Treatment of dry eye by autologous serum application in Sjogren's syndrome

Aim - To evaluate the efficacy of autologous serum application for the treatment of dry eye in Sjogren's syndrome. Methods - The stability of essential components (EGF, vitamin A, and TGF-β) in preserved serum were examined following preservation at 4°C and -20°C. In a primary clinical trial, 12 patients with Sjogren's syndrome were treated with autologous serum (diluted to 20% with sterile saline) for 4 weeks, and vital staining of the ocular surface was compared before and after treatment. The effects of serum on mucin (MUC-1) expression were observed in cultured conjunctival epithelial cells in vitro. Results - EGF, vitamin A, and TGF-β were well preserved for up to 1 month in the refrigerator at 4°C and up to 3 months in the freezer at -20°C. Rose bengal and fluorescein scores improved significantly from the initial scores of 5.3 and 5.6 to 1.7 and 2.5 after 4 weeks, respectively. The additive effect of human serum for cultured conjunctival epithelial cells showed significant MUC-1 upregulation on the cell surface. Conclusion - Autologous serum application is a safe and efficient way to provide essential components to the ocular surface in the treatment of dry eye associated with Sjogren's syndrome.