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Kim YH, Yang IJ, Nguyen LTH, Gum SI, Yu S, Lee GJ, Kim BA, Jung JC, Park YJ. Effect of Diquafosol on Hyperosmotic Stress-induced Tumor Necrosis Factor-α and Interleukin-6 Expression in Human Corneal Epithelial Cells. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 34:1-10. [PMID: 32037744 PMCID: PMC7010473 DOI: 10.3341/kjo.2019.0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose Diquafosol is a pharmaceutical drug used for dry eye treatment with a novel mechanism of action. It is a purinergic P2Y2 receptor agonist that promotes the secretion of tears and healing of corneal epithelial wounds. However, its inhibitory effect on hyperosmotic stress-induced inflammation in human corneal epithelial cells (HCECs) remains unclear. Methods A hyperosmotic stress model was established by transferring HCECs from isosmotic (312 mOsm/kg to hyperosmotic medium (500 mOsm/kg). HCECs were incubated with 500 mOsm/kg hyperosmotic medium for 30 minutes, and then treated with diquafosol (0.6–6 mg/mL) for 4 or 24 hours. Cells were then harvested and analyzed by western blot, immunocytochemistry, and real-time polymerase chain reaction to evaluate the expression of interleukin-6, tumor necrosis factor-alpha, and the phosphorylation status of nuclear factor-kappa B. Results Diquafosol significantly decreased the mRNA and protein expression of hyperosmotic stress-induced tumor necrosis factor-alpha and interleukin-6. These results were supported by immunofluorescence staining and quantitative real-time polymerase chain reaction analysis. Furthermore, diquafosol inhibits nuclear factor-kappa B activation by suppressing the phosphorylation and degradation of the inhibitor of кB. Conclusions This study shows that diquafosol inhibits nuclear factor-kappa B signaling and inflammatory factors induced by hyperosmotic stress in HCECs. This suggests that using diquafosol for the improvement of dry eye syndrome could be effective in the treatment of inflammation-related corneal and conjunctival diseases.
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Affiliation(s)
| | - In Jun Yang
- Department of Physiology, College of Korean Medicine Dongguk University, Gyeongju, Korea
| | - Ly Thi Huong Nguyen
- Department of Physiology, College of Korean Medicine Dongguk University, Gyeongju, Korea
| | | | - Sung Yu
- Central Ophthalmic Clinic, Daegu, Korea
| | | | - Bo Ae Kim
- Division of Biomedicinal & Cosmetics, College of Sciences & Technology, Mokwon University, Daejeon, Korea
| | - Jae Chang Jung
- Developmental Biology Laboratory, Department of Biology, College of Natural Sciences, Kyungpook National University, Daegu, Korea.
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de Campos TDP, da Cruz Rodrigues KC, Pereira RM, Anaruma CP, Dos Santos Canciglieri R, de Melo DG, da Silva ASR, Cintra DE, Ropelle ER, Pauli JR, de Moura LP. The protective roles of clusterin in ocular diseases caused by obesity and diabetes mellitus type 2. Mol Biol Rep 2021; 48:4637-4645. [PMID: 34036481 DOI: 10.1007/s11033-021-06419-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
Obesity is a chronic, non-transmissible and multifactorial disease commonly associated with systemic inflammation and damage to health. This disorder has been pointed out as leading to the development of a diversity of eye diseases and, consequently, damage to visual acuity. More specifically, cardiometabolic risk is associated with lacrimal gland dysfunctions, since it changes the inflammatory profile favoring the development and worsening of dry eye disease. In more severe and extreme cases, obesity, inflammation, and diabetes mellitus type 2 can trigger the total loss of vision. In this scenario, besides its numerous metabolic functions, clusterin, an apolipoprotein, has been described as protective to the ocular surface through the seal mechanism. Thus, the current review aimed to explain the role of clusterin in dry eye disease that can be triggered by obesity and diabetes.
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Affiliation(s)
- Thaís Dantis Pereira de Campos
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | - Kellen Cristina da Cruz Rodrigues
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | - Rodrigo Martins Pereira
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | - Chadi Pellegrini Anaruma
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | - Raphael Dos Santos Canciglieri
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | - Diego Gomes de Melo
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
| | | | - Dennys Esper Cintra
- Laboratory of Nutritional Genomics (LABGeN), School of Applied Sciences, University of Campinas, Limeira, SP, Brazil
- CEPECE - Center of Research in Sport Sciences. School of Applied Sciences, University of Campinas (UNICAMP), Limeira, SP, Brazil
| | - Eduardo Rochete Ropelle
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
- CEPECE - Center of Research in Sport Sciences. School of Applied Sciences, University of Campinas (UNICAMP), Limeira, SP, Brazil
| | - José Rodrigo Pauli
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil
- CEPECE - Center of Research in Sport Sciences. School of Applied Sciences, University of Campinas (UNICAMP), Limeira, SP, Brazil
| | - Leandro Pereira de Moura
- Laboratory of Molecular Biology of Exercise (LaBMEx), School of Applied Sciences, University of Campinas, 1300 Pedro Zaccaria Street, Limeira, SP, Brazil.
- CEPECE - Center of Research in Sport Sciences. School of Applied Sciences, University of Campinas (UNICAMP), Limeira, SP, Brazil.
- Postgraduate Program in Motricity Sciences, São Paulo State University (UNESP), São Paulo, Brazil.
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Hanyuda A, Sawada N, Uchino M, Kawashima M, Yuki K, Tsubota K, Tanno K, Sakata K, Yamagishi K, Iso H, Yasuda N, Saito I, Kato T, Abe Y, Arima K, Shimazu T, Yamaji T, Goto A, Inoue M, Iwasaki M, Tsugane S. Relationship between unhealthy sleep status and dry eye symptoms in a Japanese population: The JPHC-NEXT study. Ocul Surf 2021; 21:306-312. [PMID: 33845221 DOI: 10.1016/j.jtos.2021.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/31/2021] [Accepted: 04/03/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate whether and how unhealthy sleep habits (i.e., the frequency of difficulty falling or staying asleep, and the frequency of waking up tired) and the duration of sleep are related to the prevalence of dry eye disease (DED) in a general population. METHODS This study included a total of 106,282 subjects aged 40-74 years who participated in a baseline survey of the Japan Public Health Center-based Prospective Study for the Next Generation. DED was defined as the presence of clinically diagnosed DED or severe symptoms. Multivariable-adjusted logistic regression models were used to assess the relationships of various components of sleep status with DED. RESULTS Higher frequencies of having difficulty falling or staying asleep, and waking up tired were significantly related to increased DED in both sexes (Ptrend<0.001). Compared with those with 8 h/day of sleep, shorter sleepers had an increased prevalence of DED in both sexes, although DED was increased among men who slept ≥10 h/day. By comparing participants with the greatest vs. the least difficulty of falling asleep, the multivariable-adjusted odds ratios (95% confidence interval [CI]) were 2.23 (95% CI, 1.99-2.49) for men and 1.91 (95% CI, 1.76-2.07) for women. When analyzed separately, the magnitude of each relationship was stronger with severe DED symptoms than with clinically diagnosed DED. CONCLUSIONS Sleep deprivation and poor sleep quality were significantly related to DED in a Japanese population.
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Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Motoko Kawashima
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan; Ibaraki Western Medical Center, Ibaraki, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kochi, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tadahiro Kato
- Center for Education and Educational Research, Faculty of Education, Ehime University, Ehime, Japan
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Lee JD, Kim HY, Park JJ, Oh SB, Goo H, Cho KJ, Kim S, Kim KB. Metabolomics approach to biomarkers of dry eye disease using 1H-NMR in rats. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2021; 84:313-330. [PMID: 33393448 DOI: 10.1080/15287394.2020.1867274] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Dry eye disease (DED) is a chronic and progressive lesion on the ocular surface and induces symptoms, such as burning sensation, itchy eyes, heavy eyes, tired eyes, dry feeling, facial flushing, and blurred vision. The present study was performed to develop DED biomarkers using metabolomics in a rat model. DED was induced by injecting scopolamine and exposing rats to a dry condition. Scopolamine (12 mg/kg/day for 7 days) was subcutaneously injected to male Sprague-Dawley rats. The rats were placed in dry condition with air-flow and dehumidifier. Tear volume and tear breakup time (TBUT) were measured, and eyes were examined through fluorescein staining to assess DED. Mucosal damage and immune reactions were also determined. Plasma and urinary endogenous metabolites were determined using 1H-NMR analysis. Compared with control tear and TBUT levels were significantly decreased in the DED group whereas corneal damage was significantly increased. The levels of interleukins (IL-6) and IL-1β significantly elevated in the cornea and lacrimal glands in the DED group. TNF-α was numerically increased but not significantly different between groups. Pattern recognition using principal component analysis (PCA) and orthogonal projections to latent structure-discriminant analysis (OPLS-DA) of the NMR spectra in global profiling revealed different clusters between DED and control groups. Target profiling demonstrated that PCA and OPLS-DA score plots were separated between DED and controls in plasma and urine. Subsequently, 9 plasma metabolites were selected to examine different clustering between groups, and 26 urinary metabolites were also selected. Plasma metabolites showed a non-significant rising tendency in the DED group. Urinary phenylalanine, phenylacetate, pantothenate, glycine, succinate, methanol, valine, propylene glycol, histidine, threonine, lactate, and acetate were significantly different between control and DED rats. These results may contribute to understanding the metabolic regulation that is involved in DED and might be useful for potential biomarkers related to DED in rats.
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Affiliation(s)
- Jung Dae Lee
- College of Pharmacy, Dankook University, Cheonan, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Chungnam, Republic of Korea
| | - Hyang Yeon Kim
- College of Pharmacy, Dankook University, Cheonan, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Chungnam, Republic of Korea
| | - Jin Ju Park
- College of Pharmacy, Dankook University, Cheonan, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Chungnam, Republic of Korea
| | - Soo Bean Oh
- Department of Ophthalmology, Dankook University, Cheonan, Republic of Korea
| | - Hyeyoon Goo
- Department of Ophthalmology, Dankook University, Cheonan, Republic of Korea
| | - Kyong Jin Cho
- Department of Ophthalmology, Dankook University, Cheonan, Republic of Korea
| | - Suhkmann Kim
- Department of Chemistry and Chemistry Institute of Functional Materials, Pusan National University, Busan, Republic of Korea
| | - Kyu-Bong Kim
- College of Pharmacy, Dankook University, Cheonan, Republic of Korea
- Center for Human Risk Assessment, Dankook University, Chungnam, Republic of Korea
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Ganesalingam K, Ismail S, Sherwin T, Craig JP. Molecular evidence for the role of inflammation in dry eye disease. Clin Exp Optom 2021; 102:446-454. [DOI: 10.1111/cxo.12849] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/13/2018] [Accepted: 10/07/2018] [Indexed: 01/17/2023] Open
Affiliation(s)
- Kalaivarny Ganesalingam
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand,
| | - Salim Ismail
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand,
| | - Trevor Sherwin
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand,
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand,
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Yoon CH, Ryu JS, Moon J, Kim MK. Association between aging-dependent gut microbiome dysbiosis and dry eye severity in C57BL/6 male mouse model: a pilot study. BMC Microbiol 2021; 21:106. [PMID: 33832437 PMCID: PMC8033717 DOI: 10.1186/s12866-021-02173-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/24/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND While aging is a potent risk factor of dry eye disease, age-related gut dysbiosis is associated with inflammation and chronic geriatric diseases. Emerging evidence have demonstrated that gut dysbiosis contributes to the pathophysiology or exacerbation of ocular diseases including dry eye disease. However, the relationship between aging-related changes in gut microbiota and dry eye disease has not been elucidated. In this pilot study, we investigated the association between aging-dependent microbiome changes and dry eye severity in C57BL/6 male mice. RESULTS Eight-week-old (8 W, n = 15), one-year-old (1Y, n = 10), and two-year-old (2Y, n = 8) C57BL/6 male mice were used. Dry eye severity was assessed by corneal staining scores and tear secretion. Bacterial genomic 16 s rRNA from feces was analyzed. Main outcomes were microbiome compositional differences among the groups and their correlation to dry eye severity. In aged mice (1Y and 2Y), corneal staining increased and tear secretion decreased with statistical significance. Gut microbiome α-diversity was not different among the groups. However, β-diversity was significantly different among the groups. In univariate analysis, phylum Firmicutes, Proteobacteria, and Cyanobacteria, Firmicutes/Bacteroidetes ratio, and genus Alistipes, Bacteroides, Prevotella, Paraprevotella, and Helicobacter were significantly related to dry eye severity. After adjustment of age, multivariate analysis revealed phylum Proteobacteria, Firmicutes/Bacteroidetes ratio, and genus Lactobacillus, Alistipes, Prevotella, Paraprevotella, and Helicobacter to be significantly associated with dry eye severity. CONCLUSIONS Our pilot study suggests that aging-dependent changes in microbiome composition are related to severity of dry eye signs in C57BL/6 male mice.
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Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Suk Ryu
- Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jayoon Moon
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Baiula M, Spampinato S. Experimental Pharmacotherapy for Dry Eye Disease: A Review. J Exp Pharmacol 2021; 13:345-358. [PMID: 33790661 PMCID: PMC8001578 DOI: 10.2147/jep.s237487] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/11/2021] [Indexed: 01/22/2023] Open
Abstract
Dry eye disease (DED) is a complex multifactorial disease showing heterogenous symptoms, including dryness, photophobia, ocular discomfort, irritation and burning but also pain. These symptoms can affect visual function leading to restrictions in daily life activities and reduction in work productivity with a consequently high impact on quality of life. Several pathological mechanisms contribute to the disease: evaporative water loss leads to impairment and loss of tear homeostasis inducing either directly or indirectly to inflammation, in a self-perpetuating vicious cycle. Dysregulated ocular immune responses result in ocular surface damage, which further contributes to DED pathogenesis. Currently, DED treatment is based on a flexible stepwise approach to identify the most beneficial intervention. Although most of the available treatments may control to a certain extent some signs and symptoms of DED, they show significant limitations and do not completely address the needs of patients suffering from DED. This review provides an overview of the emerging experimental therapies for DED. Several promising therapeutic strategies are under development with the aim of dampening inflammation and restoring the homeostasis of the ocular surface microenvironment. Results from early phase clinical trials, testing the effects of EnaC blockers, TRPM8 agonist or mesenchymal stem cells in DED patients, are especially awaited to demonstrate their therapeutic value for the treatment of DED. Moreover, the most advanced experimental strategies in the pipeline for DED, tivanisiran, IL-1R antagonist EBI-005 and SkQ1, are being tested in Phase III clinical trials, still ongoing. Nevertheless, although promising results, further studies are still needed to confirm efficacy and safety of the new emerging therapies for DED.
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Affiliation(s)
- Monica Baiula
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Santi Spampinato
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
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Shoari A, Kanavi MR, Rasaee MJ. Inhibition of matrix metalloproteinase-9 for the treatment of dry eye syndrome; a review study. Exp Eye Res 2021; 205:108523. [PMID: 33662353 DOI: 10.1016/j.exer.2021.108523] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/06/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
Dry eye syndrome (DES) and tear dysfunction are multifactorial conditions affecting meibomian glands, lacrimal glands, and ocular surface. This ocular disorder can cause eye irritation, irregular cornea, corneal barrier disruption, and blurred vision. Uncontrolled increase in matrix metalloproteinase-9 (MMP-9) level and activity has been detected in the tears and ocular surface in the patients with DES, which has been proved to be related to disruption of tight junctions in apical corneal epithelium associated with severe signs of DES. These uncontrolled activities of MMP-9 lead to desquamation of ocular surface epithelia. Therefore, this review study was conducted to summarize the evidence regarding MMP-9 contribution in DES, and inhibition of MMP-9, as a therapeutic target for treatment of DES. For this purpose, herein, the related studies designed novel pharmaceutical compounds for direct and indirect inhibition of MMP-9 as treatment approaches for DES were reviewed. These compounds were designed to improve corneal barrier function, reduce inflammation on ocular surface, and restore tear production.
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Affiliation(s)
- Alireza Shoari
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Javad Rasaee
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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Bron AJ, Willshire C. Tear Osmolarity in the Diagnosis of Systemic Dehydration and Dry Eye Disease. Diagnostics (Basel) 2021; 11:387. [PMID: 33668748 PMCID: PMC7996182 DOI: 10.3390/diagnostics11030387] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/23/2022] Open
Abstract
Systemic dehydration due to inadequate water intake or excessive water loss, is common in the elderly and results in a high morbidity and significant mortality. Diagnosis is often overlooked and there is a need for a simple, bedside diagnostic test in at-risk populations. Body hydration is highly regulated with plasma osmolality (pOsm) being tightly controlled over a wide range of physiological conditions. By contrast, normal tear osmolarity (tOsm) is more variable since the tear film is exposed to evaporation from the open eye. While plasma hyperosmolality is a diagnostic feature of systemic dehydration, tear hyperosmolality, with other clinical features, is diagnostic of dry eye. Studies in young adults subjected to exercise and water-deprivation, have shown that tOsm may provide an index of pOsm, with the inference that it may provide a simple measure to diagnose systemic dehydration. However, since the prevalence of both dry eye and systemic dehydration increases with age, the finding of a raised tOsm in the elderly could imply the presence of either condition. This diagnostic difficulty can be overcome by measuring tear osmolality after a period of evaporative suppression (e.g., a 45 min period of lid closure) which drives tOsm osmolality down to a basal level, close to that of the pOsm. The arguments supporting the use of this basal tear osmolarity (BTO) in the diagnosis of systemic dehydration are reviewed here. Further studies are needed to confirm that the BTO can act as a surrogate for pOsm in both normally hydrated subjects and in patients with systemic dehydration and to determine the minimum period of lid closure required for a simple, "point-of-care" test.
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Affiliation(s)
- Anthony J. Bron
- Nuffield Department of Clinical Neurosciences and Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford OX2 6HZ, UK
| | - Catherine Willshire
- Ophthalmology Research, Hinchingbrooke Hospital, North West Anglia Trust, Huntingdon PE29 6NT, UK;
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Hyperosmolarity benefits cartilage regeneration by enhancing expression of chondrogenic markers and reducing inflammatory markers. In Vitro Cell Dev Biol Anim 2021; 57:290-299. [PMID: 33580417 DOI: 10.1007/s11626-020-00430-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/07/2020] [Indexed: 10/22/2022]
Abstract
Application of hyperosmolarity can be a promising strategy to promote chondrogenic differentiation in adipose-derived mesenchymal stem cells (ADSCs). Growth factors may promote different signaling pathways in parallel that is why in this study we monitor undesired pathologic or unwanted side effects as well as chondroinductive impacts of hyperosmolarity in differentiating ADSCs. Quantified gene expression, immunocytochemistry, glycosaminoglycan deposition and angiogenic secretion assays performed along with immunoassay. We observed that hyperosmolarity pressure of 480 mOsm over-expressed cartilage specific markers at gene expression level in the extra cellular matrix. Meanwhile, hyperosmolarity of 480 mOsm diminished the expression of cartilage associated pathologic markers, i.e., inflammatory and angiogenic attributes. Certain dose of hyperosmolarity could benefit chondrogenesis in a dual way, first by increasing chondrogenic markers and second by lowering tissue mineralization and angiogenic potential. The chondroprotective potential of hyperosmolarity could have a promising benefit in cartilage cell therapy and tissue engineering.
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Abstract
Ocular allergy (OA) and dry eye disease (DED) are the most common ocular surface disorders with a potential severe impact on the patient's quality of life. OA and DED may coexist and have a significant clinical overlap. Therefore, clinical features commonly believed to be distinctive of OA or DED may be sometimes insufficient for a differential diagnosis. Alterations of the tear film, epithelial barrier, and corneal innervation are described in OA and can pave the way to DED. Conversely, DED may facilitate or worsen allergic reactions in predisposed (atopic) patients. For these reasons, OA and DED should be considered as reciprocal predisposing conditions that share ocular surface inflammation as a common background.
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Affiliation(s)
- Andrea Leonardi
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | - Rocco Luigi Modugno
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
| | - Elena Salami
- Department of Neuroscience, Ophthalmology Unit, University of Padova, Padova, Italy
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Chakraborty M, Asraf H, Sekler I, Hershfinkel M. ZnR/GPR39 controls cell migration by orchestrating recruitment of KCC3 into protrusions, re-organization of actin and activation of MMP. Cell Calcium 2021; 94:102330. [PMID: 33465674 DOI: 10.1016/j.ceca.2020.102330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 12/23/2022]
Abstract
Actin re-organization and degradation of extracellular matrix by metalloproteases (MMPs) facilitate formation of cellular protrusions that are required for cell proliferation and migration. We find that Zn2+ activation of the Gq-coupled receptor ZnR/GPR39 controls these processes by regulating K+/Cl- co-transporter KCC3, which modulates cell volume. Silencing of KCC3 expression or activity reverses ZnR/GPR39 enhancement of cell proliferation, migration and invasion through Matrigel. Activation of ZnR/GPR39 recruits KCC3 into F-actin rich membrane protrusions, suggesting that it can locally control volume changes. Immunofluorescence analysis indicates that Zn2+ activation of ZnR/GPR39 and KCC3 are required to enhance formation of F-actin stress fibers and cellular protrusions. In addition, ZnR/GPR39 upregulation of KCC3-dependent transport increases the activity of matrix metalloproteases MMP2 and MMP9. Our study establishes a mechanism in which ZnR/GPR39 orchestrates localization and activation of KCC3, formation of F-actin rich cell protrusions and activation of MMPs, and thereby controls cell proliferation and migration.
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Affiliation(s)
- Moumita Chakraborty
- Department of Physiology and Cell Biology and The Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hila Asraf
- Department of Physiology and Cell Biology and The Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Israel Sekler
- Department of Physiology and Cell Biology and The Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michal Hershfinkel
- Department of Physiology and Cell Biology and The Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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63
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Eshac Y, Redfern RL, Aakalu VK. The Role of Endogenous Antimicrobial Peptides in Modulating Innate Immunity of the Ocular Surface in Dry Eye Diseases. Int J Mol Sci 2021; 22:E721. [PMID: 33450870 PMCID: PMC7828360 DOI: 10.3390/ijms22020721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 02/06/2023] Open
Abstract
The ocular surface has the challenging responsibility of maintaining a clear moist refractive surface while protecting the eye from exogenous pathogens and the environment. Homeostasis of the ocular surface, including its innate immune components, is altered in ocular surface disease states. In this review, we focus on antimicrobial peptides and the role they play in the immune response of the ocular surface during healthy states and dry eye diseases. Antimicrobial peptides are of special interest to the study of the ocular surface because of their various roles that include microbial threat neutralization, wound healing, and immune modulation. This review explores current literature on antimicrobial peptides in ocular surface diseases and discusses their therapeutic potential in ocular surface diseases and dry eye.
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Affiliation(s)
- Youssof Eshac
- Faculty of Medicine, Alexandria University, Alexandria 21131, Egypt;
| | - Rachel L. Redfern
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX 77204, USA;
| | - Vinay Kumar Aakalu
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
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64
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Liu Z, Chen D, Chen X, Bian F, Qin W, Gao N, Xiao Y, Li J, Pflugfelder SC, Li DQ. Trehalose Induces Autophagy Against Inflammation by Activating TFEB Signaling Pathway in Human Corneal Epithelial Cells Exposed to Hyperosmotic Stress. Invest Ophthalmol Vis Sci 2021; 61:26. [PMID: 32785678 PMCID: PMC7441355 DOI: 10.1167/iovs.61.10.26] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Autophagy plays an important role in balancing the inflammatory response to restore homeostasis. The aim of this study was to explore the mechanism by which trehalose suppresses inflammatory cytokines via autophagy activation in primary human corneal epithelial cells (HCECs) exposed to hyperosmotic stress. Methods An in vitro dry eye model was used in which HCECs were cultured in hyperosmolar medium with the addition of sodium chloride (NaCl). Trehalose was applied in different concentrations. The levels of TNF-α, IL-1β, IL-6, and IL-8 were detected using RT-qPCR and ELISA. Cell viability assays, immunofluorescent staining of LC3B, and western blots of Beclin1, Atg5, Atg7, LC3B, and P62 were conducted. The key factors in upstream signaling pathways of autophagy activation were measured: P-Akt, Akt, and transcription factor EB (TFEB). Results Trehalose reduced the proinflammatory mediators TNF-α, IL-1β, IL-6, and IL-8 in primary HCECs at 450 mOsM. This effect was osmolarity dependent, and a level of 1.0% trehalose showed the most suppression. Trehalose promoted autophagosome formation and autophagic flux, as evidenced by increased production of Beclin1, Atg5, and Atg7, as well as higher LC3B I protein turnover to LC3B II, with decreased protein levels of P62/SQSTM1. The addition of 3-methyladenine blocked autophagy activation and increased the release of proinflammatory cytokines. Trehalose further activated TFEB, with translocation from cytoplasm to the nucleus, but diminished Akt activity. Conclusions Our findings demonstrate that trehalose, functioning as an autophagy enhancer, suppresses the inflammatory response by promoting autophagic flux via TFEB activation in primary HCECs exposed to hyperosmotic stress, a process that is beneficial to dry eye.
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Affiliation(s)
- Zhao Liu
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States.,Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ding Chen
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States.,School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xin Chen
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States.,School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fang Bian
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
| | - Wenjuan Qin
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
| | - Ning Gao
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States.,Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yangyan Xiao
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
| | - Jinmiao Li
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
| | - Stephen C Pflugfelder
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
| | - De-Quan Li
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, United States
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Ruiz-Lozano RE, Hernandez-Camarena JC, Loya-Garcia D, Merayo-Lloves J, Rodriguez-Garcia A. The molecular basis of neurotrophic keratopathy: Diagnostic and therapeutic implications. A review. Ocul Surf 2021; 19:224-240. [DOI: 10.1016/j.jtos.2020.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 09/13/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
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Tsubota K, Pflugfelder SC, Liu Z, Baudouin C, Kim HM, Messmer EM, Kruse F, Liang L, Carreno-Galeano JT, Rolando M, Yokoi N, Kinoshita S, Dana R. Defining Dry Eye from a Clinical Perspective. Int J Mol Sci 2020; 21:ijms21239271. [PMID: 33291796 PMCID: PMC7730816 DOI: 10.3390/ijms21239271] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/21/2020] [Accepted: 11/27/2020] [Indexed: 12/21/2022] Open
Abstract
Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.
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Affiliation(s)
- Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan
- Correspondence: ; Tel.: +81-3-5363-3219
| | | | - Zuguo Liu
- Eye Institute of Xiamen University, Xiamen 361102, China;
| | | | - Hyo Myung Kim
- Korea University Medical Center, Anam Hospital, Seoul 02841, Korea;
| | - Elisabeth M. Messmer
- Department of Ophthalmology, Ludwig Maximilian University, 80539 Munich, Germany;
| | - Friedrich Kruse
- Department of Ophthalmology, University of Erlangen-Nuremberg, 91054 Erlangen, Germany;
| | - Lingyi Liang
- Zhongshan Ophthalmic Center, Guangzhou 510060, China;
| | | | - Maurizio Rolando
- ISPRE OPHTHALMICS (Instituto di Medicina Oftalmica), 16129 Genoa, Italy;
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
| | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan;
| | - Reza Dana
- Cornea & Refractive Surgery, Massachusetts Eye & Ear, Boston, MA 02114, USA; (J.T.C.-G.); (R.D.)
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Periman LM, Mah FS, Karpecki PM. A Review of the Mechanism of Action of Cyclosporine A: The Role of Cyclosporine A in Dry Eye Disease and Recent Formulation Developments. Clin Ophthalmol 2020; 14:4187-4200. [PMID: 33299295 PMCID: PMC7719434 DOI: 10.2147/opth.s279051] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/23/2020] [Indexed: 12/18/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of the ocular surface and tear film that has gained awareness as a public health problem. Characteristics of DED include tear film instability, hyperosmolarity, and ocular surface inflammation, which can occur independently or may be a sequela of numerous ocular diseases, ocular surgery or contact lens wear. Much has been learned about the impact of the disease to help affected individuals who report symptoms of poor vision, pain, and tearing. Recently, new research highlights the importance of the role of ocular surface inflammation and damage in DED-leading to a vicious cycle of inflammation as well as loss of tear film homeostasis. DED immunopathophysiology is characterized by four stages: initiation, amplification, recruitment, and re-initiation. Cyclosporine is proven to be a valuable ophthalmic therapeutic for DED through its immunomodulatory actions and regulation of the adaptive immune response. Cyclosporine mechanism of action is well described in the published literature and the myriad of benefits in all four stages lend a broad-based immunomodulatory function particularly suitable for addressing DED. Furthermore, cyclosporine has unique goblet cell density improvement capabilities as well as anti-apoptotic properties. Topical formulations of cyclosporine are centered around addressing the highly lipophilic nature of the molecule. The poor aqueous solubility of cyclosporine traditionally presented technical challenges in drug delivery to the ocular surface. Newer formulations such as cationic emulsions and nanomicellar aqueous solutions address formulation, tissue concentration, and drug delivery challenges.
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68
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Perez VL, Stern ME, Pflugfelder SC. Inflammatory basis for dry eye disease flares. Exp Eye Res 2020; 201:108294. [PMID: 33039458 PMCID: PMC7736538 DOI: 10.1016/j.exer.2020.108294] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022]
Abstract
Most patients with chronic dry eye disease (DED) have episodic flares, which can be triggered by a variety of activities and environmental stresses. These flares are typically associated with rapid exacerbation of discomfort symptoms, followed by prolonged elevation of inflammation. In an acute flare, ocular surface inflammation begins with a nonspecific innate immune response, in some cases followed by a slower but more specific adaptive immune response. At the ocular surface, epithelial cells are central to the innate immune response, and we discuss their role in DED flares alongside the other core components. Epithelial cells and other cells of the innate response (neutrophils, monocytes, macrophages and dendritic cells) trigger flares in response to increased osmolarity, detected via pattern receptors on their cell surface. Ultimately, downstream signaling pathways activate innate and adaptive immune responses, with consequent inflammation and symptoms. In chronic DED, pathogenic T cells have infiltrated the ocular surface tissues. The established adaptive immune response is likely to lead to flare-ups at lower thresholds of stress, with inflammation maintained over a longer period. Increased understanding of the inflammatory cascades activated during a flare may guide management and improve outcomes.
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Affiliation(s)
- Victor L Perez
- Duke University School of Medicine, Durham, NC, United States
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69
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Autophagy Activation Protects Ocular Surface from Inflammation in a Dry Eye Model In Vitro. Int J Mol Sci 2020; 21:ijms21238966. [PMID: 33255884 PMCID: PMC7728298 DOI: 10.3390/ijms21238966] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/18/2023] Open
Abstract
Inflammation is the main pathophysiology of dry eye, characterized by tear film instability and hyperosmolarity. The aim of this study was to investigate the association of inflammation and cellular autophagy using an in vitro dry eye model with primary cultured human corneal epithelial cells (HCECs). Primary HCECs cultured with fresh limbal explants from donors were switched to a hyperosmotic medium (450 mOsM) by adding sodium chloride into the culture medium. We observed the stimulated inflammatory mediators, TNF-α, IL-1β, IL-6 and IL-8, as well as the increased expression of autophagy related genes, Ulk1, Beclin1, Atg5 and LC3B, as evaluated by RT-qPCR and ELISA. The immunofluorescent staining of LC3B and Western blotting revealed the activated autophagosome formation and autophagic flux, as evidenced by the increased LC3B autophagic cells with activated Beclin1, Atg5, Atg7 and LC3B proteins, and the decreased levels of P62 protein in HCECs. Interestingly, the autophagy activation was later at 24 h than inflammation induced at 4 h in HCECs exposed to 450 mOsM. Furthermore, application of rapamycin enhanced autophagy activation also reduced the inflammatory mediators and restored cell viability in HCECs exposed to the hyperosmotic medium. Our findings for the first time demonstrate that the autophagy activation is a late phase response to hyperosmotic stress, and is enhanced by rapamycin, which protects HCECs by suppressing inflammation and promoting cells survival, suggesting a new therapeutic potential to treat dry eye diseases.
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70
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Kalayci M, Hassan IA, Keinan IA, Cetinkaya E, Suren E, Tahtabasi M, Sumbul HE. The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure. Int J Gen Med 2020; 13:1035-1042. [PMID: 33192087 PMCID: PMC7654548 DOI: 10.2147/ijgm.s281546] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/30/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), axial length, and ocular surface in patients with end-stage renal failure after single-session hemodialysis treatment and to examine the correlation of these findings with systemic hemodynamic parameters. Patients and Methods A total of 112 eyes of 112 patients enrolled in a hemodialysis treatment program for three times a week (approximately four hours per session) for at least three months in our hospital between December 2019 and March 2020 were included in the study. Approximately 30 minutes before and after hemodialysis, the best-corrected visual acuity measurement, slit-lamp examination, IOP measurement, and dilated fundus examination with the Goldmann applanation tonometer were performed in all patients. The axial length measurement was undertaken by ultrasonic biometry, and the CCT measurement by ultrasonic pachymetry. The ocular surface evaluation was performed based on the tear breakup time (BUT), basal secretion time (BST) and keratoepitheliopathy score. Blood pressure, serum osmolarity, and body weight were measured before and after hemodialysis. Results The mean IOP decreased from 12.2 ± 3.5 to 10.8 ± 2.2 mmHg, and the mean decrease was 1.4 ± 2 mmHg, indicating statistical significance (p<0.001). The mean CCT dropped from 502 ± 41.2 to 494.1 ± 35.4 μm, and the mean decrease was 8.1 ± 7.7 μm, which also indicated a statistically significant change (p<0.001). The mean axial length was reduced from 23.1 ± 0.8 to 22.9 ± 0.8 mm. The reduction in the axial length was significant with an average value of 0.26 ± 0.15 mm (p<0.001). When the ocular surface changes were examined, BUT decreased from 7.4 ± 3.1 to 6.3 ± 2.5 s, BST from 8.6 ± 1.7 to 6.6 ± 1.3 mm, and the keratoepitheliopathy score increased from 0.36 ± 0.61 to 1.59 ± 0.93, and all these changes were statistically significant (p<0.001). There was a significant correlation between the axial length change and the IOP change (r=0.202, p=0.03). A significant correlation was also observed between BST and plasma colloid osmotic pressure (r=−0.268, p=0.004). In addition, there was a strong correlation between serum osmolarity and the keratoepitheliopathy score (r=−0.437, p<0.001). Conclusion Hemodialysis causes significant changes in IOP, CCT, axial length, and ocular surface. These changes should be considered in the ophthalmological examination of patients after the hemodialysis session.
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Affiliation(s)
- Mustafa Kalayci
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia.,Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ibrahim Ali Hassan
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Ibrahim Abdi Keinan
- Department of Ophthalmology, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Ersan Cetinkaya
- Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Elcin Suren
- Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mehmet Tahtabasi
- Department of Radiology, Somalia Mogadishu - Turkey Education and Research Hospital, Mogadishu, Somalia
| | - Hilmi Erdem Sumbul
- Department of Internal Medicine, Somalia Mogadishu-Turkey Education and Research Hospital, Mogadishu, Somalia
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71
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Efraim Y, Chen FYT, Stashko C, Cheong KN, Gaylord E, McNamara N, Knox SM. Alterations in corneal biomechanics underlie early stages of autoimmune-mediated dry eye disease. J Autoimmun 2020; 114:102500. [PMID: 32565048 PMCID: PMC8269964 DOI: 10.1016/j.jaut.2020.102500] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022]
Abstract
Autoimmune-mediated dry eye disease is a pathological feature of multiple disorders including Sjögren's syndrome, lupus and rheumatoid arthritis that has a life-long, detrimental impact on vision and overall quality of life. Although late stage disease outcomes such as epithelial barrier dysfunction, reduced corneal innervation and chronic inflammation have been well characterized in both human patients and mouse models, there is little to no understanding of early pathological processes. Moreover, the mechanisms underlying the loss of cornea homeostasis and disease progression are unknown. Here, we utilize the autoimmune regulatory (Aire)-deficient mouse model of autoimmune-mediated dry eye disease in combination with genome wide transcriptomics, high-resolution imaging and atomic force microscopy to reveal a potential extracellular matrix (ECM)-biomechanical-based mechanism driving cellular and morphological changes at early disease onset. Early disease in the Aire-deficient mouse model is associated with a mild reduction in tear production and moderate immune cell infiltration, allowing for interrogation of cellular, molecular and biomechanical changes largely independent of chronic inflammation. Using these tools, we demonstrate for the first time that the emergence of autoimmune-mediated dry eye disease is associated with an alteration in the biomechanical properties of the cornea. We reveal a dramatic disruption of the synthesis and organization of the extracellular matrix as well as degradation of the epithelial basement membrane during early disease. Notably, we provide evidence that the nerve supply to the cornea is severely reduced at early disease stages and that this is independent of basement membrane destruction or significant immune cell infiltration. Furthermore, diseased corneas display spatial heterogeneity in mechanical, structural and compositional changes, with the limbal compartment often exhibiting the opposite response compared to the central cornea. Despite these differences, however, epithelial hyperplasia is apparent in both compartments, possibly driven by increased activation of IL-1R1 and YAP signaling pathways. Thus, we reveal novel perturbations in corneal biomechanics, matrix organization and cell behavior during the early phase of dry eye that may underlie disease development and progression, presenting new potential targets for therapeutic intervention.
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Affiliation(s)
- Yael Efraim
- Program in Craniofacial Biology, Department of Cell & Tissue Biology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Feeling Yu Ting Chen
- Program in Craniofacial Biology, Department of Cell & Tissue Biology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Connor Stashko
- Center for Bioengineering and Tissue Regeneration, Department of Surgery, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Ka Neng Cheong
- Program in Craniofacial Biology, Department of Cell & Tissue Biology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Eliza Gaylord
- Program in Craniofacial Biology, Department of Cell & Tissue Biology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Nancy McNamara
- School of Optometry and Vision Science Graduate Program, University of California, Berkeley, CA, 94720, USA; Department of Anatomy, University of California San Francisco, San Francisco, CA, 94143, USA.
| | - Sarah M Knox
- Program in Craniofacial Biology, Department of Cell & Tissue Biology, University of California San Francisco, San Francisco, CA, 94143, USA.
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Soifer M, Mousa HM, Stinnett SS, Galor A, Perez VL. Matrix metalloproteinase 9 positivity predicts long term decreased tear production. Ocul Surf 2020; 19:270-274. [PMID: 33098983 DOI: 10.1016/j.jtos.2020.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/19/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate long-term correlations between Matrix Metalloproteinase-9 (MMP-9) testing and dry eye (DE) parameters. Additionally, to evaluate variability in MMP-9 results over time and with anti-inflammatory treatment. METHODS Retrospective cohort study of DE patients with equal MMP-9 testing results (positive or negative) in both eyes and a minimum of 6 months of follow up. Our main outcome measure was to examine whether initial MMP-9 status affected change in DE parameters over time. Secondarily, we evaluated the frequency of MMP-9 status change over time and examined whether MMP-9 status change was impacted by treatment. RESULTS 67 patients (76% female) fit the inclusion criteria. Mean age was 63 years with a mean follow up of 10.6 months. The majority (37/67, 55%) had concomitant systemic immune disease. MMP-9 testing was positive in both eyes in 39 individuals (58%) and negative in both eyes in 27 (42%) individuals. Of all DE parameters, initial MMP status predicted change in tear production. Individuals in the MMP-9 positive group had a greater decrease in production from baseline to final visit compared to the negative group (-2.6 vs 2.1, P = 0.013). In those initially MMP-9 positive, the frequency of becoming MMP-9 negative was higher in eyes treated with anti-inflammatory therapy compared to artificial tears (22.9% vs 3.3%, P = 0.106). However, only Lifitegrast 5% showed statistical significance compared to artificial tears (31.3% vs 3.3%, P = 0.044). CONCLUSIONS Eyes with detectable MMP-9 had significantly decreased tear production over time compared to those without detectable MMP-9. Anti-inflammatory treatment more frequently normalized MMP-9 compared to PFATs.
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Affiliation(s)
- Matias Soifer
- Foster Center for Ocular Immunology, Duke Eye Institute, USA; Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705, USA
| | - Hazem M Mousa
- Foster Center for Ocular Immunology, Duke Eye Institute, USA; Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705, USA
| | - Sandra S Stinnett
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705, USA
| | - Anat Galor
- Miami Veterans Administration Medical Center, Miami, FL, USA; Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Victor L Perez
- Foster Center for Ocular Immunology, Duke Eye Institute, USA; Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705, USA.
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Muz OE, Orhan C, Erten F, Tuzcu M, Ozercan IH, Singh P, Morde A, Padigaru M, Rai D, Sahin K. A Novel Integrated Active Herbal Formulation Ameliorates Dry Eye Syndrome by Inhibiting Inflammation and Oxidative Stress and Enhancing Glycosylated Phosphoproteins in Rats. Pharmaceuticals (Basel) 2020; 13:ph13100295. [PMID: 33036453 PMCID: PMC7599565 DOI: 10.3390/ph13100295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/26/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023] Open
Abstract
Dry eye syndrome (DES) is a chronic condition of the eye with insufficient production of tears leading to inadequate lubrication of eyes. Symptoms of DES are associated with discomfort and redness of the eye, blurred vision, and tear film instability which leads to the damaged ocular surface. Inflammation and oxidative stress play a significant role in the pathogenesis of the disease. In this study, the protective effect of different doses (100 or 200 mg/kg) of a novel multi-component oral formulation of lutein/zeaxanthin, curcumin, and vitamin D3 (LCD) was evaluated using a rat model with benzalkonium chloride (BAC)-induced dry eye syndrome. The formulation was administered orally to rats for 4 weeks. We observed a significant improvement in tear volume, tear breakup time, tear film integrity, and reduction in overall inflammation in rats fed with the LCD at dose 200 mg/kg performing better than 100 mg/kg. Furthermore, the formulation helped in lowering oxidative stress by increasing antioxidant levels and restored protective tear protein levels including MUC1, MUC4, and MUC5AC with 200 mg of LCD having the most significant effect. The results strongly suggest that the combination of lutein/zeaxanthin, curcumin, and vitamin-D3 is effective in alleviating the symptoms of dry eye condition with a multi-modal mechanism of action.
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Affiliation(s)
- Omer Ersin Muz
- Department of Ophthalmology, Eskisehir Yunus Emre State Hospital, Eskisehir 26190, Turkey;
| | - Cemal Orhan
- Department of Animal Nutrition, Veterinary Medicine, Firat University, Elazig 23119, Turkey;
| | - Fusun Erten
- Department of Biology, Faculty of Science, Firat University, Elazig 23119, Turkey; (F.E.); (M.T.)
| | - Mehmet Tuzcu
- Department of Biology, Faculty of Science, Firat University, Elazig 23119, Turkey; (F.E.); (M.T.)
| | | | - Prafull Singh
- OmniActive Health Technologies, Phoenix House, T- 8, A Wing 462 Senapati Bapat Marg, Lower Parel, Mumbai 400 013, India; (P.S.); (A.M.); (M.P.); (D.R.)
| | - Abhijeet Morde
- OmniActive Health Technologies, Phoenix House, T- 8, A Wing 462 Senapati Bapat Marg, Lower Parel, Mumbai 400 013, India; (P.S.); (A.M.); (M.P.); (D.R.)
| | - Muralidhara Padigaru
- OmniActive Health Technologies, Phoenix House, T- 8, A Wing 462 Senapati Bapat Marg, Lower Parel, Mumbai 400 013, India; (P.S.); (A.M.); (M.P.); (D.R.)
| | - Deshanie Rai
- OmniActive Health Technologies, Phoenix House, T- 8, A Wing 462 Senapati Bapat Marg, Lower Parel, Mumbai 400 013, India; (P.S.); (A.M.); (M.P.); (D.R.)
| | - Kazim Sahin
- Department of Animal Nutrition, Veterinary Medicine, Firat University, Elazig 23119, Turkey;
- Correspondence: ; Tel.: +90-4242373938
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Tear Film Osmolarity Measurement in Japanese Dry Eye Patients Using a Handheld Osmolarity System. Diagnostics (Basel) 2020; 10:diagnostics10100789. [PMID: 33028019 PMCID: PMC7601915 DOI: 10.3390/diagnostics10100789] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/17/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022] Open
Abstract
We studied the efficacy and safety of a handheld osmolarity measurement system (I-PEN) in Japanese patients with dry eye disease (DED) and non-DED subjects. In this prospective, multicenter study, tear osmolarity was examined using the I-PEN in a total of 122 eyes divided into DED (n = 71) and non-DED (n = 51) groups. Subjective symptoms were assessed using the Dry Eye-Related Quality-of-Life Score (DEQS) questionnaire. Ocular surface condition was evaluated in terms of fluorescein tear breakup time (FBUT) and tear breakup pattern (TBUP), and by fluorescein staining and Schirmer's test. The I-PEN measurements were performed safely in the majority of cases. There was no statistically significant difference in mean tear film osmolarity between the DED and non-DED groups (294.76 ± 16.39 vs. 297.76 ± 16.72 mOsms/L, respectively, p = 0.32). No significant correlations were observed between osmolarity values and DEQS score, FBUT, or the Schirmer score. Osmolarity did not differ among TBUP subgroups. This prospective clinical study found no correlations between the tear film osmolarity values obtained with the I-PEN system and any subjective or objective parameters of DED. Further studies are required to determine the utility of the I-PEN system in other settings.
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Guzmán M, Miglio M, Keitelman I, Shiromizu CM, Sabbione F, Fuentes F, Trevani AS, Giordano MN, Galletti JG. Transient tear hyperosmolarity disrupts the neuroimmune homeostasis of the ocular surface and facilitates dry eye onset. Immunology 2020; 161:148-161. [PMID: 32702135 PMCID: PMC7496787 DOI: 10.1111/imm.13243] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 12/27/2022] Open
Abstract
Dry eye disease (DED) is a highly prevalent ocular surface disorder with neuroimmune pathophysiology. Tear hyperosmolarity (THO), a frequent finding in affected patients, is considered a key element in DED pathogenesis, yet existing animal models are based on subjecting the ocular surface to the more complex desiccating stress - decreased tear production and/or increased evaporation - instead of strict hyperosmolar stress. Here we characterized a murine model of THO that does not involve desiccating stress, thus allowing us to dissect the contribution of THO to DED. Our results showed that THO is sufficient to disrupt neuroimmune homeostasis of the ocular surface in mice, and thus reproduce many sub-clinical DED findings. THO activated nuclear factor-κB signalling in conjunctival epithelial cells and increased dendritic cell recruitment and maturation, leading to more activated (CD69+ ) and memory (CD62lo CD44hi) CD4+ T-cells in the eye-draining lymph nodes. Ultimately, THO impaired the development of ocular mucosal tolerance to a topical surrogate antigen in a chain of events that included epithelial nuclear factor-κB signalling and activation of transient receptor potential vanilloid 1 as the probable hypertonicity sensor. Also, THO reduced the density of corneal intraepithelial nerves and terminals, and sensitized the ocular surface to hypertonicity. Finally, the adoptive transfer of T-cells from THO mice to naïve recipients under mild desiccating stress favoured DED development, showing that THO is enough to trigger an actual pathogenic T-cell response. Our results altogether demonstrate that THO is a critical initiating factor in DED development.
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Affiliation(s)
- Mauricio Guzmán
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Maximiliano Miglio
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Irene Keitelman
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Carolina Maiumi Shiromizu
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Florencia Sabbione
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Federico Fuentes
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Analía S. Trevani
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Mirta N. Giordano
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
| | - Jeremías G. Galletti
- Laboratorio de Inmunidad InnataInstituto de Medicina ExperimentalAcademia Nacional de Medicina/CONICETBuenos AiresArgentina
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76
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Giannaccare G, Pellegrini M, Bovone C, Spena R, Senni C, Scorcia V, Busin M. Anti-VEGF Treatment in Corneal Diseases. Curr Drug Targets 2020; 21:1159-1180. [PMID: 32189591 DOI: 10.2174/1389450121666200319111710] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/31/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Corneal neovascularization (CN) is a clue feature of different ocular pathological conditions and can lead to corneal edema and opacification with subsequent vision loss. Vascular endothelial growth factor (VEGF), which plays a key role in new vessels formation, proliferation and migration, was found to be up-regulated in these conditions. Nowadays, it is possible to downregulate the angiogenic process by using anti-VEGF agents administered by different routes. OBJECTIVE To evaluate the efficacy, safety and possible future directions of anti-VEGF agents used for the treatment of CNV owing to different aetiologies. METHODS A computerized search of articles dealing with the topic of anti-VEGF therapy in CN was conducted in PubMed, Scopus and Medline electronic databases. The following key phrases were used: anti-VEGF agents, corneal neovascularization, bevacizumab, ranibizumab, vascular endothelial growth factor, angiogenesis. RESULTS The use of anti-VEGF therapy in the treatment of CN reduced pathological vessel density without causing significant side effects. Various administration routes such as topical, subconjunctival and intrastromal ones are available, and the choice depends on patient and disease characteristics. Much more effectiveness is achieved in case of early administration before mature and wellestablished vessels take place. A combined approach between various drugs including anti-VEGF agents should be adopted in those cases at higher risk of neovascularization recurrence such as chronic long-standing diseases where ischemic and inflammatory stimuli are not definitively reversed. CONCLUSION The efficacy and safety of anti-VEGF agents support their adoption into the daily clinical practice for the management of CN.
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Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Cristina Bovone
- Department of Ophthalmology, Ospedale Privato "Villa Igea", Forli, Italy
| | - Rossella Spena
- Department of Ophthalmology, Ospedale Privato "Villa Igea", Forli, Italy
| | - Carlotta Senni
- Ophthalmology Unit, University of Bologna, Bologna, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Massimo Busin
- Department of Ophthalmology, Ospedale Privato "Villa Igea", Forli, Italy
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Clinical Outcomes of Lifitegrast 5% Ophthalmic Solution in the Treatment of Dry Eye Disease. Eye Contact Lens 2020; 46 Suppl 1:S20-S24. [PMID: 30985492 DOI: 10.1097/icl.0000000000000601] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the clinical characteristics, outcomes, and adverse reactions after the use of lifitegrast 5% ophthalmic solution for the treatment of patients with dry eye disease (DED). METHODS Retrospective chart review was performed in 121 patients seen at the Duke Eye Center with DED who were prescribed lifitegrast 5% and seen for follow-up after treatment initiation. Charts were reviewed for meibomian gland dysfunction (MGD) grading, conjunctival and corneal staining scores, and tear breakup time (TBUT), as well as matrix metalloproteinase-9 (MMP-9) levels. Ocular Surface Disease Index (OSDI) questionnaire scores and self-reported adverse reactions were also assessed. RESULTS The average patient age was 60.5 years (range, 22-88 years); 87.6% were female, and 20.7% had a previous autoimmune disease diagnosis. Of the 54 eyes with an initial positive MMP-9, 21 eyes (38.9%) normalized after treatment. The ocular symptoms OSDI subscore demonstrated an improvement of -2.43±6.85 (P=0.011) after treatment. Corneal staining scores showed an average change of -0.15 (P=0.007). The average change in TBUT was 1.9 sec (P<0.001). Self-reported adverse reactions were noted in 31.4% of patients. There was no statistically significant change in MGD grading. Patients with moderate-severe DED showed statistically significant improvements in conjunctival and corneal staining scores and TBUT (-0.17±0.66, P=0.0442; -0.54±0.65, P<0.001; +2.02±2.63, P=0.004, respectively). CONCLUSION Lifitegrast 5% is a useful therapeutic option for DED with a moderate proportion of self-reported adverse reactions, all of which were related to ocular discomfort. Treatment with lifitegrast was associated with statistically significant improvements in MMP-9 levels, ocular symptoms, corneal staining, and TBUT.
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78
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Lipidomic analysis of epithelial corneal cells following hyperosmolarity and benzalkonium chloride exposure: New insights in dry eye disease. Biochim Biophys Acta Mol Cell Biol Lipids 2020; 1865:158728. [DOI: 10.1016/j.bbalip.2020.158728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/20/2020] [Accepted: 04/22/2020] [Indexed: 02/06/2023]
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79
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Favre H, Lahoti S, Issa N, Johnson DA, Kheirkhah A. Topical Steroids in Management of Dry Eye Disease. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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80
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Lamkin ID, Zimmerman KL, Smith Fleming KM, Martins BC. Osmolarity of basal and reflex tears of normal dogs. Vet Ophthalmol 2020; 23:747-753. [PMID: 32584492 DOI: 10.1111/vop.12798] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 05/22/2020] [Accepted: 05/30/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare basal and reflex tear osmolarity in healthy dogs and to evaluate for correlation among tear film osmolarity, tear production, and tear fern pattern. ANIMALS STUDIED The population consisted of 22 healthy adult dogs. PROCEDURES Reflex tear osmolarity was measured in both eyes using the I-PEN® VET osmometer 30 minutes following the Schirmer tear test (STT-1) measurement. Subsequently, two minutes following topical anesthetic application, the lacrimal lake and conjunctival fornices were dried, and 3 minutes later, basal tear osmolarity was measured. Tears were extracted from the dye-free STT-1 strip by centrifugation, placed on a glass slide, and the ferning pattern was determined by light microscopy. Comparisons between basal and reflex tears were performed with one-way ANOVA. Correlations between tear osmolarity, STT-1, and tear ferning were verified by Pearson's correlation coefficient. RESULTS No statistical difference was found between right and left eyes for STT-1, tear fern pattern, and osmolarity of reflex or basal tears (P < .05). There was no statistical difference between osmolarity of basal and reflex tears among individuals (P < .05). No correlation was detected between tear fern pattern and osmolarity of reflex tears. A weak positive correlation was detected between STT-1 values and osmolarity of reflex, but not basal tears. CONCLUSIONS The osmolarity of basal tears did not differ from that of reflex tears. A positive weak correlation exists between tear production and osmolarity of reflex tears. No correlation was detected between tear osmolarity measured by handheld osmometer and tear ferning.
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Affiliation(s)
- Irini D Lamkin
- Veterinary Clinical Medicine Department, College of Veterinary Medicine, University of Illinois - Champaign, Urbana, IL, USA
| | - Kelli L Zimmerman
- Veterinary Clinical Medicine Department, College of Veterinary Medicine, University of Illinois - Champaign, Urbana, IL, USA
| | - Kathryn M Smith Fleming
- Veterinary Clinical Medicine Department, College of Veterinary Medicine, University of Illinois - Champaign, Urbana, IL, USA
| | - Bianca C Martins
- Veterinary Clinical Medicine Department, College of Veterinary Medicine, University of Illinois - Champaign, Urbana, IL, USA
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81
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Anitua E, de la Fuente M, Alcalde I, Sanchez C, Merayo-Lloves J, Muruzabal F. Development and Optimization of Freeze-Dried Eye Drops Derived From Plasma Rich in Growth Factors Technology. Transl Vis Sci Technol 2020; 9:35. [PMID: 32832240 PMCID: PMC7414653 DOI: 10.1167/tvst.9.7.35] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/02/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate whether plasma rich in growth factors (PRGF) eye drops maintain their biological potential after a freeze drying process. The addition of a lyoprotectant like trehalose was also evaluated. Methods Blood from three healthy donors was collected to obtain eye drops by PRGF technology. The resultant eye drops were divided in four groups: PRGF, freeze-dried PRGF (PRGF lyo), and PRGF lyophilized mixed with 2,5% trehalose (PRGF lyo+2.5T) or 5% trehalose (PRGF lyof+5T). Chemical and biological characteristics were evaluated. Photorefractive keratectomy was performed on C57BL/6 mice which were divided in three treatment groups: control, PRGF, and PRGF lyo. Corneal wound healing and haze formation were evaluated macroscopically. Eyes were collected at 1, 2, 3, and 7 days after surgery, and were processed for histologic studies. Results The pH values of PRGF samples increased significantly after the lyophilization process. Osmolarity levels increased significantly in PRGF samples mixed with trehalose in comparison with PRGF samples without protectants. The freeze drying process maintained growth factors levels as well as the biological properties of PRGF eye drops even without the use of lyoprotectants. PRGF lyo treatment significantly decreased the re-epithelialization time and haze formation in photorefractive keratectomy-treated corneas regarding PRGF and control groups. Furthermore, the PRGF lyo group significantly decreased the number of smooth muscle actin-positive cells in comparison with the control group at each time of the study and at days 2 and 3 in the PRGF group. Conclusions The freeze drying process preserves the protein and growth factor content as well as the biological properties of PRGF eye drops, even without the use of protectants. Freeze-dried PRGF eye drops accelerate corneal tissue regeneration after photorefractive keratectomy in comparison with the control group. Translational Relevance Our study shows the feasibility to preserve the biological capability of PRGF eye drops as freeze-dried formulation, avoiding the addition of protectants.
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Affiliation(s)
- Eduardo Anitua
- Biotechnology Institute (BTI), Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - María de la Fuente
- Biotechnology Institute (BTI), Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Ignacio Alcalde
- Instituto Oftalmológico Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain
| | - Cristina Sanchez
- Instituto Oftalmológico Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain
| | - Jesús Merayo-Lloves
- Instituto Oftalmológico Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain
| | - Francisco Muruzabal
- Biotechnology Institute (BTI), Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
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82
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Kook KY, Jin R, Li L, Yoon HJ, Yoon KC. Tear Osmolarity and Matrix Metallopeptidase-9 in Dry Eye Associated with Sjögren's Syndrome. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:179-186. [PMID: 32495525 PMCID: PMC7269744 DOI: 10.3341/kjo.2019.0145] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/15/2020] [Accepted: 01/18/2020] [Indexed: 12/13/2022] Open
Abstract
Purpose To evaluate the correlations between tear osmolarity and matrix metallopeptidase-9 (MMP-9) and dry eye (DE) indices in patients with DE associated with Sjögren's syndrome (SS). Methods Sixty-three patients with DE associated with SS who underwent tear analysis were included. DE tests performed were ocular surface disease index, tear break-up time, Schirmer's test, ocular staining score, and tear osmolarity and MMP-9 tests. Correlations between tear osmolarity and DE indices, differences between patients with abnormal and normal tear osmolarity, and those between positive and negative MMP-9 patients were analyzed. Patients were classified into four groups according to tear osmolarity and MMP-9 results, and between-group differences were analyzed (group 1: abnormal tear osmolarity, MMP-9 positive; group 2: abnormal tear osmolarity, MMP-9 negative; group 3: normal tear osmolarity, MMP-9 positive; group 4: normal tear osmolarity, MMP-9 negative). Results Mean age of patients was 54.2 ± 13.9 years, and 96.2% were female. Thirty-five patients had abnormal tear osmolarity and 40 patients were MMP-9 positive. DE indices differed between groups with abnormal and normal tear osmolarity (p < 0.01), but not between positive and negative MMP-9 groups. There were 22 patients in group 1, 13 in group 2, 18 in group 3, and 10 in group 4. Compared to group 4, tear break-up time was shorter in groups 1 (p < 0.01) and 2 (p = 0.02). Schirmer's test values in group 1 were lower than those in group 4 (p = 0.03). Ocular staining score was higher in groups 1 (p < 0.01) and 2 (p < 0.05) than in group 4. Conclusions Tear osmolarity was correlated with ocular surface indices in DE associated with SS. Combination of tear osmolarity and MMP-9 test results may be helpful to determine the severity of DE associated with SS.
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Affiliation(s)
- Kyung Yun Kook
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Rujun Jin
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Lan Li
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Hyeon Jeong Yoon
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
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83
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Daull P, Amrane M, Ismail D, Georgiev G, Cwiklik L, Baudouin C, Leonardi A, Garhofer G, Garrigue JS. Cationic Emulsion-Based Artificial Tears as a Mimic of Functional Healthy Tear Film for Restoration of Ocular Surface Homeostasis in Dry Eye Disease. J Ocul Pharmacol Ther 2020; 36:355-365. [PMID: 32493105 PMCID: PMC7404832 DOI: 10.1089/jop.2020.0011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/19/2020] [Indexed: 12/12/2022] Open
Abstract
Dry eye disease (DED) is a complex multifactorial disease that affects an increasing number of patients worldwide. Close to 30% of the population has experienced dry eye (DE) symptoms and presented with some signs of the disease during their lifetime. The significant heterogeneity in the medical background of patients with DEs and in their sensitivity to symptoms renders a clear understanding of DED complicated. It has become evident over the past few years that DED results from an impairment of the ocular surface homeostasis. Hence, a holistic treatment approach that concomitantly addresses the different mechanisms that result in the destabilization of the tear film (TF) and the ocular surface would be appropriate. The goal of the present review is to compile the different types of scientific evidence (from in silico modeling to clinical trials) that help explain the mechanism of action of cationic emulsion (CE)-based eye drop technology for the treatment of both the signs and the symptoms of DED. These CE-based artificial tear (AT) eye drops designed to mimic, from a functional point of view, a healthy TF contribute to the restoration of a healthy ocular surface environment and TF that leads to a better management of DE patients. The CE-based AT eye drops help restore the ocular surface homeostasis in patients who have unstable TF or no tears.
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Affiliation(s)
| | - Mourad Amrane
- Novagali Innovation Center, Santen SAS, Evry, France
| | - Dahlia Ismail
- Novagali Innovation Center, Santen SAS, Evry, France
| | - Georgi Georgiev
- Biointerfaces and Biomaterials Laboratory, Department of Optics and Spectroscopy, School of Optometry, Faculty of Physics, St. Kliment Ohridski University of Sofia, Sofia, Bulgaria
| | - Lukasz Cwiklik
- J. Heyrovsky Institute of Physical Chemistry, Czech Academy of Sciences, Prague, Czech Republic
| | - Christophe Baudouin
- CHNO des Quinze-Vingts, IHU FOReSIGHT, INSERM-DGOS CIC 1423, Paris, France & Sorbonne Universités, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Andrea Leonardi
- Department of Neuroscience, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Gerhard Garhofer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Dean RS, Kahat DH, Graden NR, DePhillipo NN, LaPrade RF. Doxycycline improves tendon and cartilage pathologies in preclinical studies: current concepts. J ISAKOS 2020. [DOI: 10.1136/jisakos-2020-000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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85
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Utility of Tear Osmolarity Measurement in Diagnosis of Dry Eye Disease. Sci Rep 2020; 10:5542. [PMID: 32218518 PMCID: PMC7099018 DOI: 10.1038/s41598-020-62583-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/16/2020] [Indexed: 11/08/2022] Open
Abstract
The prevalence of dry eye disease is high worldwide and poses a great burden on patients' daily lives. Accurate diagnosis of the disease is important, and it requires application of various methods. Hyperosmolarity is believed to be the disease marker and thus measuring it provides useful information. In this study we investigated utility of tear osmolarity measured with TearLab osmometer, along with other diagnostic tests (Ocular Surface Disease Index questionnaire, Tear film break-up time, Ocular Protection Index, Ocular Surface Staining, Schirmer I test, Meibomian gland functionality in 757 patients (1514 eyes) with dry eye disease and 29 healthy controls (58 eyes). Statistical differences between the patient group and the control group were observed for all the tests apart from tear osmolarity, regardless of cut-off value (>308 mOsm/L, >316 mOsm/L, and inter-eye difference >8 mOsm/L). Moreover, in the receiver operating characteristics curve analyses tear osmolarity measurement could not discriminate dry eye disease pathological scores. Therefore, our study suggests that tear osmolarity measured with TearLab osmometer cannot be used as a key indicator of DED.
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86
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Li Y, Jin R, Li L, Yoon HJ, Choi JH, Park JH, Liu Z, Li W, Li Z, Yoon KC. Expression and Role of Nucleotide-Binding Oligomerization Domain 2 (NOD2) in the Ocular Surface of Murine Dry Eye. Invest Ophthalmol Vis Sci 2019; 60:2641-2649. [PMID: 31237655 DOI: 10.1167/iovs.19-27144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate expression and role of nucleotide-binding oligomerization domain 2 (NOD2) in the ocular surface of experimental dry eye (EDE), which is a nod-like receptor member and is involved in innate immune response. Methods C57/BL6 female mice were divided into the groups: untreated (UT), EDE, and NOD2 knockout (KO) mice exposed to desiccating stress for 14 days. Clinical parameters and levels of inflammatory cytokine were measured at 3,5,7, and 14 days. Immunofluorescent staining for NOD2 and Western blot for RIP2 and NF-κB were performed at 14 days. Flow cytometry, PAS staining and TUNEL staining were performed. Results After EDE induction, NOD2 was expressed in the corneal epithelium of the EDE group. The EDE group showed a significantly increased RIP2 expression compared to the UT and NOD2-KO groups. A significantly lower expression of NF-κB and lower levels of IL-1β, IL-6, IFN-γ, and TNF-α were noted in the NOD2-KO group than in the EDE group. The NOD2-KO group had lower CD11b+ and CD4+CCR5+ T cells, TUNEL-positive cells and corneal staining score and higher density of conjunctival goblet cell density, tear volume, and tear film break-up time than the EDE group. The UT group showed significant differences in inflammatory and clinical parameters compared to the EDE and NOD2-KO groups. Conclusions The NOD2 receptor pathway induced inflammation and apoptosis by activation of RIP2 and NF-κB on the ocular surface of EDE, thereby reducing tear secretion. Therefore, NOD2 pathway may be involved in the pathogenesis of dry eye.
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Affiliation(s)
- Ying Li
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Rujun Jin
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Lan Li
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Hyeon Jeong Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Joo-Hee Choi
- College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Jong-Hwan Park
- College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Zuguo Liu
- Xiamen University affiliated Xiamen Eye Center, Xiamen, China
| | - Wei Li
- Xiamen University affiliated Xiamen Eye Center, Xiamen, China
| | - Zhengri Li
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, China
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
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87
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Eshaq RS, Harris NR. Loss of Platelet Endothelial Cell Adhesion Molecule-1 (PECAM-1) in the Diabetic Retina: Role of Matrix Metalloproteinases. Invest Ophthalmol Vis Sci 2019; 60:748-760. [PMID: 30793207 PMCID: PMC6385619 DOI: 10.1167/iovs.18-25068] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To test the hypothesis that high glucose and matrix metalloproteinases (MMPs) contribute to the diabetes-induced loss of platelet endothelial cell adhesion molecule-1 (PECAM-1) in the retinal microvasculature. Methods PECAM-1 and MMP protein, activity, and interactions with PECAM-1 were assessed using western blotting, zymography, immunofluorescence, or coimmunoprecipitation assays. These assays were conducted using primary rat retinal microvascular endothelial cells (RRMECs) grown either in normal glucose (5 mM) or high glucose (25 mM) conditions and using retinas collected from streptozotocin-induced diabetic or control rats. The broad-spectrum MMP inhibitor GM6001 was administered in vivo and in vitro to ascertain the role of MMPs in the hyperglycemia-induced loss of PECAM-1. Results A dramatic decrease in PECAM-1 (western blotting, immunofluorescence) was observed in both the diabetic retina and in hyperglycemic RRMECs. The decrease in PECAM-1 was accompanied by a significant increase in the presence and activity of matrix metalloproteinase-2 (MMP-2) (but not matrix metalloproteinase-9 [MMP-9]) in the diabetic plasma (P < 0.05) and in hyperglycemic RRMECs (P < 0.05). Moreover, RRMEC PECAM-1 significantly decreased when treated with plasma collected from diabetic rats. Several MMP-2 cleavage sites on PECAM-1 were identified using in silico analysis. Moreover, PECAM-1/MMP-2 interactions were confirmed using coimmunoprecipitation. PECAM-1 was significantly decreased in RRMECs treated with MMP-2 (P < 0.05), but became comparable to controls with the MMP inhibitor GM6001 in both the diabetic retina and hyperglycemic RRMECs. Conclusions These results indicate a possible role of MMP-2 in hyperglycemia-induced PECAM-1 loss in retinal endothelial cells.
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Affiliation(s)
- Randa S Eshaq
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
| | - Norman R Harris
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, United States
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Ghiasian L, Habibi A, Aliakbar Navahi R, Hadavandkhani A, Akbarian S, Alemzadeh SA, Khorasani MA. Safety of the subconjunctival injection of doxycycline in rabbits. Cutan Ocul Toxicol 2019; 38:390-394. [PMID: 31311337 DOI: 10.1080/15569527.2019.1641112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the safety of subconjunctival injection of doxycycline in rabbit eyes. Methods: Eight white New Zealand rabbits were selected. Different concentrations of 250 micrograms (μg), 500 μg, 1000 μg, and 2000 μg in 0.1 ml were prepared for subconjunctival injection. Each concentration was injected into the two eyes of each rabbit. For each dose, dextrose was injected in one contralateral eye and the other fellow eye remained non-injected. All rabbits underwent ocular examination in the 1st, 3rd, and 30th day after injection. The rabbits were sacrificed 30 days after injections and the histopathological examination was performed. Results: No obvious change was detected in all four groups from the 1st day to the 3rd day after injection in terms of tearing, hyperaemia, and chemosis. There was no visible sign of inflammation or necrosis, and also no histological change in both clinical and histopathological examinations. Conclusion: Subconjunctival injection of doxycycline with different dosages of 250 to 2000 ug in 0.1cc in rabbit eyes was safe and no clinical or histological changes were observed after one month.
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Affiliation(s)
- Leila Ghiasian
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
| | - Abbas Habibi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
| | - Roshanak Aliakbar Navahi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
| | - Ali Hadavandkhani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
| | - Shadi Akbarian
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
| | | | - Maryam Ashraf Khorasani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences , Tehran , Iran
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Development and Long-Term Evaluation of Ocular Surface Conditions Using Ovariectomized Cynomolgus Monkey. Eye Contact Lens 2019; 45:246-253. [PMID: 30383547 DOI: 10.1097/icl.0000000000000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We aim to use the ovariectomized cynomolgus monkey to observe the effect of long-term changes of sex hormone levels on ocular surface. METHODS Six healthy adolescent cynomolgus monkeys were randomly assigned to control and experimental groups (n=3/group). Bilateral ovariectomy was performed in experimental group, and sham operation was performed on control animals with their ovaries reserved. The concentrations of serum estradiol and testosterone in cynomolgus monkeys' lower-limb venous were detected by radioimmunoassay before surgery, and at 6, 12, 18, and 24 months after the surgery. Phenol red cotton thread test, tear osmolarity, corneal fluorescein staining, and conjunctival impression cytology were performed to evaluate the ocular surface conditions before surgery, and at 6, 12, 18, and 24 months after the surgery. The histological examinations of the bulbar conjunctiva and labial glands tissues were performed at 12 and 24 months after the surgery. RESULTS There were no significant differences in the serum level of estradiol and testosterone between the experimental and control groups before surgery, at 6, and 12 months after surgery (P>0.05). Serum level of estradiol and testosterone were significantly less in experimental versus control group at 18 and 24 months after surgery (P<0.05). There was no significant differences in phenol red cotton between the experimental and control groups before surgery, at 6, 12, 18, and 24 months after surgery (P>0.05). Tear osmolarity had no significant differences between experimental and control group before surgery (P>0.05), and it was significantly higher in experimental versus control group at all four time-points after surgery (P<0.05). The number of conjunctival goblet cells had no significant differences between experimental and control group before surgery, at 6 months after surgery (P>0.05), and it was significantly lower in experimental versus control group at 12, 18, and 24 months after surgery (P<0.05). There were no significant differences in the corneal fluorescein staining score between the experimental and control groups before surgery, at 6, 12, and 18 months after surgery (P>0.05), and it was higher in experimental than control group at 24 months after surgery (P<0.05). In addition, inflammatory cell infiltration in bulbar conjunctiva and labial glands tissues was observed in experimental group and was unobserved in control group at 24 months after surgery. CONCLUSIONS Ovariectomy led to decreased sex hormone levels in cynomolgus monkey. In turn, tear osmolarity was increased, the number of conjunctival goblet cells were decreased, the corneal fluorescence staining was increased, and the pathological examination of the bulbar conjunctiva and labial glands tissues were abnormal, phenol red cotton thread test did not change significantly.
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90
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Park JH, Moon SH, Kang DH, Um HJ, Kang SS, Kim JY, Tchah H. Diquafosol Sodium Inhibits Apoptosis and Inflammation of Corneal Epithelial Cells Via Activation of Erk1/2 and RSK: In Vitro and In Vivo Dry Eye Model. Invest Ophthalmol Vis Sci 2019; 59:5108-5115. [PMID: 30372737 DOI: 10.1167/iovs.17-22925] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effect of diquafosol on corneal epithelium in a dry eye model using Transwell culture and a scopolamine-induced dry eye rat model. Methods Desiccation stress induced in an in vitro dry eye model using human corneal epithelial cells was used, and the cells were incubated with or without diquafosol media diluted at 1:100. Reactive oxygen species (ROS) generation was measured using 2',7'-dichlorofluorescein diacetate (DCFH-DA). Apoptosis was analyzed, and levels of phosphorylated Erk1/2, phosphorylated p90RSK, phosphorylated Akt, IκB-α, and NF-κB-p65 were determined. Levels of IL-1β, TNF-α, IL-6, IL-8, and GM-CSF were quantified. To investigate the in vivo effects of diquafosol, we induced dry eye in Wistar rats using scopolamine hydrobromide. The rats were divided into three groups: control, dry eye, and dry eye diquafosol; topical DIQUAS was applied four times daily for 28 days. We used immunohistochemistry to detect the levels of phosphorylated Erk1/2, phosphorylated p90RSK, and IL-1β, and used the TUNEL assay in corneal tissue. Results The distribution of highly fluorescent dichlorofluorescein and the proportion of annexin V- and PI-positive cells decreased in the diquafosol medium. Diquafosol increased the levels of phospho-Erk1/2, phospho-90RSK, phospho-Akt, and IκB-α, whereas it significantly decreased the levels of NF-κB-p65, IL-1β, and TNF-α. In vivo, apoptosis was enhanced in dry eye group. This response was markedly reduced and the level of phosphorylated p90RSK and phosphorylated ERK1/2 were upregulated and IL-1β was downregulated by DIQUAS. Conclusions Diquafosol treatment reduced intracellular ROS levels, apoptosis, and inflammation, all of which were increased in the dry eye model through desiccation.
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Affiliation(s)
- Jin Hyoung Park
- Miso Eye Clinic, Gyeonggi-do, Republic of Korea.,Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Seong-Ho Moon
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Dong Hyun Kang
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hyun Jun Um
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Soon-Suk Kang
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae Yong Kim
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hungwon Tchah
- Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.,Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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91
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Zhao M, Liu L, Zheng Y, Liu G, Che B, Li P, Chen H, Dong C, Lin L, Du Z. Anti-inflammatory effects of paeoniflorin from Paeonia lactiflora Pall. on human corneal epithelial cells and a mouse model of dry eye disease. RSC Adv 2019; 9:12998-13006. [PMID: 35520788 PMCID: PMC9063770 DOI: 10.1039/c8ra09060b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/24/2019] [Indexed: 11/21/2022] Open
Abstract
Dry eye disease (DED) is characterized by increased osmolality of tears due to a lack of production or increased evaporation of tears. Hyperosmolarity is involved in DED pathogenesis, which damages ocular surface cells and leads to inflammation of the ocular surface. We investigated the anti-inflammatory effect of paeoniflorin (PF) from Paeonia lactiflora Pall. on human corneal epithelial (HCE) cells and its molecular mechanisms, and its therapeutic effects on a mouse model of experimental dry eye (EDE). HCE cells were treated with PF-1 (PF prepared in vitro; 0.01%, 0.1% and 1.0%). Protein production/activity was determined by Western blotting, RT-PCR and immunofluorescent staining. Meanwhile, eye drops containing 0.01%, 0.1% and 1.0% of PF-2 (PF prepared in vivo) were applied to the EDE, and the tear volume, corneal fluorescein-staining score, detachment of the corneal epithelium, and immunohistochemical staining were measured after 28 days of treatment. PF reduced expression of proinflammatory factors such as interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF)-α in HCE cells, and significantly improved dry-eye signs, including tear volume, desquamation of the corneal epithelium and ocular surface inflammation in mice treated with 1.0% PF-2. Further study showed that PF improved EDE by inhibiting mitogen-activated protein kinase (MAPK), phosphorylated (p)-c-Jun N-terminal kinase (JNK) and pp-38, and nuclear factor kappa B (NF-κB) signaling pathways. These data suggest that PF can improve dry-eye symptoms and reduce expression of proinflammatory mediators. Hence, eye drops containing PF could be used as an adjunctive treatment for DED.
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Affiliation(s)
- Mincong Zhao
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
| | - Li Liu
- Infinitus (China) Company Ltd Jiangmen 529156 China
| | - Yating Zheng
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
| | | | - Biao Che
- Infinitus (China) Company Ltd Jiangmen 529156 China
| | - Penghui Li
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
| | - Huixiong Chen
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
- CNRS, UMR8601, Laboratoire de Chimine et Biochimie Pharmacologiques et Toxicologiques, CBNIT, Universite Paris Descartes PRES Sorbonne Paris Cite, UFR Biomedicale 45 Rue des Saints-Peres 75270 Paris Cedex 06 France
| | - Changzhi Dong
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
- Universite Paris Diderot, Sorbonne Paris Cite, ITODYS, UMR 7086 CNRS 15 Rue J-A de Baif 75270 Pairs Cedex 13 France
| | - Li Lin
- Allan Conney Biotechnology Company Ltd Foshan 528000 China
| | - Zhiyun Du
- Institute of Natural Medicine & Green Chemistry, School of Biomedical and Pharmaceutical Engineering, Guandong University of Technology Guangzhou 510006 China +86-20-3932-2235
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92
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Aktaş S, Temiztürk F. Evaluation of tear osmolarity and tear function in patients with Behçet's syndrome. Can J Ophthalmol 2019; 54:176-179. [PMID: 30975340 DOI: 10.1016/j.jcjo.2018.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To evaluate the effects of Behçet's syndrome (BS) on tear osmolarity and tear film function tests. METHODS Thirty patients with BS and 41 control subjects were enrolled in this study. Tear osmolarity was measured with an osmometer. Tear film function tests involved corneal fluorescein staining, tear film breakup time (TBUT), Schirmer's 1 test, and an Ocular Surface Disease Index (OSDI) Questionnaire. RESULTS The patients with BS had significantly higher tear osmolarity (p = 0.000) and OSDI scores (p = 0.000) than the healthy controls. The TBUT (p = 0.000) and Schirmer's 1 test (p = 0.033) results were significantly lower in the BS group, but the fluorescein staining results were not statistically different. A significant correlation was found between tear osmolarity, OSDI, and the activity of BS. CONCLUSIONS BS is associated with hyperosmolarity of the tear film, which can damage the ocular surface and affect tear functions.
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Affiliation(s)
- Serdar Aktaş
- Department of Ophthalmology, Dumlupinar University School of Medicine, Kütahya, Turkey.
| | - Fatih Temiztürk
- Department of Physical Medicine and Rehabilitation, Dumlupinar University School of Medicine, Kütahya, Turkey
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93
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Extracellular MMP-9-Based Assessment of Ocular Surface Inflammation in Patients with Primary Open-Angle Glaucoma. J Ophthalmol 2019; 2019:1240537. [PMID: 31073413 PMCID: PMC6470422 DOI: 10.1155/2019/1240537] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/11/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose Objective assessment of dry eye disease (DED) severity and ocular inflammation using the InflammaDry® test for extracellular matrix metalloproteinase-9 (MMP-9) and the impact of antiglaucoma eye drops in people with primary open-angle glaucoma (POAG). Methods Overall, 90 adults (180 eyes) were included: 60 had been diagnosed with POAG and were treated with prostaglandin analogue monotherapy and 30 were suspected of having POAG but did not receive any treatment (control group). Of those treated with prostaglandin eye drops, 30 received a preservative-free formulation (tafluprost) and 30 were treated with a formulation containing the preservative benzalkonium chloride (BAK) (latanoprost). Measurement of extracellular MMP-9 levels (InflammaDry test) provided a marker for ocular surface inflammation. Further assessments of disease severity and inflammation comprised Goldmann applanation tonometry for intraocular pressure (IOP), Schirmer's test with anesthesia, ocular surface staining with unpreserved fluorescein (Oxford scale index), tear breakup time (TBUT), McMonnies questionnaire, and the Ocular Surface Disease index (OSDI). Results Clinically significant MMP-9 levels (>40 ng/mL) were detected in tear film from 46.7% of subjects treated with BAK-containing medication. In contrast, only 16.7% of subjects treated with preservative-free medication or untreated individuals demonstrated similar MMP-9 levels. This difference was statistically significant (p < 0.05). MMP-9 results correlated with other indicators of inflammation and disease severity. BAK-containing medication was associated with rapid TBUT (<5 seconds) in 50% of cases, while only 10% of untreated subjects and individuals using preservative-free medication demonstrated comparable TBUT results. Conclusion Measurement of ocular surface MMP-9 level provides a useful marker for inflammation and DED in POAG. Use of a preservative-free topical prostaglandin formulation results in lower levels of ocular inflammation, compared with BAK-containing medication.
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Pepose JS, Qazi MA, Devries DK. Longitudinal changes in dry eye symptoms and signs following lifitegrast therapy and relationship to tear osmolarity. Clin Ophthalmol 2019; 13:571-579. [PMID: 30992657 PMCID: PMC6445190 DOI: 10.2147/opth.s196593] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background This study measured longitudinal changes in dry eye disease (DED) symptoms and signs following lifitegrast therapy and assessed their relationship to tear osmolarity to test the hypothesis that a decline in tear osmolarity is a reliable leading indicator of subsequent improvement in DED symptoms and signs after initiating lifitegrast treatment. Methods This phase IV, prospective, single-arm, open-label, 12-week study enrolled subjects aged ≥18 years with eye dryness score ≥40 (0–100 VAS) and tear osmolarity ≥308 mOsm/L. Subjects were prescribed lifitegrast ophthalmic solution 5%, twice daily in each eye. DED symptoms were assessed via VAS at baseline and 2, 6, and 12 weeks. Signs included tear osmolarity, meibomian gland dysfunction, tear breakup time, and fluorescein corneal staining. In post-hoc analysis, subjects with ≥5 mOsm/L decrease in osmolarity over 12 weeks were Responders. Results Of 26 subjects in the intent-to-treat population, 23 were female; mean age was 67.4 years. Baseline mean±SD eye dryness was 68.7±16.5 and tear osmolarity was 317.8±8.5 mOsm/L. All seven symptoms (dryness, burning, foreign body sensation, pain, photophobia, itching, blurred vision) declined significantly (P<0.01) from baseline to 6 and 12 weeks. Signs did not change significantly. For 13 Responders, tear osmolarity decreased from baseline to 12 weeks (319.2±8.5 to 300.6±12.3 mOsm/L, P<0.001) and corneal staining trended toward improvement (1.1±0.9 to 0.6±0.7, P=0.136). Among Nonresponders, osmolarity increased from 316.4+8.7 to 329.6+13.9 (P<0.01) and corneal staining showed no change (1.3±0.8 to 1.0±0.7 at 12 weeks, P=0.293). Conclusions Lifitegrast reduced DED symptoms among subjects with moderate-to-severe disease (severity defined by VAS for eye dryness). Potential reasons that may underlie the dichotomous effect of drug treatment on tear osmolarity are discussed.
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Affiliation(s)
| | - Mujtaba A Qazi
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO, USA
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95
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Zheng Q, Tan Q, Ren Y, Reinach PS, Li L, Ge C, Qu J, Chen W. Hyperosmotic Stress-Induced TRPM2 Channel Activation Stimulates NLRP3 Inflammasome Activity in Primary Human Corneal Epithelial Cells. Invest Ophthalmol Vis Sci 2019; 59:3259-3268. [PMID: 29971445 DOI: 10.1167/iovs.18-23965] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to determine whether either a hyperosmotic or oxidative stress induces NLRP3 inflammasome activation and increases in bioactive IL-1β secretion through transient receptor potential melastatin 2 (TRPM2) activation in primary human corneal epithelial cells (PHCECs). Methods Real-time PCR, Western blots, and immunofluorescent staining were used to evaluate TRPM2 and NLRP3, ASC, caspase-1, and IL-1β mRNA and protein expression levels, respectively. A CCK-8 assay evaluated cell viability. Hyperosmotic 500 mOsm and oxidative 0.5 mM H2O2 stresses were imposed. TRPM2 expression was inhibited with a TRPM2 inhibitor, 20 μM N-(p-amylcinnamoyl) anthranilic acid (ACA), or TRPM2 siRNA knockdown. Results In the hypertonic medium, TRPM2, NLRP3, ASC, caspase-1, and IL-1β gene and protein expression levels rose after 4 hours (P ≤ 0.043), whereas ACA preincubation suppressed these rises (P ≤ 0.044). Similarly, H2O2 upregulated TRPM2 protein expression by 80%, and induced both NLRP3 inflammasome activation and increased bioactive IL-1β secretion (P ≤ 0.036), whereas ACA pretreatment suppressed these effects (P ≤ 0.029). TRPM2 siRNA transfection reduced TRPM2 gene expression by 70% (P = 0.018) in this hyperosmotic medium and inhibited the increases in NLRP3, caspase-1, and IL-1β gene (P ≤ 0.028) and protein expression (P ≤ 0.037). Conclusions TRPM2 activation by either a hyperosmotic or oxidative stress contributes to mediating increases in NLRP3 inflammasome activity and bioactive IL-1β expression because inhibiting TRPM2 activation or its expression blunted both of these responses in PHCECs. This association points to the possibility that TRPM2 is a viable target to suppress hyperosmotic-induced corneal epithelial inflammation.
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Affiliation(s)
- Qinxiang Zheng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Qiufan Tan
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China.,Yiwu Maternal and Child Health Hospital, Jinhua, Zhejiang, China
| | - Yueping Ren
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Peter S Reinach
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Ling Li
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Chaoxiang Ge
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
| | - Wei Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, China
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96
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The Use of Conjunctival Staining to Measure Ocular Surface Inflammation in Patients With Dry Eye. Cornea 2019; 38:698-705. [DOI: 10.1097/ico.0000000000001916] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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97
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Reins RY, Lema C, Courson J, Kunnen CME, Redfern RL. MyD88 Deficiency Protects Against Dry Eye-Induced Damage. Invest Ophthalmol Vis Sci 2019; 59:2967-2976. [PMID: 30025110 PMCID: PMC5991808 DOI: 10.1167/iovs.17-23397] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Dry eye disease (DED) is a multifactorial disease associated with ocular surface inflammation. Toll-like receptors (TLRs) are integral in the initiation of inflammatory signaling. Therefore, we evaluated the effect of TLR-deficiency on dry eye–related ocular surface damage and inflammation using a mouse model of experimental dry eye (EDE). Methods C57BL/6 wild-type (WT), MyD88−/−, and IL-1R−/− mice were exposed to EDE conditions for 5 days. Tear production was measured by phenol red thread test and ocular surface damage assessed with fluorescein staining. Corneal homogenates were obtained for matrix metalloproteinase (MMP) and cytokine expression analysis by Luminex assay and quantitative PCR. In addition, whole eyes and eyelids were dissected and goblet cells and Meibomian glands were imaged, respectively. Results Following 5 days of EDE, WT mice had extensive ocular surface staining, while MyD88−/− mice had no increased staining above non-EDE conditions. Similarly, MyD88−/− mice did not have increased corneal MMP-2, 3, or 8 concentrations, as seen with WT mice. MyD88-deficiency also resulted in decreased corneal cytokine levels. In addition, MyD88−/− mice had significantly lower conjunctival goblet cell counts compared with both WT (EDE) and IL-1R−/− (non-EDE) mice. However, there was no difference in Meibomian gland morphology between WT, IL-1R−/−, and MyD88−/− mice. Conclusions These studies demonstrate the importance of TLR signaling in dry eye development. Mice lacking TLR signaling, MyD88−/−, were protected from EDE-induced ocular surface damage and inflammatory mediator expression, warranting further investigation into TLR inhibition as a potential therapeutic for DED.
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Affiliation(s)
- Rose Y Reins
- University of Houston, College of Optometry, The Ocular Surface Institute, Houston, Texas, United States
| | - Carolina Lema
- University of Houston, College of Optometry, The Ocular Surface Institute, Houston, Texas, United States
| | - Justin Courson
- University of Houston, College of Optometry, The Ocular Surface Institute, Houston, Texas, United States
| | - Carolina M E Kunnen
- University of Houston, College of Optometry, The Ocular Surface Institute, Houston, Texas, United States
| | - Rachel L Redfern
- University of Houston, College of Optometry, The Ocular Surface Institute, Houston, Texas, United States
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Sendon-Lago J, Seoane S, Martinez-Ordoñez A, Eiro N, Saa J, Vizoso FJ, Gonzalez F, Perez-Fernandez R, Bermudez MA. Corneal regeneration by conditioned medium of human uterine cervical stem cells is mediated by TIMP-1 and TIMP-2. Exp Eye Res 2019; 180:110-121. [PMID: 30557571 DOI: 10.1016/j.exer.2018.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/22/2018] [Accepted: 12/11/2018] [Indexed: 01/15/2023]
Abstract
The aim of the present study was to evaluate the effect and the mechanism of action of the conditioned medium from human uterine cervical stem cells (CM-hUCESC) on corneal wound healing in a rabbit dry eye model. To do this, dry eye and corneal epithelial injuries were induced in rabbits by topical administration of atropine sulfate and NaOH. Hematoxylin-Eosin (H&E) and Ki-67 immunostaining were carried out to evaluate corneal damage and cell proliferation, and real-time PCR was used to evaluate proinflammatory cytokines in the cornea. In addition, in order to investigate possible factors involved in corneal regeneration, primary cultures of rat corneal epithelial cells (rCECs) were used to evaluate cell migration, proliferation, and apoptosis before and after immunoprecipitation of specific factors from the CM-hUCESC. Results showed that CM-hUCESC treatment significantly improved epithelial regeneration in rabbits with dry eye induced by atropine and reduced corneal pro-inflammatory TNF-α, MCP-1, MIP-1α and IL-6 cytokines. In addition, metalloproteinase inhibitors TIMP-1 and TIMP-2, which are present at high levels in CM-hUCESC, mediated corneal regenerative effects by both inducing corneal epithelial cell proliferation and inhibiting apoptosis. In summary, CM-hUCESC induces faster corneal regeneration in a rabbit model of dry eye induced by atropine than conventional treatments, being TIMP-1 and TIMP-2 mediators in this process. The results indicate that an alternative CM-based treatment for some corneal conditions is achievable, although future studies would be necessary to investigate other factors involved in the multiple observed effects of CM-hUCESC.
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Affiliation(s)
- Juan Sendon-Lago
- Department of Physiology and Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Samuel Seoane
- Department of Physiology and Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Anxo Martinez-Ordoñez
- Department of Physiology and Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Noemi Eiro
- Research Unit, Hospital Fundacion de Jove, Gijón, Spain.
| | - Jorge Saa
- Research Unit, Hospital Fundacion de Jove, Gijón, Spain; Service of Ophthalmology, Fundación Hospital de Jove, Gijón, Spain.
| | | | - Francisco Gonzalez
- Department of Surgery and CIMUS, University of Santiago de Compostela, Spain; Service of Ophthalmology and IDIS, Complejo Hospitalario Universitario de Santiago de Compostela, Spain.
| | - Roman Perez-Fernandez
- Department of Physiology and Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Maria A Bermudez
- Department of Biology, Faculty of Science, University of A Coruña, Spain.
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Yu D, Deng Q, Wang J, Chang X, Wang S, Yang R, Yu J, Yu J. Air Pollutants are associated with Dry Eye Disease in Urban Ophthalmic Outpatients: a Prevalence Study in China. J Transl Med 2019; 17:46. [PMID: 30767763 PMCID: PMC6376760 DOI: 10.1186/s12967-019-1794-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/05/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although previous prevalence studies of DED were reported from some countries worldwide, national data are unavailable in China. We aimed to conduct an up-to-date national survey on the prevalence of DED in China and find out the potential risk factors including air pollutant. METHODS 23,922 eligible outpatients were recruited from ophthalmic clinics of 32 cities in China in 2013 by registration orders. The patients' demographic characteristics, history of keratorefractive surgery, diseases and medication history were collected and the daily air pollutant data in 2013. Multivariate logistic analysis was performed to identify the potential risk factors associated with DED. The association between related factors and dry eye diseases subtypes evaluated as p value and odds ratios (OR) with 95% confidence intervals (CI). RESULTS Among 23,922 outpatients, the prevalence of DED was 61.57%, and that of the male patients was 57.64% and of the female was 65.32% (P < 0.0001). Multivariate logistic regression suggested that the possible risk factors for DED included: female, older age, history of keratorefractive surgery, presence of arthritis, thyroid diseases, and antihistamine, diuretic, duodenal ulcer drugs, diazepam. Air pollutants including O3, PM2.5, and SO2 were also identified as the risk factors. CONCLUSION The prevalence of DED among ophthalmic outpatients in China was considerably high. Age, gender, history of keratorefractive surgery, diseases, medication history, and air pollutants were associated with DED prevalence.
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Affiliation(s)
- Donghui Yu
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, No. 301, Yanchang Road, Shanghai, China
- School of Medicine, Tongji University, No. 1239, Siping Road, Shanghai, China
| | - Qinglong Deng
- Institute of Clinical Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, No. 138, Yixueyuan Road, Shanghai, China
| | - Jiwei Wang
- Institute of Clinical Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, No. 138, Yixueyuan Road, Shanghai, China
| | - Xing Chang
- School of Environment, Tsinghua University, No. 1, Tsinghua Yuan, Haidian District, Beijing, China
| | - Shuxiao Wang
- School of Environment, Tsinghua University, No. 1, Tsinghua Yuan, Haidian District, Beijing, China
| | - Renren Yang
- Institute of Clinical Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, No. 138, Yixueyuan Road, Shanghai, China
| | - Jinming Yu
- Institute of Clinical Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, No. 138, Yixueyuan Road, Shanghai, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, No. 301, Yanchang Road, Shanghai, China
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100
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Lema C, Reins RY, Redfern RL. High-Mobility Group Box 1 in Dry Eye Inflammation. Invest Ophthalmol Vis Sci 2019; 59:1741-1750. [PMID: 29610858 PMCID: PMC5886030 DOI: 10.1167/iovs.17-23363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose To determine high-mobility group box 1 (HMGB1) expression during experimental dry eye (EDE) and dry eye-like culture conditions and elucidate its role in corneal dry eye-related inflammation. Methods EDE was induced in 8- to 12-week-old C57BL/6 mice. Corneal tissue sections and lysates from EDE and untreated mice were evaluated for HMGB1 expression by immunostaining and quantitative real-time PCR (qPCR). For in vitro studies, human corneal epithelial cells (HCEC) were treated with hyperosmolar media, toll-like receptor (TLR) agonists, or proinflammatory cytokines to determine HMGB1 expression. HCEC were also treated with human recombinant HMGB1 (hrHMGB1) alone or in combination with inflammatory stimuli, and TNFα, IL-6, and IL-8 expression evaluated by qPCR and ELISA. Nuclear factor-κB (NF-κB) p65 nuclear translocation was determined by immunostaining. Results EDE mice had higher corneal HMGB1 RNA and protein expression compared to untreated animals. In HCEC, hyperosmolar stress and TNFα treatment stimulated HMGB1 production and secretion into culture supernatants. However, in vitro stimulation with hrHMGB1 did not induce secretion of TNFα, IL-6, or IL-8 or NF-κB p65 nuclear translocation. In addition, the inflammatory response elicited by TLR agonists fibroblast-stimulating lipopeptide-1 and lipopolysaccharide was not enhanced by hrHMGB1 treatment. Conclusions HMGB1 expression was enhanced by dry eye conditions in vivo as well as in vitro, during hyperosmolar stress and cytokine exposure, suggesting an important role for HMGB1 in dry eye disease. However, no direct inflammatory effect was observed with HMGB1 treatment. Therefore, under these conditions, HMGB1 does not contribute directly to dry eye-induced inflammation and its function at the ocular surface needs to be explored further.
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Affiliation(s)
- Carolina Lema
- The Ocular Surface Institute, University of Houston, College of Optometry, Houston, Texas, United States
| | - Rose Y Reins
- The Ocular Surface Institute, University of Houston, College of Optometry, Houston, Texas, United States
| | - Rachel L Redfern
- The Ocular Surface Institute, University of Houston, College of Optometry, Houston, Texas, United States
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