1
|
Moxibustion with Walnut Shell Spectacles Could Improve the Objective Symptoms and Tear Film Stability of Patients with Dry Eye Disease: A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1773444. [PMID: 36506807 PMCID: PMC9729042 DOI: 10.1155/2022/1773444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/22/2022] [Indexed: 12/05/2022]
Abstract
Objectives This study aims to evaluate the efficacy and acceptability of moxibustion with walnut shell spectacles in treating dry eye disease (DED) patients and to provide treatment options. Methods 126 DED patients were randomly allocated into the moxibustion group (treated by moxibustion with walnut shell spectacles, 64 cases) and the artificial tears group (treated with sodium hyaluronate eye drops, 62 cases). Evaluate the changes in the ocular surface disease index (OSDI), the visual analogue scale (VAS) of ocular discomfort, the tear film break-up time (TBUT), corneal fluorescein staining (CFS), and the Schirmer I test during the trial at baseline and after 1-week, 2-week, 3-week, and 4-week treatment. Evaluate the OSDI scale and the ocular symptom VAS scale one month after the end of treatment. Results There were no significant differences in baseline characteristics between the two groups. For OSDI scores, the results showed that the efficacy of the moxibustion group was no less than that of the artificial tear group. For VAS of ocular discomfort, both groups significantly reduced their score compared with baseline, and for the moxibustion group, the decrease was more significant. For TBUT, FAS, and PPS, results showed that the efficacy of the moxibustion group was significant in both eyes after 4 weeks of treatment, but the right eye was in the artificial tear group. For CFS and Schirmer I test scores, there was no significant effect for both groups. Conclusion Moxibustion with walnut shell spectacles could improve the clinical symptoms and tear film stability of DED patients; however, it has no significant efficacy on improving corneal injury and tear secretion, just the same as sodium hyaluronate eye drops. Nevertheless, moxibustion with walnut shell spectacles may have better effects on the self-assessment of ocular discomfort than sodium hyaluronate eye drops.
Collapse
|
2
|
Barrientos RT, Godín F, Rocha-De-Lossada C, Soifer M, Sánchez-González JM, Moreno-Toral E, González AL, Zein M, Larco P, Mercado C, Piedrahita MA. Ophthalmological Approach for the Diagnosis of Dry Eye Disease in Patients with Sjögren's Syndrome. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111899. [PMID: 36431034 PMCID: PMC9692499 DOI: 10.3390/life12111899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
Dry eye has two basic subdivisions: aqueous deficient dry eye (ADDE), with SS a major cause; and evaporative dry eye (EDE), due to either intrinsic or extrinsic factors. SS is a chronic inflammatory disorder defined by dysfunction of the exocrine glands leading to dry eye and dry mouth. The objective of this article was to carry out a systematic and critical review of several scientific publications on dry eye disease, with the aim of providing general recommendations to distinguish dry eye and its different variants in patients with SS, during the period 1979 to 2020, using search engines for articles indexed in Scopus, Latindex, Scielo, Clinical Trials, Medline, Embase, and Cochrane, allowing the analysis of 132 articles published in indexed journals on the subject of dry eye disease and SS, evidencing its conceptualization, prevalence, risk factors, etiopathogenesis, clinical manifestations, diagnosis, and treatment.
Collapse
Affiliation(s)
| | - Fernando Godín
- Department of Ophthalmology, Research and Ocular Health Group, Unbosque, University of El Bosque, Bogota 110111, Colombia
| | - Carlos Rocha-De-Lossada
- Department of Ophthalmology, Qvision, VITHAS Almería Hospital, 04120 Almeria, Spain
- Department of Ophthalmology, Regional Universitary Hospital of Málaga, 18014 Granada, Spain
- Department of Surgery, Ophthalmology Area, University of Seville, 41012 Seville, Spain
- Department of Opthalmology, Vithas Malaga, 29016 Malaga, Spain
| | - Matias Soifer
- Department of Ophthalmology, National Eye Institute, National Institute of Health, Bethesda, MD 20892, USA
| | - José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain
- Correspondence:
| | - Esteban Moreno-Toral
- Department of Pharmacy and Pharmaceutical Technology, University of Seville, 41012 Seville, Spain
| | - Ana-Luisa González
- Department of Ophthalmology, Research Department Clínica La Luz, Lima 15046, Peru
| | - Mike Zein
- Department of Ophthalmology, Bascom Palmer Eye Institute, School of Medicine, University of Miami Miller, Miami, FL 33136, USA
| | - Pablo Larco
- Department of Ophthalmology, Bascom Palmer Eye Institute, School of Medicine, University of Miami Miller, Miami, FL 33136, USA
| | - Carolina Mercado
- Department of Ophthalmology, Bascom Palmer Eye Institute, School of Medicine, University of Miami Miller, Miami, FL 33136, USA
| | | |
Collapse
|
3
|
Cifuentes-González C, Uribe-Reina P, Reyes-Guanes J, Muñoz-Ortiz J, Muñoz-Vargas PT, Rojas-Carabali W, Nova-Florián DV, De-Los-Ríos AS, Mantilla-Hernández RD, de-la-Torre A. Ocular Manifestations Related to Antibodies Positivity and Inflammatory Biomarkers in a Rheumatological Cohort. Clin Ophthalmol 2022; 16:2477-2490. [PMID: 35971506 PMCID: PMC9375558 DOI: 10.2147/opth.s361243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Ocular involvement is frequent in autoimmune diseases and even can be the first manifestation. There are multiple descriptions in the literature around the world regarding this topic. However, we evidenced a lack of studies analyzing the relationship between the ocular manifestations and systemic biomarkers, especially in Latinamerica. Therefore, this study aimed to examine the relationship between the positivity of inflammatory biomarkers and the ocular manifestations in a Colombian cohort of rheumatological patients. Patients and Methods We conducted an observational, descriptive, non-comparative cross-sectional study in a rheumatology center, in Bogotá, Colombia, from 2013 to 2019. We calculated a sample size of 797 patients to assess the prevalence of ocular manifestations and inflammatory biomarkers. We performed univariate analyses for categorical and continuous variables and bivariate analyses using the Chi-square and Fisher’s exact test for categorical variables. Results Women represented 84% of the population, and the mean age was 54.61± 15.64 years. Of 797 patients, 21.45% reported one or more ophthalmological diagnoses, being keratoconjunctivitis sicca (KCS) the most common (15.93%), followed by uveitis, and cataract (1.38%, each one). Regarding ophthalmological symptoms, 35% presented at least one, being dry eye sensation (DE) the most common (30.86%), followed by ocular pain (2.76%), red eye, and decreased visual acuity (2.63%, each one). The antibodies or inflammatory biomarkers most frequently found were antinuclear antibodies (ANAs) (35.3%), C-reactive protein (28.7%), and rheumatoid factor (27.9%). We found statistical associations between consumption of complement 3, anti-CCP, anti-RO, and anti-LA antibodies with ocular manifestations such as photophobia, DE, conjunctivitis, KCS, uveitis, retinal vasculitis, and maculopathy. Conclusion Ocular manifestations are frequently found in patients with positive antibodies and inflammatory biomarkers. Our results suggest antibodies and inflammatory molecules could be biomarkers for ocular manifestations in patients with rheumatological diseases. This study provides the basis for future longitudinal studies.
Collapse
Affiliation(s)
- Carlos Cifuentes-González
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Pilar Uribe-Reina
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juliana Reyes-Guanes
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juliana Muñoz-Ortiz
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Paula Tatiana Muñoz-Vargas
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Dora Victoria Nova-Florián
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Ana Sofía De-Los-Ríos
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | | | - Alejandra de-la-Torre
- Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- Correspondence: Alejandra de-la-Torre, Neuroscience Research Group (NEUROS), Neurovitae Center, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 # 63C 69, Bogotá, Colombia, Tel +2970200 ext. 3320, Email
| |
Collapse
|
4
|
Hao R, Ding Y, Li X. Alterations in corneal epithelial dendritic cell in Sjogren's syndrome dry eye and clinical correlations. Sci Rep 2022; 12:11167. [PMID: 35778532 PMCID: PMC9249752 DOI: 10.1038/s41598-022-15537-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
We aimed to investigate the density and morphology of corneal dendritic cells (DCs) in dry eye (DE) patients with or without Sjogren’s syndrome (SS). This study included 28 patients with Sjogren’s syndrome dry eye (SSDE), 33 patients with non-Sjogren’s syndrome dry eye (NSSDE), and 30 age and sex matched healthy volunteers. In vivo confocal microscopy (IVCM) was used to investigate density and morphology (size, dendrites, and field) of DC. Compared with NSSDE and healthy group, SSDE showed significantly higher DC density, larger DC size, more DC dendrites with larger DC field (all P < 0.001). Comparison between NSSDE and healthy group demonstrated that DC density, dendrites and field were significantly higher in NSSDE. However, there was no significant difference in DC size (P = 0.076). DC density and morphological parameters showed significant associations with the systemic severity (salivary gland biopsy and serum antibodies) and ocular surface damage. The corneal epithelium DC density and morphological alterations were obvious in SSDE, which reflected higher level of immune activation and inflammatory response in SS. Marked correlations were found between DC density/morphology and systemic/ocular severity. Dynamic assessment of corneal DC may facilitate to clarify pathogenesis, stratify patient, and tailor treatment in SS patients.
Collapse
Affiliation(s)
- Ran Hao
- Department of Ophthalmology, Peking University Third Hospital, No. 49, North Garden Street, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, China
| | - Yi Ding
- Capital Medical University, No.10, Xi Toutiao, Youanmen Wai Street, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, No. 49, North Garden Street, Beijing, China. .,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, China.
| |
Collapse
|
5
|
Huang R, Su C, Fang L, Lu J, Chen J, Ding Y. Dry eye syndrome: comprehensive etiologies and recent clinical trials. Int Ophthalmol 2022; 42:3253-3272. [PMID: 35678897 PMCID: PMC9178318 DOI: 10.1007/s10792-022-02320-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/18/2022] [Indexed: 12/07/2023]
Abstract
Dry eye syndrome (DES) is multifactorial and likely to be a cause of concern more so than ever given the rapid pace of modernization, which is directly associated with many of the extrinsic causative factors. Additionally, recent studies have also postulated novel etiologies that may provide the basis for alternative treatment methods clinically. Such insights are especially important given that current approaches to tackle DES remains suboptimal. This review will primarily cover a comprehensive list of causes that lead to DES, summarize all the upcoming and ongoing clinical trials that focuses on treating this disease as well as discuss future potential treatments that can improve inclusivity.
Collapse
Affiliation(s)
- Ruojing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Caiying Su
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Lvjie Fang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiaqi Lu
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China
| | - Jiansu Chen
- Institute of Ophthalmology, Medical College, Jinan University, Huangpu Avenue West 601, Tianhe District, Guangzhou, 510632, China.
| | - Yong Ding
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Huangpu Avenue West 613, Tianhe District, Guangzhou, 510630, China.
| |
Collapse
|
6
|
Fox RI, Fox CM, Gottenberg JE, Dörner T. Treatment of Sjögren's syndrome: current therapy and future directions. Rheumatology (Oxford) 2021; 60:2066-2074. [PMID: 31034046 DOI: 10.1093/rheumatology/kez142] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 03/08/2019] [Indexed: 12/12/2022] Open
Abstract
SS is usually described as having severe fatigue, dryness, diffuse pain, glandular swelling, and various extraglandular (systemic) manifestations. Clinical trials have generally failed because the vast majority of enrolled patients had no extraglandular manifestations at the time of enrolment but suffered from fatigue, dryness and pain that did not significantly respond to the study medication. A number of hypotheses on the pathogenesis of pSS have been put forward, including disturbances of innate and adaptive immunity as well as abnormalities of the interface between immune disorders and the neuro-endocrine system related to lacrimal and secretory gland dysfunction. Thus, future therapies must be designed for improvement of the symptoms of dry eyes and dry mouth, extraglandular disease, and fatigue and cognitive deficits. Given the inadequacies and limitations of current treatment options, we suggest that innovative directions involving interactions with neuroscientists and neuropsychiatrists together or combined with new immune targeting may be hold promise for better treating pSS.
Collapse
Affiliation(s)
- Robert I Fox
- Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, CA
| | - Carla M Fox
- Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, CA
| | - Jacques Eric Gottenberg
- Strasbourg University Hospital, National Center for Rare Systemic Autoimmune Diseases, Strasbourg, France
| | - Thomas Dörner
- Department of Medicine/Rheumatology and Clinical Immunology, Charite Universitätsmedizin Berlin & DRFZ Berlin, Berlin, Germany
| |
Collapse
|
7
|
Hong SC, Ha JH, Lee JK, Jung SH, Kim JC. In Vivo Anti-Inflammation Potential of Aster koraiensis Extract for Dry Eye Syndrome by the Protection of Ocular Surface. Nutrients 2020; 12:nu12113245. [PMID: 33113960 PMCID: PMC7690718 DOI: 10.3390/nu12113245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/16/2020] [Accepted: 10/17/2020] [Indexed: 12/18/2022] Open
Abstract
Dry eye syndrome (DES) is a corneal disease often characterized by an irritating, itching feeling in the eyes and light sensitivity. Inflammation and endoplasmic reticulum (ER) stress may play a crucial role in the pathogenesis of DES, although the underlying mechanism remains elusive. Aster koraiensis has been used traditionally as an edible herb in Korea. It has been reported to have wound-healing and inhibitory effects against insulin resistance and inflammation. Here, we examined the inhibitory effects of inflammation and ER stress by A. koraiensis extract (AKE) in animal model and human retinal pigmented epithelial (ARPE-19) cells. Oral administration of AKE mitigated DE symptoms, including reduced corneal epithelial thickness, increased the gap between lacrimal gland tissues in experimental animals and decreased tear production. It also inhibited inflammatory responses in the corneal epithelium and lacrimal gland. Consequently, the activation of NF-κB was attenuated by the suppression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Moreover, AKE treatment ameliorated TNF-α-inducible ocular inflammation and thapsigargin (Tg)-inducible ER stress in animal model and human retinal pigmented epithelial (ARPE-19) cells. These results prove that AKE prevents detrimental functional and histological remodeling on the ocular surface and in the lacrimal gland through inhibition of inflammation and ER stress, suggesting its potential as functional food material for improvement of DES.
Collapse
Affiliation(s)
- Sung-Chul Hong
- Natural Informatics Research Center, Korea Institute of Science and Technology (KIST), Gangneung 25451, Korea;
| | - Jung-Heun Ha
- Research Center for Industrialization of Natural Neutralization, Dankook University, Cheonan 31116, Korea;
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Jennifer K. Lee
- Food Science & Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA;
| | - Sang Hoon Jung
- Natural Product Research Center, Korea Institute of Science and Technology (KIST), Gangneung 25451, Korea;
- Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology (UST), Daejeon 34113, Korea
| | - Jin-Chul Kim
- Natural Informatics Research Center, Korea Institute of Science and Technology (KIST), Gangneung 25451, Korea;
- Correspondence: ; Tel.: +82-33-650-3515
| |
Collapse
|
8
|
Bastola P, Song L, Gilger BC, Hirsch ML. Adeno-Associated Virus Mediated Gene Therapy for Corneal Diseases. Pharmaceutics 2020; 12:pharmaceutics12080767. [PMID: 32823625 PMCID: PMC7464341 DOI: 10.3390/pharmaceutics12080767] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022] Open
Abstract
According to the World Health Organization, corneal diseases are the fourth leading cause of blindness worldwide accounting for 5.1% of all ocular deficiencies. Current therapies for corneal diseases, which include eye drops, oral medications, corrective surgeries, and corneal transplantation are largely inadequate, have undesirable side effects including blindness, and can require life-long applications. Adeno-associated virus (AAV) mediated gene therapy is an optimistic strategy that involves the delivery of genetic material to target human diseases through gene augmentation, gene deletion, and/or gene editing. With two therapies already approved by the United States Food and Drug Administration and 200 ongoing clinical trials, recombinant AAV (rAAV) has emerged as the in vivo viral vector-of-choice to deliver genetic material to target human diseases. Likewise, the relative ease of applications through targeted delivery and its compartmental nature makes the cornea an enticing tissue for AAV mediated gene therapy applications. This current review seeks to summarize the development of AAV gene therapy, highlight preclinical efficacy studies, and discuss potential applications and challenges of this technology for targeting corneal diseases.
Collapse
Affiliation(s)
- Prabhakar Bastola
- Ophthalmology, University of North Carolina, Chapel Hill, NC 27599, USA; (P.B.); (L.S.); (B.C.G.)
- Gene Therapy Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Liujiang Song
- Ophthalmology, University of North Carolina, Chapel Hill, NC 27599, USA; (P.B.); (L.S.); (B.C.G.)
- Gene Therapy Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Brian C. Gilger
- Ophthalmology, University of North Carolina, Chapel Hill, NC 27599, USA; (P.B.); (L.S.); (B.C.G.)
- Clinical Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - Matthew L. Hirsch
- Ophthalmology, University of North Carolina, Chapel Hill, NC 27599, USA; (P.B.); (L.S.); (B.C.G.)
- Gene Therapy Center, University of North Carolina, Chapel Hill, NC 27599, USA
- Correspondence: ; Tel.: +1-919-966-0696
| |
Collapse
|
9
|
Liang CY, Cheang WM, Wang CY, Lin KH, Wei LC, Chen YY, Shen YC. The association of dry eye syndrome and psychiatric disorders: a nationwide population-based cohort study. BMC Ophthalmol 2020; 20:123. [PMID: 32228638 PMCID: PMC7106586 DOI: 10.1186/s12886-020-01395-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/20/2020] [Indexed: 12/17/2022] Open
Abstract
Background Several previous studies reported a greater prevalence of dry eye syndrome (DES) among patients with psychiatric diseases. The aim of this study is to investigate the prevalence and risk factors of DES in patients with psychiatric disorders (PD) using nationwide population-based data in Taiwan. Methods This population-based cohort study retrospectively identified patients with PD from 1997 to 2011. Patients with both PD and DES served as the DES cohort, and PD patients without DES comprised the non-DES cohort. PD was defined as a diagnosis of PD (ICD-9-CM 290–319) made by psychiatrists only, with at least three consecutive outpatient visits or at least one inpatient visit. DES was defined as a diagnosis of DES (ICD-9-CM 375.15) and a prescription for an eye lubricant (anatomical therapeutic chemical code, ATC code: S01XA). The main outcome measures were the prevalence of DES in these patients and associated risk factors. Results A total of 75,650 patients with PD (3665 in the DES cohort and 71,985 in the non-DES cohort) were included in the final analysis. The majority of patients in the DES group were women (72.6%), compared the non-DES group (57.8%). The mean age of patients in the DES cohort was 62.2 ± 14.9, which was significantly older than those in the non-DES group (50.9 ± 17.5). The patients with DES had a significantly greater likelihood of having dementia, bipolar disorder, depression, and neurotic disorders. Conditional regression analyses revealed that patients with dry eye disease were more likely to have schizophrenia (OR = 1.34), bipolar disorder (OR = 1.9), depression (OR = 1.54), and neurotic disorders (OR = 1.62). In addition, patients with DES were more likely to use 1st generation anti-psychotics (OR = 1.28) and had a lower risk of using 2nd generation anti-psychotics (OR = 0.64). Conclusion The study demonstrated that among PD patients, DES is highly prevalence in certain subtypes of PD, such as depression, bipolar disorder, and neurotic disorders, after adjusting for the comorbidities.
Collapse
Affiliation(s)
- Chiao-Ying Liang
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China.,Graduate institute of biomedical sciences, China Medical University, Taichung, Taiwan, Republic of China
| | - Wai-Man Cheang
- Department of Ophthalmology, Taichung Tzu Chi Hospital, Taichung, Taiwan, Republic of China
| | - Chun-Yuan Wang
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China
| | - Keng-Hung Lin
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China
| | - Li-Chen Wei
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China
| | - Yu-Yen Chen
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China
| | - Ying-Cheng Shen
- Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Xitun Dist, Taichung, 40705, Taiwan, Republic of China.
| |
Collapse
|
10
|
Kim SJ, Park B, Huh HW, Na YG, Kim M, Han M, Lee H, Pham TMA, Lee HK, Lee JY, Kim CS, Baek JS, Cho CW. Achyranthis radix Extract-Loaded Eye Drop Formulation Development and Novel Evaluation Method for Dry Eye Treatment. Pharmaceutics 2020; 12:pharmaceutics12020165. [PMID: 32079194 PMCID: PMC7076473 DOI: 10.3390/pharmaceutics12020165] [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: 12/18/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 12/11/2022] Open
Abstract
Recently, Achyranthis radix extract has been studied as a therapeutic agent for dry eye disease that occurs from fine dust. The aim of this study was the development of Achyranthis radix extract-loaded eye drop formulations using lubricants, generally used for artificial tear eye drops. Ecdysterone was used as a marker compound for Achyranthis radix extract and 1% Achyranthis radix extract solution contained 14.37 ± 0.04 μg/mL of ecdysterone. Before formulation studies, a new method was performed to evaluate pigmentation, which might be caused by eye drops of herbal extract. A comparative study of the water retention ability of each formulation and ability to prevent the death of conjunctival epithelial cells in dry conditions was conducted. Moreover, treatment of Achyranthis radix extract (USL) eye drop formulation exhibited a significant inhibitory effect on inflammation in a concentration-dependent manner. The long-term and accelerated stability tests showed that lubricants could contribute to the stability of herbal extracts in solution. In conclusion, hyaluronic acid showed a good effect on the development of eye drop formulation using Achyranthis radix extracts for treating dry eye disease.
Collapse
Affiliation(s)
- Sung-Jin Kim
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Bongkyun Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (B.P.); (C.-S.K.)
| | - Hyun Wook Huh
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Young-Guk Na
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Minki Kim
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Mingu Han
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Hyunmin Lee
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Thi Mai Anh Pham
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Hong-Ki Lee
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Jae-Young Lee
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
| | - Chan-Sik Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea; (B.P.); (C.-S.K.)
- Korean Convergence Medicine, University of Science and Technology (UST), Daejeon 34054, Korea
| | - Jong-Suep Baek
- Department of Herbal Medicine Resource, Kangwon National University, 346 Hwangjo-gil, Dogye-eup, Samcheok-si, Gangwon-do 25949, Korea;
| | - Cheong-Weon Cho
- College of Pharmacy and Institute of Drug Research & Development, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea; (S.-J.K.); (H.W.H.); (Y.-G.N.); (M.K.); (M.H.); (H.L.); (T.M.A.P.); (H.-K.L.); (J.-Y.L.)
- Correspondence: ; Tel.: +82-42-821-5934
| |
Collapse
|
11
|
Abughanam G, Elkashty OA, Liu Y, Bakkar MO, Tran SD. Mesenchymal Stem Cells Extract (MSCsE)-Based Therapy Alleviates Xerostomia and Keratoconjunctivitis Sicca in Sjogren's Syndrome-Like Disease. Int J Mol Sci 2019; 20:ijms20194750. [PMID: 31557796 PMCID: PMC6801785 DOI: 10.3390/ijms20194750] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 12/16/2022] Open
Abstract
Sjogren’s syndrome (SS) is an autoimmune disease that manifests primarily in salivary and lacrimal glands leading to dry mouth and eyes. Unfortunately, there is no cure for SS due to its complex etiopathogenesis. Mesenchymal stem cells (MSCs) were successfully tested for SS, but some risks and limitations remained for their clinical use. This study combined cell- and biologic-based therapies by utilizing the MSCs extract (MSCsE) to treat SS-like disease in NOD mice. We found that MSCsE and MSCs therapies were successful and comparable in preserving salivary and lacrimal glands function in NOD mice when compared to control group. Cells positive for AQP5, AQP4, α-SMA, CK5, and c-Kit were preserved. Gene expression of AQP5, EGF, FGF2, BMP7, LYZ1 and IL-10 were upregulated, and downregulated for TNF-α, TGF-β1, MMP2, CASP3, and IL-1β. The proliferation rate of the glands and serum levels of EGF were also higher. Cornea integrity and epithelial thickness were maintained due to tear flow rate preservation. Peripheral tolerance was re-established, as indicated by lower lymphocytic infiltration and anti-SS-A antibodies, less BAFF secretion, higher serum IL-10 levels and FoxP3+ Treg cells, and selective inhibition of B220+ B cells. These promising results opened new venues for a safer and more convenient combined biologic- and cell-based therapy.
Collapse
Affiliation(s)
- Ghada Abughanam
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada.
| | - Osama A Elkashty
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada.
| | - Younan Liu
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada.
| | - Mohammed O Bakkar
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada.
| | - Simon D Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dentistry, McGill University, Montreal, QC H3A 0C7, Canada.
| |
Collapse
|
12
|
Di Iorio E, Barbaro V, Alvisi G, Trevisan M, Ferrari S, Masi G, Nespeca P, Ghassabian H, Ponzin D, Palù G. New Frontiers of Corneal Gene Therapy. Hum Gene Ther 2019; 30:923-945. [PMID: 31020856 DOI: 10.1089/hum.2019.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Corneal diseases are among the most prevalent causes of blindness worldwide. The transparency and clarity of the cornea are guaranteed by a delicate physiological, anatomic, and functional balance. For this reason, all the disorders, including those of genetic origin, that compromise this state of harmony can lead to opacity and eventually vision loss. Many corneal disorders have a genetic etiology, and some are associated with rather rare and complex syndromes. Conventional treatments, such as corneal transplantation, are often ineffective, and to date, many of these disorders are still incurable. Gene therapy carries the promise of being a potential cure for many of these diseases, with solutions and strategies that did not seem possible until a few years ago. With its potential to treat genetic disease by means of deletion, replacement, or editing of a defective gene, the challenge can also be extended to corneal disorders in order to achieve long-term, if not definitive, relief. The aim of this paper is to review the state of the art of the different gene therapy approaches as potential treatments for corneal diseases and the future perspectives for the development of personalized gene-based medicine.
Collapse
Affiliation(s)
- Enzo Di Iorio
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Vanessa Barbaro
- 2Fondazione Banca Degli Occhi Del Veneto Onlus, Zelarino, Venezia, Italy
| | - Gualtiero Alvisi
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Marta Trevisan
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Stefano Ferrari
- 2Fondazione Banca Degli Occhi Del Veneto Onlus, Zelarino, Venezia, Italy
| | - Giulia Masi
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Patrizia Nespeca
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Hanieh Ghassabian
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Diego Ponzin
- 2Fondazione Banca Degli Occhi Del Veneto Onlus, Zelarino, Venezia, Italy
| | - Giorgio Palù
- 1Department of Molecular Medicine, University of Padova, Padova, Italy
| |
Collapse
|
13
|
Gomes JAP, Santo RM. The impact of dry eye disease treatment on patient satisfaction and quality of life: A review. Ocul Surf 2018; 17:9-19. [PMID: 30419303 DOI: 10.1016/j.jtos.2018.11.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 12/23/2022]
Abstract
Several aspects of the quality of life (QoL) and treatment satisfaction of patients with dry eye disease (DED) may be underestimated. Ocular symptoms, which are assessed by validated patient-reported questionnaires and may include stinging, burning, itchiness, grittiness, dryness and discomfort, reduce QoL by affecting daily activities and work productivity. Self-reported symptoms do not always correlate with post-treatment improvements in clinical measures such as tear film break-up time, inflammation and osmolarity. Thus, treatments may improve clinical ocular features without improving symptoms that affect daily life. This review explores 1500 abstracts from congress presentations and peer-reviewed journals for QoL and treatment satisfaction data on the use of active lubricants, osmoprotectants, secretagogues, and immunomodulators present in topical formulations for DED treatment, and validated symptom questionnaires. Patient-reported symptoms of DED are generally improved after treatment with topical formulations for tear replacement, tear stimulation or anti-inflammatory therapy compared with baseline or a control treatment. However, more data are required to compare the performance of active ingredients. It is fundamental to diagnose patients with DED accurately, recognising the major cause behind their dry eyes. Studies are also necessary to identify how patient satisfaction and QoL may be improved through long-term use of topical preparations. We conclude that careful and thorough consideration of patient-reported symptoms should be integrated into DED management to help tailor treatment to patient needs.
Collapse
Affiliation(s)
- José A P Gomes
- Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP/EPM), Brazil.
| | - Ruth M Santo
- Department of Ophthalmology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
| |
Collapse
|
14
|
Fajnkuchen F, Barritault D, Giocanti-Aurégan A. Evaluation of a new matrix regenerating agent in patients with Sjögren syndrome and superficial ulcerative keratitis resistant to conventional therapy: A report of 3 cases. Medicine (Baltimore) 2018. [PMID: 29517701 PMCID: PMC5882434 DOI: 10.1097/md.0000000000009935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Sjögren syndrome (SS) is frequently associated with ulcerative keratitis, which is difficult to treat due to lacrimal tear deficiency and inflammation of the ocular surface. PATIENT CONCERNS We report the successful additive effect of a matrix regenerating agent (RGTA, Cacicol) in SS patients with severe superficial ulcerative keratitis resistant to conventional therapy. DIAGNOSES Retrospective, noncomparative case series of patients with primary or secondary SS associated with chronic diffuse keratitis. INTERVENTIONS All patients (3 women, aged 46, 59, and 84 years) had several years of dry-eye disease history and recurrent keratitis despite having used maximal dose topical therapies including artificial tear substitutes, topical vitamin A, and cyclosporine 0.05% emulsion. All patients suffered from dry, diffuse, and chronic superficial keratitis of at least 75% of the corneal surface, with no sign of corneal neovascularization or opacity. OUTCOMES RGTA treatment led to a rapid and marked decrease of ocular pain, burning, irritation, foreign body sensation, and improvement of visual acuity. Total diffuse keratitis healing occurred after several months of treatment. Discontinuation of RGTA administration led to the recurrence of severe keratitis; re-introduction of RGTA was successful. No local or systemic adverse effects related to treatment were reported. LESSONS RGTA treatment was effective and safe in this small series of 3 patients suffering from SS associated with recurrent or chronic superficial ulcerative keratitis resistant to conventional therapy.
Collapse
Affiliation(s)
- Franck Fajnkuchen
- Ophthalmology Department, Avicenne Hospital, DHU Vision and Handicaps, APHP, Paris 13 University, Bobigny
- Centre d’Imagerie et de Laser, Paris
| | | | - Audrey Giocanti-Aurégan
- Ophthalmology Department, Avicenne Hospital, DHU Vision and Handicaps, APHP, Paris 13 University, Bobigny
- CRRET CNRS U 4971, Paris, France
| |
Collapse
|
15
|
Chou A, Gonzales JA, Daniels TE, Criswell LA, Shiboski SC, Shiboski CH. Health-related quality of life and depression among participants in the Sjögren's International Collaborative Clinical Alliance registry. RMD Open 2017; 3:e000495. [PMID: 29018565 PMCID: PMC5623329 DOI: 10.1136/rmdopen-2017-000495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/01/2017] [Accepted: 08/30/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine health-related quality of life (HRQoL) and depression among participants in an international Sjögren's syndrome (SS) registry, comparing those with and without SS. METHODS Cross-sectional study of participants in the Sjögren's International Collaborative Clinical Alliance (SICCA) registry. The 2016 American College of Rheumatology/European League Against Rheumatism SS classification criteria were used to determine disease status. HRQoL was assessed using the Short Form 12, version 2 Health Survey to derive scores for physical component summary (PCS) and mental component summary (MCS). Depression was assessed using the 9-Item Patient Health Questionnaire. Multivariate linear and logistic regression analyses were performed to identify predictors of HRQoL and depression while controlling for potential confounders. RESULTS Among 2401 SICCA participants who had symptoms of dry eyes and dry mouth, 1051 had SS (44%) and 1350 did not (56%). After controlling for confounders, when compared with non-SS participants, those with SS had better PCS (p<0.001, β=2.43, 95% CI 1.57 to 3.29), MCS (p=0.002, β=1.37, 95% CI 0.50 to 2.23) and lower adjusted odds of depression (p<0.001, OR 0.67, 95% CI 0.55 to 0.81). Other significant predictors of HRQoL and depression included employment, country of residence and use of medication with anticholinergic effect or for management of SS-related signs and symptoms. CONCLUSION Our results suggest that among symptomatic patients, having a diagnosis of SS may be associated with better emotional and psychological well-being compared with patients without a diagnosis. Having a definitive diagnosis of SS may encourage patients to obtain a better understanding of their disease and have coping mechanisms in place to better manage their symptoms.
Collapse
Affiliation(s)
- Annie Chou
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - John A Gonzales
- F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Troy E Daniels
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Lindsey A Criswell
- Department of Medicine, School of Medicine, University of California, San Francisco, California, USA
| | - Stephen C Shiboski
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA
| | - Caroline H Shiboski
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| |
Collapse
|
16
|
Hou A, Bose T, Chandy KG, Tong L. A Chronic Autoimmune Dry Eye Rat Model with Increase in Effector Memory T Cells in Eyeball Tissue. J Vis Exp 2017. [PMID: 28654074 PMCID: PMC5608287 DOI: 10.3791/55592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Dry eye disease is a very common condition that causes morbidity and healthcare burden and decreases the quality of life. There is a need for a suitable dry eye animal model to test novel therapeutics to treat autoimmune dry eye conditions. This protocol describes a chronic autoimmune dry eye rat model. Lewis rats were immunized with an emulsion containing lacrimal gland extract, ovalbumin, and complete Freund's adjuvant. A second immunization with the same antigens in incomplete Freund's adjuvant was administered two weeks later. These immunizations were administered subcutaneously at the base of the tail. To boost the immune response at the ocular surface and lacrimal glands, lacrimal gland extract and ovalbumin were injected into the forniceal subconjunctiva and lacrimal glands 6 weeks after the first immunization. The rats developed dry eye features, including reduced tear production, decreased tear stability, and increased corneal damage. Immune profiling by flow cytometry showed a preponderance of CD3+ effector memory T cells in the eyeball.
Collapse
Affiliation(s)
- Aihua Hou
- Singapore Eye Research Insitute, A Member of SingHealth; DUKE-National University of Singapore Medical School
| | - Tanima Bose
- Lee Kong Chian School of Medicine, Nanyang Technological University
| | - K George Chandy
- Lee Kong Chian School of Medicine, Nanyang Technological University;
| | - Louis Tong
- Singapore Eye Research Insitute, A Member of SingHealth; DUKE-National University of Singapore Medical School; Singapore National Eye Center; Yong Loo Lin School of Medicine, National University of Singapore;
| |
Collapse
|
17
|
Nebbioso M, Fameli V, Gharbiya M, Sacchetti M, Zicari AM, Lambiase A. Investigational drugs in dry eye disease. Expert Opin Investig Drugs 2016; 25:1437-1446. [DOI: 10.1080/13543784.2016.1249564] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
18
|
Destefanis S, Giretto D, Muscolo MC, Di Cerbo A, Guidetti G, Canello S, Giovazzino A, Centenaro S, Terrazzano G. Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca. BMC Vet Res 2016; 12:214. [PMID: 27658509 PMCID: PMC5034585 DOI: 10.1186/s12917-016-0841-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 09/14/2016] [Indexed: 12/30/2022] Open
Abstract
Background Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms. Results Fifty dogs of different breeds affected by immune-mediated cKSC were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001). Conclusions Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in a significant amelioration of clinical signs and symptoms in cKSC. The beneficial effects, likely due to the presence of supplemented nutraceuticals in the diet, appeared to specifically reduce the immune-mediated ocular symptoms in those cKCS-affected dogs that were poorly responsive or unresponsive to classical immunosuppressive drugs. These data suggest that metabolic changes could affect the immune response orchestration in a model of immune-mediated ocular disease, as represented by cKSC.
Collapse
Affiliation(s)
- Simona Destefanis
- Clinica Veterinaria Porta Venezia, via Lambro 12, 20121, Milan, Italy
| | - Daniela Giretto
- Clinica Veterinaria Cartesio, viale Olanda 3B, Melzo, 20066, Milan, Italy
| | | | - Alessandro Di Cerbo
- School of Specialization in Clinical Biochemistry, "G. d'Annunzio" University, Chieti, Italy
| | - Gianandrea Guidetti
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy
| | - Sergio Canello
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy
| | - Angela Giovazzino
- Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy
| | - Sara Centenaro
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy.
| | - Giuseppe Terrazzano
- Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy.,Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| |
Collapse
|
19
|
Pimecrolimus micelle exhibits excellent therapeutic effect for Keratoconjunctivitis Sicca. Colloids Surf B Biointerfaces 2016; 140:1-10. [DOI: 10.1016/j.colsurfb.2015.11.059] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 11/03/2015] [Accepted: 11/27/2015] [Indexed: 12/25/2022]
|
20
|
Comparison of Topical Application of TSG-6, Cyclosporine, and Prednisolone for Treating Dry Eye. Cornea 2016; 35:536-42. [DOI: 10.1097/ico.0000000000000756] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
21
|
Beckman KA, Luchs J, Milner MS. Making the diagnosis of Sjögren's syndrome in patients with dry eye. Clin Ophthalmol 2015; 10:43-53. [PMID: 26766898 PMCID: PMC4699514 DOI: 10.2147/opth.s80043] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Sjögren’s syndrome (SS) is a chronic and progressive systemic autoimmune disease that often presents initially with symptoms of dry eye and dry mouth. Symptoms are often nonspecific and develop gradually, making diagnosis difficult. Patients with dry eye complaints warrant a step-wise evaluation for possible SS. Initial evaluation requires establishment of a dry eye diagnosis using a combination of patient questionnaires and objective ocular tests, including inflammatory biomarker testing. Additional work-up using the Schirmer test and tear film break-up time can differentiate between aqueous-deficient dry eye (ADDE) and evaporative dry eye. The presence of ADDE should trigger further work-up to differentiate between SS-ADDE and non-SS-ADDE. There are numerous non-ocular manifestations of SS, and monitoring for SS-related comorbid findings can aid in diagnosis, ideally in collaboration with a rheumatologist. The clinical work-up of SS can involve a variety of tests, including tear function tests, serological tests for autoantibody biomarkers, minor salivary gland and lacrimal gland biopsies. Examination of classic SS biomarkers (SS-A/Ro, SS-B/La, antinuclear antibody, and rheumatoid factor) is a convenient and non-invasive way of evaluating patients for the presence of SS, even years prior to confirmed diagnosis, although not all SS patients will test positive, particularly those with early disease. Recently, newer biomarkers have been identified, including autoantibodies to salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI, and may allow for earlier diagnosis of SS. A diagnostic test kit is commercially available (Sjö®), incorporating these new biomarkers along with the classic autoantibodies. This advanced test has been shown to identify SS patients who previously tested negative against traditional biomarkers only. All patients with clinically significant ADDE should be considered for serological assessment for SS, given the availability of new serological diagnostic tests and the potentially serious consequences of missing the diagnosis.
Collapse
Affiliation(s)
- Kenneth A Beckman
- Comprehensive EyeCare of Central Ohio, Westerville, OH, USA; The Ohio State University, Columbus, OH, USA
| | - Jodi Luchs
- Hofstra University School of Medicine, Hempstead, NY, USA; South Shore Eye Care, Wantagh, NY, USA
| | - Mark S Milner
- The Eye Center of Southern Connecticut, PC, Hamden, CT, USA; Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
22
|
Bartlett JD, Keith MS, Sudharshan L, Snedecor SJ. Associations between signs and symptoms of dry eye disease: a systematic review. Clin Ophthalmol 2015; 9:1719-30. [PMID: 26396495 PMCID: PMC4577273 DOI: 10.2147/opth.s89700] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The accurate diagnosis and classification of dry eye disease (DED) is challenging owing to wide variations in symptoms and lack of a single reliable clinical assessment. In addition, changes and severity of clinical signs often do not correspond to patient-reported symptoms. To better understand the inconsistencies observed between signs and symptoms, we conducted a systematic literature review to evaluate published studies reporting associations between patient-reported symptoms and clinical signs of DED. METHODS PubMed and Embase were searched for English-language articles on the association between clinical signs and symptoms of DED up to February 2014 (no lower limit was set). RESULTS Thirty-four articles were identified that assessed associations between signs and symptoms, among which 33 unique studies were reported. These included 175 individual sign-symptom association analyses. Statistical significance was reported for associations between sign and symptom measures in 21 of 33 (64%) studies, but for only 42 of 175 (24%) individual analyses. Of 175 individual analyses, 148 reported correlation coefficients, of which the majority (129/148; 87%) were between -0.4 and 0.4, indicating low-to-moderate correlation. Of all individual analyses that demonstrated a statistically significant association, one-half (56%) of reported correlation coefficients were in this range. No clear trends were observed in relation to the strength of associations relative to study size, statistical methods, or study region, although results from three studies did suggest that disease severity may be a factor. CONCLUSION Associations between DED signs and symptoms are low and inconsistent, which may have implications for monitoring the response to treatment, both in the clinic and in clinical trials. Further studies to increase understanding of the etiopathogenesis of DED and to identify the most reliable and relevant measures of disease are needed to enhance clinical assessment of DED and the measurement of response to therapeutic interventions.
Collapse
Affiliation(s)
- Jimmy D Bartlett
- Department of Optometry, School of Optometry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael S Keith
- Global Health Economics, Outcomes Research, and Epidemiology Department, Research and Development Division, Shire, Wayne, PA, USA
| | | | | |
Collapse
|
23
|
|
24
|
Finley JK, Farmer D, Emmerson E, Cruz Pacheco N, Knox SM. Manipulating the murine lacrimal gland. J Vis Exp 2014:e51970. [PMID: 25490187 DOI: 10.3791/51970] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The lacrimal gland (LG) secretes aqueous tears necessary for maintaining the structure and function of the cornea, a transparent tissue essential for vision. In the human a single LG resides in the orbit above the lateral end of each eye delivering tears to the ocular surface through 3 - 5 ducts. The mouse has three pairs of major ocular glands, the most studied of which is the exorbital lacrimal gland (LG) located anterior and ventral to the ear. Similar to other glandular organs, the LG develops through the process of epithelial branching morphogenesis in which a single epithelial bud within a condensed mesenchyme undergoes multiple rounds of bud and duct formation to form an intricate interconnected network of secretory acini and ducts. This elaborate process has been well documented in many other epithelial organs such as the pancreas and salivary gland. However, the LG has been much less explored and the mechanisms controlling morphogenesis are poorly understood. We suspect that this under-representation as a model system is a consequence of the difficulties associated with finding, dissecting and culturing the LG. Thus, here we describe dissection techniques for harvesting embryonic and post-natal LG and methods for ex vivo culture of the tissue.
Collapse
Affiliation(s)
- Jennifer K Finley
- Craniofacial and Mesenchymal Biology, Cell and Tissue Biology, University of California San Francisco
| | - D'Juan Farmer
- Craniofacial and Mesenchymal Biology, Cell and Tissue Biology, University of California San Francisco
| | - Elaine Emmerson
- Craniofacial and Mesenchymal Biology, Cell and Tissue Biology, University of California San Francisco
| | - Noel Cruz Pacheco
- Craniofacial and Mesenchymal Biology, Cell and Tissue Biology, University of California San Francisco
| | - Sarah M Knox
- Craniofacial and Mesenchymal Biology, Cell and Tissue Biology, University of California San Francisco;
| |
Collapse
|