Lysozyme content of tears in some external eye infections

Altered hyaluronic acid content in tear fluid of patients with adenoviral conjunctivitis

The adenoviral conjunctivitis is one of the biggest causes of conjunctival infection in the world. Conjunctivitis causes relatively nonspecific symptoms, as hyperaemia and chemosis. Even after biomicroscopy, complex laboratory tests, such as viral culture, are necessary to identify the pathogen or its etiology. To contribute to the better understanding of the pathobiology of the adenoviral conjunctivitis, the tear fluids of patients with unilateral acute adenovirus conjunctivitis (UAAC), normal donors (control) and patients with allergic conjunctivitis were analyzed. Tear samples were collected with Schirmer strips from control, allergic conjunctivitis and UAAC patients, diagnosed by clinical signs. UAAC tears were tested positive in viral cultures. After the elution, HA was quantified using an ELISA-like fluorometric assay and the protein profile was determined by SDS-PAGE. A profound increase in the HA tear content in UAAC patients was found when compared to control and ALC. This HA increase in UAAC tears remarkably was not observed in tears from contralateral eyes without clinical signs, nor in allergic conjunctivitis. In addition a distinct profile of UAAC tear proteins was observed in patients with UAAC. The quantification of HA in the tear fluid is a rapid, sensitive and specific test. This molecule might be a biomarker candidate for acute conjunctivitis.

Establishment of the human reflex tear two-dimensional polyacrylamide gel electrophoresis reference map: new proteins of potential diagnostic value

To understand the changes in protein expression associated with various physiological states as well as the development of pathological eye disease, we have begun to map the protein components of normal human reflex tears. An analytical reference map of normal human reflex tears was created using two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) with pH 3.5-10 immobilized pH gradients (IPGs). Micropreparatively loaded gels were transferred to polyvinylidene difluoride (PVDF) and analysed by a combination of N-terminal sequence tagging and amino acid compositional analysis. Thirty spots were sequence tagged, resulting in identification of six different proteins (lipocalin, lysozyme, lactotransferrin, zinc-alpha-2 glycoprotein, cystatin S, cystatin SN) that matched to entries in the SWISS-PROT database. A group of N-terminally blocked proteins was clearly identified from SWISS-PROT by amino acid analysis, isoelectric point (pI) and molecular weight (Mr). A number of highly expressed protein components remain unidentified despite being subjected to amino acid analysis and Edman sequencing. A majority of the abundant proteins showed varying degrees of charge heterogeneity attributed to post-translational processing such as glycosylation and N-terminal truncation. We have identified a previously undescribed protein that we have named lacryglobin. This protein displays strong homology with mammaglobin, a protein overexpressed in breast cancer. The discovery of this homologue in tears offers the potential for disease diagnosis by screening tear fluid proteins.

Lysozyme in tears during post-operative inflammation of the eye

Lysozyme (ly) concentration in tears was measured the day before and the days following intracapsular cataract extraction in 25 patients. A median ly concentration of 1.30 mg/ml was found pre-operatively. On the first post-operative day a significant drop in the median ly concentration was observed (0.58 mg/ml). Thereafter a gradual rise towards pre-operative level was found at the 12th post-operative day. An inverse correlation existed between ly concentrations and Schirmer values during the observation period, and dilution thus seems to be an important cause of the post-operative drop in ly concentration. We observed an inverse relationship between ly level, and the number (%) of patients displaying bacterial colonization of the conjunctival sac 24 h later. The most frequently isolated bacteria were staphylococcus albus and diphteroids. It is proposed that the drop in ly concentration post-operatively may contribute to an increased risk of bacterial colonization of the eye post-operatively.

Immunoassay of tear lysozyme in acute adenovirus conjunctivitis

The tear lysozyme levels were measured by immunoassay in 92 healthy subjects and 98 patients with acute adenovirus conjunctivitis. They were found to be significantly decreased during the acute phase of the disease. The extent of this decline in the tear lysozyme level was correlated with increased severity of disease. There was no significant difference in the tear lysozyme level in viral isolation-positive and isolation-negative patients. The tear lysozyme level showed return to normal levels with clinical improvement.

Separation of human tear proteins by high performance liquid chromatography

The optimal conditions for separating human tear proteins by high performance liquid chromatography (HPLC) using a Waters I-125 gel filtration column were investigated. Several elution buffers were tested including phosphate buffer alone and phosphate buffer to which varying amounts of NaCl or 0.1% Tween was added. The combination of phosphate buffer (pH 5.28), 0.5 M NaCl and 0.1% Tween gave the best resolution and a recovery of 90% of the proteins applied. Tear lactoferrin was shown to adhere to the column packing when the molarity of the elution buffer was not high enough. Using optimal conditions, the tear proteins IgA, lactoferrin and lysozyme were identified in distinct peaks after a preparative HPLC run. When used in combination with Schirmer strips as a tear sampling method, HPLC was shown to be a rapid, simple and reproducible way of investigating the composition of tear proteins.

Lysozyme content of tears in normal subjects and in patients with external eye infections

We studied the lysozyme content of tears in 267 subjects (521 eyes), including 241 healthy subjects, 7 patients (14 eyes) with bilateral blepharitis, 8 patients (12 eyes) with conjunctivitis, and 11 patients (16 eyes) with keratitis. The concentration of lysozyme in the tears rises with age between childhood and maturity. The highest values were seen in the age group of 21-40 years, and a decrease of lysozyme concentration occurred with an increase in age from 30-40 years. The mean lysozyme content of tears was 1,768 micrograms/ml in healthy subjects; no significant differences occurred between the sexes. Patients with blepharitis, conjunctivitis, and keratitis had normal mean lysozyme content of tears. The tears of patients with herpes simplex keratitis had low lysozyme values.