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Xuan Y, Zhang X, Wu H. Impact of sex differences on the clinical presentation, pathogenesis, treatment and prognosis of Sjögren's syndrome. Immunology 2024; 171:513-524. [PMID: 38156505 DOI: 10.1111/imm.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Sjögren's syndrome is a common chronic autoimmune disease that manifests as dry mouth, dry eyes and systemic complications. There are sex differences in the clinical manifestations between men and women, with the average age of onset being around 55 years and the majority of female patients developing the disease during the menopausal years. Understanding the impact of sex differences on SS may help in the treatment and prognosis of patients. Studies have confirmed that a number of factors are associated with the onset of SS, but the exact mechanisms are not fully understood. Sex hormones (especially oestrogens and androgens) play a very important role, and the balance of sex hormone levels in the body is crucial for maintaining homeostasis in the acinar cells of the lacrimal and salivary glands. In addition, chromosomes play a very important role in the sex differences in SS. The gut microbiota also has some influence on sex differences in SS. In this review, we focus on oestrogens and androgens, which are important in the pathogenesis of SS, and summarize the progress of non-clinical studies. Sex differences may influence differences in individualized treatment regimens and further studies are needed.
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Affiliation(s)
- Yuhao Xuan
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-Infammatory and lmmune Medicine, Hefei, Anhui Province, China
| | - Xiao Zhang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-Infammatory and lmmune Medicine, Hefei, Anhui Province, China
| | - Huaxun Wu
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-Infammatory and lmmune Medicine, Hefei, Anhui Province, China
- Anhui Provincial Institute of Translational Medicine, Hefei, Anhui Province, China
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Zhang X, Zhao P, Ma M, Wu H, Liu R, Liu Z, Cai Z, Liu M, Xie F, Ma X. Missing link between tissue specific expressing pattern of ERβ and the clinical manifestations in LGBLEL. Front Med (Lausanne) 2023; 10:1168977. [PMID: 37457559 PMCID: PMC10346852 DOI: 10.3389/fmed.2023.1168977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Lacrimal gland benign lymphoepithelial lesion (LGBLEL) is an IgG4-related disease of unknown etiology with a risk for malignant transformation. Estrogen is considered to be related to LGBLEL onset. Methods Seventy-eight LGBLEL and 13 control clinical samples were collected and studied to determine the relationship between estrogen and its receptors and LGBLEL development. Results The serological analysis revealed no significant differences in the levels of three estrogens be-tween the LGBLEL and control groups. However, immunohistochemical analyses indicated that the expression levels of ERβ and its downstream receptor RERG were relatively lower in LGBLEL samples than in control samples, with higher expression in the lacrimal gland and lower expression in the lymphocyte infiltration region. However, low expression of ERα was detected. The transcriptome sequence analysis revealed upregulated genes associated with LGBLEL enriched in lymphocyte proliferation and activation function; downregulated genes were enriched in epithelial and vascular proliferation functions. The key genes and gene networks were further analyzed. Interactions between B cells and epithelial cells were analyzed due to the identified involvement of leukocyte subsets and epithelial cells. B cell proliferation was found to potentially contribute to lacrimal gland apoptosis. Conclusion Therefore, the tissue-heterogeneous expression pattern of ERβ is potentially related to the clinical manifestations and progression of LGBLEL, although further investigations are required to confirm this finding.
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Affiliation(s)
- Xujuan Zhang
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Pengxiang Zhao
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Mingshen Ma
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Rui Liu
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ziyi Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Zisong Cai
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Mengyu Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Fei Xie
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
| | - Xuemei Ma
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
- Beijing Molecular Hydrogen Research Center, Beijing, China
- Beijing International Science and Technology Cooperation Base of Antivirus Drug, Beijing, China
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Sex-based differences in conjunctival goblet cell responses to pro-inflammatory and pro-resolving mediators. Sci Rep 2022; 12:16305. [PMID: 36175572 PMCID: PMC9522727 DOI: 10.1038/s41598-022-20177-9] [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: 03/25/2022] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
Many conjunctival inflammatory diseases differ between the sexes and altered conjunctival goblet cells (CGCs) response is often involved. Inflammation is initiated by the release of pro-inflammatory mediators and terminated by the biosynthesis of specialized pro-resolution mediators (SPMs). Herein, we determined the sex-based difference in the responses of CGCs to inflammatory stimuli or pro-resolving lipid SPMs and their interaction with sex hormones. GCs were cultured from pieces of human conjunctiva in RPMI media. CGCs were transferred 24 h before the start of experiments to phenol red-free and FBS-free media to minimize exogenous hormones. RT-PCR, immunofluorescence microscopy (IF), and Western Blot (WB) were performed to determine the presence of sex hormone receptors. Cellular response to pro-inflammatory stimuli or SPMs was studied by measuring the increase in intracellular [Ca2+] ([Ca2+]i) using fura 2/AM microscopy. Use of RT-PCR demonstrated estrogen receptor (ER) α in 4/5 males and 3/3 females; ERβ in 2/4 males and 2/3 females; and androgen receptors (AR) in 3/3 male and 3/3 female CGCs. Positive immunoreactivity by IF and protein expression by WB was detected using antibodies for the ERα and ERβ in 3/3 males and 3/3 females, while AR were only present in males. Significantly different Ca2+ responses between sexes were found with carbachol only at 10–3 M, but not with histamine or leukotriene (LT) B4 at any concentration used. Incubation with dihydrotestosterone (DHT), estrone (E1), or estradiol (E2) at 10–7 M for 30 min significantly inhibited the LTB4-stimulated [Ca2+]i increase in male and female CGCs. Incubation with DHT, E1, and E2 overnight significantly inhibited the LTB4 response in females, while DHT and E2 significantly inhibited the LTB4 response in males. The SPM lipoxin A4 (LXA4) (10–9–10−8 M), but not the resolvins D1 or D2, induced an [Ca2+]i increase that was significantly higher in males compared to females. We conclude that male and female CGCs showed differences in the expression of sex hormone receptors. Treatment with sex hormones altered pro-inflammatory mediator LTB4-induced response. Males compared to females have a higher response to the ω-6-fatty acid derived SPM LXA4, indicating males may terminate inflammation in conjunctival goblet cells faster than females.
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Sánchez-González JM, De-Hita-Cantalejo C, Sánchez-González MC. Hyaluronic Acid and Galacto-Xyloglucan Eyedrop Efficacy in Young-Adult Oral Contraceptive Users of Childbearing Age. J Clin Med 2022; 11:jcm11154458. [PMID: 35956073 PMCID: PMC9369423 DOI: 10.3390/jcm11154458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
To assess the efficacy of 0.4% hyaluronic acid and 0.2% galacto-xyloglucan for the subjective symptoms of dry eye disease and tear film invasive and noninvasive signs in 34 young-adult oral contraceptive users of childbearing age, a prospective, longitudinal, single-blind, clinical study was performed in a population of childbearing-age oral-contraceptive consumers. Subjective dry eye disease questionnaires, and invasive and noninvasive tear film assessments were reported before and after six weeks of hyaluronic acid with galacto-xyloglucan (HA-GX) treatment versus hyaluronic acid alone (HA). HA-GX treatment resulted in a greater decrease in the ocular surface disease index (17.01 ± 11.36 score points, p < 0.01) than the HA variation (11.61 ± 11.18 score points, p < 0.01). The standard patient evaluation of eye dryness also decreased more in the HA-GX group (4.06 ± 5.50 score points, p < 0.01) than in the HA alone group (0.70 ± 3.16, p = 0.21). Regarding noninvasive break-up time (NIBUT), the HA-GX group’s first NIBUT achieved an increase of 1.75 ± 1.16 s, p < 0.01, while the HA-alone group increased by only 0.54 ± 1.01 s, p < 0.01. The HA-GX group’s mean NIBUT reported an increase of 3.72 ± 5.69 s, p < 0.01; however, the HA-alone group achieved 2.19 ± 5.26 s, p = 0.05. Hyaluronic acid in combination with galacto-xyloglucan significantly decreased subjective dry eye disease symptoms and increased first and mean NIBUT compared to hyaluronic acid alone. Galacto-xyloglucan added efficacy in young-adult childbearing-age oral contraceptive users.
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Dry eye signs and symptoms in patients on aromatase inhibitor therapy. Eye (Lond) 2022; 36:766-772. [PMID: 33875824 PMCID: PMC8956617 DOI: 10.1038/s41433-021-01538-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The study aimed to test whether symptomatic dry eye in aromatase inhibitor (AI) patients is associated with the clinical features of evaporative dry eye. METHODS A cross-sectional, observational study of postmenopausal women treated with AI was conducted. Clinical information was gathered from their treating clinician. Ocular and treatment symptoms were assessed using validated questionnaires. Clinical assessments were performed to assess for dry eye. The primary outcome measure for this study was dry eye symptoms measured via questionnaire. The secondary outcome measures were clinical signs of dry eye and hormone levels. RESULTS A total of 25 women on AI were recruited. 64% of women reported symptoms of dry eye (ocular surface disease index ≥ 13). Higher tear osmolarity (323 vs 307 mOsm/L, p = 0.002) and increased meibomian gland dropout (4 vs 1, p = 0.002) were observed in patients with symptomatic dry eye when compared to asymptomatic patients. Multivariate logistic regression identified that longer duration of AI use and higher tear osmolarity increased the likelihood of a patient experiencing dry eye symptoms. CONCLUSION Our study found increased tear osmolarity and meibomian gland drop out in women on AI with symptomatic dry eye. Longer duration of AI therapy and higher tear osmolarity may increase the risk of developing dry eye.
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Yücekul B, Gürlek B. Non-invasive evaluation of meibomian gland morphology and tear film and anterior segment parameters in women with polycystic ovarian syndrome. Photodiagnosis Photodyn Ther 2021; 37:102654. [PMID: 34844002 DOI: 10.1016/j.pdpdt.2021.102654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the meibomian glands (MG), non-invasive tear film break-up time (NITBUT), and corneal and anterior segment measurements in patients with polycystic ovary syndrome and healthy women. METHODS The study included 66 polycystic ovarian syndrome (PCOS) patients and 42 healthy volunteers aged 18-35 years. The first and average NITBUT, MG loss, mean keratometry (Km), central (CCT) and thinnest (TCT) corneal thicknesses, anterior chamber depth (ACD), anterior chamber volume (ACV), irido-corneal angle (ICA), corneal volume (CV) and Ocular Surface Disease Index (OSDI) results were analyzed. RESULTS The mean MG loss values were 29.9 ± 11.9 and 20.8 ± 11.0 in the PCOS and control groups, respectively (p < 0.001). MG loss (meiboscale ≥ 1) was determined in 64 (96.9%) eyes in the PCOS group and in 36 (85.7%) eyes in the control group. There was no significant difference between the groups in respect of NITBUT, OSDI, Km, CCT, TCT, ACD, ACV, ICA and CV values (p > 0.05, for all). CONCLUSION MG loss is a physiological process which is distinct in PCOS patients, but does not cause tear film alterations. Further studies are needed to show the contributing factors of MGD in PCOS patients.
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Affiliation(s)
- Burcu Yücekul
- Department of Ophthalmology, Haseki Training and Research Hospital, Sultangazi, Istanbul 34265, Turkey.
| | - Beril Gürlek
- Department of Obstetrics and Gynecology, Recep Tayyip Erdogan University Faculty of Medicine, Rize, Turkey
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Grasso A, Di Zazzo A, Giannaccare G, Sung J, Inomata T, Shih KC, Micera A, Gaudenzi D, Spelta S, Romeo MA, Orsaria P, Coassin M, Altomare V. Sex Hormones Related Ocular Dryness in Breast Cancer Women. J Clin Med 2021; 10:jcm10122620. [PMID: 34198684 PMCID: PMC8232194 DOI: 10.3390/jcm10122620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Dry eye syndrome (DES) is strictly connected to systemic and topical sex hormones. Breast cancer treatment, the subsequent hormonal therapy, the subsequent hyperandrogenism and the early sudden menopause, may be responsible for ocular surface system failure and its clinical manifestation as dry eye disease. This local dryness is part of the breast cancer iatrogenic dryness, which affects overall mucosal tissue in the fragile population of those with breast cancer. Methods: A literature review regarding the role of sex hormone changes and systemic hormonal replacement treatments (SHRT) in DES available on PubMed and Web of Science was made without any restriction of language. Results: Androgens exert their role on the ocular surface supporting meibomian gland function and exerting a pro-sebaceous effect. Estrogen seems to show a pro/inflammatory role on the ocular surface, while SHRT effects on dry eye are still not well defined, determining apparently contradictory consequences on the ocular surface homeostasis. The role of sex hormones on dry eye pathogenesis is most likely the result of a strict crosstalk between the protective androgens effects and the androgen-modulating effects of estrogens on the meibomian glands. Conclusions: Patients with a pathological or iatrogenic hormonal imbalance, such as in the case of breast cancer, should be assessed for dry eye disease, as well as systemic dryness, in order to restore their social and personal quality of life.
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Affiliation(s)
- Antonella Grasso
- Breast Unit, University Campus Bio-Medico, 00128 Rome, Italy; (A.G.); (P.O.); (V.A.)
| | - Antonio Di Zazzo
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, 00128 Rome, Italy; (D.G.); (S.S.); (M.C.)
- Correspondence: ; Tel.: +39-06225418893; Fax: +39-9622541456
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Jaemyoung Sung
- Department of Ophthalmology, School of Medicine, Juntendo University, 1130033 Tokyo, Japan; (J.S.); (T.I.)
| | - Takenori Inomata
- Department of Ophthalmology, School of Medicine, Juntendo University, 1130033 Tokyo, Japan; (J.S.); (T.I.)
| | - Kendrick Co Shih
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong;
| | - Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS–Fondazione Bietti, 00198 Rome, Italy;
| | - Daniele Gaudenzi
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, 00128 Rome, Italy; (D.G.); (S.S.); (M.C.)
| | - Sara Spelta
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, 00128 Rome, Italy; (D.G.); (S.S.); (M.C.)
| | | | - Paolo Orsaria
- Breast Unit, University Campus Bio-Medico, 00128 Rome, Italy; (A.G.); (P.O.); (V.A.)
| | - Marco Coassin
- Ophthalmology Operative Complex Unit, University Campus Bio-Medico, 00128 Rome, Italy; (D.G.); (S.S.); (M.C.)
| | - Vittorio Altomare
- Breast Unit, University Campus Bio-Medico, 00128 Rome, Italy; (A.G.); (P.O.); (V.A.)
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Jakob-Girbig J, Meller D. [Unilateral dry eye syndrome]. Ophthalmologe 2021; 118:587-589. [PMID: 32647926 PMCID: PMC8187192 DOI: 10.1007/s00347-020-01168-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Es wird über den Fall eines streng einseitigen Sicca-Syndroms bei einem männlichen Patienten berichtet. Im Rahmen einer Stufendiagnostik konnte das Spektrum möglicher Ursachen immer weiter eingegrenzt werden, wobei v. a. die MRT-morphologische Darstellung der Tränendrüsenloge auf der betroffenen Seite wichtige diagnostische Informationen lieferte. Schlussendlich konnte in Zusammenschau der Befunde und in Verbindung mit der Anamnese des Patienten eine traumatisch bedingte Atrophie der Tränendrüse als auslösender Faktor eruiert werden.
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Affiliation(s)
- J Jakob-Girbig
- Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
| | - D Meller
- Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
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Louis-Jean S, Ching PR, Wallingford A. Distal Renal Tubular Acidosis in Sjögren's Syndrome: A Case Report. Cureus 2020; 12:e10962. [PMID: 33083163 PMCID: PMC7567320 DOI: 10.7759/cureus.10962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 01/23/2023] Open
Abstract
Sjögren's syndrome is an autoimmune lymphocytic infiltrative disease that leads to chronic inflammatory and degradatory changes to exocrine glands and extra-glandular systemic organs. It rarely affects children and adolescents. In cases where adolescents are affected, a paucity of sicca symptoms, xerostomia, and xerophthalmia often leads to a missed diagnosis. Consequently, the first presenting sign of Sjögren's syndrome in adolescents may be heterogeneous, with varying clinical symptoms related to parotitis or systemic organ involvement. In this case report, we discuss a 19-year-old girl with distal renal tubular acidosis (RTA), who had experienced severe hypokalemic episodes since the age of 14 years; the patient was eventually diagnosed with Sjögren's syndrome. She was managed and maintained on potassium and alkali repletion therapy.
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Affiliation(s)
- Scarlet Louis-Jean
- Department of Medicine, American University of Antigua, Saint John's, ATG
| | - Patrick R Ching
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, USA
| | - Allison Wallingford
- Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, USA
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The effect of hormone therapy on the ocular surface and intraocular pressure for postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. ACTA ACUST UNITED AC 2020; 27:929-940. [PMID: 32520901 DOI: 10.1097/gme.0000000000001559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the impact of hormone therapy (HT) on the ocular surface and intraocular pressure in postmenopausal women. METHODS This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. PubMed, EMBASE, Cochrane Library of Systematic Reviews, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure were searched from inception to November 2019 without language restrictions. Only randomized controlled trials that evaluated the impact of HT on the ocular surface and intraocular pressure in postmenopausal women were eligible. The trials had to report at least one of the following outcomes: break-up time, Schirmer test, corneal staining, ocular surface symptom score, and intraocular pressure. Two investigators independently extracted the information, assessed the risk of bias, and evaluated the publication bias. All data were analyzed by Review Manager V.5.3. Sensitivity analysis and subgroup analysis were performed to find the source of heterogeneity and evaluate the different effects among subgroups. RESULTS Nine randomized controlled trials (N = 612) were included. The HT group showed significant improvements compared with the control group in break-up time (mean difference [MD] = 2.09, 95% confidence interval [CI] 1.00-3.19, P = 0.0002), Schirmer test without anesthesia (MD = 4.17, 95% CI 1.55-6.80, P = 0.002), Schirmer test with anesthesia (MD = 1.44, 95% CI 0.71-2.18, P = 0.0001), and corneal staining scores (standardized mean difference [SMD] = -0.85, 95% CI -1.39 to -0.30, P = 0.002). Moreover, significant beneficial effects were observed on all four symptoms, including dryness (SMD = -1.21, 95% CI -1.99 to -0.44, P = 0.002), foreign body sensation (SMD = -1.02, 95% CI -1.29 to -0.76, P < 0.00001), ocular fatigue (SMD = -1.74, 95% CI -2.12 to -1.36, P < 0.00001), and burning (SMD = -0.53, 95% CI -0.78 to -0.29, P < 0.0001) after HT. Subgroup analysis revealed that, in terms of break-up time, postmenopausal women younger than 55 years achieved more improvements (MD = 0.88, 95% CI 0.16-1.59, P = 0.02) than women older than 55 years old (MD = 2.60, 95% CI -1.34 to 6.55, P = 0.20), and the estrogen subgroup received more benefits (MD = 3.11, 95% CI 0.93-5.30, P = 0.005) than the estrogen plus progestogen subgroup (MD = 0.42, 95% CI -0.02 to 0.85, P = 0.06). Sensitivity analysis and subgroup analysis suggested that the heterogeneity might derive from the methodological quality, the age of participants, and the intervention of the control group. Intraocular pressure (MD = -1.54, 95% CI -3.39 to 0.32, P = 0.10) was not evidently decreased after HT. No more specific adverse events (relative risk = 1.66, 95% CI 0.41-6.77, P = 0.48) were found in the HT group. CONCLUSIONS Our study revealed that HT could improve ocular surface function in postmenopausal women effectively and safely, especially for those who were younger than 55 years, and estrogen only showed more improvements than estrogen plus progestogen. The effectiveness of HT in treating dry eye in postmenopausal women is, however, still a controversial topic. In addition, we did not find HT led to a significant reduction of intraocular pressure.
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Colorado LH, Edwards K, Dinh L, Ha S, Liu D, Luu A, Trang S, Yu-Ting TH, Schmid KL. Associations between the menstrual cycle, lifestyle factors and clinical assessment of the ocular surface: a prospective observational study. BMC Womens Health 2020; 20:23. [PMID: 32033559 PMCID: PMC7006113 DOI: 10.1186/s12905-020-0894-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/29/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Little is known about the ocular surface changes over the menstrual cycle in young women and the interactions with lifestyle factors. Therefore, the purpose of this study was to explore the associations between modifiable lifestyle factors and menstrual cycle phases on the ocular signs and symptoms of dry eye in young healthy women. METHODS This was a prospective 1-month observational study. Thirty young healthy women with regular, 24 to 32-day menstrual cycles were recruited. Participants attended three visits at day 7, 14, and 21 (± 1) of their menstrual cycle. At baseline, general health questionnaire was conducted. At each visit, symptomology was quantified using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Ocular signs were assessed using Efron scales, tear break-up time (TBUT) and phenol red thread (PRT). Pearson's correlation was used to determine associations between variables at each visit. RESULTS A total of 26 participants (mean age = 22.3 ± 3.7 years) with an average menstrual cycle of 28.3 ± 1.3 days completed the 3 visits. The interaction between signs/symptoms and lifestyle factors changed over the cycle. At the follicular phase (day 7), lifestyle factors such diet and levels of stress were correlated with PRT and OSDI, (r = - 0.4, p = 0.022; r = 0.4, p = 0.045 respectively). At the ovulation phase (day 14), the general health score was correlated with OOC scores (r = 0.4, p = 0.047). At day 14, exercise frequency correlated with PRT (r = - 0.4, p = 0.028) and caffeine intake was positively correlate with both; TBUT (r = 0.5, p = 0.020) and PRT (r = 0.5, p = 0.014). At the luteal phase (day 21), we found no correlations between lifestyle factors and dry eye signs or symptoms. CONCLUSIONS The associations between lifestyle factors and objective and subjective ocular surface assessment appeared to be more pronounced during the ovulation phase of the menstrual cycle compared to the follicular and luteal phases. Misalignment of these factors with the ocular health during the luteal phase could be attributed to central sensitization and changes in levels of luteinising hormone. Natural hormonal changes during menstrual cycle should be considered for diagnosis and treatment of dry eye in young healthy women.
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Affiliation(s)
- Luisa H Colorado
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia.
| | - Katie Edwards
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Lynne Dinh
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Sarah Ha
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Danica Liu
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Annie Luu
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Shona Trang
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Tina H Yu-Ting
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
| | - Katrina L Schmid
- Institute of Health and Biomedical Innovation, School of Optometry and Vision Science, Queensland University of Technology, Room Q-504, Level 5, Kelvin Grove, Queensland, 4059, Australia
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Marangoz D, Oner C, Schicht M, Turgut Cosan D, Paulsen F, Yildiz E, Zibandeh N, Sahin A. The Effect of Androgens on Proinflammatory Cytokine Secretion from Human Ocular Surface Epithelial Cells. Ocul Immunol Inflamm 2019; 29:546-554. [PMID: 31738650 DOI: 10.1080/09273948.2019.1686155] [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: 10/25/2022]
Abstract
Purpose: The purpose of this study is to explore the effects of dihydrotestosterone (DHT) on lipopolysaccharide (LPS)-induced proinflammatory cytokine release in human ocular surface epithelial cells exposed to LPS and LPS-binding protein (LBP).Methods: Immortalized human corneal, conjunctival, and meibomian gland epithelial cells were cultured in keratinocyte-free medium. After confluency, they were exposed to a stratification medium Dulbecco's modified Eagle medium (DMEM)/F12 in the presence of fetal bovine serum and were exposed to vehicle, LPS + LBP, or DHT. Culture media were processed for multiplex-bead analysis of specific proinflammatory cytokines including interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-4, IL-8, IL-6, IL-10, IL-1β, vascular endothelial growth factor (VEGF)-A. Cytokine concentrations were compared by analysis of variance with Tukey post hoc testing. p < 0.05 was considered statistically significant.Results: The results are LPS + LBP-induced the secretion of IFN-γ, IL-6, IL-10, IL-1β, VEGF-A cytokines in corneal epithelial cells; TNF-α, IL-2, IL-8, IL-6, IL-1β, VEGF-A cytokines in conjunctival epithelial cells; and IL-8, IL-6, IL-1β, VEGF-A cytokines in meibomian gland epithelial cells. When these LPS + LBP-stimulated cells were exposed to DHT for 2 days, it was found that DHT suppressed the secretion of IL-6, IL-10, IL-1β, VEGF-A cytokines in corneal epithelial cells; TNF-α, IL-6, IL-1β, VEGF-A cytokines in conjunctival epithelial cells; and IL-6, IL-1β, VEGF-A cytokines in meibomian gland epithelial cells.Conclusion: LPS + LBP is shown to induce the secretion of certain proinflammatory cytokines from ocular surface and adnexal epithelial cells. DHT showed anti-inflammatory activity by suppressing some of those cytokines in these cell lines.
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Affiliation(s)
- Deniz Marangoz
- Department of Ophthalmology, Koc University Medical School, Istanbul, Turkey
| | - Cagri Oner
- Department of Biology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey
| | - Martin Schicht
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Didem Turgut Cosan
- Department of Biology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Erdost Yildiz
- Department of Ophthalmology, Koc University Medical School, Istanbul, Turkey
| | - Noushin Zibandeh
- Department of Ophthalmology, Koc University Medical School, Istanbul, Turkey
| | - Afsun Sahin
- Department of Ophthalmology, Koc University Medical School, Istanbul, Turkey
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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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Pontelli RCN, Souza MCO, Fantucci MZ, de Andrade M, Rocha EM. The role of endocrine disruptors in ocular surface diseases. Med Hypotheses 2018; 122:157-164. [PMID: 30593402 DOI: 10.1016/j.mehy.2018.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/05/2018] [Accepted: 11/20/2018] [Indexed: 11/28/2022]
Abstract
Endocrine disruptors are a group of compounds that occur in increasing amounts in the environment. These compounds change the hormone homeostasis of the target organs regulated by those hormones, mostly by binding to their receptors and affecting their signaling pathways. Among the hormones altered by endocrine disruptors are sex hormones, thyroid hormones, and insulin. Studies have documented abnormalities in the reproductive and metabolic systems of various animal species exposed to endocrine disruptors. Endocrine disruptors can play a significant role in ocular diseases once hormone deficiency or excess are involved in the mechanism of that disease. Cataracts, dry eye disease and retinal diseases, such as macular hole and diabetic retinopathy, are some of the frequent problems where hormones have been implicated. We found that some compounds function as endocrine disruptors in the metabolism of body organs and systems. The increasing frequency of dry eye and other ocular diseases indicates the need to better investigate the potential relationships beyond the isolated associations mentioned by patients and documented as rare case reports. The evidence from case-control studies and experimental assays can provide the information necessary to confirm the endocrine effects of these chemicals in the pathophysiology of dry eye disease. We hypothesize that endocrine disruptors may contribute to the increase of ocular diseases, such as dry eye disease, in recent years.
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Affiliation(s)
- Regina C N Pontelli
- Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Marília C O Souza
- Department of Clinical, Toxicological and Bromatological Analyzes, ASTox - Laboratory of Analytical and Systems Toxicology, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Brazil
| | - Marina Z Fantucci
- Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Mônica de Andrade
- Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Eduardo M Rocha
- Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.
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Sandhya P, Kurien BT, Danda D, Scofield RH. Update on Pathogenesis of Sjogren's Syndrome. Curr Rheumatol Rev 2018; 13:5-22. [PMID: 27412602 DOI: 10.2174/1573397112666160714164149] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 11/15/2015] [Accepted: 01/01/2016] [Indexed: 01/06/2023]
Abstract
Sjogren's syndrome is a common autoimmune disease that presents with sicca symptoms and extraglandular features. Sjogren's syndrome is presumably as common as RA; yet it is poorly understood, underdiagnosed and undertreated. From the usual identity as an autoimmune exocrinopathy to its most recent designate as an autoimmune epithelitis - the journey of SS is complex. We herein review some of the most important milestones that have shed light on different aspects of pathogenesis of this enigmatic disease. This includes role of salivary gland epithelial cells, and their interaction with cells of the innate and adaptive immune system. Non-immune factors acting in concert or in parallel with immune factors may also be important. The risk genes identified so far have only weak association, nevertheless advances in genetics have enhanced understanding of disease mechanisms. Role of epigenetic and environmental role factors is also being explored. SS has also some unique features such as congenital heart block and high incidence of lymphoma; disease mechanisms accounting for these manifestations are also reviewed.
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Nooh HZ, El-Saify GH, Eldien NMN. Neuroprotective effects of food restriction on autonomic innervation of the lacrimal gland in the rat. Ann Anat 2017; 213:8-18. [DOI: 10.1016/j.aanat.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 04/29/2017] [Accepted: 05/11/2017] [Indexed: 01/14/2023]
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Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, Willcox MDP. TFOS DEWS II Sex, Gender, and Hormones Report. Ocul Surf 2017; 15:284-333. [PMID: 28736336 DOI: 10.1016/j.jtos.2017.04.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/16/2017] [Indexed: 12/21/2022]
Abstract
One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.
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Affiliation(s)
- David A Sullivan
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
| | - Eduardo M Rocha
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Pasquale Aragona
- Department of Biomedical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Sicily, Italy
| | - Janine A Clayton
- National Institutes of Health Office of Research on Women's Health, Bethesda, MD, USA
| | - Juan Ding
- Schepens Eye Research Institute, Massachusetts Eye & Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Ulrike Hampel
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alison M McDermott
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, USA
| | - Debra A Schaumberg
- Harvard School of Public Health, Boston, MA, USA; University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sruthi Srinivasan
- Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada
| | - Piera Versura
- Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Relationship Between Dynamic Changes in Expression of IL-17/IL-23 in Lacrimal Gland and Ocular Surface Lesions in Ovariectomized Mice. Eye Contact Lens 2016; 44:35-43. [PMID: 27341090 DOI: 10.1097/icl.0000000000000289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE An ovariectomized mouse model was constructed to observe the dynamic effects of hormone changes on the expression of interleukin (IL)-17A and IL-23 in the lacrimal glands. METHODS The ovariectomized mouse model was constructed by bilateral ovary removal. The concentrations of serum estradiol and testosterone in mouse cardiac blood were detected by radioimmunoassay. Mice in both groups underwent the phenol red cotton thread test and corneal fluorescein staining to assess the ocular surface, whereas Th17 cells in blood and spleen were detected by flow cytometry. IL-17A and IL-23 expression in the lacrimal glands was detected by immunohistochemistry, enzyme-linked immunosorbent assay, and real-time fluorescence quantitative polymerase chain reaction. RESULTS Serum estradiol and testosterone levels were significantly lower in the ovariectomized group compared with those in the control group. There was lymphocytic infiltration in the lacrimal gland of the ovariectomized group mice. At 6 months after the surgery, aqueous tear production was significantly lower, and statistically significant corneal fluorescein staining was found in the ovariectomized group, compared with that in the control group. In the ovariectomized group, IL-17A and the IL-23 expression in the lacrimal glands and the Th17 expression in the blood and spleen were significantly higher than in the control group. CONCLUSION The hormone levels are significantly reduced and lymphocytic infiltration in the lacrimal gland in ovariectomized mice, whereas the frequency of Th17 cells in the blood and spleen and IL-17A and IL-23 expression in the lacrimal glands are increased, leading to reduced tear production and positive fluorescein staining in the cornea.
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Mantelli F, Moretti C, Macchi I, Massaro-Giordano G, Cozzupoli GM, Lambiase A, Bonini S. Effects of Sex Hormones on Ocular Surface Epithelia: Lessons Learned From Polycystic Ovary Syndrome. J Cell Physiol 2015; 231:971-5. [PMID: 26491950 DOI: 10.1002/jcp.25221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/20/2015] [Indexed: 11/08/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in women of reproductive age. Although its clinical consequences have been known for a long time to extend beyond the reproductive system, with type-2 diabetes and obesity being the most common, the involvement of the ocular surface in PCOS has been described only more recently. The ocular surface is a morphofunctional unit comprising eyelid margin, tear film, cornea, and conjunctiva. Increasing evidence indicates that these structures are under a sex hormone control and relevant diseases such as ocular allergy and dry eye are often caused by alterations in circulating or local steroid hormones levels. Novel treatments targeting sex hormone receptors on ocular surface epithelial cells are also being developed. In this review we aim to describe the current knowledge on the effects of sex hormones at the ocular surface, with a special focus on the effects of androgen imbalance in PCOS.
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Affiliation(s)
- Flavio Mantelli
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, Pennsylvania
| | - Costanzo Moretti
- Department of Endocrinology, Tor Vergata University of Rome, Rome, Italy
| | - Ilaria Macchi
- Department of Ophthalmology, Campus Bio-Medico University of Rome, Rome, Italy
| | | | | | | | - Stefano Bonini
- Department of Ophthalmology, Campus Bio-Medico University of Rome, Rome, Italy
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Da Y, Niu K, Wang K, Cui G, Wang W, Jin B, Sun Y, Jia J, Qin L, Bai W. A comparison of the effects of estrogen and Cimicifuga racemosa on the lacrimal gland and submandibular gland in ovariectomized rats. PLoS One 2015; 10:e0121470. [PMID: 25793872 PMCID: PMC4368816 DOI: 10.1371/journal.pone.0121470] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/07/2015] [Indexed: 11/18/2022] Open
Abstract
This study aims to observe the effects of estradiol and Cimicifuga racemosa on the lacrimal gland and submandibular gland of ovariectomized rats. We randomly divided 20 adult female SD rats into four groups-a sham-operated group (SHAM), ovariectomized (OVX) group, ovariectomized group treated with estradiol (OVX+ E), and ovariectomized group treated with the isopropanolic extract of Cimicifuga racemosa (OVX+ iCR). The SHAM group and OVX group used distilled water to instead the drugs. Two weeks after ovariectomy, the estradiol and iCR were administered for 4 weeks. Next, we used H&E staining and electron microscopy to observe any histological changes in the lacrimal and submandibular glands and immunohistochemical staining to observe the expressions of cleaved caspase-3 (Casp-3) and Cu-Zn SOD (superoxide dismutase). The H&E staining find that both drugs can prevent the cells of area from shrinkage in the two kinds of gland. But under the electron microscopy, estradiol and iCR have different efficacy. Estradiol is more effective at protecting mitochondria in lacrimal gland acinar cells than iCR, and iCR is more effective at suppressing endoplasmic reticulum expansion than estradiol. Both estradiol and iCR have a similar protective function on mitochondria in the submandibular gland. The protective function of the two glands may inhibit apoptosis by suppressing the expression of Casp-3. In addition, iCR increases the expression of Cu-Zn SOD in duct system of submandibular gland. The results suggest that both estradiol and iCR confer a protective effect on the lacrimal and submandibular glands of ovariectomized rats via different mechanisms.
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Affiliation(s)
- Yunmeng Da
- Department of Stomatology, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Kaiyu Niu
- Department of Stomatology, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Ke Wang
- Department of Anatomy and Embryology, Peking University Health Science Center, Beijing, China
| | - Guangxia Cui
- Department of Obstetrics and Gynecology, Civil Aviation General Hospital, Beijing, China
| | - Wenjuan Wang
- Department of Anatomy and Embryology, Peking University Health Science Center, Beijing, China
| | - Biao Jin
- Department of Anatomy and Embryology, Peking University Health Science Center, Beijing, China
| | - Yu Sun
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Jing Jia
- Department of Stomatology, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
- * E-mail: (JJ); (LQ); (WB)
| | - Lihua Qin
- Department of Anatomy and Embryology, Peking University Health Science Center, Beijing, China
- * E-mail: (JJ); (LQ); (WB)
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
- * E-mail: (JJ); (LQ); (WB)
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Rahimi Darabad R, Suzuki T, Richards SM, Jakobiec FA, Zakka FR, Barabino S, Sullivan DA. Does estrogen deficiency cause lacrimal gland inflammation and aqueous-deficient dry eye in mice? Exp Eye Res 2014; 127:153-60. [PMID: 25084452 DOI: 10.1016/j.exer.2014.07.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/17/2014] [Accepted: 07/21/2014] [Indexed: 01/24/2023]
Abstract
Researchers have proposed that estrogen deficiency will lead to a Sjögren's syndrome (SjS)-like lacrimal gland inflammation, aqueous tear deficiency and dry eye. The purpose of this study was to determine whether this proposal is correct. Lacrimal glands were obtained from adult, age-matched wild type (WT) and aromatase knockout (ArKO) mice, in which estrogen synthesis is completely eliminated. Tissues were also obtained from autoimmune MRL/Mp-lpr/lpr (MRL/lpr) mice as inflammation controls. Tear volumes in WT and ArKO mice were measured and glands were processed for molecular biological and histological evaluation. Our results demonstrate that estrogen absence does not lead to a SjS-like inflammation in lacrimal tissue or to an aqueous-deficient dry eye. There was no upregulation of genes associated with inflammatory pathways in lacrimal glands of male or female ArKO mice. Such inflammatory activity was prominent in autoimmune MRL/lpr tissues. We also found no evidence of inflammation in lacrimal gland tissue sections of estrogen-deficient mice, and tear volumes of ArKO males were actually increased as compared to those WT controls. Interestingly, our study did show that estrogen absence influences the expression of thousands of lacrimal gland genes, and that this impact is sex- and genotype-specific. Our findings demonstrate that estrogen absence is not a risk factor for the development of SjS-like lacrimal gland inflammation or for aqueous-deficient dry eye in mice.
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Affiliation(s)
- Raheleh Rahimi Darabad
- Schepens Eye Research Institute, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tomo Suzuki
- Schepens Eye Research Institute, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Stephen M Richards
- Schepens Eye Research Institute, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Frederick A Jakobiec
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Fouad R Zakka
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Stefano Barabino
- Schepens Eye Research Institute, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - David A Sullivan
- Schepens Eye Research Institute, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
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El-Fadaly AB, El-Shaarawy EAA, Rizk AA, Nasralla MM, Shuaib DMA. Age-related alterations in the lacrimal gland of adult albino rat: a light and electron microscopic study. Ann Anat 2014; 196:336-51. [PMID: 25048844 DOI: 10.1016/j.aanat.2014.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 06/14/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Age related changes in the lacrimal gland are associated with alterations in the structural organization and functional response in the gland of diverse mammalian species. Dry eye syndrome is one of the most common ocular problems in the world especially in old age. It results when the lacrimal gland fails to secrete proteins and fluid in sufficient quantity or appropriate composition. AIM OF THE WORK The present study is designed to demonstrate the influence of aging on the structure of the lacrimal gland of albino rat and to provide a morphological basis to explain the pathogenesis of the dry eye syndrome with ageing. It also aims to carry out a comparative analysis of age-dependent changes in male and female rats and to address how the lacrimal gland ages in each sex. MATERIAL AND METHODS Eighty albino rats were used in this study. The animals were divided into two age groups, young adult and senile. Tear secretion was measured using a modified Schirmer test. Corneal impression cytology of the anesthetized rats was done. The glands were subjected to gross morphologic examination, microscopic examination using H&E, PAS, Masson's trichrome and Giemsa stains. Electron microscopic examination was done in addition to quantitative histomorphometric estimations included acinar density, ductal count and mast cell count. RESULTS Light microscopic examination of the lacimal glands of the senile rats revealed different pathological changes. These included acinar, ductal as well as stromal changes. Electron microscope examination of the lacrimal gland of the senile group showed a decrease in the electron dense secretory vesicles, mitochondrial swelling and lipofuscin-like inclusions were frequently seen in the cytoplasm of acinar cells in senile rats. CONCLUSION The structural changes in the lacrimal glands of senile rats were associated with reduction in tear secretion as well as alterations in corneal epithelium. Gender difference in lacrimal gland structure was recorded.
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Affiliation(s)
- Amina B El-Fadaly
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt
| | - Ehab A A El-Shaarawy
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt.
| | - Ayman A Rizk
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt
| | - Mogeda M Nasralla
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt
| | - Doaa M A Shuaib
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Egypt
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Truong S, Cole N, Stapleton F, Golebiowski B. Sex hormones and the dry eye. Clin Exp Optom 2014; 97:324-36. [PMID: 24689906 DOI: 10.1111/cxo.12147] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 11/26/2013] [Accepted: 01/19/2014] [Indexed: 01/15/2023] Open
Abstract
The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. This review aims to present evidence for how sex hormones may affect the ocular structures involved in the production, regulation and maintenance of the normal tear film. It is hypothesised that hormone changes alter the homeostasis of the ocular surface and contribute to dry eye. Androgens impact on the structure and function of the meibomian and lacrimal glands and therefore androgen deficiency is, at least in part, associated with the aetiology of dry eye. In contrast, reports of the effects of oestrogen and progesterone on these ocular structures and on the conjunctiva are contradictory and the mechanisms of action of these female-specific sex hormones in the eye are not well understood. The uncertainty of the effects of oestrogen and progesterone on dry eye symptoms is reflected in the controversial relationship between hormone replacement therapy and the signs and symptoms of dry eye. Current understanding of sex hormone influences on the immune system suggests that oestrogen may modulate a cascade of inflammatory events, which underlie dry eye.
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Affiliation(s)
- Susan Truong
- The University of New South Wales, Kensington, New South Wales, Australia
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Coksuer H, Ozcura F, Oghan F, Haliloglu B, Coksuer C. Effects of estradiol–drospirenone on ocular and nasal functions in postmenopausal women. Climacteric 2011; 14:482-7. [DOI: 10.3109/13697137.2010.539724] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Immunohistochemical detection of estrogen and progesterone receptors in the human lacrimal gland. ARCH BIOL SCI 2011. [DOI: 10.2298/abs1102319g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The nature and extent of estrogen and progesterone action on the lacrimal
gland is not known, and neither are the targets for their action.
Immunohistochemical detection of estrogen and progesterone receptors in the
human lacrimal glands in both sexes in different age groups was performed in
this study. Twenty human lacrimal glands from autopsies were analyzed by the
immunohistochemical method of cell counting and the ?? test. Estrogen and
progesterone receptors were detected in the lacrimal glands of both sexes
with significantly higher total and average cell counts in females (p<0,001).
Estrogen and progesterone receptors are present in human lacrimal glands with
age and gender dependent expression.
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Influence of bilateral medial collateral ligament injury on mRNA expression in distal corneal tissues of control and ovariohysterectomized rabbits. Cornea 2010; 29:418-31. [PMID: 20164746 DOI: 10.1097/ico.0b013e3181bd45ec] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Corneal tissues are reported to be impacted by physiological changes (eg, menopause), systemic autoimmune diseases, and osteoarthritic-like conditions. In this study, changes in specific mRNA levels in the cornea after a ligament injury in normal and rabbits subjected to surgical menopause were examined. METHODS Skeletally mature female rabbits were either sham-operated (control) or were subjected to surgical menopause (OVX). Eight weeks post-OVX, subsets of control and OVX animals were subjected to bilateral injuries to their medial collateral ligaments (MCL) of the knee, and 6 and 14 weeks postinjury, corneal tissues were harvested. Using reverse transcriptase-polymerase chain reaction, mRNA levels for several relevant molecules, including matrix molecules, growth factors, cytokines, proteinases, and hormone receptors, were assessed. RESULTS mRNA levels for estrogen receptor, decorin, collagens, several growth factors, and inflammatory cytokines decreased in central corneal tissue 6 weeks after distal MCL injury in control animals. The central corneal tissues of animals subjected to OVX alone also exhibited decreases in mRNA levels for a similar set of molecules. When OVX animals were further subjected to MCL injury, the mRNA levels for many of these molecules did not vary from those in the uninjured OVX group. Interestingly, mRNA levels for most molecules were still altered 14 weeks post-MCL injury in the control and OVX animals, a time when the MCL has healed. CONCLUSIONS Corneal tissues respond to changes resulting from OVX and/or injury. OVX combined with a ligament injury does not appear to have an additive impact on corneal mRNA levels for most of the molecules assessed.
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Wagner H, Fink BA, Zadnik K. Sex- and gender-based differences in healthy and diseased eyes. ACTA ACUST UNITED AC 2009; 79:636-52. [PMID: 19811761 DOI: 10.1016/j.optm.2008.01.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Revised: 12/18/2007] [Accepted: 01/08/2008] [Indexed: 02/08/2023]
Abstract
PURPOSE The aim of this study was to identify sex- and gender-based differences in ocular anatomy, physiology, and disease susceptibility or manifestation. METHODS Review of current indexed literature was conducted. RESULTS Sex and sex hormones influence the lacrimal system, eyelids and blinking, corneal anatomy and disease, aqueous humor dynamics and glaucoma, crystalline lens and cataract, uveitis and retinal disease, ocular circulation, and optic nerve anatomy and disease. Systemic conditions, particularly autoimmune disease, and conditions that are unique to women, such as pregnancy and menopause, further illustrate the effects of sex hormones on the eye. Gender-based differences in ocular conditions and disease should be considered within the context of the underlying physical and social environment. CONCLUSIONS Many sex- and gender-based differences exist in healthy and diseased eyes.
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Affiliation(s)
- Heidi Wagner
- Nova Southeastern University College of Optometry, Ft. Lauderdale, Florida 33328, USA.
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Seamon V, Vellala K, Zylberberg C, Ponamareva O, Azzarolo AM. Sex hormone regulation of tear lipocalin in the rabbit lacrimal gland. Exp Eye Res 2008; 87:184-90. [PMID: 18653183 DOI: 10.1016/j.exer.2008.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Revised: 04/01/2008] [Accepted: 05/21/2008] [Indexed: 11/25/2022]
Abstract
Tear lipocalin (TL) (approximately 18 kDa), a member of the lipocalin superfamily, has been identified as one of the major proteins present in rabbit lacrimal fluid. The concentration of TL has been found to be decreased in the tears of patients with dry eye disease. Lacrimal gland insufficiency, one of the major causes of dry eye disease, is known to affect mainly postmenopausal women, where there is a significant decrease in the production of androgen and estrogen. These observations suggest that sex hormones might influence dry eye indirectly by regulating the expression of TL. The purpose of this study was to determine: (1) the effect of sexual maturation on the expression of TL; and (2) if the expression of TL is regulated by the estrogen, 17beta-estradiol, and/or the androgen, dihydrotestosterone, in sexually mature female rabbits. Lacrimal fluid (LF) and lacrimal gland soluble fraction (Si) was collected from juvenile (2 kg) and sexually mature (4 kg) male and female New Zealand white (NZW) rabbits. In addition, LF and Si were collected from 4 kg rabbits, 7 days after being either sham operated (control), ovariectomized (OVX), ovariectomized treated with estrogen (OVX+E) or ovariectomized treated with dihydrotestosterone (OVX+DHT). Samples were analyzed for protein levels of TL by SDS-PAGE and Western blotting using a polyclonal rat anti-rabbit TL antibody. Densitometry analysis showed that TL protein levels in both LF and Si increased with age in male and female rabbits. In addition, TL protein levels were significantly higher in the sexually mature 4 kg male compared with the 4 kg female, while no significant difference in TL protein levels were seen among the juvenile male and female rabbits. Furthermore, ovariectomy decreased the protein levels of TL in LF and Si fraction by 50% and 20% respectively, compared with control values. Estrogen treatment increased TL protein levels by 30% and 50% in the LF and Si fraction respectively, compared with the sham operated group. DHT treatment also increased TL protein levels by approximately 150% in both LF and Si fraction compared with control values. These results support the hypothesis that sex hormones influence TL protein levels in rabbit lacrimal glands. The possibility of a role of TL in dry eye needs to be further investigated.
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Affiliation(s)
- Vanessa Seamon
- Department of Clinical Science and Medical Education, Florida Atlantic University, Charles E. Schmidt College of Biomedical Science, Boca Raton, FL 33431-0991, USA
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Sullivan DA. Tearful relationships? Sex, hormones, the lacrimal gland, and aqueous-deficient dry eye. Ocul Surf 2007; 2:92-123. [PMID: 17216082 DOI: 10.1016/s1542-0124(12)70147-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sex and the endocrine system exert a significant influence on the physiology and pathophysiology of the lacrimal gland. The purpose of this article is to briefly review the nature and magnitude of these interactions between sex, hormones and lacrimal tissue, and to address how they may relate to the pathogenesis of aqueous-deficient dry eye. Towards this end, this article has a 3-fold approach: first, to summarize the influence of androgens, estrogens, glucocorticoids, mineralocorticoids, retinoic acid, prolactin, alpha-melanocyte stimulating hormone, adrenocorticotropic hormone, luteinizing hormone, follicle-stimulating hormone, growth hormone, thyroid-stimulating hormone, arginine vasopressin, oxytocin, thyroxine, parathyroid hormone, insulin, glucagon, melatonin, human chorionic gonadotropin and cholecystokinin on the structure and function of the lacrimal gland; second, to discuss the mechanism of action of each hormone on lacrimal tissue; and third, to discuss the clinical relevance of the endocrine-lacrimal gland interrelationship, with a particular focus on each hormone's role (i.e. if relevant) in the development of aqueous-tear deficiency.
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Affiliation(s)
- David A Sullivan
- Schepens Eye Research Institute and Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Dollin M, Srinivasan S, Leith E, Slomovic A. Unilateral lacrimal gland atrophy in a patient with hereditary angioedema. Cornea 2007; 26:505-6. [PMID: 17457207 DOI: 10.1097/ico.0b013e318033b4cb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To report a case of unilateral lacrimal gland atrophy in a patient with hereditary angioedema (HAE). METHODS Observational case report with literature review. RESULTS A 32-year-old woman with HAE presented with dryness and irritation of the left eye (OS). Investigations revealed features of unilateral severe dry OS with atrophy of the ipsilateral lacrimal gland confirmed by magnetic resonance imaging (MRI). CONCLUSIONS Dry eye should be included in the ocular manifestations of HAE. Recurrent mucosal and soft-tissue inflammation secondary to HAE may lead to lacrimal gland atrophy. MRI is a useful, noninvasive tool in diagnosing lacrimal gland atrophy.
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Affiliation(s)
- Michael Dollin
- Faculty of Medicine, University of Toronto, Toronto, Canada
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Bonini S, Mantelli F, Moretti C, Lambiase A, Bonini S, Micera A. Itchy-dry eye associated with polycystic ovary syndrome. Am J Ophthalmol 2007; 143:763-771. [PMID: 17362862 DOI: 10.1016/j.ajo.2007.01.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Revised: 01/17/2007] [Accepted: 01/18/2007] [Indexed: 11/21/2022]
Abstract
PURPOSE The authors aimed to define the ocular symptomatology of women with polycystic ovaries and hyperandrogenism. DESIGN Prospective, observational case series. METHODS Of the 62 consecutive patients with an ultrasonographic diagnosis of polycystic ovary (PCO), 16 were identified as having clinical and biochemical signs of hyperandrogenism. All women with a history of ocular symptoms (20/62 total patients [32.3%], 15/16 polycystic ovary syndrome (PCOS) patients [93.7%], and 5/46 PCO patients [10.8%]) underwent a complete eye examination with conjunctival impression cytologic sampling. Clinical measurements of tear function (tear film break-up time [BUT], Schirmer I test) were completed along with analysis of conjunctival goblet cell number, conjunctival immunostaining, and reverse-transcriptase polymerase chain reaction for the mucins MUC1 and MUC5AC. Clinical, histologic, and biochemical data of patients with PCOS were compared statistically with that of patients with PCO and with eight age- and gender-matched healthy controls. Eight of the most severely affected patients received systemic antiandrogen therapy and underwent further ocular evaluation four months after systemic therapy. RESULTS Women with PCOS had greater conjunctival hyperemia (P < .001), dryness (P < .001), itching (P < .001), mucous discharge (P < .001), and contact lens intolerance (P < .001) than patients with PCO. Patients with PCOS had a significant reduction of the tear film BUT accompanied by a significant increase in goblet cell number and conjunctival MUC5AC messenger ribonucleic acid expression compared with both PCO patients and healthy subjects. CONCLUSIONS Evaluation of the ocular surface should be considered in patients with PCO or PCOS. Women with PCOS were more likely to have itchy-dry eyes, decreased tear film BUT, and increased goblet cell density.
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Affiliation(s)
- Stefano Bonini
- Interdisciplinary Center for Biomedical Research (CIR), Laboratory of Ophthalmology, University Campus Bio-Medico of Rome, Rome, Italy.
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Paliwal A, De PK. Marked sexual dimorphism of lacrimal gland peroxidase in hamster: repression by androgens and estrogens. Biochem Biophys Res Commun 2006; 341:1286-93. [PMID: 16469299 DOI: 10.1016/j.bbrc.2006.01.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Accepted: 01/22/2006] [Indexed: 11/27/2022]
Abstract
Peroxidase secreted in tears by the lacrimal glands is a marker of secretory activity of these glands and is believed to have an antimicrobial function. We report for the first time a marked sex difference in lacrimal gland (LG) peroxidase in hamsters ( approximately 3.4-fold higher activity in females), which is due to an unusual repression by physiological levels of androgens in males. LG peroxidase activity was markedly induced in a time-dependent manner after gonadectomy in males and also females ( approximately 8- and 2-fold, respectively) and was strongly repressed by androgen treatment in a dose- and time-dependent manner. Estrogen treatment of gonadectomized hamsters could also repress LG peroxidase but not below female levels. These repressions by androgens and estrogens were significantly prevented upon co-treatment with their respective receptor antagonists. Western blotting showed that differences in LG peroxidase specific activity, in different sex hormonal states and treatments were due to changes in the levels of peroxidase protein in LG. A tear peroxidase with a clear sex difference suggests that it might also have other novel function(s) in hamster tears.
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Affiliation(s)
- Anupam Paliwal
- Centre for Cellular and Molecular Biology, Uppal Road, Hyderabad-500007, Andhra Pradesh, India
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Mircheff AK, Wang Y, Jean MDS, Ding C, Trousdale MD, Hamm-Alvarez SF, Schechter JE. Mucosal Immunity and Self-Tolerance in the Ocular Surface System. Ocul Surf 2005; 3:182-92. [PMID: 17131026 DOI: 10.1016/s1542-0124(12)70204-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This paper articulates a new working hypothesis that explains many of the pathophysiological conditions described under the common rubric "dry eye" as altered states of mucosal immune regulation. A central principle of mucosal immune physiology is that the parenchymal tissues at the effector sites, i.e., the sites at which secretory antibodies are produced, maintain local signaling milieus that support differentiation of IgA+ plasmablasts and survival of IgA+ plasmacytes. These local signaling milieus also support robust regulatory networks that maintain tolerance to commensual microbes, benign antigens, and parenchymal autoantigens. The regulatory networks are mediated by cycles of interactions between successive generations of dendritic cells, which normally mature with tolerogenic functions, and regulatory T cells, which normally reinforce the system's ability to generate new tolerogenic dendritic cells. The systemic endocrine environment controls expression of the local signaling milieu in the mammary gland and in the prostate and male urethral glands. Emerging evidence indicates that the local signaling milieu in the lacrimal gland also is determined, in part, by the systemic endocrine environment. This working hypothesis suggests explanations for the excess incidence of Sjogren syndrome among women and for the mechanisms of several different immunophysiological states in addition to Sjogren syndrome that, like Sjogren syndrome, are associated with the classical symptoms and signs of dry eye. It also comprises a promising rationale for specific new approaches to therapy.
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Affiliation(s)
- Austin K Mircheff
- Department of Physiology & Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
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Tani S, Matsuda K, Tanaka T. Induction of apoptosis in cultured rat gastric epithelial cells by ipriflavone: comparison with indomethacin. Biol Pharm Bull 2005; 27:647-51. [PMID: 15133238 DOI: 10.1248/bpb.27.647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Based on a previous report illustrating severe gastrointestinal side effects with ipriflavone, we examined the effects of ipriflavone on cell death in cultured rat gastric epithelial cells compared with other chemicals, including indomethacin. Low concentrations of ipriflavone, indomethacin, dexamethasone, and estradiol all induced cell death in gastric epithelial cells. DNA from cultured cells treated with ipriflavone showed fragmentation by electrophoresis. Also, some of the cultured cells treated with ipriflavone were positively stained by TUNEL. In order to confirm induction of apoptosis by ipriflavone, rescue from ipriflavone-induced cell death with Z-DEVD-FMK (0.02-0.1 mM), which is a caspase 3 inhibitor, or PGE(2) (0.01-10 mM), was tested. Only Z-DEVD-FMK was observed to rescue the cells from cell death. Similar results were obtained with indomethacin, dexamethasone and estradiol. These results suggest that ipriflavone, indomethacin, dexamethasone and estradiol induce cell death of cultured rat gastric epithelial cells by apoptosis.
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Affiliation(s)
- Satoru Tani
- Faculty of Pharmaceutical Sciences, Josai University, Saitama, Japan.
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Qian L, Xie J, Rose CM, Sou E, Zeng H, Hamm-Alvarez SF, Mircheff AK. Altered traffic to the lysosome in an ex vivo lacrimal acinar cell model for chronic muscarinic receptor stimulation. Exp Eye Res 2004; 79:665-75. [PMID: 15500825 DOI: 10.1016/j.exer.2004.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2004] [Accepted: 07/19/2004] [Indexed: 10/26/2022]
Abstract
Evidence suggests that lacrimal and salivary epithelial cells constitutively expose potentially pathogenic autoantigens, but that active regulatory networks normally suppress pathological autoimmune responses . Events that potentially disrupt the regulatory networks include increased exposure of constitutive autoantigens and induced exposure of previously cryptic autoantigen epitopes. Chronic muscarinic receptor (MAChR) stimulation in an ex vivo rabbit lacrimal acinar cell model induces functional and biochemical alterations reminiscent of the functional quiescence associated with Sjogren's syndrome . Chronic MAChR stimulation also elicits changes in the compartmental distribution of beta-hexosaminidase, a product that normally is dually targeted into the lysosomal pathway and the regulated apical secretory pathway. Here, we use subcellular fractionation analyses to further explore the nature of the stimulation-induced traffic changes and to identify effectors that might mediate this change. Overnight stimulation of primary cultured rabbit lacrimal gland acinar cells with 10 microM carbachol (CCh) significantly decreased the abundance of mature cathepsin B in the pre-lysosome and lysosome; decreased the abundance of preprocathepsin B in fractions containing the TGN and late endosome; increased the abundance of procathepsin B in fractions containing the basal-lateral membrane; and increased the accumulation of endocytosed [(125)I]-EGF in the recycling endosome. Alterations in distribution or abundance of traffic effectors included: increased abundances of rab5A and rab6 in the TGN; decreased overall abundance of gamma-adaptin; remarkably increased relative abundance of membrane phase-associated actin; redistribution of cytoplasmic dynein from biosynthetic and proximal endocytic compartments to the lysosome; and redistribution of p150(Glued) from the lysosome to biosynthetic or proximal endocytic compartments. We conclude that chronic MAChR stimulation blocks traffic from the early endosome and the TGN to the lysosome, causing lysosomal proteins to reflux to the TGN, endosomes, and basal-lateral membrane. These traffic alterations may be mediated through action on one or more of the effectors noted.
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Affiliation(s)
- Limin Qian
- Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, 1333 San Pablo Street, MMR 626, Los Angeles, CA 90033, USA
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