lachrymal
glands and surface). This mucosal inflammation
leads to dysfunctional and dry tear and saliva syndromes as in Gougerot-Sjögren's
syndrome. Some neuropathies may encompass this
disease and further compromise these superficial tissues. The first
ocular signs of GVHD usually appear between the 2d and the 4th week after
the graft: blepharitis, conjonctivitis
and keratitis.
The lachrymal accessory
glands are often destroyed. The disease may evolve into ulceration
episodes, neovascularisation and opacification of the cornea.
Only the
ocular aspects of this disease enter the scope of action
defined by Keratos.
Sjögren-Goujerot
This systemic autoimmune disease is
characterised by damaged exocrines glands, in particular the lachrymal
and salivary glands (respectively called xerophtalmia and xerostomia in
this context).
Skin dryness (xerosis) may occur in rare cases, as the disease may
affect any mucosa (nose, lungs and vagina, etc). The
disease is more prevalent in women than men. The disease may either be primitive
(isolated) or coexist with another auto-immune disease: lupus or
polyarthritis for instance.
Only the
ocular aspects of this disease enter the scope of action
defined by Keratos.
Diabetes
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Keratoss 2007
