Role of CD4(+) T Helper Cells in the Development of BAC-Induced Dry Eye Syndrome in Mice

PURPOSE: To evaluate the role of CD4(+) T helper cells in benzalkonium chloride (BAC)-induced ocular surface disorder in C57BL/6 mice. METHODS: Topical 0.075% BAC was applied twice daily in C57BL/6 mice for 7 consecutive days; PBS-treated and untreated mice served as controls. Adoptive transfer of CD4(+) T cells isolated from the BAC-treated mice or PBS-treated mice into nude mice was conducted to identify the roles of CD4(+) T cells, with untreated nude mice as controls. Oregon green dextran staining, PAS staining, and the phenol red cotton test were carried out in these two models. The gene and protein levels of T-bet, IFN-γ, RORγt, and IL-17 were detected by quantitative RT-PCR and ELISA, respectively. The activation and subsets of CD4(+) T cells were identified by double immunofluorescent staining and flow cytometry. RESULTS: An increase in CD4(+)CD69(+), CD4(+)IFN-γ(+), and CD4(+)IL-17(+) cells was induced by BAC in C57BL/6 mice. IFN-γ, IL-17, Th1, Th17, and the transcription factors T-bet and RORγt were increased in BAC-treated mice compared with control mice. In addition, ocular surface damage, including corneal barrier dysfunction, goblet cell loss, and decreased tear production, was induced by BAC. Interestingly, adoptive transfer of CD4(+) T cells isolated from BAC-treated mice into nude mice resulted in ocular surface manifestations similar to those of direct topical BAC treatment of C57BL/6 mice, including increased CD4(+) T cells, IFN-γ, IL-17, and ocular surface disorders. CONCLUSIONS: Topical application of BAC induced a dry-eye-like ocular surface disorder partly through the CD4(+) T cell-mediated inflammatory response.