The dominant human conjunctival epithelial CD8αβ+ T cell population is maintained with age but the number of CD4+ T cells increases

Theconjunctivaisahighlyspecializedocular mucosal surface that, like other mucosa, houses a number of leukocyte populations. These leukocytes have been implicated in age-related inflammatory diseases such as dry-eye, but their phenotypic character- istics remain largely undetermined. Existing literature provides rudimentary data from predominantly immu- nohistochemical analyses of tissue sections, prohibiting detailed and longitudinal examination of these cells in health and disease. Using recovered cells from ocular surface impression cytology and flow cytometry, we examined the frequency of leukocyte subsets in human conjunctival epithelium and how this alters with age. Of the total CD45+ leukocyte population within the conjunctival epithelium, 87% (32-99) (median) (range) comprised lymphocytes, with 69% (47-90) identified as CD3+CD56- Tcells. In contrast to peripheral blood, the dominant conjunctival epithelial population was TCRαβ+CD8αβ+(80% (37-100)) with only 10% (0-56%) CD4+ cells. Whilst a significant increase in the CD4+ population was seen with age (r=0.5; p 65 years, 43 (20-145); p<0.05). The elevation of CD4+ cells high- lights a potentially important age-related alteration in the conjunctival intra-epithelial leukocyte population, which may account for the vulnerability of the aging ocular surface to disease.