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PURPOSE: To translate and validate a Spanish-language adaptation of the 5-Item Dry Eye Questionnaire for the Mexican population. METHODS: Based on the MAPI Institute guidelines, the linguistic validation procedures consisted of four steps. Every step was reviewed by the committee. The translated validated questionnaire was applied to 25 Mexican subjects. The questionnaires were completed by the same subjects at three time points, 8 h apart on the same day and then 3 days later. Sensitivity and specificity of the DEQ-5 to predict DE signs was subsequently estimated in 200 patients see in the Asociación para Evitar la Ceguera ophthalmology clinic. RESULTS: During the forward translation step analysis, the committee decided to change the severity scale, as the words "constantly" and "frequently" are synonymous in Spanish, so it was modified by changing "constantly" to "always" for better understanding. Overall, the intra-test intra-class correlation coefficient from tests administered on the same day was 0.9 (95% CI 0.77-0.95, p = 0.0005). The intra-test intra-class correlation coefficient from tests administered 3 days apart was 0.9 (95% CI 0.88-0.97, p = 0.0005). When applying the questionnaire to 200 patients seen in an eye clinic, we found a sensitivity of 76% and a specificity of 31% for a DEQ-5 score of ≥ 6, against 2 or more positive signs of dry eye. CONCLUSION: MAPI methodology proved to be a reliable strategy for the transcultural Dry Eye Questionnaire for translation from English to Spanish for the Mexican population.

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Los receptores tipo toll (RTT) desempeñan un papel importante en la respuesta inmune innata en las infecciones oculares, particularmente las producidas por adenovirus (Ad). Los objetivos de este estudio fueron determinar si la infección adenoviral induce citocinas proinflamatorias en células epiteliales corneales (CEC) humanas y evaluar la contribución de los RTT al microambiente pro inflamatorio por las células epiteliales limbales (CEL) humanas. Métodos: Las CEC fueron aisladas de córneas humanas sanas y cultivadas en medio epitelial hormonal suplementado hasta su confluencia. Las CEL fueron obtenidas a partir de rodetes limbales humanos y cultivadas en medio KSFM hasta su confluencia. Posteriormente, las CEC fueron infectadas con Ad5 y cultivadas en diferentes tiempos (24 h, 48 h, 72 h). Las CEL fueron estimuladas con agonistas de RTT por 24 h. Los sobrenadantes de cultivo fueron recuperados y analizados por ELISA para determinar las concentraciones de interleucina (IL) 1b, IL-6, factor de necorsis tumoral alfa (FNT-α) e interferón alfa (IFN-α). Resultados: La infección de CEC por Ad5 indujo la producción de IL-6 desde las 24 h. No se detectó IL-1b, FNT-α o IFN-α en los sobrenadantes de cultivo de las células infectadas en ningún tiempo de cultivo. La estimulación por agonistas de RTT en CEL indujo la producción de IL-6 a través de RTT8> RTT4 = RTT2. Conclusiones: La infección por Ad5 indujo la producción de IL-6 por CEC. El RTT8 podría estar implicado con la producción de esta citocina en CEL.

Toll-like receptors (TLRs) play an important role in theinnate immune response to ocular infections particularlyby adenovirus (Ad). The objectives of this study were todetermine whether adenoviral infection inducesproinflammatory cytokines by human corneal epithelialcells (CEC) and to evaluate TLR contribution to the proinflammatorymicroenvironment by human limbalepithelial cells (LEC). Methods: CEC were isolated fromhuman healthy corneas and grown in supplementedhormonal epithelial medium until confluence. LEC wereobtained from human limbal rims, and cultured in KSFMmedium until confluence. Then CEC were infected withAd5 and cultured at different times (24 h, 48 h, 72 h).LEC were stimulated with TLRs-agonist for 24 h. Culturessupernatants were recovered and analyzed by ELISA todetermine IL-1b, IL-6, TNF-α and IFN-α concentrations.Results: Ad5 infection of CEC induced the production ofIL-6 since 24 h. Nor IL-1b, TNF-α, or IFN-α were detectedin the culture supernatants of infected cells in any timeof culture. TLRs-agonist stimulation of LEC induced IL-6production through TLR8 > TLR4 = TLR2. Conclusions:Ad5 infection induced IL-6 production by CEC. TLR8 couldbe implicated in the production of this cytokine in LEC.

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PURPOSE: To report the clinical and molecular study of a family with an autosomal dominant stromal granular dystrophy of the cornea caused by a novel and unusual TGFBI gene mutation. METHODS: A complete ophthalmological examination, corneal dystrophy phenotype characterization, PCR amplification, and automated nucleotidic sequencing of exons 4, 11,12, 13, and 14 of the TGFBI gene was carried out on the family. DNA from 40 unrelated ethnically matched healthy individuals were analyzed as controls. RESULTS: Corneal dystrophy in two sisters was characterized by multiple grayish-white lesions located in the anterior and mid-stroma. Numerous small sized non-coalescent opacities were observed in the peripheral cornea while fewer larger lesions were apparent towards the central part of the cornea. A heterozygous missense mutation, consisting of a G to A transition at nucleotide position 384 in TGFBI exon 4 that predicts a valine (GTT) to isoleucine (ATT) replacement in residue 113 (Val113Ile) of the TGFBI protein was identified. CONCLUSIONS: This is the most 5' located mutation detected so far in subjects with TGFBI-linked corneal dystrophy. Valine 113 is strictly conserved in TGFBI from several species and we suggest that the phenotype observed in these patients is related to the unusual location of the mutation. Our results expand the mutational spectrum in the group of TGFBI-linked corneal dystrophies.

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