Emerging roles of air pollution and meteorological factors in autoimmune eye diseases

Exploring association between ambient air pollution and glaucoma in China: a nationwide analysis with predictive modeling based on the China Health and Retirement Longitudinal Study

Background

Glaucoma, a leading global cause of blindness, has garnered increasing research attention in recent years concerning its potential association with environmental factors. This study investigates the influence of various environmental pollutants on glaucoma prevalence among middle-aged and older adult populations in China, a country with a high incidence of the disease.

Methods

Using data from 17,184 participants in the 2015 China Health and Retirement Longitudinal Study (CHARLS), individuals were grouped based on glaucoma diagnosis. Environmental pollutant exposure levels were derived from satellite-based spatiotemporal models. Standardized linear regression and restricted cubic spline (RCS) analysis were applied to evaluate the impact of pollutants on glaucoma across different covariate-adjusted models, while logistic regression was used to assess significant variables for constructing and evaluating a predictive model.

Results

After adjusting for covariates, six pollutants (PM2.5, PM10, PM1, NH4, Cl, and NO3) demonstrated significant associations with glaucoma incidence. Subsequent logistic regression revealed that the occurrence of glaucoma may be influenced by a combination of environmental pollutants (NH4 and NO3), regional categories, gender, age, educational level, and diabetes history.

Conclusion

In conclusion, this study offers a novel perspective on glaucoma risk prediction by integrating environmental pollutants, potentially contributing to enhanced preventive strategies for this condition.

Hyaluronic acid-curcumin nanoparticles for preventing the progression of experimental autoimmune uveitis through the Keap1/Nrf2/HO-1 signaling pathway

Globally, uveitis is a collection of intraocular inflammatory disorders that affect mainly the uvea, resulting in irreversible blindness and a heavy socioeconomic burden. Excessive autoimmune inflammation and oxidative stress are major drivers that contribute to the initiation and progression of uveitis. Nevertheless, current therapeutic methods for uveitis are limited and are accompanied by several serious adverse effects. Recently, nanotechnology-based antioxidant strategies have provided novel options for the treatment of ocular diseases. Although curcumin (CUR) has prominent antioxidant capacity and reactive oxygen species (ROS) scavenging ability, its low bioavailability and undetermined mechanisms limit its extensive application. This investigation demonstrated that esterified hyaluronic acid-curcumin nanoparticles (HA-CUR NPs) with superior aqueous dispersion exhibited exceptional antioxidant enzyme mimetic activity, incorporating superoxide dismutase (SOD), glutathione (GSH), catalase (CAT), and free radical scavenging ability. Further in vitro and in vivo experimental results validated the protective function of HA-CUR NPs against oxidative stress-induced damage and inflammatory responses, attenuated pathological progression, relieved microvascular damage, and regulated fundus blood flow in retinal vascular networks. This may be attributable to the specific ability of HA-CUR NPs to target the CD44 receptor and activate the Keap1/Nrf2/HO-1 signaling pathway, suggesting a potential mechanism. In summary, this study revealed that HA-CUR NPs, which are composed of a natural product and biomacromolecules with outstanding artificial antioxidant enzyme activities, may be novel agents for effectively and safely treating uveitis and other ROS-related diseases.

Prevalence and associated factors of epiretinal membrane using spectralis OCT in Fujian Eye Study

We aimed to determine the prevalence and risk factors of epiretinal membrane in a population-based study of residents aged 50 years and older in Fujian Province, Southeast China. The Fujian Eye Study is a population-based cross-sectional eye study in Fujian province, Southeast China. Residents aged 50 years and older were enrolled and did the questionnaire (educational background, income, blood type, disease history, medication history, smoking, drinking and tea consumption, et al.), physical and ophthalmological examinations with height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), refraction, intraocular pressure (IOP), slit lamp, nonmydriatic fundus photograph and spectralis optical coherence tomography (OCT) imaging. Nonmydriatic fundus photograph and Spectralis OCT were used to assess ERM according to a standardised protocol. A total of 8173 residents were included in this study. Among them, 8.42% (95% CI 0.0782-0.0902) had ERM in at least one eye. Multiple logistic regression showed the presence of ERM was only associated with urbanization and geographic location, but not with age, sex, refractive error, IOP, SBP, DBP, HR, BMI, hypertension, diabetic mellitus, hyperlipidemia, education, income, smoking, alcohol and tea consumption. ERM is common among Chinese with 8.42% in at least one eye. Urbanization and geographic location are the only associated factors for ERM in Fujian Eye Study.

Association between traffic-related air pollution and risk of outpatient visits for dry eye disease in a megacity along the subtropical coast in South China

BACKGROUND

Traffic-related air pollution especially in highly socioeconomically developed megacity is usually considered as a severe problem leading to inevitable adverse health outcomes. This study aimed to investigate the associations between traffic-related air pollutants with risk of dry eye disease (DED) outpatient visits in a megacity (Guangzhou) along the subtropical coast in South China.

METHODS

Daily data on DED outpatient visits and environmental variables from 1 January 2014 to 31 December 2020 in Guangzhou were obtained. A time-series study using a quasi-Poisson generalized linear model (GLM) combined with distributed lag non-linear model (DLNM) was adopted. Subgroup analyses stratified by age, gender, and season were conducted.

RESULTS

Totally, 27, 828 DED cases were identified during the study period including 2557 days. Daily number of outpatient visits for DED ranged from 0 to 41. An increase of 10 μg/m3 in PM2.5, NO2 and SO2 concentration was associated with 3.1%, 5.9% and 17.4% increase in the risk of DED outpatient visits, respectively (RRPM2.5 = 1.031, 95%CI: 1.004-1.059, lag 0-11 day; RRNO2 = 1.059, 95% CI: 1.027-1.092, lag0-14 day; RRSO2 = 1.174, 95% CI: 1.036-1.330, lag0-13 day). Subgroup analyses indicated that the effects of PM2.5 exposure on the risk of DED outpatient visits remained significant in aged < 60 years (RR max = 1.008, 95% CI: 1.003-1.013, lag0 day) and the effects of SO2 exposure on the DED outpatient visits risk remained significant in the females (RR max = 1.025, 95% CI: 1.006-1.044, lag0 day). The associations of PM2.5 (RR = 1.010, 95% CI: 1.003-1.016, lag0 day) and SO2 (RR = 1.030, 95% CI: 1.003-1.058, lag14 day) exposure with DED outpatient visits risk remained significant in warm seasons, whereas NO2 (RR = 1.006, 95% CI: 1.002-1.009, lag14 day) exposure was significantly associated with DED outpatient visits in cold seasons. The associations of PM2.5 (first visit, RR = 1.006, 95% CI: 1.001-1.011, lag0 day; re-visit, RR = 1.002, 95% CI: 1.000-1.005, lag6 day), NO2 (first visit, RR = 1.006, 95% CI: 1.001-1.012, lag0 day; re-visit, RR = 1.007, 95% CI: 1.002-1.012, lag0 day), and SO2 (first visit, RR = 1.023, 95% CI: 1.002-1.044, lag0 day; re-visit, RR = 1.023, 95% CI: 1.000-1.045, lag0 day) exposure with risk of DED outpatient visits were significant for both first- and re-visits.

CONCLUSIONS

Our study revealed that short-term exposure to PM2.5, NO2 and SO2 were positively associated with risk of DED outpatient visits, especially for the youngers, females and during warm seasons, providing evidence for making public health policy to improve life quality in developed megacity.

YAP O-GlcNAcylation contributes to corneal epithelial cell ferroptosis under cigarette smoke exposure

Cigarette smoke (CS) is an important indoor air pollutant associated with an increased risk of ocular surface disease. As the eye's outermost layer, the cornea is highly sensitive to air pollutants like CS. However, the specific mechanisms linking CS exposure to corneal dysfunction have not been fully elucidated. In the present study, we found that CS exposure damages corneal epithelial cells, accompanied by increased iron (Fe2+) levels and lipid peroxidation, both hallmarks of ferroptosis. Ferroptosis inhibitors, including Ferrostatin-1 (Fer-1) and Deferoxamine mesylate (DFO), protect against CS-induced cell damage. To understand the underlying mechanisms, we investigated how CS affects iron and lipid metabolism. Our results showed that CS could upregulate intracellular iron levels by increasing TFRC expression and promote lipid peroxidation by increasing ACSL4 expression. Silencing ACSL4 or TFRC expression prevented CS-induced ferroptosis. Furthermore, we found that the upregulation of TFRC and ACSL4 was driven by increased YAP transcription. Pharmacological or genetic inhibition of YAP effectively prevented corneal epithelial cell ferroptosis under CS stimulation. Additionally, our results suggest that CS exposure could increase O-GlcNAc transferase activity, leading to YAP O-GlcNAcylation. This glycosylation of YAP interfered with its K48-linked ubiquitination, resulting in YAP stabilization. Collectively, we found that CS exposure induces corneal epithelial cell ferroptosis via the YAP O-GlcNAcylation, and provide evidence that CS exposure is a strong risk factor for ocular surface disease.

Adverse event reporting of the IGF-1R monoclonal antibody teprotumumab: a real-world study based on the US food and drug administration adverse event reporting system

Background

Teprotumumab, an IGF-1R monoclonal antibody, has shown significant efficacy in treating thyroid eye disease (TED). However, since teprotumumab was launched in 2020 and first approved in the United States, there were limited reports of post-marketing adverse events (AEs). In this study, we aimed to mine and analyze the AEs signals with teprotumumab on the basis of the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) to provide instructions in clinical practice concerning adverse reactions and assistance in drug development and import/export into other countries.

Methods

All AE reports were obtained from the FAERS database from the first quarter of 2020 to the fourth quarter of 2023. To comprehensively analyze the AEs, we applied four disproportionality analysis algorithms, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), and the multi-item gamma Poisson shrinker (MGPS) algorithms.

Results

A total of 687 reports from 200 patients related to administration of teprotumumab were obtained, and 78% of the cases was female. Signal detection of teprotumumab at the system organ class (SOC) level included gastrointestinal disorders, ear and labyrinth disorders, general disorders and administration site conditions, nervous system disorders, and musculoskeletal and connective tissue disorders. AEs that ranked top five at the preferred terms (PTs) level were muscle spasms, fatigue, tinnitus, headache, and deafness. The median time to those AEs onsets was 48 days (interquartile range 19.0-92.0 days) after administering drugs. Additionally, our results indicated the AEs in reproductive system and breast disorders because the prevalence of TED was more common in women.

Conclusion

This study identified many AEs associated with teprotumumab and unveiled potential new AE signals. These results can provide valuable evidence for further clinical application of teprotumumab and are important in enhancing clinical medication safety.

Association between long-term exposure to air pollution and diabetic retinopathy: Evidence from the Fujian Eye Study

BACKGROUND

Diabetic retinopathy (DR), one of the most common microvascular complications of diabetes mellitus (DM), is a major contributor of vision impairment and blindness worldwide. Studies have shown that air pollution exposure is adversely associated with DM. However, evidence is scarce regarding how air pollution exposure affects DR. This study aimed to investigate the association between ambient air pollution exposure and DR risk.

METHODS

The study population was based on the Fujian Eye Study (FJES), an ophthalmologic, epidemiologic survey investigating the eye health condition of residents in Fujian Province from 2018 to 2019. Daily average concentrations of ambient air pollutants (PM2.5, PM10, SO2, NO2, and O3) were acquired from a high-resolution air quality dataset in China from 2013 to 2018. We used a logistic regression model to examine the associations between DR risk and long-term air pollution at various exposure windows.

RESULTS

A total of 2405 out of the 8211 participants were diagnosed with diabetes, among whom 183 had DR. Ambient air pollution, especially particulate matter (i.e., PM2.5 and PM10) and NO2 were positively associated with DR prevalence among all the study subjects. Ambient SO2 and O3 concentrations were not associated with DR prevalence. PM2.5 and NO2 seemed to be borderline significantly associated with increased prevalence of DR in subjects with DM, especially under the model adjusted for sex, age, BMI, SBP, and DBP.

CONCLUSIONS

These findings showed that long-term exposure to ambient particulate matter and NO2 was associated with a high DR risk in Fujian province, where ambient air pollution is relatively low.

Exposure to volatile organic compounds is a risk factor for diabetes retinopathy: a cross-sectional study

Introduction

A few past experimental studies have indicated that exposure to volatile organic compounds (VOCs) might be a potential risk factor for diabetes retinopathy (DR). However, these findings lack substantial support from extensive epidemiological research. This large-scale cross-sectional study aimed to examine whether exposure to low levels of VOCs in the general population is associated with diabetes mellitus (DM) and DR.

Methods

The analytical data was from the National Health and Nutrition Examination Survey (NHANES) dataset (2011-2018). To minimize the potential impact of gender and age on the findings, propensity score matching was utilized to align the data selection. Relationships between blood VOCs and DM and DR were assessed in a sample of 2,932 adults using the logistic regression models. Additionally, Bayesian kernel machine regression (BKMR) models and Weighted Quantile Sum (WQS) were conducted for mixture exposure analysis.

Results

The result shows VOCs were positive associated with DM and DR in US adults, as assessed by WQS model, and the calculated odd ratios (ORs) [95% confidence interval (C.I)] were 53.91(34.11 ~ 85.22) and 7.38(3.65 ~ 14.92), respectively. Among the components of VOCs, 1,2-Dibromoethane, Carbon Tetrachloride and 2,5-Dimethylfuran were positive related with the DR, and ORs (95%C.I) were 2.91(2.29 ~ 3.70), 2.86(2.25 ~ 3.65) and 2.19(1.79 ~ 2.94), respectively. BKMR model shows that there was a dose-response relationship between combined VOCs and DR, although the relationship was non-linearly.

Conclusion

This study suggested that exposure to VOCs may increase the risk of DR, which had important public health implications.