51
|
Jeyalatha MV, Qu Y, Liu Z, Ou S, He X, Bu J, Li S, Reinach PS, Liu Z, Li W. Function of meibomian gland: Contribution of proteins. Exp Eye Res 2017; 163:29-36. [DOI: 10.1016/j.exer.2017.06.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/04/2017] [Accepted: 06/12/2017] [Indexed: 10/18/2022]
|
52
|
Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, Willcox MDP. TFOS DEWS II Sex, Gender, and Hormones Report. Ocul Surf 2017; 15:284-333. [PMID: 28736336 DOI: 10.1016/j.jtos.2017.04.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/16/2017] [Indexed: 12/21/2022]
Abstract
One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.
Collapse
Affiliation(s)
- David A Sullivan
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
| | - Eduardo M Rocha
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Pasquale Aragona
- Department of Biomedical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Sicily, Italy
| | - Janine A Clayton
- National Institutes of Health Office of Research on Women's Health, Bethesda, MD, USA
| | - Juan Ding
- Schepens Eye Research Institute, Massachusetts Eye & Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Ulrike Hampel
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alison M McDermott
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, USA
| | - Debra A Schaumberg
- Harvard School of Public Health, Boston, MA, USA; University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sruthi Srinivasan
- Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada
| | - Piera Versura
- Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| |
Collapse
|
53
|
Abstract
PURPOSE Studies indicate that contact lens (CL) discontinuation mostly occurs because of dryness and discomfort symptoms. This study aimed to investigate relationships between changes in the concentration of tear inflammatory mediators with subjective comfort ratings with CL wear and no contact lens wear between morning and evening. METHOD Forty-five subjects collected tears twice daily in the morning and in the evening with or without lenses. Comfort was rated subjectively on a scale from 1 to 100 (where 100 was extremely comfortable) just before each tear collection. Tear samples were assayed for complement components (C3 and C3a), leukotriene B4 (LTB4), secretory phospholipase A2 (sPLA2), secretory immunoglobulin A (sIgA), and bradykinin using commercially available immuno-based assay kits. RESULTS Comfort ratings showed a statistically significant decline from morning to evening both with CL (89.0±10.1 AM vs. 76.7±15.2 PM; P<0.001) and without CL (89.1±10.2 AM vs. 84.2±12.6 PM; P<0.005) wear. The decline was steeper with lens wear (P<0.001). Bradykinin and sPLA2 levels did not change between morning and evening or with CL wear (P>0.05). Leukotriene B4 levels were slightly higher in CL (CL 43.4±12.6 pg/ml vs. No CL 39.4±13.4 pg/mL; P=0.034), whereas the concentration of LTB4, C3, C3a, and sIgA dropped by the end of the day in the presence or absence of lens wear (P<0.001). For most mediators, tear levels were not correlated with comfort ratings in any of the conditions. Leukotriene B4 had a higher concentration in the evening, and when measured as a ratio to sIgA, there was a trend for increased concentration of this mediator during CL wear. CONCLUSION Although specific mediators showed changes from morning to evening with and without lens wear, most of these were not correlated with subjective comfort ratings in lens wear. The only mediator that showed an increase in concentration during the day and during lens wear was LTB4, and further studies on this mediator are warranted.
Collapse
|
54
|
Qiu J, Huang F, Wang Z, Xu J, Zhang C. The evaluation of diagnostic efficiency for stromal herpes simplex keratitis by the combination of tear HSV-sIgA and HSV-DNA. Graefes Arch Clin Exp Ophthalmol 2017; 255:1409-1415. [DOI: 10.1007/s00417-017-3653-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/12/2017] [Accepted: 03/20/2017] [Indexed: 11/30/2022] Open
|
55
|
Molecular and Histopathological Changes Associated with Keratoconus. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7803029. [PMID: 28251158 PMCID: PMC5303843 DOI: 10.1155/2017/7803029] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/16/2016] [Accepted: 01/04/2017] [Indexed: 12/13/2022]
Abstract
Keratoconus (KC) is a corneal thinning disorder that leads to loss of visual acuity through ectasia, opacity, and irregular astigmatism. It is one of the leading indicators for corneal transplantation in the Western countries. KC usually starts at puberty and progresses until the third or fourth decade; however its progression differs among patients. In the keratoconic cornea, all layers except the endothelium have been shown to have histopathological structural changes. Despite numerous studies in the last several decades, the mechanisms of KC development and progression remain unclear. Both genetic and environmental factors may contribute to the pathogenesis of KC. Many previous articles have reviewed the genetic aspects of KC, but in this review we summarize the histopathological features of different layers of cornea and discuss the differentially expressed proteins in the KC-affected cornea. This summary will help emphasize the major molecular defects in KC and identify additional research areas related to KC, potentially opening up possibilities for novel methods of KC prevention and therapeutic intervention.
Collapse
|
56
|
|
57
|
|
58
|
Du G, Liu C, Li X, Chen W, He R, Wang X, Feng P, Lan W. Induction of matrix metalloproteinase-1 by tumor necrosis factor-α is mediated by interleukin-6 in cultured fibroblasts of keratoconus. Exp Biol Med (Maywood) 2016; 241:2033-2041. [PMID: 27207902 DOI: 10.1177/1535370216650940] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Inflammatory molecules and matrix metalloproteinase (MMPs) have been found over-expressed in the tear film of patients with keratoconus. However, the mechanistic link between inflammatory molecules and MMPs in the pathogenesis of keratoconus remains still elusive. Therefore, we investigated the effect of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) on MMP-1 expression and used IL-6 antibody (IL-6 Ab) to examine the role of IL-6 on TNF-α mediated regulation of MMP-1 in fibroblasts of normal cornea and keratoconus. Real-time polymerase chain reaction, Enzyme-linked immunosorbent assay, and Western blot data demonstrated that MMP-1 and IL-6 were expressed in fibroblasts of normal cornea and keratoconus. Levels of MMP-1 and IL-6 were significantly higher in keratoconus than normal cornea. TNF-α treatment led to a significant increase in IL-6 levels. IL-6 treatment induced MMP-1 synthesis in normal cornea and keratoconus. TNF-α increased MMP-1 expression in a dose- and time-dependent manner and this response was completely inhibited by the IL-6 Ab. In conclusion, these results indicate that fibroblasts of keratoconus shows increased levels of IL-6 and MMP-1 gene and protein expression and IL-6 mediates the TNF-α-induced MMP-1 expression.
Collapse
Affiliation(s)
- Genlai Du
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| | - Chengxing Liu
- 2 Department of Biology, Taiyuan Normal University, Taiyuan 030031, China
| | - Xiaona Li
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| | - Weiyi Chen
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| | - Rui He
- 3 Department of Excimer Laser, Shanxi Eye Hospital, Taiyuan 030002, China
| | - Xiaojun Wang
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| | - Pengfei Feng
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| | - Weiwei Lan
- 1 Shanxi Key Lab of Material Strength & Structural Impact, Taiyuan University of Technology, Taiyuan 030024, China
| |
Collapse
|
59
|
Intolerant contact lens wearers exhibit ocular surface impairment despite 3 months wear discontinuation. Graefes Arch Clin Exp Ophthalmol 2016; 254:1825-31. [DOI: 10.1007/s00417-016-3400-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 05/24/2016] [Indexed: 11/26/2022] Open
|
60
|
Scheimpflug Imaging Parameters Associated with Tear Mediators and Bronchial Asthma in Keratoconus. J Ophthalmol 2016; 2016:9392640. [PMID: 26881061 PMCID: PMC4737447 DOI: 10.1155/2016/9392640] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/14/2015] [Indexed: 01/19/2023] Open
Abstract
Purpose. To determine associations between mediators in tears in the whole spectrum of keratoconus (KC); to explore connections between mediators and Scheimpflug parameters; to examine correlations between Scheimpflug parameters and bronchial asthma. Methods. Tear samples were collected from 69 patients and 19 controls. Concentrations of mediators—IL-6, -10; CXCL8, CCL5; MMP-9, -13; TIMP-1; t-PA, PAI-1—were measured by Cytometric Bead Array. Measured Pentacam parameters include keratometry values (K1, K2, Kmax), corneal thickness (Pachy Pupil, Apex, Min), and elevations and indices (including Belin-Ambrósio deviation (BAD-D)). Results. A number of significant positive associations were observed between pairs of mediator concentrations. Significant positive correlations were found between BAD-D and CXCL8/MMP-9 and K2 and MMP-9. Significant negative associations were explored between Pachy Min and CXCL8/t-PA. Significant associations were found between pairs of mediators (IL-6 and CXCL8; CCL5 and CXCL8/MMP-9; TIMP-1 and MMP-9/-13/t-PA; t-PA and CXCL8/CCL5/PAI-1) and the severity of KC. Significant positive correlation between asthma and the severity of KC was explored. Conclusion. Cooperation of different mediators in tears all taking part in the complex pathomechanism of keratoconus was revealed. Our research verifies that inflammation plays a crucial role in the pathogenesis of KC. Additionally this study confirms the effect of bronchial asthma on keratoconus.
Collapse
|
61
|
Expression of HGF and c-Met Proteins in Human Keratoconus Corneas. J Ophthalmol 2015; 2015:852986. [PMID: 26697215 PMCID: PMC4677219 DOI: 10.1155/2015/852986] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/30/2015] [Accepted: 11/12/2015] [Indexed: 11/21/2022] Open
Abstract
Keratoconus (KC) is a progressive degenerative inflammatory-related disease of the human cornea leading to decreased visual function. The pathogenesis of KC remains to be understood. Recent genetic studies indicate that gene variants of an inflammation-related molecule, hepatocyte growth factor (HGF), are associated with an increased susceptibility for developing KC. However HGF protein expression in KC has not been explored. In this initial study, we investigated late-stage KC and control corneas for the expression of HGF and its receptor mesenchymal-epithelial transition factor (c-Met/Met). KC buttons (~8 mm diameter) (n = 10) and whole control corneas (n = 6) were fixed in 10% formalin or 2% paraformaldehyde, paraffin embedded and sectioned. Sections were immunolabelled with HGF and c-Met antibodies, visualised using immunofluorescence, and examined with scanning laser confocal microscopy. Semiquantitative grading was used to compare HGF and c-Met immunostaining in KC and control corneas. Overall, KC corneas showed increased HGF and c-Met immunostaining compared to controls. KC corneal epithelium displayed heterogeneous moderate-to-strong immunoreactivity for HGF and c-Met, particularly in the basal epithelium adjacent to the cone area. Taken together with the recent genetic studies, our results further support a possible role for HGF/c-Met in the pathogenesis of KC.
Collapse
|
62
|
Wisse RP, Kuiper JJ, Gans R, Imhof S, Radstake TR, Van der Lelij A. Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review. Ocul Surf 2015; 13:272-83. [DOI: 10.1016/j.jtos.2015.04.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/11/2015] [Accepted: 04/01/2015] [Indexed: 12/26/2022]
|
63
|
Jung JW, Han SJ, Song MK, Kim TI, Kim EK, Min YH, Cheong JW, Seo KY. Tear Cytokines as Biomarkers for Chronic Graft-versus-Host Disease. Biol Blood Marrow Transplant 2015; 21:2079-2085. [PMID: 26303101 DOI: 10.1016/j.bbmt.2015.08.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/14/2015] [Indexed: 01/11/2023]
Abstract
We investigated the tear cytokine profiles in patients who underwent stem cell transplantation (SCT) and attempted to evaluate whether tear cytokines are associated with the presence of systemic chronic graft-versus-host disease (GVHD), regardless of ocular GVHD status. We also tested tear cytokines as biomarkers for chronic ocular GVHD severity. Forty-four patients who underwent SCT were enrolled and their diagnosis of chronic GVHD was confirmed. Ocular surface parameters and tear cytokine profiles were evaluated and the correlations between concentrations of cytokines and ocular surface parameters or several chronic ocular GVHD severity scales were evaluated. Tear interleukin (IL)-2, IL-10, IL-17α, interferon (IFN)-γ, IL-6, and tumor necrosis factor (TNF)-α were elevated in patients with chronic systemic GVHD compared with patients without chronic systemic GVHD. Receiver-operating characteristic curve analysis revealed that area under the curve (AUC) values for tear IL-10 (AUC = .795), IL-17α (AUC = .821), IL-6 (AUC = .912), and TNF-α (AUC = .910) were significantly correlated with the presence of chronic GVHD (all P < .001). Tear IL-10, IL-6, and TNF-α showed a stronger correlation with ocular surface parameters than other cytokines and these cytokines also correlated with several chronic ocular GVHD severity scales (all P < .05). Our data suggest the tear cytokines are useful biomarkers for the diagnosis of chronic GVHD after SCT and chronic ocular GVHD severity.
Collapse
Affiliation(s)
- Ji Won Jung
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Department of Ophthalmology and Inha Vision Science Laboratory, Inha University School of Medicine, Incheon, South Korea
| | - Soo Jung Han
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Mi Kyung Song
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea/Institute of Vision Research, Severance Biomedical Science Institute, Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoo Hong Min
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
| |
Collapse
|
64
|
Bioengineered Lacrimal Gland Organ Regeneration in Vivo. J Funct Biomater 2015; 6:634-49. [PMID: 26264034 PMCID: PMC4598675 DOI: 10.3390/jfb6030634] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 07/18/2015] [Accepted: 07/23/2015] [Indexed: 12/23/2022] Open
Abstract
The lacrimal gland plays an important role in maintaining a homeostatic environment for healthy ocular surfaces via tear secretion. Dry eye disease, which is caused by lacrimal gland dysfunction, is one of the most prevalent eye disorders and causes ocular discomfort, significant visual disturbances, and a reduced quality of life. Current therapies for dry eye disease, including artificial tear eye drops, are transient and palliative. The lacrimal gland, which consists of acini, ducts, and myoepithelial cells, develops from its organ germ via reciprocal epithelial-mesenchymal interactions during embryogenesis. Lacrimal tissue stem cells have been identified for use in regenerative therapeutic approaches aimed at restoring lacrimal gland functions. Fully functional organ replacement, such as for tooth and hair follicles, has also been developed via a novel three-dimensional stem cell manipulation, designated the Organ Germ Method, as a next-generation regenerative medicine. Recently, we successfully developed fully functional bioengineered lacrimal gland replacements after transplanting a bioengineered organ germ using this method. This study represented a significant advance in potential lacrimal gland organ replacement as a novel regenerative therapy for dry eye disease. In this review, we will summarize recent progress in lacrimal regeneration research and the development of bioengineered lacrimal gland organ replacement therapy.
Collapse
|
65
|
Galvis V, Sherwin T, Tello A, Merayo J, Barrera R, Acera A. Keratoconus: an inflammatory disorder? Eye (Lond) 2015; 29:843-59. [PMID: 25931166 PMCID: PMC4506344 DOI: 10.1038/eye.2015.63] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 03/08/2015] [Indexed: 02/06/2023] Open
Abstract
Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition.
Collapse
Affiliation(s)
- V Galvis
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
- Faculty of Health Sciences, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - T Sherwin
- Faculty of Medical and Health Sciences, Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - A Tello
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
- Faculty of Health Sciences, Universidad Autonoma de Bucaramanga, Floridablanca, Colombia
| | - J Merayo
- Instituto Oftalmologico Fernandez-Vega, Oviedo, Spain
| | - R Barrera
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia
| | - A Acera
- Bioftalmik Applied Research, Derio, Spain
| |
Collapse
|
66
|
|
67
|
Farandos NM, Yetisen AK, Monteiro MJ, Lowe CR, Yun SH. Contact lens sensors in ocular diagnostics. Adv Healthc Mater 2015; 4:792-810. [PMID: 25400274 DOI: 10.1002/adhm.201400504] [Citation(s) in RCA: 212] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 09/23/2014] [Indexed: 01/15/2023]
Abstract
Contact lenses as a minimally invasive platform for diagnostics and drug delivery have emerged in recent years. Contact lens sensors have been developed for analyzing the glucose composition of tears as a surrogate for blood glucose monitoring and for the diagnosis of glaucoma by measuring intraocular pressure. However, the eye offers a wider diagnostic potential as a sensing site and therefore contact lens sensors have the potential to improve the diagnosis and treatment of many diseases and conditions. With advances in polymer synthesis, electronics and micro/nanofabrication, contact lens sensors can be produced to quantify the concentrations of many biomolecules in ocular fluids. Non- or minimally invasive contact lens sensors can be used directly in a clinical or point-of-care setting to monitor a disease state continuously. This article reviews the state-of-the-art in contact lens sensor fabrication, their detection, wireless powering, and readout mechanisms, and integration with mobile devices and smartphones. High-volume manufacturing considerations of contact lenses are also covered and a case study of an intraocular pressure contact lens sensor is provided as an example of a successful product. This Review further analyzes the contact lens market and the FDA regulatory requirements for commercialization of contact lens sensors.
Collapse
Affiliation(s)
- Nicholas M. Farandos
- Department of Chemical Engineering; Imperial College London; South Kensington Campus London SW7 2AZ UK
| | - Ali K. Yetisen
- Department of Chemical Engineering and Biotechnology; University of Cambridge; Tennis Court Road Cambridge CB2 1QT UK
| | - Michael J. Monteiro
- Australian Institute for Bioengineering and Nanotechnology; University of Queensland; Brisbane QLD 4072 Australia
| | - Christopher R. Lowe
- Department of Chemical Engineering and Biotechnology; University of Cambridge; Tennis Court Road Cambridge CB2 1QT UK
| | - Seok Hyun Yun
- Harvard Medical School and Wellman Center for Photomedicine; Massachusetts General Hospital; 50 Blossom Street Boston MA 02114 USA
| |
Collapse
|
68
|
Abstract
PURPOSE Neutrophil-to-lymphocyte ratio (NLR) is a new potential predictor of systemic inflammation in several diseases. In this study, we aimed to evaluate NLR in patients with keratoconus. METHODS This cross-sectional observational study included 54 patients with keratoconus and 25 age- and sex-matched control subjects. All participants underwent a detailed ophthalmological examination and corneal topography. The patients were divided into progressive and nonprogressive keratoconus groups on the basis of topographic parameters. Serum samples were obtained from all subjects, and the NLR was calculated. RESULTS The NLR was 3.27 ± 1.37 in the progressive keratoconus group versus 1.87 ± 0.39 and 1.87 ± 0.52 in the nonprogressive and control groups, respectively (P < 0.01). There was a positive correlation between NLR and progression (P < 0.05). In the receiver-operating characteristic analysis, an NLR ≥ 2.24 predicted the presence of progression with 79% sensitivity and 81% specificity. CONCLUSIONS The NLR is a simple and inexpensive marker of systemic inflammation. The NLR was found to be higher in patients with progressive keratoconus than in the nonprogressive group and controls.
Collapse
|
69
|
|
70
|
Pieragostino D, D'Alessandro M, di Ioia M, Di Ilio C, Sacchetta P, Del Boccio P. Unraveling the molecular repertoire of tears as a source of biomarkers: beyond ocular diseases. Proteomics Clin Appl 2015; 9:169-86. [PMID: 25488355 DOI: 10.1002/prca.201400084] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/23/2014] [Accepted: 11/24/2014] [Indexed: 01/06/2023]
Abstract
Proteomics and metabolomics investigations of body fluids present several challenges for biomarker discovery of several diseases. The search for biomarkers is actually conducted in different body fluids, even if the ideal biomarker can be found in an easily accessible biological fluid, because, if validated, the biomarker could be sought in the healthy population. In this regard, tears could be considered an optimum material obtained by noninvasive procedures. In the past years, the scientific community has become more interested in the study of tears for the research of new biomarkers not only for ocular diseases. In this review, we provide a discussion on the current state of biomarkers research in tears and their relevance for clinical practice, and report the main results of clinical proteomics studies on systemic and eye diseases. We summarize the main methods for tear samples analyses and report recent advances in "omics" platforms for tears investigations. Moreover, we want to take stock of the emerging field of metabolomics and lipidomics as a new and integrated approach to study protein-metabolites interplay for biomarkers research, where tears represent a still unexplored and attractive field.
Collapse
Affiliation(s)
- Damiana Pieragostino
- Department of Experimental and Clinical Sciences, University "G. d'Annunzio" of Chieti- Pescara, Chieti, Italy; Analytical Biochemistry and Proteomics Unit, Research Centre on Aging (Ce.S.I.), University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | | | | | | | | |
Collapse
|
71
|
Abstract
Mucosal immunity defends the ocular surface against antigenic challenge and microbial invasion. The principal effector site is the lacrimal gland, where immunoglobulin A (IgA) antibodies are produced. Nasal-associated lymphoid tissue and posterior cervical lymph nodes function as major inductive sites for tear IgA responses. Neural connections and systemic hormones maintain the integrity and function of the ocular surface. Neuroenzyme activities in the lacrimal gland are influenced by ocular infections, leading to reduced expression of acetylcholine and modulation of receptors on acinar cells and on plasma cells, thereby decreasing fluid and immunoglobulin secretion. T lymphocyte-dependent responses result in production of interleukin-4 in lacrimal glands, thereby influencing cholinergic enzyme activity affecting immune processes and lacrimal physiology. Furthermore, neuropeptides released into lymphoid structures or inflamed tissues are chemotactic for antigen-presenting cells and affect their interactions with T cells. Thus, in developing therapeutic approaches for treating dry-eye conditions and vaccination strategies to elicit protective ocular mucosal immune responses, the entire lacrimal functional unit should be considered.
Collapse
|
72
|
Saraygord-Afshari N, Naderi-Manesh H, Naderi M. Increasing proteome coverage for gel-based human tear proteome maps: towards a more comprehensive profiling. Biomed Chromatogr 2014; 29:1056-67. [DOI: 10.1002/bmc.3392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 09/29/2014] [Accepted: 10/20/2014] [Indexed: 01/25/2023]
Affiliation(s)
- Neda Saraygord-Afshari
- Department of Biophysics, Faculty of Biological Sciences; Tarbiat Modares University; Tehran Iran
| | - Hossein Naderi-Manesh
- Department of Biophysics, Faculty of Biological Sciences; Tarbiat Modares University; Tehran Iran
| | - Mostafa Naderi
- Department of Ophthalmology; Bina eye hospital; Tehran Iran
| |
Collapse
|
73
|
Mafi R, Pelton R, Cui Y, Ketelson H. Weak Gelation of Hydrophobic Guar by Albumin in Simulated Human Tear Solutions. Biomacromolecules 2014; 15:4637-42. [PMID: 25380278 DOI: 10.1021/bm501278g] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roozbeh Mafi
- Department
of Chemical Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Robert Pelton
- Department
of Chemical Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Yuguo Cui
- Department
of Chemical Engineering, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Howard Ketelson
- Alcon Research, Ltd., 6201
South Freeway, Fort Worth, Texas 76134-2099, United States
| |
Collapse
|
74
|
Arakaki R, Eguchi H, Yamada A, Kudo Y, Iwasa A, Enkhmaa T, Hotta F, Mitamura-Aizawa S, Mitamura Y, Hayashi Y, Ishimaru N. Anti-inflammatory effects of rebamipide eyedrop administration on ocular lesions in a murine model of primary Sjögren's syndrome. PLoS One 2014; 9:e98390. [PMID: 24866156 PMCID: PMC4035282 DOI: 10.1371/journal.pone.0098390] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 05/01/2014] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Topical therapy is effective for dry eye, and its prolonged effects should help in maintaining the quality of life of patients with dry eye. We previously reported that the oral administration of rebamipide (Reb), a mucosal protective agent, had a potent therapeutic effect on autoimmune lesions in a murine model of Sjögren's syndrome (SS). However, the effects of topical treatment with Reb eyedrops on the ocular lesions in the murine model of SS are unknown. METHODS AND FINDING Reb eyedrops were administered to the murine model of SS aged 4-8 weeks four times daily. Inflammatory lesions of the extraorbital and intraorbital lacrimal glands and Harderian gland tissues were histologically evaluated. The direct effects of Reb on the lacrimal glands were analyzed using cultured lacrimal gland cells. Tear secretions of Reb-treated mice were significantly increased compared with those of untreated mice. In addition to the therapeutic effect of Reb treatment on keratoconjunctivitis, severe inflammatory lesions of intraorbital lacrimal gland tissues in this model of SS were resolved. The mRNA expression levels of IL-10 and mucin 5Ac in conjunctival tissues from Reb-treated mice was significantly increased compared with those of control mice. Moreover, lactoferrin production from lacrimal gland cells was restored by Reb treatment. CONCLUSION Topical Reb administration had an anti-inflammatory effect on the ocular autoimmune lesions in the murine model of SS and a protective effect on the ocular surfaces.
Collapse
Affiliation(s)
- Rieko Arakaki
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Hiroshi Eguchi
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Akiko Yamada
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yasusei Kudo
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Akihiko Iwasa
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Tserennadmid Enkhmaa
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Fumika Hotta
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Sayaka Mitamura-Aizawa
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yoshio Hayashi
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Naozumi Ishimaru
- Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| |
Collapse
|
75
|
Ghosh A, Zhou L, Ghosh A, Shetty R, Beuerman R. Proteomic and gene expression patterns of keratoconus. Indian J Ophthalmol 2014; 61:389-91. [PMID: 23925320 PMCID: PMC3775070 DOI: 10.4103/0301-4738.116056] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Keratoconus is a progressive corneal thinning disease associated with significant tissue remodeling activities and activation of a variety of signaling networks. However, it is not understood how differential gene and protein expression direct function in keratoconus corneas to drive the underlying pathology, ectasia. Research in the field has focused on discovering differentially expressed genes and proteins and quantifying their levels and activities in keratoconus patient samples. In this study, both microarray analysis of total ribonucleic acid (RNA) and whole proteome analyses are carried out using corneal epithelium and tears from keratoconus patients and compared to healthy controls. A number of structural proteins, signaling molecules, cytokines, proteases, and enzymes have been found to be deregulated in keratoconus corneas. Together, the data provide clues to the complex process of corneal degradation which suggest novel ways to clinically diagnose and manage the disease. This review will focus on discussing these recent advances in the knowledge of keratoconus biology from a gene expression and function point-of-view.
Collapse
Affiliation(s)
- Arkasubhra Ghosh
- Genes, Repair and Regeneration at Ophthalmic Workstation (GROW Research Laboratory), Narayana Nethralaya, Bangalore, Karnataka, India
| | | | | | | | | |
Collapse
|
76
|
You J, Willcox MD, Madigan MC, Wasinger V, Schiller B, Walsh BJ, Graham PH, Kearsley JH, Li Y. Tear fluid protein biomarkers. Adv Clin Chem 2014; 62:151-96. [PMID: 24772667 DOI: 10.1016/b978-0-12-800096-0.00004-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The tear film covers and protects the ocular surface. It contains various molecules including a large variety of proteins. The protein composition of the tear fluid can change with respect to various local and systemic diseases. Prior to the advent of the proteomic era, tear protein analysis was limited to a few analytical techniques, the most common of which was immunoelectrophoresis, an approach dependent on antibody availability. Using proteomics, hundreds of tear proteins could potentially be identified and subsequently studied. Although detection of low-abundance proteins in the complex tear proteome remains a challenge, advances in sample fractionation and mass spectrometry have greatly enhanced our ability to detect these proteins. With increasing proteomic applications, tears show great potential as biomarkers in the development of clinical assays for various human diseases. In this chapter, we discuss the structure and functions of the tear film and methods for its collection. We also summarize potential tear protein biomarkers identified using proteomic techniques for both ocular and systemic diseases. Finally, modern proteomic techniques for tear biomarker research and future challenges are explored.
Collapse
|
77
|
Tear HSV-specific secretory IgA as a potential indicator for recurrent stromal herpes simplex keratitis: a preliminary study. Cornea 2014; 32:987-91. [PMID: 23594767 DOI: 10.1097/ico.0b013e31828a8b96] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the herpes simplex virus-specific tear secretory IgA (sIgA) and its correlation with specific serum antibodies and to evaluate the possible value of specific tear sIgA for prediction of herpes simplex keratitis (HSK) recurrence. METHODS Tear sIgA and paired serum IgG/IgM/IgA from 41 stromal HSK patients and 15 controls were analyzed by enzyme-linked immunosorbent assay. Subsequent follow-up for monitoring recurrence was performed from the time of first cure on all patients for 4 months to 1 year. RESULTS Serum IgG was positive in all participants. The concentration of serum IgA increased with the levels of tear sIgA (P = 0.017). The tear sIgA-positive rate was 36.59% in stromal keratitis, whereas none of the controls were found as sIgA positive. Positivity of sIgA was the only potential factor for predicting the risk of herpes keratitis recurrence (hazard ratio = 9.04; 95% confidence interval, 1.06-77.44; P = 0.045), with a sensitivity of 83.3% and a specificity of 71.4% (P = 0.034; 95% confidence interval, 0.58-0.97). Tear sIgA-positive patients had significantly shorter relapse-free survival compared with tear sIgA-negative patients (P = 0.015). CONCLUSIONS This is the first preliminary study suggesting that the levels of tear sIgA could be a potential prognostic parameter for the recurrence of HSK.
Collapse
|
78
|
Tears as a source of biomarkers for ocular and systemic diseases. Exp Eye Res 2013; 117:126-37. [DOI: 10.1016/j.exer.2013.07.015] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 07/05/2013] [Accepted: 07/12/2013] [Indexed: 12/23/2022]
|
79
|
Abstract
Keratoconus is characterized by progressive corneal protrusion and thinning, leading to irregular astigmatism and impairment in visual function. The etiology and pathogenesis of the condition are not fully understood. However, significant strides have been made in early clinical detection of the disease, as well as towards providing optimal optical and surgical correction for improving the quality of vision in affected patients. The past two decades, in particular, have seen exciting new developments promising to alter the natural history of keratoconus in a favorable way for the first time. This comprehensive review focuses on analyzing the role of advanced imaging techniques in the diagnosis and treatment of keratoconus and evaluating the evidence supporting or refuting the efficacy of therapeutic advances for keratoconus, such as newer contact lens designs, collagen crosslinking, deep anterior lamellar keratoplasty, intracorneal ring segments, photorefractive keratectomy, and phakic intraocular lenses.
Collapse
Affiliation(s)
- Jayesh Vazirani
- Cornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, India
| | | |
Collapse
|
80
|
Runström G, Mann A, Tighe B. The Fall and Rise of Tear Albumin Levels: A Multifactorial Phenomenon. Ocul Surf 2013; 11:165-80. [DOI: 10.1016/j.jtos.2013.03.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 11/25/2022]
|