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Markoulli M, Ahmad S, Arcot J, Arita R, Benitez-Del-Castillo J, Caffery B, Downie LE, Edwards K, Flanagan J, Labetoulle M, Misra SL, Mrugacz M, Singh S, Sheppard J, Vehof J, Versura P, Willcox MDP, Ziemanski J, Wolffsohn JS. TFOS Lifestyle: Impact of nutrition on the ocular surface. Ocul Surf 2023; 29:226-271. [PMID: 37100346 DOI: 10.1016/j.jtos.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/28/2023]
Abstract
Nutrients, required by human bodies to perform life-sustaining functions, are obtained from the diet. They are broadly classified into macronutrients (carbohydrates, lipids, and proteins), micronutrients (vitamins and minerals) and water. All nutrients serve as a source of energy, provide structural support to the body and/or regulate the chemical processes of the body. Food and drinks also consist of non-nutrients that may be beneficial (e.g., antioxidants) or harmful (e.g., dyes or preservatives added to processed foods) to the body and the ocular surface. There is also a complex interplay between systemic disorders and an individual's nutritional status. Changes in the gut microbiome may lead to alterations at the ocular surface. Poor nutrition may exacerbate select systemic conditions. Similarly, certain systemic conditions may affect the uptake, processing and distribution of nutrients by the body. These disorders may lead to deficiencies in micro- and macro-nutrients that are important in maintaining ocular surface health. Medications used to treat these conditions may also cause ocular surface changes. The prevalence of nutrition-related chronic diseases is climbing worldwide. This report sought to review the evidence supporting the impact of nutrition on the ocular surface, either directly or as a consequence of the chronic diseases that result. To address a key question, a systematic review investigated the effects of intentional food restriction on ocular surface health; of the 25 included studies, most investigated Ramadan fasting (56%), followed by bariatric surgery (16%), anorexia nervosa (16%), but none were judged to be of high quality, with no randomized-controlled trials.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia.
| | - Sumayya Ahmad
- Icahn School of Medicine of Mt. Sinai, New York, NY, USA
| | - Jayashree Arcot
- Food and Health, School of Chemical Engineering, UNSW Sydney, Australia
| | - Reiko Arita
- Department of Ophthalmology, Itoh Clinic, Saitama, Japan
| | | | | | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Katie Edwards
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Judith Flanagan
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia; Vision CRC, USA
| | - Marc Labetoulle
- Ophthalmology Department, Hospital Bicêtre, APHP, Paris-Saclay University, Le Kremlin-Bicêtre, France; IDMIT (CEA-Paris Saclay-Inserm U1184), Fontenay-aux-Roses, France
| | - Stuti L Misra
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | | | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - John Sheppard
- Virginia Eye Consultants, Norfolk, VA, USA; Eastern Virginia Medical School, Norfolk, VA, USA
| | - Jelle Vehof
- Departments of Ophthalmology and Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Section of Ophthalmology, School of Life Course Sciences, King's College London, London, UK; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Piera Versura
- Cornea and Ocular Surface Analysis - Translation Research Laboratory, Ophthalmology Unit, DIMEC Alma Mater Studiorum Università di Bologna, Italy; IRCCS AOU di Bologna Policlinico di Sant'Orsola, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Jillian Ziemanski
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
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Dammak A, Pastrana C, Martin-Gil A, Carpena-Torres C, Peral Cerda A, Simovart M, Alarma P, Huete-Toral F, Carracedo G. Oxidative Stress in the Anterior Ocular Diseases: Diagnostic and Treatment. Biomedicines 2023; 11:biomedicines11020292. [PMID: 36830827 PMCID: PMC9952931 DOI: 10.3390/biomedicines11020292] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
The eye is a metabolically active structure, constantly exposed to solar radiations making its structure vulnerable to the high burden of reactive oxygen species (ROS), presenting many molecular interactions. The biomolecular cascade modification is caused especially in diseases of the ocular surface, cornea, conjunctiva, uvea, and lens. In fact, the injury in the anterior segment of the eye takes its origin from the perturbation of the pro-oxidant/antioxidant balance and leads to increased oxidative damage, especially when the first line of antioxidant defence weakens with age. Furthermore, oxidative stress is related to mitochondrial dysfunction, DNA damage, lipid peroxidation, protein modification, apoptosis, and inflammation, which are involved in anterior ocular disease progression such as dry eye, keratoconus, uveitis, and cataract. The different pathologies are interconnected through various mechanisms such as inflammation, oxidative stress making the diagnostics more relevant in early stages. The end point of the molecular pathway is the release of different antioxidant biomarkers offering the potential of predictive diagnostics of the pathology. In this review, we have analysed the oxidative stress and inflammatory processes in the front of the eye to provide a better understanding of the pathomechanism, the importance of biomarkers for the diagnosis of eye diseases, and the recent treatment of anterior ocular diseases.
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Nutraceuticals: A Promising Therapeutic Approach in Ophthalmology. Nutrients 2022; 14:nu14235014. [PMID: 36501043 PMCID: PMC9740859 DOI: 10.3390/nu14235014] [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: 10/15/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
Oxidative stress represents one of the main factors driving the pathophysiology of multiple ophthalmic conditions including presbyopia, cataracts, dry eye disease (DED), glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). Currently, different studies have demonstrated the role of orally administered nutraceuticals in these diseases. For instance, they have demonstrated to improve lens accommodation in presbyopia, reduce protein aggregation in cataracts, ameliorate tear film stability, break up time, and tear production in dry eye, and participate in the avoidance of retinal neuronal damage and a decrease in intraocular pressure in glaucoma, contribute to the delayed progression of AMD, or in the prevention or treatment of neuronal death in diabetic retinopathy. In this review, we summarized the nutraceuticals which have presented a positive impact in ocular disorders, emphasizing the clinical assays. The characteristics of the different types of nutraceuticals are specified along with the nutraceutical concentration used to achieve a therapeutic outcome in ocular diseases.
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Alanazi MA, El-Hiti GA, Alshehri JA, Alhadyan AS, Fagehi R, Masmali AM, Almubrad T. The Effect of the Addition of Electrolyte Solutions on the Ferning Patterns of Tears Collected from Normal Eye Subjects. Optom Vis Sci 2022; 99:463-469. [PMID: 35412507 DOI: 10.1097/opx.0000000000001897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE The current study is the first report to describe the improvement of ferning patterns of human tears using electrolyte solutions. The results can help in the production of new artificial tears to improve the quality of tears. PURPOSE This study aimed to investigate the effect of the addition of different volumes of various electrolyte solutions on ferning patterns of human tears. METHODS Tear samples (20 μL) were collected from the right eye of 13 subjects (5 men and 5 women) aged 19 to 36 years (27.1 ± 5.1 years) with normal eyes. Then, 1 μL of each tear sample was dried on a microscopic glass slide, and obtained ferns were observed using light microscopy and graded using the 5-point tear ferning (TF) grading scale. Homogenous mixtures of each tear sample (0.5 μL) and different volumes (0.5 to 5 μL) of each electrolyte were prepared. A sample (1 μL) of each mixture was dried, and the ferns obtained were graded and compared with those of the corresponding tears collected from subjects before the addition of electrolyte solutions. RESULTS After the addition of electrolyte solutions, the TF grades of tears collected from healthy humans were generally improved. Significant (Wilcoxon test) improvements have been seen in the TF grades of the tear samples after the addition of a solution of potassium chloride (P = .03), calcium chloride (P = .01), magnesium chloride hexahydrate (P = .002), and sodium dihydrogen phosphate (P = .002). No significant improvements in the TF grades were seen after the addition of sodium chloride solution (P = .33). CONCLUSIONS Ferning grades of human tears improved with most of the electrolytes used.
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Affiliation(s)
| | - Gamal A El-Hiti
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Jaber A Alshehri
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed S Alhadyan
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Raied Fagehi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali M Masmali
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Turki Almubrad
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Abstract
Dry eye disease (DED) is a major public health problem worldwide that seriously impairs the quality of life, reduces work productivity, and poses significant economic burden. In DED, tear film instability or hyperosmolarity activates a self-perpetuating vicious cycle that may aggravate ocular surface inflammation and damage. Thus, treatment approaches should focus on interrupting this cycle and ameliorating inflammation. In addition to anti-inflammatory medications, such as corticosteroids, cyclosporine, and lifitegrast, nutrients with anti-inflammatory and anti-oxidative properties may also be effective for the treatment of DED. Evidence indicates that vitamin deficiencies may be associated with an increased risk of DED and that vitamin supplementation can be an effective treatment for DED. In the present review, we introduce the results of clinical and experimental studies on the association between vitamin deficiencies and DED. The potential efficacy of systemic and topical supplementation in the treatment of DED is also discussed.
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Diagnostic tests based on pattern formation in drying body fluids - A mapping review. Colloids Surf B Biointerfaces 2021; 208:112092. [PMID: 34537495 DOI: 10.1016/j.colsurfb.2021.112092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 01/25/2023]
Abstract
There are numerous diagnostic tests based on pattern formation in desiccating body fluids, where the pattern or some of its characteristics constitute the diagnostic test outcome. However, partially due to the development in different time periods, and partially due to publications in languages different from English, most of these diagnostic tests exist as separate approaches and have never been grouped, systematized, nor compared with each other. In the present mapping review, we performed a wide literature search with the aim to collect all diagnostic tests based on pattern formation in desiccating body fluids. Furthermore, we grouped the identified diagnostic tests according to their experimental protocols, type of body fluids investigated, and target conditions, and propose so for the first time a classification of different diagnostic tests based on pattern formation in desiccating body fluids. The literature search revealed 1603 publications, out of which 141 were included into the review. Following three main classification criteria (way of deposition of the fluid for desiccation, addition of reagents, and spatial restrictions during evaporation), we identified six different methods; following a further classification concerning the analyzed body fluid we identified 30 different diagnostic tests based on pattern formation in evaporating body fluids. Amongst these tests are well-known procedures such as ferning tests (tear ferning for the assessment of tear film quality, saliva and cervical mucus ferning for the detection of the fertile period, and amniotic fluid ferning for the diagnosis of fetal membrane rupture), whereas other tests are less well-established. In the latter group, the most frequently investigated body fluids were serum, saliva, and blood; the most frequently addressed target conditions were cancer, inflammation, and benign tumors. We recommend conducting further systematic reviews and meta-analyses concerning groups of methods addressing the same target condition.
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Fogagnolo P, De Cilla’ S, Alkabes M, Sabella P, Rossetti L. A Review of Topical and Systemic Vitamin Supplementation in Ocular Surface Diseases. Nutrients 2021; 13:nu13061998. [PMID: 34200595 PMCID: PMC8228525 DOI: 10.3390/nu13061998] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/24/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
In the homeostasis of the ocular surface, vitamins play a critical role in regulating inflammatory responses and promoting cell differentiation, development and correct function. Systemic vitamin supplementation has been available for many decades; in recent years, thanks to pharmacological advancements, topical vitamin delivery has also become available in an attempt to better treat ocular surface disease (OSD) and dry eye disease (DED). In this paper, we reviewed the current evidence on the role of vitamin supplementation in OSD and DED. We originally searched the PubMed archive, inspected the references and restricted the search to pertinent papers. The body of evidence was evaluated using the amelioration of both signs and symptoms as the outcome, when available. We found that in patients with vitamin deficiency, systemic supplementation of Vitamin A is effective in treating OSD, reducing both DED signs and symptoms. Additionally, systemic supplementation of vitamin D is useful in reducing DED symptoms and increasing tear volume. Vitamin A is also effective in reducing DED signs and symptoms when administered locally. The efficacy of supplementation with other vitamins is still not fully proven. In conclusion, the inclusion of vitamins into the treatment strategies for OSD and DED allows for better treatment customization and better outcomes in these patients.
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Affiliation(s)
- Paolo Fogagnolo
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
- Correspondence:
| | - Stefano De Cilla’
- Ophthalmology Unit, Ospedale Maggiore della Carita, 28100 Novara, Italy; (S.D.C.); (M.A.)
| | - Micol Alkabes
- Ophthalmology Unit, Ospedale Maggiore della Carita, 28100 Novara, Italy; (S.D.C.); (M.A.)
| | - Pierfilippo Sabella
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
| | - Luca Rossetti
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
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8
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Tummanapalli SS, Kuppusamy R, Yeo JH, Kumar N, New EJ, Willcox MDP. The role of nitric oxide in ocular surface physiology and pathophysiology. Ocul Surf 2021; 21:37-51. [PMID: 33940170 DOI: 10.1016/j.jtos.2021.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/31/2022]
Abstract
Nitric oxide (NO) has a wide array of biological functions including the regulation of vascular tone, neurotransmission, immunomodulation, stimulation of proinflammatory cytokine expression and antimicrobial action. These functions may depend on the type of isoform that is responsible for the synthesis of NO. NO is found in various ocular tissues playing a pivotal role in physiological mechanisms, namely regulating vascular tone in the uvea, retinal blood circulation, aqueous humor dynamics, neurotransmission and phototransduction in retinal layers. Unregulated production of NO in ocular tissues may result in production of toxic superoxide free radicals that participate in ocular diseases such as endotoxin-induced uveitis, ischemic proliferative retinopathy and neurotoxicity of optic nerve head in glaucoma. However, the role of NO on the ocular surface in mediating physiology and pathophysiological processes is not fully understood. Moreover, methods used to measure levels of NO in the biological samples of the ocular surface are not well established due to its rapid oxidation. The purpose of this review is to highlight the role of NO in the physiology and pathophysiology of ocular surface and propose suitable techniques to measure NO levels in ocular surface tissues and tears. This will improve the understanding of NO's role in ocular surface biology and the development of new NO-based therapies to treat various ocular surface diseases. Further, this review summarizes the biochemistry underpinning NO's antimicrobial action.
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Affiliation(s)
| | - Rajesh Kuppusamy
- School of Optometry & Vision Science, University of New South Wales, Australia; School of Chemistry, University of New South Wales, Australia
| | - Jia Hao Yeo
- The University of Sydney, School of Chemistry, NSW, 2006, Australia
| | - Naresh Kumar
- School of Chemistry, University of New South Wales, Australia
| | - Elizabeth J New
- The University of Sydney, School of Chemistry, NSW, 2006, Australia; The University of Sydney Nano Institute (Sydney Nano), The University of Sydney, NSW, 2006, Australia
| | - Mark D P Willcox
- School of Optometry & Vision Science, University of New South Wales, Australia
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Liu X, Liu H, Lu X, Tombran-Tink J, Zhao S. PEDF Attenuates Ocular Surface Damage in Diabetic Mice Model Through Its Antioxidant Properties. Curr Eye Res 2020; 46:302-308. [PMID: 32862727 DOI: 10.1080/02713683.2020.1805770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate the antioxidative effect and mechanism of pigment epithelium-derived factor (PEDF) on the ocular surface damage in diabetic mice. METHODS C57BL/6 mice were injected intraperitoneally with streptozocin to generate diabetic models and then 50 nM PEDF or artificial tears were used to treat the diabetic mice. Treatment was given three times a day for eight weeks. Corneal epithelial damage, corneal sensitivity, and tear volume were quantified by fluorescein staining, esthesiometer, and phenol red cotton thread, respectively. Animals were sacrificed at 16 weeks after diabetes and the whole globe specimens were subjected to histochemical staining. Reactive oxygen species (ROS) generation was detected by 2',7-dichlorodihydrofluorescein probe. The levels of receptor for advanced glycation end products (RAGE) and superoxide dismutase 1 (SOD1) were examined by quantitative real-time PCR and western blotting. RESULTS Topical application of PEDF improved corneal epithelial damage, increased corneal sensitivity, and tear volume in diabetic mice. ROS levels in the cornea were significantly higher in the diabetic mice than in the normal mice. Moreover, PEDF attenuated the accumulation of ROS, decreased the expression of RAGE, and elevated SOD1 expression in the cornea. CONCLUSIONS Topical application of PEDF can alleviate diabetes-related ocular surface damage and increase tear volume, along with the improvement of oxidative stress status.
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Affiliation(s)
- Xuemei Liu
- College of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, Tianjin Medical University , Tianjin, China
| | - Hui Liu
- College of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, Tianjin Medical University , Tianjin, China
| | - Xiaoxiao Lu
- College of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, Tianjin Medical University , Tianjin, China
| | - Joyce Tombran-Tink
- Department of Neural and Behavioral Sciences and Department of Ophthalmology, Penn State College of Medicine , Hershey, PA, USA
| | - Shaozhen Zhao
- College of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, Tianjin Medical University , Tianjin, China
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Pellegrini M, Senni C, Bernabei F, Cicero AFG, Vagge A, Maestri A, Scorcia V, Giannaccare G. The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases. Nutrients 2020; 12:nu12040952. [PMID: 32235501 PMCID: PMC7230622 DOI: 10.3390/nu12040952] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of the ocular surface system whose chore mechanisms are tear film instability, inflammation, tear hyperosmolarity and epithelial damage. In recent years, novel therapies specifically targeting inflammation and oxidative stress are being investigated and used in this field. Therefore, an increasing body of evidence supporting the possible role of different micronutrients and nutraceutical products for the treatment of ocular surface diseases is now available. In the present review, we analyzed in detail the effects on ocular surface of omega-3 fatty acids, vitamins A, B12, C, D, selenium, curcumin and flavonoids. Among these, the efficacy of omega-3 fatty acid supplementation in ameliorating DED signs and symptoms is supported by robust scientific evidence. Further long-term clinical trials are warranted to confirm the safety and efficacy of the supplementation of the other micronutrients and nutraceuticals.
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Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (C.S.); (F.B.)
- Correspondence: ; Tel.: +39-3343-308141
| | - Carlotta Senni
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (C.S.); (F.B.)
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, 40138 Bologna, Italy; (C.S.); (F.B.)
| | - Arrigo F. G. Cicero
- Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy;
| | - Aldo Vagge
- Eye Clinic of Genoa, Policlinico San Martino, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, 16132 Genoa, Italy;
| | - Antonio Maestri
- Medical Oncology Department, Santa Maria della Scaletta Hospital, 40026 Imola, Italy;
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.S.); (G.G.)
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Græcia of Catanzaro, 88100 Catanzaro, Italy; (V.S.); (G.G.)
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11
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Levy N, Wang Yin GH, Noharet R, Ghazouane R, Grimaud F, Aboudou H, Darque A, Delmotte N, Veran J, Hoffart L, Denis D, Sabatier F, Magalon J. A retrospective analysis of characteristic features of responder patients to autologous serum eye drops in routine care. Ocul Surf 2019; 17:787-792. [PMID: 31103732 DOI: 10.1016/j.jtos.2019.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/18/2019] [Accepted: 05/15/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE Autologous serum eye drops (ASEDs) are used worldwide to treat dry eye disease (DED). However, the biological composition of ASEDs has not been well investigated, and effectiveness predictive factors remain to be identified. The main objective of this study was to compare the response of patients treated with ASEDs biologically characterized and used for DED routine care. METHODS This retrospective observational study was conducted in a single university hospital, and included 50 patients (87 eyes) with DED refractory to conventional treatment and resulting from various etiologies with Ocular Surface Disease Index (OSDI) ≥ 20. Each patient used eight drops a day per treated eye with 20% diluted ASEDs. Undiluted serum extensive biological characterizations were performed, and symptoms were recorded before the initiation of ASEDs and closer to the sixth month of treatment. Responders were defined as presenting an improvement from baseline ≥14 points in OSDI and/or ≥1 grade in corneal fluorescence staining for all eyes treated. RESULTS The OSDI and the Oxford scale were significantly reduced from 68.7 ± 23.2 to 54.8 ± 25.7 and 3.2 ± 1.5 to 2.1 ± 1.3 (p ≤ 0.0001), respectively. A total of 68% of the patients were responders. Nonresponding patients had significantly higher epidermal growth factor concentrations in the serum compared to responders (p = 0.017). CONCLUSIONS ASED administration resulted in significant clinical improvement in the management of DED. Biological differences observed between responders and nonresponders suggested that a better understanding of the biological activity of ASEDs is still required.
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Affiliation(s)
- Natanael Levy
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France
| | - Gaelle Ho Wang Yin
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France; Equipe DiMABio, Université d'Aix-Marseille, Institut Fresnel, Faculté des Sciences de Saint-Jérôme, Avenue Escadrille Normandie-Niemen, 13397, Marseille, Cedex, France
| | - Roxane Noharet
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Rkia Ghazouane
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Fanny Grimaud
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Houssein Aboudou
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Albert Darque
- Pharmacy Department, CHU Conception, AP-HM, Marseille, France
| | | | - Julie Veran
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Louis Hoffart
- Ophtalmology Department, Ramsay Générale de Santé, Clinique Monticelli-Velodrome, Marseille, France
| | - Daniele Denis
- Ophtalmology Department, CHU Timone, AP-HM, Marseille, France
| | - Florence Sabatier
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France
| | - Jeremy Magalon
- Cell Therapy Laboratory, CBT-1409, INSERM, Assistance Publique Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France.
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12
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Masmali AM. Improvement of ferning patterns of lubricant eye drops mixed with various electrolytes and carboxymethylcellulose. Cont Lens Anterior Eye 2019; 42:633-639. [PMID: 31010720 DOI: 10.1016/j.clae.2019.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the effect of the addition of electrolytes, basic tear solution (BTS), and sodium carboxymethylcellulose (SCMS) on the tear ferning (TF) patterns of Blink Contact Soothing Eye Drops® and Refresh Plus Tears®. METHOD Samples of Blink Contact Soothing Eye Drops® and Refresh Plus Tears® (10 μL) were mixed with different volumes (3-30 μL) of several electrolytes, namely sodium chloride, potassium chloride, calcium chloride, magnesium chloride hexahydrate, sodium hydrogen carbonate, and sodium dihydrogen phosphate, BTS, and SCMS. Samples (1 μL) of the mixtures were dried on a glass slide at room temperature and the TF patterns were inspected using a light microscope, graded using the Masmali five-point grading scale and compared to the corresponding TF grades of the artificial tears. RESULTS The TF grades of Blink Contact Soothing Eye Drops® and Refresh Plus Tears® improved from 1.2 and 1.5, respectively to 0.2 when calcium chloride was used as the electrolyte. Improvements in TF grades were also observed when other electrolytes (e.g., sodium dihydrogen phosphate), BTS, and SCMS were used. CONCLUSION The tear ferning test can be used to evaluate the effect of the addition of electrolytes to an artificial tear in-vitro. The TF patterns of artificial tear solutions such as Blink Contact Soothing Eye Drops® and Refresh Plus Tears® can be improved with the addition of various concentrations of electrolytes, BTS, and SCMS, however further research is still needed to understand the clinical relevance of TF patterns with respect to the management of dry eye symptoms and their potential role in the development of new artificial tears.
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Affiliation(s)
- Ali M Masmali
- Cornea Research Chair, Optometry Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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13
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Seen S, Tong L. Dry eye disease and oxidative stress. Acta Ophthalmol 2018; 96:e412-e420. [PMID: 28834388 DOI: 10.1111/aos.13526] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/04/2017] [Indexed: 12/13/2022]
Abstract
Dry eye, an age-related condition, is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability. Environmental factors are also often implicated in dry eye including exposure to pollutants, ultraviolet (UV) radiation and ozone as well as the chronic use of preserved eyedrops such as in the treatment of glaucoma. These factors increase oxidative stress and ocular surface inflammation. Here, we reviewed the cellular, animal and clinical studies that point to the role of oxidative stress in dry eye disease. The biomarkers used to indicate oxidative damage in ocular surface tissues include 8-hydroxy-2 deoxyguanosine (8-OHdG), 4-hydroxynonenal (HNE) and malondialdehyde (MDD). Antioxidative defences in the ocular surface occur in the form of tear proteins such as lactoferrin and S100A proteins, and enzymes such as superoxide dismutase (SOD), peroxidase, catalase and mitochondrial oxidative enzymes. An imbalance between the level of reactive oxygen species (ROS) and the action of protective enzymes will lead to oxidative damage, and possibly inflammation. A small number of interventional studies suggest that oxidative stress may be directly targeted in topical therapy of dry eye treatment. For example, in vitro studies suggest that L-carnitine and pterostilbene, a blueberry component may reduce oxidative stress, and in animal studies, alpha-lipoic acid (ALP) and selenoprotein P may be helpful. Examples of treatments used in clinical trials include vitamin B12 eyedrops and iodide iontophoresis. With recent emphasis on ageing medicine and preventive holistic health, as well as the role of environmental science, research on oxidative stress in the ocular surface is likely to have increasing impact in the coming years.
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Affiliation(s)
- Sophia Seen
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Louis Tong
- Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Singapore National Eye Centre; Singapore Singapore
- Singapore Eye Research Institute; Singapore Singapore
- Duke-NUS Medical School; Singapore Singapore
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14
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Waldron AL, Schroder PA, Bourgon KL, Bolduc JK, Miller JL, Pellegrini AD, Dubois AL, Blaszkiewicz M, Townsend KL, Rieger S. Oxidative stress-dependent MMP-13 activity underlies glucose neurotoxicity. J Diabetes Complications 2018; 32:249-257. [PMID: 29306589 PMCID: PMC5820202 DOI: 10.1016/j.jdiacomp.2017.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND A complication of diabetes is neuropathy, a condition of sensory axon degeneration that originates in the epidermis. The mechanisms remain unknown but reactive oxygen species (ROS) have been implicated in this condition. In this study, we assessed the role of ROS and a candidate downstream target, MMP-13 in glucose-induced sensory axon degeneration in zebrafish and mice. METHODS The effects of glucose on metabolism and sensory axon degeneration were assessed using qPCR and live imaging. ROS were analyzed using pentafluorobenzene-sulfonyl fluorescein and activation of the NF-κB stress response was determined using Tg(NF-κB:GFP) zebrafish. The role of MMP-13 and ROS in glucose-dependent axon degeneration was determined in zebrafish following treatment with the antioxidant, N-acetylcysteine and the MMP-13 inhibitor, DB04760. Neuropathic mice fed on a high-fat/high-sugar diet were treated with the MMP-13 inhibitor, CL-82198 to assess sensory recovery. RESULTS Glucose treatment of zebrafish induced metabolic changes that resemble diabetes. Sensory axon degeneration was mediated by ROS-induced MMP-13 and prevented upon antioxidant treatment or MMP-13 inhibition. MMP-13 inhibition also reversed neuropathy in diabetic mice. CONCLUSION We demonstrate that zebrafish are suitable to study glucose-induced neurotoxicity. Given the effects in zebrafish and mice, MMP-13 inhibition may be beneficial in the treatment of human diabetic neuropathy.
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Affiliation(s)
- Ashley L Waldron
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - Patricia A Schroder
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - Kelly L Bourgon
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - Jessie K Bolduc
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - James L Miller
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - Adriana D Pellegrini
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA
| | - Amanda L Dubois
- School of Biology and Ecology, Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Magdalena Blaszkiewicz
- School of Biology and Ecology, Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Kristy L Townsend
- School of Biology and Ecology, Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME 04469, USA
| | - Sandra Rieger
- Davis Center for Regenerative Biology and Medicine, MDI Biological Laboratory, Kathryn W. Davis Building 227, Old Bar Harbor Road, Salisbury Cove, ME 04672, USA.
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15
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Drouault-Holowacz S, Bieuvelet SÉV, Burckel A, Rigal D, Dubray C, Lichon JL, Bringer P, Pilon F, Chiambaretta F. Antioxidants Intake and Dry Eye Syndrome: A Crossover, Placebo-Controlled, Randomized Trial. Eur J Ophthalmol 2018; 19:337-42. [DOI: 10.1177/112067210901900302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Danièle Rigal
- CHU Clermont-Ferrand, Service d'Opthalmologie, Hôpital Gabriel
- Université Clermont 1, UFR Médecine Clermont-Ferrand
| | | | | | | | - François Pilon
- CHU Clermont-Ferrand, Service d'Opthalmologie, Hôpital Gabriel
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16
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Traipe-Salas F, Traipe-Castro L, Salinas-Toro D, López D, Valenzuela F, Cartes C, Toledo-Araya H, Pérez C, López Solís R. Progress in tear microdesiccate analysis by combining various transmitted-light microscope techniques. Biol Res 2016; 49:28. [PMID: 27255980 PMCID: PMC4891913 DOI: 10.1186/s40659-016-0089-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/24/2016] [Indexed: 11/21/2022] Open
Abstract
Background Tear desiccation on a glass surface followed by transmitted-light microscopy has served as diagnostic test for dry eye. Four distinctive morphological domains (zones I, II, III and transition band) have been recently recognized in tear microdesiccates. Physicochemical dissimilarities among those domains hamper comprehensive microscopic examination of tear microdesiccates. Optimal observation conditions of entire tear microdesiccates are now investigated. One-μl aliquots of tear collected from individual healthy eyes were dried at ambient conditions on microscope slides. Tear microdesiccates were examined by combining low-magnification objective lenses with transmitted-light microscopy (brightfield, phase contrasts Ph1,2,3 and darkfield). Results Fern-like structures (zones II and III) were visible with all illumination methods excepting brightfield. Zone I was the microdesiccate domain displaying the most noticeable illumination-dependent variations, namely transparent band delimited by an outer rim (Ph1, Ph2), homogeneous compactly built structure (brightfield) or invisible domain (darkfield, Ph3). Intermediate positions of the condenser (BF/Ph1, Ph1/Ph2) showed a structured roughly cylindrical zone I. The transition band also varied from invisibility (brightfield) to a well-defined domain comprising interwoven filamentous elements (phase contrasts, darkfield). Conclusions Imaging of entire tear microdesiccates by transmitted-light microscopy depends upon illumination. A more comprehensive description of tear microdesiccates can be achieved by combining illumination methods.
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Affiliation(s)
- Felipe Traipe-Salas
- Cellular and Molecular Biology Program, Faculty of Medicine-ICBM, University of Chile, Independencia 1027, Independencia, Postal code 8380453, Santiago, Chile
| | - Leonidas Traipe-Castro
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Daniela Salinas-Toro
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Daniela López
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Felipe Valenzuela
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Christian Cartes
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Héctor Toledo-Araya
- Cellular and Molecular Biology Program, Faculty of Medicine-ICBM, University of Chile, Independencia 1027, Independencia, Postal code 8380453, Santiago, Chile
| | - Claudio Pérez
- Fundación Oftalmológica Los Andes Ophthalmology Clinic (FOLA), Las Hualtatas 5951, Vitacura, Postal code 7650710, Santiago, Chile
| | - Remigio López Solís
- Cellular and Molecular Biology Program, Faculty of Medicine-ICBM, University of Chile, Independencia 1027, Independencia, Postal code 8380453, Santiago, Chile.
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17
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Cheishvili D, Maayan C, Holzer N, Tsenter J, Lax E, Petropoulos S, Razin A. Tocotrienol Treatment in Familial Dysautonomia: Open-Label Pilot Study. J Mol Neurosci 2016; 59:382-91. [PMID: 27129499 DOI: 10.1007/s12031-016-0760-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/22/2016] [Indexed: 10/21/2022]
Abstract
Familial dysautonomia (FD) is an autosomal recessive congenital neuropathy, primarily presented in Ashkenazi Jews. The most common mutation in FD patients results from a single base pair substitution of an intronic splice site in the IKBKAP gene which disrupts normal mRNA splicing and leads to tissue-specific reduction of IKBKAP protein (IKAP). To date, treatment of FD patients remains preventative, symptomatic and supportive. Based on previous in vitro evidence that tocotrienols, members of the vitamin E family, upregulate transcription of the IKBKAP gene, we aimed to investigate whether a similar effects was observed in vivo. In the current study, we assessed the effects of tocotrienol treatment on FD patients' symptoms and IKBKAP expression in white blood cells. The initial daily doses of 50 or 100 mg tocotrienol, doubled after 3 months, was administered to 32 FD patients. Twenty-eight FD patients completed the 6-month study. The first 3 months of tocotrienol treatment was associated with a significant increase in IKBKAP expression level in FD patients' blood. Despite doubling the dose after the initial 3 months of treatment, IKBKAP expression level returned to baseline by the end of the 6-month treatment. Clinical improvement was noted in the reported clinical questionnaire (with regard to dizziness, bloching, sweating, number of pneumonia, cough episodes, and walking stability), however, no significant effect was observed in any clinical measurements (weight, height, oxygen saturation, blood pressure, tear production, histamine test, vibration threshold test, nerve conduction, and heart rate variability) following Tocotrienol treatment. In conclusion, tocotrienol treatment appears significantly beneficial by clinical evaluation for some FD patients in a few clinical parameters; however it was not significant by clinical measurements. This open-label study shows the complexity of effect of tocotrienol treatment on FD patients' clinical outcomes and on IKBKAP expression level compared to in vitro results. A longitudinal study with an increased sample size is required in the future to better understand tocotrienol affect on FD patients.
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Affiliation(s)
- David Cheishvili
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel. .,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel. .,Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada. .,Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel.
| | - Channa Maayan
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Naama Holzer
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Jeanna Tsenter
- Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel
| | - Elad Lax
- Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada
| | - Sophie Petropoulos
- Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada
| | - Aharon Razin
- Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel
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Abstract
OBJECTIVE To examine the evidence for the role of autologous serum eye drops (ASD) in disease of the ocular surface. METHODS A search of the literature published through May 2014 using PubMed, the ISI Web of Knowledge database, and the Cochrane Library was performed. Qualified articles were selected after review of titles, abstracts, and references. RESULTS There was a significant improvement in either symptoms or some of the clinical examination findings, including tear breakup time, corneal staining, Schirmer values, and impression cytology in eyes with persistent corneal epithelial defect, graft-versus-host disease, Sjögren- and non-Sjögren-related dry eye disease, limbal stem-cell deficiency, recurrent corneal erosion, superior limbic keratoconjunctivitis, and postrefractive surgery. However, most of the studies were nonrandomized in nature. CONCLUSIONS Despite the paucity of strong supporting evidence from randomized double-masked clinical studies, there seems to be a trend toward superiority of ASD in alleviating some of the clinical signs and symptoms associated with corneal pathology in a variety of conditions that affect the ocular surface compared with conventional lubricating drops/ointments.
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19
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Abdelkawi SA, Abdel-Salam AM, Ghoniem DF, Ghaly SK. Vitreous humor rheology after Nd:YAG laser photo disruption. Cell Biochem Biophys 2014; 68:267-74. [PMID: 23797611 DOI: 10.1007/s12013-013-9706-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This work aimed to consider the hazardous side effect of eye floaters treatment with Q-switched Nd:YAG laser on the protein and viscoelastic properties of the vitreous humor, and evaluate the protective role of vitamin C against laser photo disruption. Five groups of New Zealand rabbits were divided as follows: control group for (n = 3) without any treatment, the second group (n = 9) treated with Q-switched Nd:YAG laser energy of 5 mJ × 100 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 for each). The third group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. The fourth group (n = 9) treated with 10 mJ 9 50 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 rabbits each). The fifth group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. After 2 weeks of laser treatment, the protein content, refractive index (RI), and the rheological properties of vitreous humor, such as consistency, shear stress, and viscosity, were determined. The results showed that, the anterior vitreous group exposed to of 5 mJ × 100 pulse and/or supplemented with vitamin C, showed no obvious change. Furthermore, all other treated groups especially for mid-vitreous and posterior vitreous humor showed increase in the protein content, RI and the viscosity of vitreous humor. The flow index remained below unity indicating the non-Newtonian behavior of the vitreous humor. Application of Q-switched Nd:YAG laser should be restricted to the anterior vitreous humor to prevent the deleterious effect of laser on the gel state of the vitreous humor.
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20
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Calvo-Maroto AM, Perez-Cambrodí RJ, Albarán-Diego C, Pons A, Cerviño A. Optical quality of the diabetic eye: a review. Eye (Lond) 2014; 28:1271-80. [PMID: 25125072 DOI: 10.1038/eye.2014.176] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/26/2014] [Indexed: 12/15/2022] Open
Abstract
Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia. Several structural, morphological, and physiological changes in each of ocular component have been described in detail during the past decades. Due to these abnormalities, the diabetic patient undergoes a degradation of the retinal image by an increase of higher ocular aberrations and ocular scattering coming from mainly tear film, cornea, and crystalline lens. This review aims to provide an overview of current knowledge about the effects of diabetes mellitus in these optical phenomena and its consequence on the visual quality of the diabetic patient.
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Affiliation(s)
- A M Calvo-Maroto
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - R J Perez-Cambrodí
- Department of Ophthalmology, Oftalmar, Medimar International Hospital, Alicante, Spain
| | - C Albarán-Diego
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - A Pons
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
| | - A Cerviño
- Optometry Research Group, Department of Optics, University of Valencia, Valencia, Spain
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21
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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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22
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Coursey TG, Chen PW, Niederkorn JY. IFN-γ-independent intraocular tumor rejection is mediated by a macrophage-dependent process that leaves the eye intact. J Leukoc Biol 2012; 92:939-50. [PMID: 22693246 DOI: 10.1189/jlb.0312122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Intraocular tumors reside in an immune-privileged site, yet in certain circumstances, they can undergo immune rejection. Ocular tumor rejection can follow one of two pathways. One pathway is CD4(+) T cell-dependent and culminates in ischemic necrosis of the tumor and phthisis (atrophy) of the eye. A second pathway is also CD4(+) T cell-dependent but does not inflict collateral injury to ocular tissues, and the eye is preserved. We isolated two clones of a murine tumor, Ad5E1 that undergo profoundly different forms of immune rejection in the eye. Clone 2.1 tumors undergo an ischemic necrotizing form of rejection that requires IFN-γ, T cells, and ocular macrophages and culminates in destruction of the eye. By contrast, the second clone of Ad5E1, clone 4, undergoes rejection that also requires T cells and ocular macrophages, but leaves the eye in pristine condition (nonphthisical rejection). Here, we demonstrate that nonphthisical tumor rejection of clone 4 tumors is IFN-γ-independent but requires an ocular macrophage population that contains M1 and M2 macrophages. Clone 4 tumor-bearing eyes displayed ten- and 15-fold increases in M2- and M1-associated markers Arg1 and NO2, respectively. This is in sharp contrast to previous results with clone 2.1 tumor rejection, in which M2 markers were undetectable, and the eye was destroyed. These results suggest that the presence of M2 macrophages tempers the immune rejection of intraocular tumors and promotes immune effectors that inflict minimal injury to innocent bystander cells and thereby preserve the integrity and function of the eye.
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Affiliation(s)
- Terry G Coursey
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA
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23
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Kim J, Kim CS, Sohn E, Jeong IH, Kim H, Kim JS. Involvement of advanced glycation end products, oxidative stress and nuclear factor-kappaB in the development of diabetic keratopathy. Graefes Arch Clin Exp Ophthalmol 2010; 249:529-36. [PMID: 21104267 DOI: 10.1007/s00417-010-1573-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 11/04/2010] [Accepted: 11/04/2010] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of the experiment reported here was to assess the involvement of advanced glycation end products (AGEs), oxidative stress, and nuclear factor kappa-B (NF-κB) activation in the development of diabetic keratopathy. METHODS Diabetes was induced by intraperitoneal streptozotocin injection in male Sprague-Dawley rats. The thickness of the cornea was measured. Apoptosis was detected by TUNEL assay and western blot for caspase-3. The expression of AGEs and 8-hydroxydeoxyguanosine (8-OHdG) were studied by immunohistochemistry in corneal tissues of normoglycaemic and diabetic rats. NF-κB activation was evaluated by electrophoretic mobility shift assay and southwestern histochemistry. RESULTS Corneal edema was observed in diabetic rats. The thickness of cornea was higher in diabetic than in control rats. AGEs were accumulated in corneal tissues. 8-OHdG and NF-κB were identified in corneal epithelium, stroma and endothelium, and its expressions were greater in diabetic than in those of control rats. Diabetes induces significant alterations in rat corneal tissue structure. CONCLUSIONS The higher expression of AGE, 8-OHdG and NF-κB in corneal tissues of diabetic rats suggests that these factors are involved in apoptosis and in subsequent corneal alterations related to diabetic keratopathy.
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Affiliation(s)
- Junghyun Kim
- Diabetic Complications Research Center, Division of Traditional Korean Medicine Integrated Research, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, South Korea
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24
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Larmo PS, Järvinen RL, Setälä NL, Yang B, Viitanen MH, Engblom JRK, Tahvonen RL, Kallio HP. Oral sea buckthorn oil attenuates tear film osmolarity and symptoms in individuals with dry eye. J Nutr 2010; 140:1462-8. [PMID: 20554904 DOI: 10.3945/jn.109.118901] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dry eye is a common condition that can severely impair the quality of life. We aimed to find out whether oral sea buckthorn (SB) oil, containing (n-3) and (n-6) fatty acids and antioxidants, affects dry eye. In this double-blind, randomized, parallel trial, 20- to 75-y-old women and men experiencing dry eye symptoms consumed 2 g of SB or placebo oil daily for 3 mo from fall to winter. One hundred participants were recruited and 86 completed the study. Clinical dry eye tests and symptom follow-ups were performed. Tear film hyperosmolarity is a focal factor in dry eye. There was a general increase in the osmolarity from baseline to the end of the intervention. Compared with the placebo group, the increase was significantly less in the SB group when all participants were included [intention to treat (ITT), P = 0.04] and when only participants consuming the study products for at least 80% of the intervention days were included [per protocol (PP), P = 0.02]. The maximum intensities of redness and burning tended to be lower in the SB group. In the ITT participants, the group difference was significant for redness (P = 0.04) but not for burning (P = 0.05). In the PP participants, the group difference was significant for burning (P = 0.04) but not for redness (P = 0.11). In conclusion, SB oil attenuated the increase in tear film osmolarity during the cold season and positively affected the dry eye symptoms.
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Affiliation(s)
- Petra S Larmo
- Department of Biochemistry and Food Chemistry, University of Turku, Turku, Finland
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25
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Módulo CM, Jorge AG, Dias AC, Braz AM, Bertazolli-Filho R, Jordão AA, Sérgio Marchini J, Rocha EM. Influence of insulin treatment on the lacrimal gland and ocular surface of diabetic rats. Endocrine 2009; 36:161-8. [PMID: 19551521 DOI: 10.1007/s12020-009-9208-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 04/17/2009] [Accepted: 06/02/2009] [Indexed: 12/18/2022]
Abstract
Previous studies have observed changes in the lacrimal gland and ocular surface related to diabetes mellitus and related it to insulin resistance or insufficiency and oxidative damage. The aim of this study was to evaluate whether insulin treatment inhibits those changes. Diabetes was induced in male Wistar rats with a single intravenous injection of streptozotocin and a subgroup was treated with insulin. After 5 and 10 weeks, the three groups (n = 5-10/group/experimental procedure) were compared for biochemical, functional, and histological parameters. After 5 weeks, changes in morphology and increased numbers of lipofucsin-like inclusions were observed in lacrimal glands of diabetic but not insulin-treated rats. After 5 weeks, malonaldehyde and total peroxidase activity were significantly higher in diabetic rats, but similar to control in insulin-treated diabetic rats (P = 0.03, P = 0.02, respectively). Our data indicate that diabetes induces histological alterations in lacrimal gland and suggests that hyperglycemia-related oxidative stress may participate in diabetic dry eye syndrome. Prevention by insulin replacement suggests direct hormone action and/or benefit by early sub optimal metabolic control.
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Affiliation(s)
- Carolina Maria Módulo
- Department of Ophthalmology, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
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26
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Jorge AG, Módulo CM, Dias AC, Braz AM, Filho RB, Jordão AA, de Paula JS, Rocha EM. Aspirin prevents diabetic oxidative changes in rat lacrimal gland structure and function. Endocrine 2009; 35:189-97. [PMID: 19191035 DOI: 10.1007/s12020-009-9151-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 12/08/2008] [Accepted: 12/10/2008] [Indexed: 12/26/2022]
Abstract
The aim of this study is to evaluate whether aspirin reduces Diabetis Mellitus (DM) oxidative damage in the lacrimal gland (LG), and ocular surface (OS). Ten weeks after streptozotocin induced DM and aspirin treatment, LG and OS of rats were compared for tear secretion, hidtology, peroxidase activity, and expression of uncoupling proteins (UCPs). DM reduction of tear secretion was prevented by aspirin (P < 0.01). Alterations of LG morphology and increased numbers of lipofucsin-like inclusions were observed in diabetic but not in aspirin-treated diabetic rats. Peroxidase activity levels were higher and UCP-2 was reduced in DM LG but not in aspirin treated (P = 0.0025 and P < 0.05, respectively). The findings prevented by aspirin indicate a direct inhibitory effect on oxidative pathways in LG and their inflammatory consequences, preserving the LG structure and function against hyperglycemia and/or insulin deficiency damage.
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Affiliation(s)
- Angélica Gobbi Jorge
- Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço e, FMRP, Universidade de São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, SP, Brazil
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27
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Bashan N, Kovsan J, Kachko I, Ovadia H, Rudich A. Positive and negative regulation of insulin signaling by reactive oxygen and nitrogen species. Physiol Rev 2009; 89:27-71. [PMID: 19126754 DOI: 10.1152/physrev.00014.2008] [Citation(s) in RCA: 351] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Regulated production of reactive oxygen species (ROS)/reactive nitrogen species (RNS) adequately balanced by antioxidant systems is a prerequisite for the participation of these active substances in physiological processes, including insulin action. Yet, increasing evidence implicates ROS and RNS as negative regulators of insulin signaling, rendering them putative mediators in the development of insulin resistance, a common endocrine abnormality that accompanies obesity and is a risk factor of type 2 diabetes. This review deals with this dual, seemingly contradictory, function of ROS and RNS in regulating insulin action: the major processes for ROS and RNS generation and detoxification are presented, and a critical review of the evidence that they participate in the positive and negative regulation of insulin action is provided. The cellular and molecular mechanisms by which ROS and RNS are thought to participate in normal insulin action and in the induction of insulin resistance are then described. Finally, we explore the potential usefulness and the challenges in modulating the oxidant-antioxidant balance as a potentially promising, but currently disappointing, means of improving insulin action in insulin resistance-associated conditions, leading causes of human morbidity and mortality of our era.
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Affiliation(s)
- Nava Bashan
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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28
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Shoham A, Hadziahmetovic M, Dunaief JL, Mydlarski MB, Schipper HM. Oxidative stress in diseases of the human cornea. Free Radic Biol Med 2008; 45:1047-55. [PMID: 18718524 DOI: 10.1016/j.freeradbiomed.2008.07.021] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 07/22/2008] [Accepted: 07/23/2008] [Indexed: 01/26/2023]
Abstract
Intense exposure to light, robust metabolic activity, and high oxygen tension render the human eye particularly vulnerable to oxidative damage and the list of ophthalmological disorders implicating reactive oxygen and nitrogen species is rapidly expanding. Here, we review the roles of oxidative stress in the etiopathogeneses and pathophysiology of diseases of the human cornea including pterygium, keratoconus, trauma and chemical injury, and a host of inflammatory, metabolic, degenerative, and iatrogenic conditions. Data from animal and tissue culture experimentation germane to these conditions are also adduced.
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Affiliation(s)
- Akiva Shoham
- Department of Ophthalmology, Ben-Gurion University, Beersheva, Israel
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29
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Grossklaus R, Henning KJ. [Vitamins for the eyes? Risks and opportunities for physician and patient]. Ophthalmologe 2008; 106:521-6. [PMID: 18690459 DOI: 10.1007/s00347-008-1819-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This article discusses the effects of dietetic measures and specialized food supplements on age-related macular degeneration (AMD) and diabetic retinopathy. The sale of products in doctors' offices is already prohibited by laws governing the medical profession. The results of the Age-Related Eye Disease Study (AREDS) concerning high doses of vitamins and zinc cannot simply be transferred to other doses and substances. Furthermore, there are health risks that have to be examined. Opportunities could arise for both doctor and patient if the AREDS formulation were granted authorization to be marketed as a medicinal product; however, a certain protective effect can be expected only for specific forms of AMD after a careful risk-benefit analysis and assessment within the statutory marketing authorization procedure for medicinal products.
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Affiliation(s)
- R Grossklaus
- Bundesinstitut für Risikobewertung (BfR), Berlin, Deutschland.
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Liu X, Gu YS, Xu YS. Changes of tear film and tear secretion after phacoemulsification in diabetic patients. J Zhejiang Univ Sci B 2008; 9:324-8. [PMID: 18381808 DOI: 10.1631/jzus.b0710359] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification. METHODS Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively. RESULTS Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups. CONCLUSION Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.
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Affiliation(s)
- Xi Liu
- Ophthalmology Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
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31
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Creuzot C, Passemard M, Viau S, Joffre C, Pouliquen P, Elena PP, Bron A, Brignole F. Amélioration de la symptomatologie chez des patients atteints de sécheresse oculaire et traités oralement par des acides gras polyinsaturés. J Fr Ophtalmol 2006; 29:868-73. [PMID: 17075501 DOI: 10.1016/s0181-5512(06)70106-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Polyunsaturated fatty acids (PUFAs) are involved in inflammatory pathways via prostaglandins. Conjunctival inflammation is a hallmark of all dry eye syndromes. We investigated the role of dietary n-6 and n-3 fatty acids in patients suffering from ocular dryness. PATIENTS AND METHODS Seventy-one patients presenting with mild to moderate dry eye syndromes were randomly assigned to Nutrilarm or placebo capsules, twice a day for 6 months. The Schirmer test, BUT, fluorescein staining, and lissamin green stainings were performed at inclusion and after 1, 3, and 6 months. Furthermore, a questionnaire related to the dry eye symptoms and global discomfort was provided at every visit. RESULTS The Schirmer test, BUT, fluorescein staining, and lissamin green stainings were improved with treatment when compared to placebo but the difference was not statistically significant. The efficacy evaluated by the patients and the investigator were nearly significant (p=0.052 and p=0.054, respectively). For some signs, such as reflex tearing and conjunctival hyperemia, the improvement reached the threshold of significance (p=0.047 and p=0.045, respectively). The same results were found with skin quality and emotional condition, which were improved (61% with treatment versus 36% with placebo). CONCLUSION This double-masked pilot study shows that PUFAs seem to be an interesting tool to alleviate the symptoms related to dry eye syndrome. These results should be confirmed using a larger study population.
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Affiliation(s)
- C Creuzot
- Service d'Ophtalmologie, CHU, Dijon.
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Alves M, Calegari VC, Cunha DA, Saad MJA, Velloso LA, Rocha EM. Increased expression of advanced glycation end-products and their receptor, and activation of nuclear factor kappa-B in lacrimal glands of diabetic rats. Diabetologia 2005; 48:2675-81. [PMID: 16283249 DOI: 10.1007/s00125-005-0010-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Accepted: 07/12/2005] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS To assess the involvement of the AGE-specific receptor (AGER, also known as RAGE) axis and nuclear factor kappa-B (NFKB, also known as NF-kappaB) activation in the development of lacrimal gland and tear film dysfunction in diabetes, the present study evaluated: (1) lacrimal gland and tear film alterations in diabetic rats; and (2) the expression of AGE, AGER and NFKB in ocular tissues of normoglycaemic and diabetic rats. MATERIALS AND METHODS Diabetes was induced in male Wistar rats with intravenous streptozotocin. Tear secretion parameters were measured and NFKB expression was evaluated in lacrimal glands of control and diabetic rats by western blot. Immunohistochemistry with confocal microscopy was used to assess AGE, AGER and NFKB expression in lacrimal glands of both groups. RESULTS Lacrimal gland weight and tear film volume were lower in diabetic than in control rats (p=0.01 and 0.02, respectively). IL1B and TNF concentrations in tears were higher in diabetic than in control rats (p=0.007 and 0.02, respectively). NFKB protein was identified in rat cornea, conjunctiva and lacrimal glands. AGE, AGER and NFKB expression were greater in lacrimal glands of diabetic than in those of control rats. CONCLUSIONS/INTERPRETATION Diabetes induces significant alterations in rat lacrimal gland structure and secretion. The higher expression of AGE, AGER and NFKB in lacrimal glands of diabetic rats suggests that these factors are involved in signalling and in subsequent inflammatory alterations related to dry eye in diabetes mellitus.
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MESH Headings
- Animals
- Blotting, Western
- Conjunctiva/metabolism
- Conjunctiva/physiopathology
- Cornea/metabolism
- Cornea/physiopathology
- Diabetes Mellitus, Experimental/genetics
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/physiopathology
- Dry Eye Syndromes/physiopathology
- Gene Expression
- Glycation End Products, Advanced/analysis
- Glycation End Products, Advanced/genetics
- Glycation End Products, Advanced/metabolism
- Immunohistochemistry
- Interleukin-1/metabolism
- Lacrimal Apparatus/metabolism
- Lacrimal Apparatus/physiopathology
- Male
- NF-kappa B/genetics
- NF-kappa B/metabolism
- Rats
- Rats, Wistar
- Receptor for Advanced Glycation End Products
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Tears/metabolism
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- M Alves
- Laboratory of Clinical Physiopathology, Department of Clinical Medicine, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
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Abstract
OBJECTIVES To compare Schirmer tear test (STT) values, corneal sensitivity, tear film break up times (TFBUTs), and tear glucose concentrations in relation to conjunctival microflora, and conjunctival cytologic and histologic findings among diabetic cataractous, nondiabetic cataractous, and nondiabetic noncataractous dogs. Procedures Fifteen dogs in each category underwent neuro-ophthalmic examination; aerobic, anaerobic and fungal conjunctival cultures; assessment of corneal touch threshold (CTT), STT, tear glucose, TFBUT; and conjunctival cytology and histology (in certain cases only). Degree of cataract and uveitis were critically graded. Glycemic control was estimated using serum fructosamine and glycosylated hemoglobin. RESULTS STT values were significantly lower in diabetic cataractous than nondiabetic noncataractous dogs. CTT of diabetic cataractous dogs was significantly lower than that of nondiabetic noncataractous dogs. Mean TFBUTs were significantly less in diabetic cataractous dogs than nondiabetic cataractous and nondiabetic noncataractous dogs. Tear glucose concentrations were significantly higher in diabetic cataractous dogs than nondiabetic cataractous and nondiabetic noncataractous dogs. Conjunctival microbial isolates did not differ among groups. There were no significant differences in degree of cataract or uveitis between diabetic cataractous and nondiabetic cataractous groups. There was mild submucosal inflammatory infiltrate in conjunctival specimens from diabetic dogs. Conjunctival epithelial dysplasia and/or squamous metaplasia was/were detected in conjunctival biopsies of 5/7 diabetic dogs. Reductions in conjunctival goblet cell (GC) densities were noted in 4/7 diabetic dogs; there were no significant differences in mean GC densities among the three groups. CONCLUSIONS Diabetic cataractous dogs have significantly altered keratoconjunctival characteristics compared to nondiabetic cataractous and nondiabetic noncataractous dogs.
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Affiliation(s)
- Cheryl L Cullen
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3.
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Affiliation(s)
- Andrea M Vincent
- Department of Neurology at University of Michigan, Ann Arbor, MI, 48109, USA
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35
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Abstract
Oxidative stress results from a cell or tissue failing to detoxify the free radicals that are produced during metabolic activity. Diabetes is characterized by chronic hyperglycemia that produces dysregulation of cellular metabolism. This review explores the concept that diabetes overloads glucose metabolic pathways, resulting in excess free radical production and oxidative stress. Evidence is presented to support the idea that both chronic and acute hyperglycemia cause oxidative stress in the peripheral nervous system that can promote the development of diabetic neuropathy. Proteins that are damaged by oxidative stress have decreased biological activity leading to loss of energy metabolism, cell signaling, transport, and, ultimately, to cell death. Examination of the data from animal and cell culture models of diabetes, as well as clinical trials of antioxidants, strongly implicates hyperglycemia-induced oxidative stress in diabetic neuropathy. We conclude that striving for superior antioxidative therapies remains essential for the prevention of neuropathy in diabetic patients.
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Affiliation(s)
- Andrea M Vincent
- Department of Neurology, University of Michigan, Room 4414, Kresge III, 200 Zina Pitcher Place, Ann Arbor 48109, USA.
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Giannoulaki V, Papathanassiou M, Sitaras NM, Tiligada E. Nadroparine inhibits the hypersensitivity response in the conjunctiva. Eur J Pharmacol 2003; 481:119-24. [PMID: 14637183 DOI: 10.1016/j.ejphar.2003.08.080] [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: 11/25/2022]
Abstract
This study sought to investigate the effects of nadroparine on an in vivo experimental model of type I hypersensitivity response in the rat conjunctiva. Following drug application onto the eye, either before or after challenge with the mast cell degranulator, basic polyamine compound 48/80, the conjunctival histamine content and the nitrite levels in the conjunctival lavage fluid were quantified fluorometrically and spectrophotometrically, respectively. Instillation into the eye of nadroparine inhibited the C48/80-induced decreases in conjunctival histamine and the delayed increases in nitrite levels, without influencing basal mediator levels. Protamine did not induce histamine release and only partially reversed the effects of nadroparine post-challenge, yet it had no effect on the protective action of the drug when administered prior to degranulation. The results showed that nadroparine was equally effective in attenuating the effects of compound 48/80 in the eye when administered topically either before or after challenge.
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Affiliation(s)
- Vassiliki Giannoulaki
- Department of Experimental Pharmacology, Medical School, University of Athens, M. Asias 75, GR-11527 Athens, Greece
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