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Bou Ghannam A, Istambouli R, Hamam MS, Chalhoub JM, Fahed AC, Hamam RN. Ocular manifestations of severe familial hypercholesterolemia. Heliyon 2024; 10:e30487. [PMID: 38737271 PMCID: PMC11088316 DOI: 10.1016/j.heliyon.2024.e30487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024] Open
Abstract
Background To study ocular manifestations of patients with severe familial hypercholesterolemia (FH). Methods In this population-based case-control study, patients suffering from severe familial hypercholesterolemia from the Lebanese Familial Hypercholesterolemia Registry, along with age and gender-matched healthy controls were recruited. All participants underwent a comprehensive eye examination, and patients underwent fluorescein angiography as well. Logistic regression models were used to identify any association between patients with severe familial hypercholesterolemia and abnormal eye findings, while adjusting for hypertension and pack-year smoking. The main outcome measure of this study was the development of ocular vascular abnormalities. Results 28 patients and 28 controls were recruited. Patients with severe familial hypercholesterolemia had significantly greater odds of developing corneal arcus and xanthelasmas than the control group (p < 0.001). Retinal vascular abnormalities (plaques) were exclusively and more significantly present in patients with familial hypercholesterolemia (18 %). Similarly, retinal arteriosclerosis was exclusively and significantly more prevalent in the familial hypercholesterolemia group (p < 0.001, adjusted odds ratio 6.8). Stratification by LDL levels and genotypes did not show any significant change in the prevalence of any ocular finding. Conclusion In addition to the well-established increase in incidence of corneal arcus and xanthelasmas, severe familial hypercholesterolemia patients have more prevalent retinal vascular abnormalities that include vascular plaques and arteriosclerosis.
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Affiliation(s)
- Alaa Bou Ghannam
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rachid Istambouli
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohamed S. Hamam
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jean M. Chalhoub
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Akl C. Fahed
- Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rola N. Hamam
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
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2
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Yang Y, Zhong J, Cui D, Jensen LD. Up-to-date molecular medicine strategies for management of ocular surface neovascularization. Adv Drug Deliv Rev 2023; 201:115084. [PMID: 37689278 DOI: 10.1016/j.addr.2023.115084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
Ocular surface neovascularization and its resulting pathological changes significantly alter corneal refraction and obstruct the light path to the retina, and hence is a major cause of vision loss. Various factors such as infection, irritation, trauma, dry eye, and ocular surface surgery trigger neovascularization via angiogenesis and lymphangiogenesis dependent on VEGF-related and alternative mechanisms. Recent advances in antiangiogenic drugs, nanotechnology, gene therapy, surgical equipment and techniques, animal models, and drug delivery strategies have provided a range of novel therapeutic options for the treatment of ocular surface neovascularization. In this review article, we comprehensively discuss the etiology and mechanisms of corneal neovascularization and other types of ocular surface neovascularization, as well as emerging animal models and drug delivery strategies that facilitate its management.
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Affiliation(s)
- Yunlong Yang
- Department of Cellular and Genetic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
| | - Junmu Zhong
- Department of Ophthalmology, Longyan First Hospital Affiliated to Fujian Medical University, Longyan 364000, Fujian Province, China
| | - Dongmei Cui
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Lasse D Jensen
- Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine, Unit of Cardiovascular Medicine, Linköping University, Linköping, Sweden.
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3
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Butovich IA, Wilkerson A, Yuksel S. Dysregulation of Lipid Metabolism in Aging Meibomian Glands and Its Molecular Markers. Int J Mol Sci 2023; 24:13512. [PMID: 37686319 PMCID: PMC10488057 DOI: 10.3390/ijms241713512] [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: 07/27/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The main function of exocrine Meibomian glands (MGs) is to produce a lipid-rich secretion called meibum which plays a critical role in maintaining the ocular surface homeostasis of humans and most mammals. The chemical composition of meibum, and its quantity produced by MGs, largely determine whether it can fulfill its role successfully. Aging was frequently associated with the onset of various MG-related pathologies. The goal of this study was to determine how aging affects the chemical composition and quantity of meibum in mice, and identify possible molecular markers of aging. Unbiased, untargeted and targeted lipidomic evaluation of mouse MG lipids was conducted using liquid chromatography-high-resolution mass spectrometry, and the results were analyzed using Principal Component, Orthogonal Projections to Latent Structures Discriminant, and Partial Least Square Discriminant Analyses. We found that aging leads to dysregulation of lipid metabolism in MGs, changing the ratios of major classes of MG lipids (such as wax esters, triacylglycerols, and phospholipids) in a progressive manner. Several lipid species that belong to these groups of MG lipids are proposed as clear markers of aging in a mouse model.
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Affiliation(s)
- Igor A. Butovich
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA; (A.W.); (S.Y.)
- Graduate School of Biomedical Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA
| | - Amber Wilkerson
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA; (A.W.); (S.Y.)
| | - Seher Yuksel
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA; (A.W.); (S.Y.)
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4
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Ana RD, Gliszczyńska A, Sanchez-Lopez E, Garcia ML, Krambeck K, Kovacevic A, Souto EB. Precision Medicines for Retinal Lipid Metabolism-Related Pathologies. J Pers Med 2023; 13:jpm13040635. [PMID: 37109021 PMCID: PMC10145959 DOI: 10.3390/jpm13040635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Oxidation of lipids and lipoproteins contributes to inflammation processes that promote the development of eye diseases. This is a consequence of metabolism dysregulation; for instance, that of the dysfunctional peroxisomal lipid metabolism. Dysfunction of lipid peroxidation is a critical factor in oxidative stress that causes ROS-induced cell damage. Targeting the lipid metabolism to treat ocular diseases is an interesting and effective approach that is now being considered. Indeed, among ocular structures, retina is a fundamental tissue that shows high metabolism. Lipids and glucose are fuel substrates for photoreceptor mitochondria; therefore, retina is rich in lipids, especially phospholipids and cholesterol. The imbalance in cholesterol homeostasis and lipid accumulation in the human Bruch's membrane are processes related to ocular diseases, such as AMD. In fact, preclinical tests are being performed in mice models with AMD, making this area a promising field. Nanotechnology, on the other hand, offers the opportunity to develop site-specific drug delivery systems to ocular tissues for the treatment of eye diseases. Specially, biodegradable nanoparticles constitute an interesting approach to treating metabolic eye-related pathologies. Among several drug delivery systems, lipid nanoparticles show attractive properties, e.g., no toxicological risk, easy scale-up and increased bioavailability of the loaded active compounds. This review analyses the mechanisms involved in ocular dyslipidemia, as well as their ocular manifestations. Moreover, active compounds as well as drug delivery systems which aim to target retinal lipid metabolism-related diseases are thoroughly discussed.
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Affiliation(s)
- Raquel da Ana
- UCIBIO-Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Anna Gliszczyńska
- Department of Food Chemistry and Biocatalysis, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, Norwida 25, 50-375 Wrocław, Poland
| | - Elena Sanchez-Lopez
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08007 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08007 Barcelona, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, 08034 Barcelona, Spain
| | - Maria L Garcia
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08007 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08007 Barcelona, Spain
| | - Karolline Krambeck
- UCIBIO-Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Health Sciences School, Guarda Polytechnic Institute, 6300-035 Guarda, Portugal
| | - Andjelka Kovacevic
- Department of Pharmaceutical Technology, Institute of Pharmacy, Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Eliana B Souto
- UCIBIO-Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Yu H, Zeng W, Zhou W, Feng Y. Apolipoprotein A1 is associated with meibomian gland dropout. Ocul Surf 2023; 27:38-40. [PMID: 36535494 DOI: 10.1016/j.jtos.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/08/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Haozhe Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Weizhen Zeng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wenyan Zhou
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yun Feng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China; Institute of Medical Technology, Peking University Health Science Centre, Beijing, China.
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6
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Hua Z, Han X, Li G, Lv L, He X, Gu L, Luo J, Yang J. Prevalence and associated factors for climatic droplet keratopathy in Kazakhs adults: a cross-sectional study in Tacheng, Xinjiang, China. BMC Ophthalmol 2021; 21:316. [PMID: 34461871 PMCID: PMC8404251 DOI: 10.1186/s12886-021-02065-4] [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] [Received: 01/25/2021] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Investigation of the prevalence of climatic droplet keratopathy (CDK) in Tacheng, Xinjiang, China. Methods A total of 1030 participants, in their 40s or older, from the Kazakh ethnic group in Tacheng, were randomly sampled by stratification method. Ophthalmic examinations and surveys were carried out on these participants. Factors associated with CDK were analyzed with logistic regression models. Results CDK was found in 66 (6.4%; 95% confidence interval [CI]: 4.9–7.9%) Kazakh individuals. After multiple regression model analysis, it demonstrated that age (< 0.001), exposure time (< 0.001), exposure protection (< 0.001), and vegetable intake (< 0.001) were of correlation with CDK, of which age (OR = 1.21[CI]: 1.16–1.27) and long-term outdoor exposure (OR = 2.42[CI]: 1.26–4.67) were the risk factors, and that vegetable intake (OR = 0.29[CI]: 0.14–0.59) and wearing a hat (OR = 0.24[CI]: 0.10–0.56) were protective factors. Conclusions This study has revealed the risk and protective factors of CDK, providing a new insight on related research. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-02065-4.
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Affiliation(s)
- Zhixiang Hua
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, People's Republic of China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiaoyan Han
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, People's Republic of China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Guoqing Li
- Ninth Division Hospital of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Li Lv
- Emin County People's Hospital, Xinjiang, China
| | - Xiaolan He
- Ninth Division Hospital of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Laman Gu
- Ninth Division Hospital of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, 130 Dongan Rd., Shanghai, 200032, China. .,NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China. .,Key Laboratory of Public Health Safety of Ministry of Education (Fudan University), Shanghai, China.
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, People's Republic of China. .,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China.
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Relation of Dietary Fatty Acids and Vitamin D to the Prevalence of Meibomian Gland Dysfunction in Japanese Adults: The Hirado-Takushima Study. J Clin Med 2021; 10:jcm10020350. [PMID: 33477594 PMCID: PMC7831319 DOI: 10.3390/jcm10020350] [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: 12/01/2020] [Revised: 12/29/2020] [Accepted: 01/14/2021] [Indexed: 01/04/2023] Open
Abstract
Intervention studies have shown that n-3 polyunsaturated fatty acid (PUFA) supplementation is effective for the treatment of meibomian gland dysfunction (MGD). Ointment containing an analog of vitamin D has also been found to improve symptoms and signs of MGD. We have now evaluated the relation of MGD prevalence to dietary intake of fatty acids (FAs) and vitamin D among a Japanese population. Subjects comprised 300 adults aged 20 to 92 years residing on Takushima Island. MGD was diagnosed on the basis of subjective symptoms, lid margin abnormalities, and meibomian gland obstruction. Dietary FA and vitamin D intake was estimated with a brief-type self-administered diet history questionnaire. MGD prevalence was 35.3%. Multivariate adjusted odds ratios (95% confidence intervals) between extreme quintiles of intake for MGD prevalence were 0.40 (0.16–0.97) for total fat, 0.40 (0.17–0.97) for saturated FAs, 0.40 (0.17–0.97) for oleic acid, 0.52 (0.23–1.18) for n-3 PUFAs, 0.63 (0.27–1.49) for n-6 PUFAs, 1.32 (0.59–2.95) for the n-6/n-3 PUFA ratio, and 0.38 (0.17–0.87) for vitamin D. Total fat, saturated FA, oleic acid, and vitamin D intake may thus be negatively associated with MGD prevalence in the Japanese.
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8
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Meibomian Gland Dysfunction: What Have Animal Models Taught Us? Int J Mol Sci 2020; 21:ijms21228822. [PMID: 33233466 PMCID: PMC7700490 DOI: 10.3390/ijms21228822] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/16/2022] Open
Abstract
Studies have estimated that currently 344 million people worldwide and 16.4 million adults in the US have some form of dry eye disease (DED). It is believed that approximately 70% of DED cases are due to some form of evaporative dry eye, for which Meibomian gland dysfunction (MGD) is the major cause. Unfortunately, currently there is no effective treatment for MGD, and solely palliative care is available. Given the importance of MGD in DED, there has been a growing interest in studying Meibomian gland development, homeostasis and pathology, and, also, in developing therapies for treating and/or preventing MGD. For such, animal models have shown to be a vital tool. Much of what is known today about the Meibomian gland and MGD was learnt from these important animal models. In particular, canine and rabbit models have been essential for studying the physiopathology and progression of DED, and the mouse model, which includes different knockout strains, has enabled the identification of specific pathways potentially involved in MGD. Herein, we provide a bibliographic review on the various animal models that have been used to study Meibomian gland development, Meibomian gland homeostasis and MGD, primarily focusing on publications between 2000 and 2020.
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Yoon CH, Ryu JS, Hwang HS, Kim MK. Comparative Analysis of Age-Related Changes in Lacrimal Glands and Meibomian Glands of a C57BL/6 Male Mouse Model. Int J Mol Sci 2020; 21:ijms21114169. [PMID: 32545199 PMCID: PMC7313015 DOI: 10.3390/ijms21114169] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 12/21/2022] Open
Abstract
It is not known how biological changes in the lacrimal (LGs) and meibomian (MGs) glands contribute to dry eye disease (DED) in a time-dependent manner. In this study, we investigated time-sequenced changes in the inflammation, oxidative stress, and senescence of stem cells in both glands of an aging-related DED mouse model. Eight-week (8W)-, one-year (1Y)-, and two-year (2Y)-old C57BL/6 male mice were used. MG areas of the upper and lower eyelids were analyzed by transillumination meibography imaging. The number of CD45+, 8-OHdG+, Ki-67+, and BrdU+ cells was compared in both glands. Increased corneal staining and decreased tear secretion were observed in aged mice. The MG dropout area increased with aging, and the age-adjusted MG area in lower lids was negatively correlated with the National Eye Institute (NEI) score. Increased CD4+ interferon (IFN)-γ+ cells in LGs were found in both aged mice. An increase in 8-OHdG+ cells in both glands was evident in 2Y-old mice. Reduced Ki-67+ cells, but no change in CD45+ cells, was observed in the MGs of 1Y-old mice. Increased BrdU+ cells were observed in the LGs of aged mice. This suggests that age-dependent DED in C57BL/6 mice is related to inflammation of the LGs, the development of MG atrophy, and oxidative stress in both glands.
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Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Korea;
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Korea
| | - Jin Suk Ryu
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
- Correspondence: (H.S.H.); (M.K.K.); Tel.: +82-2-3779-1025 (H.S.H.); +82-2-2072-2665 (M.K.K.); Fax: +82-2-761-6869 (H.S.H.); +82-2-741-3187 (M.K.K.)
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Korea;
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Korea
- Correspondence: (H.S.H.); (M.K.K.); Tel.: +82-2-3779-1025 (H.S.H.); +82-2-2072-2665 (M.K.K.); Fax: +82-2-761-6869 (H.S.H.); +82-2-741-3187 (M.K.K.)
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10
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Association Between Dyslipidemia and Dry Eye Syndrome Among the Korean Middle-Aged Population. Cornea 2019; 39:161-167. [DOI: 10.1097/ico.0000000000002133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Osae EA, Steven P, Redfern R, Hanlon S, Smith CW, Rumbaut RE, Burns AR. Dyslipidemia and Meibomian Gland Dysfunction: Utility of Lipidomics and Experimental Prospects with a Diet-Induced Obesity Mouse Model. Int J Mol Sci 2019; 20:ijms20143505. [PMID: 31319467 PMCID: PMC6678820 DOI: 10.3390/ijms20143505] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 12/16/2022] Open
Abstract
Meibomian gland dysfunction (MGD) is the leading cause of dry eye disease and loss of ocular surface homeostasis. Increasingly, several observational clinical studies suggest that dyslipidemia (elevated blood cholesterol, triglyceride or lipoprotein levels) can initiate the development of MGD. However, conclusive evidence is lacking, and an experimental approach using a suitable model is necessary to interrogate the relationship between dyslipidemia and MGD. This systematic review discusses current knowledge on the associations between dyslipidemia and MGD. We briefly introduce a diet-induced obesity model where mice develop dyslipidemia, which can serve as a potential tool for investigating the effects of dyslipidemia on the meibomian gland. Finally, the utility of lipidomics to examine the link between dyslipidemia and MGD is considered.
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Affiliation(s)
- Eugene A Osae
- University of Houston, College of Optometry, Houston, TX 77204, USA.
| | - Philipp Steven
- Department of Ophthalmology, Division for Dry-Eye and Ocular GvHD, Medical Faculty, University of Cologne, 50937 Cologne, Germany
| | - Rachel Redfern
- University of Houston, College of Optometry, Houston, TX 77204, USA
| | - Samuel Hanlon
- University of Houston, College of Optometry, Houston, TX 77204, USA
| | - C Wayne Smith
- Baylor College of Medicine, Children's Nutrition Center, Houston, TX 77030, USA
| | - Rolando E Rumbaut
- Baylor College of Medicine, Children's Nutrition Center, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA
| | - Alan R Burns
- University of Houston, College of Optometry, Houston, TX 77204, USA
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12
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Dyslipidemia and its Association with Meibomian Gland Dysfunction: A Systematic Review. Int Ophthalmol 2017; 38:1809-1816. [PMID: 28688025 DOI: 10.1007/s10792-017-0633-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To perform a systematic review of the literature examining the association between meibomian gland dysfunction (MGD) and dyslipidemia. METHODS A systematic literature search was performed using the Medline database. A total of four studies directly relevant to our search are reviewed here. RESULTS In a series of four studies, all but one found that the prevalence of dyslipidemia was significantly higher in those with MGD compared to those without. Factors such as age, total cholesterol, LDL, HDL, and triglycerides demonstrated a significant association whereas sex, BMI, serum creatinine, and serum glucose did not. Various subsets within the MGD group, such as males between the ages of 24-64, were found to have higher total cholesterol levels compared to controls, highlighting the association of dyslipidemia with sex and age. CONCLUSION While each study carried its own limitations preventing a causal relationship from being established, it is evident that a strong positive correlation exists between dyslipidemia and MGD. As such, eye care practitioners, through the detection of MGD, may be identifying patients with dyslipidemia who were previously believed to have normal serum lipid profiles. This may imply that eye care providers have a role in detecting a well-known risk factor for cardiovascular disease. Additionally, if prospective studies can demonstrate a temporal relationship with MGD preceding dyslipidemia, clinicians could consider lipid-lowering agents as management for both conditions.
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Age-related spontaneous lacrimal keratoconjunctivitis is accompanied by dysfunctional T regulatory cells. Mucosal Immunol 2017; 10:743-756. [PMID: 27706128 PMCID: PMC5380589 DOI: 10.1038/mi.2016.83] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 08/29/2016] [Indexed: 02/04/2023]
Abstract
In both humans and animal models, the development of Sjögren syndrome (SS) and non-SS keratoconjunctivitis sicca (KCS) increases with age. Here, we investigated the ocular surface and lacrimal gland (LG) phenotype of NOD.B10.H2b mice at 7-14, 45-50, and 96-100 weeks. Aged mice develop increased corneal permeability, CD4+ T-cell infiltration, and conjunctival goblet cell loss. Aged mice have LG atrophy with increased lymphocyte infiltration and inflammatory cytokine levels. An increase in the frequency of CD4+Foxp3+ T regulatory cells (Tregs) was observed with age in the cervical lymph node (CLN), spleen, and LG. These CD4+CD25+ cells lose suppressive ability, while maintaining expression of Foxp3 (forkhead box P3) and producing interleukin-17 (IL-17) and interferon-γ (IFN-γ). An increase of Foxp3+IL-17+ or Foxp3+IFN-γ+ cells was observed in the LG and LG-draining CLN. In adoptive transfer experiments, recipients of either purified Tregs or purified T effector cells from aged donors developed lacrimal keratoconjunctivitis, whereas recipients of young Tregs or young T effector cells failed to develop disease. Overall, these results suggest inflammatory cytokine-producing CD4+Foxp3+ cells participate in the pathogenesis of age-related ocular surface disease.
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14
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Baser G, Yildiz N, Calan M. Evaluation of Meibomian Gland Dysfunction in Polycystic Ovary Syndrome and Obesity. Curr Eye Res 2016; 42:661-665. [PMID: 27791408 DOI: 10.1080/02713683.2016.1233985] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose/Aim of the study: The purpose of this study was to evaluate the interaction between Polycystic ovary syndrome (PCOS) and Meibomian gland dysfunction (MGD) and obesity, to reveal whether there is a correlation between the testosterone levels and body-mass index (BMI) levels and the dry-eye complaints of these patients. MATERIAL AND METHODS The study included 92 patients with PCOS and 52 healthy patients from March 2013 to March 2014. All patients underwent a physical examination, pelvic ultrasound, and clinical and biochemical tests, including free testosterone levels to confirm the diagnosis of PCOS. The BMIs of all subjects were recorded. In addition, the presence of posterior blepharitis, as an indicator of MGD, was recorded. All patients underwent the dry-eye tests including Schirmer 1 and tear film break-up time (BUT). Complaints of dry-eye of the patients were evaluated with the ocular surface disease index (OSDI) questionnaire. The scores of both groups were compared. RESULTS The presence of MGD was 72.82% in the PCOS group and 61.53% in the control group. There was no correlation between the testosterone levels and study parameters in both groups. BUT levels negatively correlated with BMI in subjects without PCOS (r = -0.520, p = 0.001), whereas positively correlated with MGD and OSDI scores (r = 0.610, p = 0.632; p = 0.001, p = 0.001; respectively). CONCLUSION Tear film instability due to MGD is common in PCOS and in subjects with high BMI. The MGD in PCOS patients is independent of the BMI.
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Affiliation(s)
- Gonen Baser
- a Ozel Egepol Hospital Eye Clinic , Izmir , Turkey
| | - Nurdan Yildiz
- b Department of Gynecology and Obstetrics , Sifa University Izmir , Turkey
| | - Mehmet Calan
- c Department of Endocrinology , Bozyaka Education and Investigation Hospital, Izmir , Turkey
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You IC, Bian F, Volpe EA, de Paiva CS, Pflugfelder SC. Age-Related Conjunctival Disease in the C57BL/6.NOD-Aec1Aec2 Mouse Model of Sjögren Syndrome Develops Independent of Lacrimal Dysfunction. Invest Ophthalmol Vis Sci 2015; 56:2224-33. [PMID: 25758816 DOI: 10.1167/iovs.14-15668] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To investigate parameters of ocular surface disease in C57BL/6.NOD-Aec1Aec2 (Aec) mice with aging and their correlation with development of Sjögren syndrome (SS)-like lacrimal gland (LG) disease. METHODS Aec and C57BL/6 wild-type (B6) female mice were evaluated at 4, 12, and 20 weeks of age. Whole LG and eyes and adnexa were excised for histology and gene expression analysis and evaluated by flow cytometry and immunohistochemistry. Tear volume and goblet cell density was measured. Quantitative PCR evaluated T-cell-related cytokine expression in cornea and conjunctiva. RESULTS Both strains showed age-related conjunctival goblet cell loss that was more pronounced in the Aec strain and significantly greater than in B6 mice at 12 weeks. This was accompanied by CD4+ T-cell infiltration of the conjunctiva that was greater in Aec strain at 20 weeks. Aec mice had higher levels of IL-17A, IL-17R, IL-1α, IL-1β, and TNF-α in the conjunctiva, and they significantly increase with aging. Aec mice had greater lymphocytic infiltration of the LG and conjunctiva at 20 weeks that consisted of a mixture of CD4+ and CD8+ cells. Flow cytometry showed a significant increase in CD4+ T cells in Aec LG compared to B6 mice. Tear volume was significantly increased in both strains at 20 weeks. CONCLUSIONS Aec mice developed greater conjunctival goblet cell loss associated with lymphocytic infiltration of the LG and conjunctiva with aging. Increased expression of certain T helper or inflammatory cytokines in these tissues was observed in Aec mice. The conjunctival disease appeared to be due to inflammation and not a decrease in tear volume.
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Affiliation(s)
- In-Cheon You
- Department of Ophthalmology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Jeonbuk, Korea 2Ocular Surface Center, Department of Ophthalmology, Cullen Eye
| | - Fang Bian
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Eugene A Volpe
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Cintia S de Paiva
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
| | - Stephen C Pflugfelder
- Ocular Surface Center, Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
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McClellan AJ, Volpe EA, Zhang X, Darlington GJ, Li DQ, Pflugfelder SC, de Paiva CS. Ocular surface disease and dacryoadenitis in aging C57BL/6 mice. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:631-43. [PMID: 24389165 DOI: 10.1016/j.ajpath.2013.11.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/30/2013] [Accepted: 11/04/2013] [Indexed: 11/17/2022]
Abstract
Dry eye in humans displays increased prevalence in the aged and in women. Here, we investigated the ocular surfaces and lacrimal glands of aged mice of both sexes. We surveyed three different ages [young, middle-aged (6 to 9 months), and elderly] by investigating severity markers of dry eye disease (DED). We observed an age-dependent dry eye phenotype as early as 6 to 9 months: increased corneal surface irregularity, increased corneal barrier disruption, conjunctival CD4(+) T-cell infiltration, and loss of mucin-filled goblet cells. Expression of interferon-γ, IL-17 mRNA transcripts was increased in the conjunctiva and IL-17A, matrix metallopeptidase 9, and chemokine ligand 20 in the corneas of elderly mice. Elderly male mice develop more of a skewed response of type 1 T helper cell, whereas female mice have a bias toward type 17 T helper cell in the conjunctiva. In the lacrimal gland, an increase in CD4(+) and CD8(+) T cells and B cells and a decrease in activated dendritic cells were observed. Adoptive transfer of CD4(+) T cells isolated from elderly mice transferred DED into young immunodeficient recipients, which was more pronounced from male donors. Our findings show the development of DED in aging mice. Pathogenic CD4(+) T cells that develop with aging are capable of transferring DED from older mice to naive immunodeficient recipients. Taken together, our results indicate that age-related autoimmunity contributes to development of DED with aging.
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Affiliation(s)
- Andrew J McClellan
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Eugene A Volpe
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Xiaobo Zhang
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas; Shenyang He Eye Hospital, Shenyang, Liaoning Province, China
| | | | - De-Quan Li
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Stephen C Pflugfelder
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas
| | - Cintia S de Paiva
- Department of Ophthalmology, Ocular Surface Center, Cullen Eye Institute, Houston, Texas.
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Jalbert I. Diet, nutraceuticals and the tear film. Exp Eye Res 2013; 117:138-46. [DOI: 10.1016/j.exer.2013.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 08/21/2013] [Accepted: 08/23/2013] [Indexed: 01/26/2023]
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Chun YH, Kim HR, Han K, Park YG, Song HJ, Na KS. Total cholesterol and lipoprotein composition are associated with dry eye disease in Korean women. Lipids Health Dis 2013; 12:84. [PMID: 23734839 PMCID: PMC3680171 DOI: 10.1186/1476-511x-12-84] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to determine the relationship between dyslipidemia and dry eye disease (DED) in a Korean population. Methods This population-based study enrolled 5,627 adults (aged >19 years) who were participating in the first year of the fifth annual Korea National Health and Nutrition Examination Survey from 2010 to 2011. Clinically diagnosed DED and its symptoms were surveyed, and biochemical blood analysis data were collected. Dyslipidemia was defined as any of the following: hypercholesterolemia (total cholesterol > 200 mg/dL), hypertriglyceridemia (triglyceride > 150 mg/dL), low levels of high-density lipoprotein (<40 mg/dL), or high levels of low-density lipoprotein (>100 mg/dL). Results After adjusting for demographics (age and body mass index), lifestyle (smoking, drinking, exercise, and residential district), and medical factors (diabetes, hypertension, previous ophthalmic surgery, menopause, and rheumatologic disease), elevated serum cholesterol level was found to be associated with increased likelihood of DED (odds ratio, 1.77; 95% confidence interval, 1.127–2.78) in women. Conclusions DED in a Korean population was found to be associated with high serum cholesterol levelsThe results of this study highlight the significance of eye examinations and independent lipid profile monitoring in patients with dyslipidemia because of its possible correlation with DED progression.
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Affiliation(s)
- Yoon Hong Chun
- Department of Pediatrics, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Abstract
Farnesoid x receptor (FXR) is a ligand-dependent nuclear transcription factor, belonging to the nuclear receptor superfamily. It is activated by bile acids (BAs) and is expressed in the liver, intestine, kidney, and adrenal gland. Upon activation by endogenous ligand (BAs), FXR can regulate triglyceride (TG) metabolism by modulating the activity of related enzymes, lipoprotein and receptors, and maintaining the balance between the contents of TG in the liver and circulation. This review aims to elucidate the regulation of triglyceride metabolism by FXR.
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