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Parekh M, Adhikari Y, Deshpande N, Miller P, Sperling AS, Tesfaigzi Y, Jurkunas UV. Long-term persistent exposure to cigarette smoke induces AhR driven corneal endothelial dysfunction in mice. Exp Eye Res 2024; 248:110089. [PMID: 39265717 DOI: 10.1016/j.exer.2024.110089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 08/31/2024] [Accepted: 09/09/2024] [Indexed: 09/14/2024]
Abstract
Epidemiological studies show cigarette smoking enhances corneal endothelial dysfunction, but mechanisms remain unclear. Our study reveals that prolonged smoke exposure activates the aryl hydrocarbon receptor (AhR), increasing CYP1B1 expression and accelerating senescence and fibrosis in corneal endothelium, potentially reflecting adaptive responses to maintain corneal resilience. Although these molecular modifications indicate early endothelial dysfunction, no pathological changes were observed. The findings indicate that while chronic cigarette smoke exposure triggers initial molecular alterations and endothelial dysfunction, the progression to Fuchs endothelial corneal dystrophy likely requires additional environmental or genetic factors beyond smoke exposure alone.
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Affiliation(s)
- Mohit Parekh
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Yadav Adhikari
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Neha Deshpande
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Peter Miller
- Center for Cancer Research, Massachusetts General Hospital, Boston, MA, USA; Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Adam S Sperling
- Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yohannes Tesfaigzi
- Harvard Medical School, Boston, MA, USA; Pulmonary and Critical Care Medicine Brigham and Women's Hospital, Boston, MA, USA
| | - Ula V Jurkunas
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
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Galor A, Britten-Jones AC, Feng Y, Ferrari G, Goldblum D, Gupta PK, Merayo-Lloves J, Na KS, Naroo SA, Nichols KK, Rocha EM, Tong L, Wang MTM, Craig JP. TFOS Lifestyle: Impact of lifestyle challenges on the ocular surface. Ocul Surf 2023; 28:262-303. [PMID: 37054911 DOI: 10.1016/j.jtos.2023.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
Many factors in the domains of mental, physical, and social health have been associated with various ocular surface diseases, with most of the focus centered on aspects of dry eye disease (DED). Regarding mental health factors, several cross-sectional studies have noted associations between depression and anxiety, and medications used to treat these disorders, and DED symptoms. Sleep disorders (both involving quality and quantity of sleep) have also been associated with DED symptoms. Under the domain of physical health, several factors have been linked to meibomian gland abnormalities, including obesity and face mask wear. Cross-sectional studies have also linked chronic pain conditions, specifically migraine, chronic pain syndrome and fibromyalgia, to DED, principally focusing on DED symptoms. A systematic review and meta-analysis reviewed available data and concluded that various chronic pain conditions increased the risk of DED (variably defined), with odds ratios ranging from 1.60 to 2.16. However, heterogeneity was noted, highlighting the need for additional studies examining the impact of chronic pain on DED signs and subtype (evaporative versus aqueous deficient). With respect to societal factors, tobacco use has been most closely linked to tear instability, cocaine to decreased corneal sensitivity, and alcohol to tear film disturbances and DED symptoms.
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Affiliation(s)
- Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; Surgical Services, Miami Veterans Administration, Miami, FL, USA.
| | - Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Yun Feng
- Department of Ophthalmology, Peking University Eye Center, Peking University Third Hospital, Beijing, China
| | - Giulio Ferrari
- Cornea and Ocular Surface Unit, Eye Repair Lab, San Raffaele Scientific Institute, Milan, Italy
| | - David Goldblum
- Pallas-Kliniken, Olten, Bern, Zurich, Switzerland; University of Basel, Basel, Switzerland
| | - Preeya K Gupta
- Triangle Eye Consultants, Raleigh, NC, USA; Department of Ophthalmology, Tulane University, New Orleans, LA, USA
| | - Jesus Merayo-Lloves
- Instituto Universitario Fernandez-Vega, Universidad de Oviedo, Principality of Asturias, Spain
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Kelly K Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eduardo M Rocha
- Department of Ophthalmology, Othorynolaringology and Head & Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Louis Tong
- Cornea and External Eye Disease Service, Singapore National Eye Center, Ocular Surface Research Group, Singapore Eye Research Institute, Eye Academic Clinical Program, Duke-National University of Singapore, Singapore
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Antičić-Eichwalder M, Lex S, Sarny S, Schweighofer J, Marić I, El-Shabrawi Y. Effects of Type 2 Diabetes Mellitus and Smoking on Changes in Corneal Endothelial Morphology and Cell Density. Cornea 2022; 41:1255-1259. [PMID: 34812784 PMCID: PMC9473709 DOI: 10.1097/ico.0000000000002917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to compare the corneal endothelial morphology and cell density of diabetic smokers and nonsmokers with 50 to 70 age-matched healthy subjects and to determine whether smoking increases the effects of type 2 diabetes mellitus (DM) on these corneal parameters. METHODS This prospective cohort study included 200 patients who were assigned to 4 groups, including smokers with type 2 DM (group 1), nonsmokers with type 2 DM (group 2), healthy smokers (group 3), and healthy nonsmokers (control group, group 4). Noncontact specular microscopy was used to measure central endothelial cell density (ECD), coefficient of variation of cell area, percentage of hexagonal cells, and central corneal pachymetry (CCT). RESULTS According to the ECD and CCT values ( P < 0.001 and P = 0.013, respectively), a significant difference was observed between the groups. The mean ECD was lowest in diabetic smokers (1917 ± 399 cells/mm 2 ). Healthy smokers and diabetic smokers had significantly lower ECD compared with the control group ( P = 0.03 and P < 0.001, respectively). Healthy smokers and diabetic smokers had significantly lower ECD compared with diabetic nonsmokers ( P = 0.012 and P < 0.001, respectively). The cornea was significantly thicker in the diabetic smokers than in the control group ( P = 0.013). CONCLUSIONS The coexistence of DM and smoking causes a significant decrease in ECD and an increase in CCT. Cigarette smoking is more harmful to corneal endothelial cells than DM alone.
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Affiliation(s)
| | - Susanne Lex
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria; and
| | - Stephanie Sarny
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria; and
| | - Jakob Schweighofer
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria; and
| | - Ivana Marić
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Yosuf El-Shabrawi
- Department of Ophthalmology, General Hospital Klagenfurt, Klagenfurt, Austria; and
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Son HS, Lum F, Li C, Schein O, Pramanik S, Srikumaran D. Risk Factors for Repeat Keratoplasty after Endothelial Keratoplasty - an IRIS® Registry Analysis. Am J Ophthalmol 2022; 242:77-87. [PMID: 35738395 DOI: 10.1016/j.ajo.2022.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To assess risk factors for repeat keratoplasty after endothelial keratoplasty (EK). DESIGN Retrospective cohort study METHODS: : EK procedures performed between 2013-2018 in the IRIS® Registry (Intelligent Research in Sight) were identified. STUDY POPULATION Patients aged 18 years and older who underwent EK. MAIN OUTCOME MEASURES 1) Risk factors for repeat keratoplasty, and 2) complication rates after EK. A Kaplan-Meier survival analysis was used to determine the probability of repeat keratoplasty. A multivariable shared frailty survival model was used to assess risk factors. RESULTS 59,344 procedures were identified in the registry, of which 30,600 EK procedures met the inclusion criteria for the analysis. The probability of repeat keratoplasty was 17.4% (95% CI:16.7-18.0%) at five years. Risk factors for repeat keratoplasty include post-operative re-bubbling procedure (HR 2.24, 95% CI:2.05-2.45); prior failed graft (HR 2.07, 95% CI:1.84-2.32) or bullous keratopathy (HR 1.47, 95% CI:1.33-1.61) versus Fuchs dystrophy as surgical indication; subsequent routine cataract surgery (HR 1.61, 95% CI:1.45-1.79); as well as subsequent (HR 1.53, 95% CI:1.39-1.69) and prior/concurrent (HR 1.23, 95% CI:1.11-1.36) glaucoma surgery or history of glaucoma (HR 1.24, 95% CI:1.14-1.35). Medicaid (HR 1.47, 95% CI:1.13-1.92), military/government (HR 1.29, 95% CI:1.03-1.60), Medicare Fee-for-Service (HR 1.17, 95% CI:1.05-1.31) or Medicare Managed (HR 1.17, 95% CI:1.01-1.36) insurances versus private insurance, as well as Black versus White race (HR 1.25, 95% CI:1.11-1.40) and smoking (HR 1.16, 95% CI:1.05-1.27) were also associated with an increased risk of undergoing repeat keratoplasty. CONCLUSIONS Black race, government-based insurance plans, and smoking were identified as independent factors associated with repeat keratoplasty in addition to history of glaucoma, glaucoma surgery, and prior graft failure or bullous keratopathy as surgical indication.
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Affiliation(s)
- Hyeck-Soo Son
- The Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Ophthalmology, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, CA
| | - Charles Li
- American Academy of Ophthalmology, San Francisco, CA
| | - Oliver Schein
- The Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Divya Srikumaran
- The Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
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Examining the effects of cigarette smoke on mouse lens through a multi OMIC approach. Sci Rep 2021; 11:18801. [PMID: 34552108 PMCID: PMC8458305 DOI: 10.1038/s41598-021-95013-7] [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: 12/30/2020] [Accepted: 07/14/2021] [Indexed: 11/22/2022] Open
Abstract
Here, we report a multi OMIC (transcriptome, proteome, and metabolome) approach to investigate molecular changes in lens fiber cells (FC) of mice exposed to cigarette smoke (CS). Pregnant mice were placed in a whole-body smoke chamber and a few days later pups were born, which were exposed to CS for 5 hours/day, 5 days/week for a total of 3½ months. We examined the mice exposed to CS for CS-related cataractogenesis after completion of the CS exposure but no cataracts were observed. Lenses of CS-exposed and age-matched, untreated control mice were extracted and lens FC were subjected to multi OMIC profiling. We identified 348 genes, 130 proteins, and 14 metabolites exhibiting significant (p < 0.05) differential levels in lens FC of mice exposed to CS, corresponding to 3.6%, 4.3%, and 5.0% of the total genes, protein, and metabolites, respectively identified in this study. Our multi OMIC approach confirmed that only a small fraction of the transcriptome, the proteome, and the metabolome was perturbed in the lens FC of mice exposed to CS, which suggests that exposure of CS had a minimal effect on the mouse lens. It is worth noting that while our results confirm that CS exposure does not have a substantial impact on the molecular landscape of the mouse lens FC, we cannot rule out that CS exposure for longer durations and/or in combination with other morbidities or environmental factors would have a more robust effect and/or result in cataractogenesis.
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