High levels of 17 β -estradiol are associated with increased matrix metalloproteinase-2 and metalloproteinase-9 activity in tears of postmenopausal women with dry eye

Purpose. to determine the serum levels of sex steroids and tear matrix metalloproteinases (mmp) 2 and 9 concentrations in postmenopausal women with dry eye. methods. forty-four postmenopausal women with dry eye and 22 asymptomatic controls were enrolled. blood was drawn and analyzed for serum levels of sex steroids and lipids. then,the following tests were performed: tear collection,ocular surface disease index (osdi) questionnaire,fluorescein tear film break-up time (tbut),corneal fluorescein staining,schirmer test,and conjunctival impression cytology. the conjunctival mrna expression and tear concentrations of mmp-2 and mmp-9 were measured. results. serum 17β-estradiol levels were significantly higher in the dry eye subjects than in the controls (p = 0.03),whereas there were no significant differences in levels of testosterone,dehydroepiandrosterone sulfate (dhea-s),and progesterone. tear mmp-2 and mmp-9 concentrations (p < 0.001),as well as the mmp-9 mrna expression in conjunctival samples (p = 0.02),were significantly higher in dry eye subjects than in controls. serum 17β-estradiol levels were positively correlated with tear mmp-2 and mmp-9 concentrations and negatively correlated with schirmer test values. conclusions. high levels of 17β-estradiol are associated with increased matrix metalloproteinase-2 and metalloproteinase-9 activity in tears of postmenopausal women with dry eye. © 2016 guanglin shen and xiaoping ma.