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Kwong A, Zawistowski M, Fritsche LG, Zhan X, Bragg-Gresham J, Branham KE, Advani J, Othman M, Ratnapriya R, Teslovich TM, Stambolian D, Chew EY, Abecasis GR, Swaroop A. Whole genome sequencing of 4,787 individuals identifies gene-based rare variants in age-related macular degeneration. Hum Mol Genet 2024; 33:374-385. [PMID: 37934784 PMCID: PMC10840384 DOI: 10.1093/hmg/ddad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/12/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023] Open
Abstract
Genome-wide association studies have contributed extensively to the discovery of disease-associated common variants. However, the genetic contribution to complex traits is still largely difficult to interpret. We report a genome-wide association study of 2394 cases and 2393 controls for age-related macular degeneration (AMD) via whole-genome sequencing, with 46.9 million genetic variants. Our study reveals significant single-variant association signals at four loci and independent gene-based signals in CFH, C2, C3, and NRTN. Using data from the Exome Aggregation Consortium (ExAC) for a gene-based test, we demonstrate an enrichment of predicted rare loss-of-function variants in CFH, CFI, and an as-yet unreported gene in AMD, ORMDL2. Our method of using a large variant list without individual-level genotypes as an external reference provides a flexible and convenient approach to leverage the publicly available variant datasets to augment the search for rare variant associations, which can explain additional disease risk in AMD.
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Affiliation(s)
- Alan Kwong
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Matthew Zawistowski
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Lars G Fritsche
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Xiaowei Zhan
- Southwestern Medical Center, University of Texas, 5323 Harry Hines Blvd, Dallas, TX 75390, United States
| | - Jennifer Bragg-Gresham
- Kidney Epidemiology and Cost Center, Department of Internal Medicine-Nephrology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Kari E Branham
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, 1000 Wall St, Ann Arbor, MI 48105, United States
| | - Jayshree Advani
- Neurobiology-Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, 6 Center Drive, MSC 0610, Bethesda, MD 20892, United States
| | - Mohammad Othman
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, 1000 Wall St, Ann Arbor, MI 48105, United States
| | - Rinki Ratnapriya
- Neurobiology-Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, 6 Center Drive, MSC 0610, Bethesda, MD 20892, United States
| | - Tanya M Teslovich
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Rd, Tarrytown, NY 10591, United States
| | - Dwight Stambolian
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania Medical School, 51 N. 39th Street, Philadelphia, PA 19104, United States
| | - Emily Y Chew
- Division of Epidemiology and Clinical Application, National Eye Institute, National Institutes of Health, 10 Center Drive Building 10-CRC, Bethesda, MD 20892, United States
| | - Gonçalo R Abecasis
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Rd, Tarrytown, NY 10591, United States
| | - Anand Swaroop
- Neurobiology-Neurodegeneration and Repair Laboratory, National Eye Institute, National Institutes of Health, 6 Center Drive, MSC 0610, Bethesda, MD 20892, United States
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2
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Zhao L, Yu JJ, Liu Y, Zuo T, Zhou H, Ju P, Li Y, Cao Y, Dong B. An enhanced model for environmental dry eye: Exploring pathological features and underlying factors. Exp Eye Res 2024; 239:109744. [PMID: 38072354 DOI: 10.1016/j.exer.2023.109744] [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: 06/30/2023] [Revised: 09/17/2023] [Accepted: 11/27/2023] [Indexed: 12/31/2023]
Abstract
This study aimed to develop an enhanced environmental dry eye (EDE) model that accurately reproduces the etiology of prolonged visual fatigue and investigates the underlying pathological features. A total of 40 adult SPF-grade Wistar rats were randomly assigned to control (n = 20) and model (n = 20) groups. Rats in the control group were maintained under normal conditions, while rats in the model group were exposed to a controlled frontal airflow of 2-4 m/s from a fan for 7.5 h daily while placed on a suspended cylindrical wire mesh frame. Various assessments were performed at different time points during the 14-day experiment, including blink frequency, tear secretion (phenol red thread test), tear film breakup time (BUT), fluorescein staining (FL), corneal epithelial status (light microscopy), ultrastructure of corneal epithelial cells (electron microscopy), and expression levels of inflammatory cytokines (IL-1β, TNF-α) in tears (enzyme-linked immunosorbent assay). Additionally, mRNA and protein expression levels of MMP-9, IL1β, IL6, TNF-α, IFN-γ, and caspase-3 in corneal tissues were quantified (real-time quantitative PCR and Western blotting). Compared to the control group, the model group rats exhibited significant decreases in blink frequency (P < 0.001), tear secretion (Schirmer I test) values (P < 0.001), and tear film breakup time levels (P < 0.001). There was also a significant increase in fluorescein staining scores (P < 0.001) in the model group. Histological examination revealed distinct differences of the corneal epithelium between groups. The corneal epithelium of the model group appeared thicker, with disorganized cell arrangement in the superficial and basal layers, partial defects or detachment of superficial epithelial cells, and a rough, uneven surface. Scanning electron microscopy observations showed a rough corneal epithelial surface with numerous cracks and scattered vesicular-like structures in the model group. Furthermore, the model group rats exhibited a significant increase in expression of IL-1β and TNF-α in tears (P < 0.001), and upregulated expression levels of MMP-9, TNF-α, IL-1β, caspase-3, IL-6, and IFN-γ at both the mRNA and protein levels in corneal tissues (P < 0.001). In conclusion, the modified "wire-meshing cylindrical board" model effectively overcomes the limitations of the traditional "jogging board " dry eye model and successfully simulates the etiology of prolonged visual fatigue. This innovative EDE model demonstrates a high degree of relevance to dry eye conditions resulting from prolonged visual tasks, with a high success rate of model induction. Moreover, it proves to be a simple, practical, and easily replicable model, making it highly suitable for further studies on prolonged visual fatigue and facilitating its widespread adoption in research and clinical applications.
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Affiliation(s)
- Lei Zhao
- Liaoning University of Traditional Chinese Medicine, China; Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China
| | - Jj Jiajia Yu
- Liaoning University of Traditional Chinese Medicine, China
| | - Yulin Liu
- Liaoning University of Traditional Chinese Medicine, China
| | - Tao Zuo
- Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China
| | - Huimin Zhou
- Liaoning University of Traditional Chinese Medicine, China
| | - Pin Ju
- Liaoning University of Traditional Chinese Medicine, China
| | - Yuexin Li
- Liaoning University of Traditional Chinese Medicine, China
| | - Yingyue Cao
- Liaoning University of Traditional Chinese Medicine, China
| | - Baoqiang Dong
- Liaoning University of Traditional Chinese Medicine, China.
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3
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Zhou Y, Ma B, Liu Q, Duan H, Huo Y, Zhao L, Chen J, Han W, Qi H. Transmembrane Protein CMTM6 Alleviates Ocular Inflammatory Response and Improves Corneal Epithelial Barrier Function in Experimental Dry Eye. Invest Ophthalmol Vis Sci 2024; 65:4. [PMID: 38165704 PMCID: PMC10768713 DOI: 10.1167/iovs.65.1.4] [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: 09/30/2023] [Accepted: 12/04/2023] [Indexed: 01/04/2024] Open
Abstract
Purpose To investigate the impact of transmembrane protein CMTM6 on the pathogenesis of dry eye disease (DED) and elucidate its potential mechanisms. Methods CMTM6 expression was confirmed by database analysis, real-time polymerase chain reaction (RT-PCR), western blot, and immunohistochemistry. Tear secretion was measured using the phenol red thread test. Immune cell infiltration was assessed through flow cytometry. Barrier function was evaluated by fluorescein sodium staining, immunofluorescence staining of zonula occludens 1 (ZO-1), and electric cell-substrate impedance sensing (ECIS) assessment. For silencing CMTM6 expression, siRNA and shRNA were employed, along with lentiviral vector-mediated overexpression of CMTM6. Proinflammatory cytokine levels were analyzed by RT-PCR and cytometric bead array (CBA) analysis. Results CMTM6 showed high expression in healthy human and mouse corneal and conjunctival epithelium but was notably reduced in DED. Notably, this downregulation was correlated with disease severity. Cmtm6-/- dry eye (DE) mice displayed reduced tear secretion, severe corneal epithelial defects, decreased conjunctival goblet cell density, and upregulated inflammatory response. Additionally, Cmtm6-/- DE mice and CMTM6 knockdown human corneal epithelial cell-transformed (HCE-T) cells showed more severe barrier disruption and reduced expression of ZO-1. Knockdown of CMTM6 in HCE-T cells increased inflammatory responses induced by hyperosmotic stress, which was significantly mitigated by CMTM6 overexpression. Moreover, the level of phospho-p65 in hyperosmolarity-stimulated HCE-T cells increased after silencing CMTM6. Nuclear factor kappa B (NF-κB) p65 inhibition (JSH-23) reversed the excessive inflammatory responses caused by hyperosmolarity in CMTM6 knockdown HCE-T cells. Conclusions The reduction in CMTM6 expression on the ocular surface contributes to the pathogenesis of DED. The CMTM6-NF-κB p65 signaling pathway may serve as a promising therapeutic target for DED.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Baikai Ma
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Qiyao Liu
- Department of Immunology, Peking University Health Science Center, NHC Key Laboratory of Medical Immunology, Beijing, China
- Peking University Center for Human Disease Genomics, Beijing, China
| | - Hongyu Duan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yangbo Huo
- Department of Immunology, Peking University Health Science Center, NHC Key Laboratory of Medical Immunology, Beijing, China
- Peking University Center for Human Disease Genomics, Beijing, China
| | - Lu Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Jiawei Chen
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Wenling Han
- Department of Immunology, Peking University Health Science Center, NHC Key Laboratory of Medical Immunology, Beijing, China
- Peking University Center for Human Disease Genomics, Beijing, China
| | - Hong Qi
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
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4
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Acupuncture Alleviates Corneal Inflammation in New Zealand White Rabbits with Dry Eye Diseases by Regulating α7nAChR and NF-κB Signaling Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6613144. [DOI: 10.1155/2022/6613144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/15/2022]
Abstract
Purpose. The purpose of this study is to determine the mechanism of improvement in dry eye diseases (DEDs) treated by acupuncture. The inflammatory molecules and related pathways will be analyzed in our study. Methods. In order to establish the animal model for DEDs, healthy New Zealand white rabbits were treated with scopolamine (Scop) hydrobromide for 21 consecutive days. After 21 days, acupuncture, fluorometholone (Flu), and α7nAChR antagonist (α-BGT) treatments were performed, and the Scop injections were continued until day 35. The therapeutic effect of acupuncture on DED inflammation was evaluated by corneal fluorescence staining, tear film rupture time, tear flow measurement, in vivo confocal microscopy (IVCM), corneal histopathology, and cytokine protein chip technology. The influence of acupuncture on the corneal pathology and inflammatory factors ACh, α7nAChR, and NF-κB was detected by enzyme-linked immunosorbent assay (ELISA) and western blot. Results. Compared with the group Scop, acupuncture can significantly reduce corneal staining and increase the tear film rupture time and tear flow, which are accompanied by a decrease in corneal epithelial detachment and lymphocyte infiltration. Acupuncture can relieve the inflammation of corneal stroma and mitigate the expression of proinflammatory factors and chemokines. Acupuncture can upregulate the expression of ACh and α7nAChR and downregulate the expression of NF-κB. Conclusion. Our findings demonstrate that acupuncture can alleviate corneal inflammation in New Zealand white rabbits with DEDs via α7nAChR and NF-κB signaling pathway regulation. The expression indicates that α7nAChR/NF-κB signaling pathway may be active and that acupuncture is a potential therapeutic target for dry eye.
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5
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Zhu J, Inomata T, Shih KC, Okumura Y, Fujio K, Huang T, Nagino K, Akasaki Y, Fujimoto K, Yanagawa A, Miura M, Midorikawa-Inomata A, Hirosawa K, Kuwahara M, Shokirova H, Eguchi A, Morooka Y, Chen F, Murakami A. Application of Animal Models in Interpreting Dry Eye Disease. Front Med (Lausanne) 2022; 9:830592. [PMID: 35178415 PMCID: PMC8844459 DOI: 10.3389/fmed.2022.830592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
Different pathophysiologic mechanisms are involved in the initiation, development, and outcome of dry eye disease (DED). Animal models have proven valuable and efficient in establishing ocular surface microenvironments that mimic humans, thus enabling better understanding of the pathogenesis. Several dry eye animal models, including lacrimal secretion insufficiency, evaporation, neuronal dysfunction, and environmental stress models, are related to different etiological factors. Other models may be categorized as having a multifactorial DED. In addition, there are variations in the methodological classification, including surgical lacrimal gland removal, drug-induced models, irradiation impairment, autoimmune antibody-induced models, and transgenic animals. The aforementioned models may manifest varying degrees of severity or specific pathophysiological mechanisms that contribute to the complexity of DED. This review aimed to summarize various dry eye animal models and evaluate their respective characteristics to improve our understanding of the underlying mechanism and identify therapeutic prospects for clinical purposes.
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Affiliation(s)
- Jun Zhu
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kendrick Co Shih
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ken Nagino
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ai Yanagawa
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizu Kuwahara
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hurramhon Shokirova
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuki Morooka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fang Chen
- Department of Ophthalmology, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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6
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Koca S, Koca SB, İnan S. Ocular surface alterations and changes of meibomian glands with meibography in type 1 diabetic children. Int Ophthalmol 2022; 42:1613-1621. [PMID: 35088356 DOI: 10.1007/s10792-021-02155-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/18/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To observe the changes of the ocular surface and meibomian glands by non-contact meibography in patients with type 1 diabetic children. METHODS A total of forty-three patients with type 1 diabetic children and 43 age-matched healthy subjects were included in the study. The ocular surface disease index (OSDI) questionnaire, invasive tear film break-up time (TF-BUT), fluorescein staining of the ocular surface and Schirmer II test were performed for all participants. Ocular surface and lid margins were evaluated by slit lamp. Non-contact meibography was performed with the Phoenix-Meibography module in Sirius corneal topographic device. RESULTS Both groups consisted of 25 (58.1%) female and 18 (41.9%) male children and the mean age was 14.4 ± 2.5 years. In the T1DM group, the mean disease duration was 6.8 ± 3.1 years. The mean TF-BUT (p = 0.002) and Schirmer II test (p = 0.007) measurements were lower in the diabetic group than those of in controls. Total eyelid score (p = 0.027) and meibomian gland (MG) secretion score (p = 0.007) were significantly high in diabetic children. MG area loss was also significantly high in both lower and upper eyelid (p < 0.001). In morphological analyses of meibomian glands thinning, shortening and presence of ghost areas (p = 0.05, p = 0.027 and p = 0.000, respectively) were more common in the diabetic group. There was no correlation between both lower and upper eyelid meiboscores and disease duration (p = 0.51 and p = 0.61), BMI (p = 0.08 and p = 0.51), serum HbA1c level (p = 0.06 and p = 0.49) and IGF-1 SDS (p = 0.38 and p = 0.68). CONCLUSION The study revealed that the MG loss area increases and morphological alterations of meibomian glands occur in type 1 diabetic children. Disease duration and metabolic control of diabetes do not affect meibography measurements. CLINICAL TRIALS REGISTRATION The study was organized in accordance with the ethical standards settled by the Ethics Committee of Faculty of Medicine, Afyonkarahisar Health Sciences University. TRIAL REGISTRATION NUMBER 2011-KAEK-2, 2021/106. TRIAL REGISTRATION DATE 02.05.2021.
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Affiliation(s)
- Semra Koca
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Serkan Bilge Koca
- Division of Pediatric Endocrinology, Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Sibel İnan
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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7
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Huang W, Tourmouzis K, Perry H, Honkanen RA, Rigas B. Animal models of dry eye disease: Useful, varied and evolving (Review). Exp Ther Med 2021; 22:1394. [PMID: 34650642 PMCID: PMC8506913 DOI: 10.3892/etm.2021.10830] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/10/2021] [Indexed: 02/07/2023] Open
Abstract
Dry eye disease (DED), which is a prevalent disease that still lacks successful treatment options, remains a major challenge in ophthalmology. Multiple animal models of DED have been used to decipher its pathophysiology and to develop novel treatments. These models use mice, rats, rabbits, cats, dogs and non-human primates. Each model assesses aspects of DED by focusing on elements of the lacrimal functional unit, which controls the homeostasis of the tear film. The present review outlines representative DED animal models and assesses their contribution to the study of DED. Murine models are the most extensively used, followed by rabbit models; the latter offer the advantage of larger eyes, a favorable biochemical profile for drug studies, experimental ease and relatively low cost, contrasting with non-human primates, which, although closer to humans, are not as accessible and are expensive. No comprehensive ‘ideal’ animal model encompassing all aspects of human DED exists nor is it feasible. Investigators often choose an animal model based on their experimental needs and the following four features of a given model: The size of the eye, its biochemical composition, the available research reagents and cost. As research efforts in DED expand, more refined animal models are needed to supplement the enormous contribution made to date by existing models.
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Affiliation(s)
- Wei Huang
- Department of Ophthalmology, Stony Brook University, Stony Brook, NY 11794, USA.,Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | | | - Henry Perry
- Ophthalomology Consultants of Long Island, Westbury, NY 11590, USA
| | - Robert A Honkanen
- Department of Ophthalmology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Basil Rigas
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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8
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Bhallamudi S, Roos BB, Teske JJ, Wicher SA, McConico A, M Pabelick C, Sathish V, Prakash YS. Glial-derived neurotrophic factor in human airway smooth muscle. J Cell Physiol 2021; 236:8184-8196. [PMID: 34170009 DOI: 10.1002/jcp.30489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/18/2021] [Accepted: 06/09/2021] [Indexed: 11/09/2022]
Abstract
Airway smooth muscle (ASM) cells modulate the local airway milieu via production of inflammatory mediators and growth factors including classical neurotrophins, such as brain-derived neurotrophic factor (BDNF). The glial cell-derived neurotrophic factor (GDNF) family of ligands (GFLs) are nonclassical neurotrophins and their role in the airway is barely understood. The major GFLs, GDNF and Neurturin (NRTN) bind to GDNF family receptor (GFR) α1 and α2 respectively that pair with Ret receptor to accomplish signaling. In this study, we found GDNF is expressed in human lung and increased in adult asthma, while human ASM expresses GDNF and its receptors. Accordingly, we used human ASM cells to test the hypothesis that ASM expression and autocrine signaling by GFLs regulate [Ca2+ ]i . Serum-deprived ASM cells from non-asthmatics were exposed to 10 ng/ml GDNF or NRTN for 15 min (acute) or 24 h (chronic). In fura-2 loaded cells, acute GDNF or NRTN alone induced [Ca2+ ]i responses, and further enhanced responses to 1 µM ACh or 10 µM histamine. Ret inhibitor (SPP86; 10 µM) or specific GDNF chelator GFRα1-Fc (1 µg/ml) showed roles of these receptors in GDNF effects. In contrast, NRTN did not enhance [Ca2+ ]i response to histamine. Furthermore, conditioned media of nonasthmatic and asthmatic ASM cells showed GDNF secretion. SPP86, Ret inhibitor and GFRα1-Fc chelator markedly decreased [Ca2+ ]i response compared with vehicle, highlighting autocrine effects of secreted GDNF. Chronic GDNF treatment increased histamine-induced myosin light chain phosphorylation. These novel data demonstrate GFLs particularly GDNF/GFRα1 influence ASM [Ca2+ ]i and raise the possibility that GFLs are potential targets of airway hyperresponsiveness.
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Affiliation(s)
- Sangeeta Bhallamudi
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota, USA
| | - Benjamin B Roos
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jacob J Teske
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah A Wicher
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrea McConico
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota, USA
| | - Christina M Pabelick
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Venkatachalem Sathish
- Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota, USA
| | - Y S Prakash
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
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9
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Musayeva A, Jiang S, Ruan Y, Zadeh JK, Chronopoulos P, Pfeiffer N, Müller WE, Ackermann M, Xia N, Li H, Gericke A. Aged Mice Devoid of the M 3 Muscarinic Acetylcholine Receptor Develop Mild Dry Eye Disease. Int J Mol Sci 2021; 22:ijms22116133. [PMID: 34200187 PMCID: PMC8201107 DOI: 10.3390/ijms22116133] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/28/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022] Open
Abstract
The parasympathetic nervous system is critically involved in the regulation of tear secretion by activating muscarinic acetylcholine receptors. Hence, various animal models targeting parasympathetic signaling have been developed to induce dry eye disease (DED). However, the muscarinic receptor subtype (M1–M5) mediating tear secretion remains to be determined. This study was conducted to test the hypothesis that the M3 receptor subtype regulates tear secretion and to evaluate the ocular surface phenotype of mice with targeted disruption of the M3 receptor (M3R−/−). The experimental techniques included quantification of tear production, fluorescein staining of the ocular surface, environmental scanning electron microscopy, assessment of proliferating cells in the corneal epithelium and of goblet cells in the conjunctiva, quantification of mRNA for inflammatory cytokines and prooxidant redox enzymes and quantification of reactive oxygen species. Tear volume was reduced in M3R−/− mice compared to age-matched controls at the age of 3 months and 15 months, respectively. This was associated with mild corneal epitheliopathy in the 15-month-old but not in the 3-month-old M3R−/− mice. M3R−/− mice at the age of 15 months also displayed changes in corneal epithelial cell texture, reduced conjunctival goblet cell density, oxidative stress and elevated mRNA expression levels for inflammatory cytokines and prooxidant redox enzymes. The findings suggest that the M3 receptor plays a pivotal role in tear production and its absence leads to ocular surface changes typical for DED at advanced age.
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Affiliation(s)
- Aytan Musayeva
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
- Laboratory of Corneal Immunology, Transplantation and Regeneration, Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
- Correspondence: (A.M.); (A.G.); Tel.: +49-613-117-8276 (A.G.)
| | - Subao Jiang
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
| | - Yue Ruan
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
| | - Jenia Kouchek Zadeh
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
| | - Panagiotis Chronopoulos
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
| | - Werner E.G. Müller
- ERC Advanced Investigator Grant Research Group at the Institute for Physiological Chemistry, University Medical Center, Johannes Gutenberg University Mainz, Duesbergweg 6, 55128 Mainz, Germany;
| | - Maximilian Ackermann
- Institute of Functional and Clinical Anatomy, University Medical Center, Johannes Gutenberg University Mainz, Johann-Joachim-Becher-Weg 13, 55128 Mainz, Germany;
| | - Ning Xia
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.X.); (H.L.)
| | - Huige Li
- Department of Pharmacology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.X.); (H.L.)
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (S.J.); (Y.R.); (J.K.Z.); (P.C.); (N.P.)
- Correspondence: (A.M.); (A.G.); Tel.: +49-613-117-8276 (A.G.)
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Chang YA, Wu YY, Lin CT, Kawasumi M, Wu CH, Kao SY, Yang YP, Hsu CC, Hung KF, Sun YC. Animal models of dry eye: Their strengths and limitations for studying human dry eye disease. J Chin Med Assoc 2021; 84:459-464. [PMID: 33871392 DOI: 10.1097/jcma.0000000000000529] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Dry eye disease (DED), also called the keratoconjunctivitis sicca, is one of the most common diseases in the ophthalmology clinics. While DED is not a life-threatening disease, life quality may be substantially affected by the discomfort and the complications of poor vision. As such, a large number of studies have made contributions to the investigation of the DED pathogenesis and novel treatments. DED is a multifactorial disease featured with various phenotypic consequences; therefore, animal models are valuable tools suitable for the related studies. Accordingly, selection of the animal model to recapitulate the clinical presentation of interest is important for appropriately addressing the research objective. To this end, we systemically reviewed different murine and rabbit models of DED, which are categorized into the quantitative (aqueous-deficient) type and the qualitative (evaporative) type, based on the schemes to establish. The clinical manifestations of dry eye on animal models can be induced by mechanical or surgical approaches, iatrogenic immune response, topical eye drops, blockage of neural pathway, or others. Although these models have shown promising results, each has its own limitation and cannot fully reproduce the pathophysiological mechanisms that occur in patients. Nonetheless, the animal models remain the best approximation of human DED and represent the valuable tool for the DED studies.
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Affiliation(s)
- Yu-An Chang
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Yi-Ying Wu
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Chung-Tien Lin
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - Masaoki Kawasumi
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Cheng-Hsien Wu
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chih-Chien Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Kai-Feng Hung
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yi-Chen Sun
- Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taiwan, ROC; and College of Medicine, Tzu-Chi University, Hualien, Taiwan
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11
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Kim CE, Kim YJ, Hwang MW, Park YJ, Yang J. Cevimeline-induced anti-inflammatory effect through upregulations of mucins in the ocular surface of a dry eye mouse model. Biomed Pharmacother 2021; 139:111571. [PMID: 33857915 DOI: 10.1016/j.biopha.2021.111571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 01/30/2023] Open
Abstract
This study aimed to investigate the effects of various concentrations of cevimelines (CVMs) and compare them with commercial drugs in a murine model of dry eye. The experimental mouse model used male and female NOD.B10.H2b mice over 12 weeks of age. Desiccation stress was performed at 30-40% ambient humidity, and subcutaneous injection of 0.5 mg/0.2 mL scopolamine hydrobromide was performed four times a day for 10 days. The efficacy of various concentrations of CVMs (seven experimental groups) was first evaluated, and then 2% CVM was compared with commercial drugs, such as cyclosporine A (CsA), diquafosol (DQS), and rebamipide (REB) (seven experimental groups). The clinical changes, including tear production, corneal irregularity, and fluorescein staining, were measured after the instillation of various concentrations of CVMs and commercial drugs for 0, 3, 5, 7, and 10 days. Histological changes, such as corneal detachment, conjunctival goblet cell and mucin density staining, were assessed by staining the cornea or conjunctiva with hematoxylin-eosin, periodic acid-Schiff, and alcian blue. The expression of inflammatory markers and mucin factors was detected by immunohistochemistry and immunofluorescence in the lacrimal gland, cornea, and conjunctiva. Tear production was significantly increased in the 2% CVM group and was similar to that in the DQS and REB groups (P < 0.05). The corneal smoothness and fluorescein staining score were significantly improved in the 2% CVM group and were similar to those in the REB group (P < 0.05). Corneal epithelial cells were significantly decreased in the 2% CVM group, with similar observations made in the DQS and REB groups (P < 0.05). The conjunctival goblet cells and mucin density recovered in the 2% CVM group were similar to those in the CsA and REB groups (P < 0.05). The 2% CVM group showed suppressed expression of inflammatory factors in the lacrimal gland and was comparable to that seen in the CsA and REB groups. The expression of mucin factors was upregulated in the cornea and conjunctiva of the 2% CVM group and was similar to that of the CsA and REB groups. In conclusion, administration of CVM resulted in recovery or clinical and histological improvement of the murine dry eye model, and all the observed parameters were comparable to those with commercial drugs.
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Affiliation(s)
- Chae Eun Kim
- T2B infrastructure Center for Ocular Disease, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea
| | - Young Jin Kim
- Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea
| | - Moon Won Hwang
- Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea
| | - Young-Joon Park
- College of Pharmacy, Ajou University, Suwon 16499, Republic of Korea; IMDpharm Inc., Suwon 16226, Republic of Korea.
| | - Jaewook Yang
- T2B infrastructure Center for Ocular Disease, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea; Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea.
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12
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Zou X, Wang S, Zhang P, Lu L, Zou H. Quantitative Proteomics and Weighted Correlation Network Analysis of Tear Samples in Adults and Children With Diabetes and Dry Eye. Transl Vis Sci Technol 2020; 9:8. [PMID: 33344052 PMCID: PMC7718812 DOI: 10.1167/tvst.9.13.8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/20/2020] [Indexed: 12/18/2022] Open
Abstract
Purpose Diabetics are more prone to suffer from dry eye (DE). The ages of diabetes are decreasing, so ocular surface status in younger generations is worthy of attention. We used tandem mass tag (TMT)–labeled proteomics and weighted correlation network analysis (WGCNA) to identify differentially expressed proteins in the tear proteome of adults and children with diabetic DE. Methods Study subjects were divided into six groups of 10, including three groups each for adults and children. The adult groups included diabetics with DE (A), diabetics without DE (B), and normal controls (C); the corresponding groups of children were identified as (D), (E), and (F). DE tests were performed on all subjects. We extracted total proteins and labeled them with TMTs for analysis. WGCNA was used to recognize hub genes. Results Tear film function was poorer in patients with diabetic DE. In adults, 1922 proteins were identified, and WGCNA analysis revealed three hub genes related to diabetic DE. For children, 2709 proteins were identified, and WGCNA analysis identified one hub gene related to diabetic DE. Kyoto Encyclopedia of Genes and Genomes analysis found similarities among metabolic pathways involved in differential expression of proteins in adult and child tear samples. Conclusions The pathogenesis of diabetic DE was highly similar in adults and children. The differentially expressed tear proteins in type 2 diabetes of adults and children was associated with inflammation, immune factors, and lipid metabolism. Translational Relevance Our findings found high similarities in the pathogenesis of diabetic DE in adults and children.
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Affiliation(s)
- Xinrong Zou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China.,Department of Ophthalmology, Fengcheng Hospital, Fengxian District, Shanghai, China
| | - Shanshan Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Pei Zhang
- Department of Ophthalmology, Gonghui Hospital, Jingan District, Shanghai, China
| | - Lina Lu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Haidong Zou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
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13
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Li H, Wei F, Li S, Yan L, Lu P. The effect of sinomenine eye drops on experimental dry eye in mice. Cutan Ocul Toxicol 2020; 39:389-395. [PMID: 33103493 DOI: 10.1080/15569527.2020.1840580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Hui Li
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Ophthalmology, The Shanghai Sixth People's Hospital , Shanghai, China
| | - Feng Wei
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shiwei Li
- Department of Ophthalmology, The Shanghai Sixth People's Hospital , Shanghai, China
| | - Liang Yan
- Department of Ophthalmology, The Shanghai Sixth People's Hospital , Shanghai, China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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14
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Morel L, Domingues O, Zimmer J, Michel T. Revisiting the Role of Neurotrophic Factors in Inflammation. Cells 2020; 9:cells9040865. [PMID: 32252363 PMCID: PMC7226825 DOI: 10.3390/cells9040865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 12/13/2022] Open
Abstract
The neurotrophic factors are well known for their implication in the growth and the survival of the central, sensory, enteric and parasympathetic nervous systems. Due to these properties, neurturin (NRTN) and Glial cell-derived neurotrophic factor (GDNF), which belong to the GDNF family ligands (GFLs), have been assessed in clinical trials as a treatment for neurodegenerative diseases like Parkinson’s disease. In addition, studies in favor of a functional role for GFLs outside the nervous system are accumulating. Thus, GFLs are present in several peripheral tissues, including digestive, respiratory, hematopoietic and urogenital systems, heart, blood, muscles and skin. More precisely, recent data have highlighted that different types of immune and epithelial cells (macrophages, T cells, such as, for example, mucosal-associated invariant T (MAIT) cells, innate lymphoid cells (ILC) 3, dendritic cells, mast cells, monocytes, bronchial epithelial cells, keratinocytes) have the capacity to release GFLs and express their receptors, leading to the participation in the repair of epithelial barrier damage after inflammation. Some of these mechanisms pass on to ILCs to produce cytokines (such as IL-22) that can impact gut microbiota. In addition, there are indications that NRTN could be used in the treatment of inflammatory airway diseases and it prevents the development of hyperglycemia in the diabetic rat model. On the other hand, it is suspected that the dysregulation of GFLs produces oncogenic effects. This review proposes the discussion of the biological understanding and the potential new opportunities of the GFLs, in the perspective of developing new treatments within a broad range of human diseases.
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15
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Zou X, Zhang P, Xu Y, Lu L, Zou H. Quantitative Proteomics and Weighted Correlation Network Analysis of Tear Samples in Type 2 Diabetes Patients Complicated with Dry Eye. Proteomics Clin Appl 2020; 14:e1900083. [PMID: 31951085 DOI: 10.1002/prca.201900083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 12/30/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Diabetic patients are more likely to experience dry eye (DE). TMT-based proteomics and WGCNA are used to identify the differentially expressed proteins in tear proteome of type 2 diabetes with DE. The aim is to provide a molecular basis for exploring possible mechanisms underlying the pathogenesis of diabetic DE. EXPERIMENTAL DESIGN Subjects are divided into four groups (ten in each): type 2 diabetes with DE; type 2 diabetes without DE; non-diabetes with DE and normal controls. All subjects undergo DE tests. Total proteins are extracted and quantitatively labeled with TMT, then analyzed using liquid chromatography-mass spectrometry. WGCNA is used to identify the hub genes. Finally, differentially expressed proteins are validated by ELISA. RESULTS A total of 1922 proteins are identified, of which 1814 contain quantitative information. Ultimately, 650 of these proteins yield quantitative values. WGCNA performed on these 650 proteins reveal four distinct hub genes of diabetic DE. CONCLUSIONS AND CLINICAL RELEVANCE DE is associated with the differential expression of tear proteins in type 2 diabetes. Inflammation, immune factors, and lipid metabolism may play a role in the development of diabetic DE. LTF, LYZ, ZAG, and DNAJC3 have the potential to be the biomarkers of DE in diabetes.
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Affiliation(s)
- Xinrong Zou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, 200040, China.,Department of Ophthalmology, Fengcheng Hospital, Fengxian District, Shanghai, 201411, China
| | - Pei Zhang
- Department of Ophthalmology, Gonghui Hospital, Jingan District, Shanghai, 200041, China
| | - Yi Xu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Lina Lu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Haidong Zou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
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16
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Yu T, Han XG, Gao Y, Song AP, Dang GF. Morphological and cytological changes of meibomian glands in patients with type 2 diabetes mellitus. Int J Ophthalmol 2019; 12:1415-1419. [PMID: 31544036 DOI: 10.18240/ijo.2019.09.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/21/2019] [Indexed: 12/28/2022] Open
Abstract
AIM To observe the changes of microcellular structure of meibomian glands (MGs) in type 2 diabetes mellitus (DM), and to explore its correlation with the duration of diabetes. METHODS The study assessed 132 eyes of 132 patients with type 2 diabetes mellitus (DM group) and 100 eyes of 100 non-diabetic participants (NDM group). All patients underwent the examination of the Keratograph 5M system to obtain the meibography which were used to evaluate the structure dropout of the MGs. And then laser scanning confocal microscopy (LSCM) was performed for observing the acinar cells and ducts of the MGs to obtain the following parameters: the MG acinar unit density (MGAUD), MG acinar longest diameter (MGALD) and MG acinar shortest diameter (MGASD). The examination results of the right eye were selected for analysis. RESULTS Compared with that in NDM group, the meiboscore was significantly higher (Z=-4.057, P<0.001), and there were more MGs dropout in DM group. With the prolongation of the course of diabetes, the absence of MGs aggravated and the MGs dropout score increased (r=0.596; P<0.001). LSCM showed that there were various cytological alterations in acinar cells of MGs with the progress of diabetes duration, such as expansion, atrophy or fibrosis of MG acinar units, decreased density of MG acinar units, deposition of lipid substances, infiltration of inflammatory cells, proliferation of fibrous tissues, etc. And the opening of the glandular duct changed from smooth at the beginning to narrow, blocked, fibrotic and so on. Compared with that in NDM group, the MGAUD in DM group was significantly lower (Z=-9.713; P<0.001), the MGALD and MGASD were significantly larger (Z=-9.751, -6.416; P<0.001). With the duration of diabetes, the MGAUD reduced, the MGASD increased (r=0.860, 0.364, P<0.001); but the MGALD had no correlation with diabetic duration (r=0.133, P=0.151). CONCLUSION With the progress of diabetes, the meibomian glandular acinar cells of diabetic patients show various manifestations. Those changes may result in the dysfuction of the MGs, tear film instability and dry eye symptoms in patients with type 2 DM.
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Affiliation(s)
- Tao Yu
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Xu-Guang Han
- Jinan Aier Ophthalmology Hospital, Aier Eye Hospital Group, Jinan 250014, Shandong Province, China
| | - Yang Gao
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Ai-Ping Song
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Guang-Fu Dang
- Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China
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17
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Ocular mucins in dry eye disease. Exp Eye Res 2019; 186:107724. [PMID: 31325452 DOI: 10.1016/j.exer.2019.107724] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 12/12/2022]
Abstract
Dry eye disease is a common and multifactorial disease with a high prevalence worldwide. Water loss, reduced expression of glycocalyx mucins, and loss of goblet cells secreting gel-forming mucins are hallmarks of dry eye disease. Mucins are large and complex heavily glycosylated proteins. Their organization in the tear film remains unclear, but they play a key role to protect and maintain integrity of the ocular surface. Mice have been extremely valuable mammalian models with which to study ocular physiology and disease, and to evaluate eye therapies. Genetically modified mice and spontaneously occurring mutants with eye defects have proven to be powerful tools for the pharmaceutical industry, clinicians, and basic researchers investigating dry eye disease. However, ocular mucins remain relatively under-studied and inadequately characterized. This review aims to summarize current knowledge about mucin production at the ocular surface in healthy individuals and in dry eye disease, and to compile an overview of mouse models available for the study of mucins in dry eye disease.
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Abstract
Post-LASIK dry eye is the most common postoperative dry eye after ophthalmic surgeries. The clinical signs of post-LASIK dry eye include positive vital staining of the ocular surface, decreased tear breakup time and Schirmer test values, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs usually last for about 1 month after LASIK. A small number of patients continue to experience symptoms more than 1 year postoperatively. It has been suggested that the loss of corneal innervation caused by flap-making is the major cause, affecting the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland reflexes, resulting in decreased aqueous and lipid tear secretion and mucin expression. A new type of corneal refractive surgery, SMILE, which has less impact on corneal nerves, induces less postoperative dry eye, supporting the association between corneal denervation and postoperative dry eye. As LASIK enhancement by flap-lifting induces fewer dry eye symptoms and signs than initial surgery, factors other than neurotrophic effects may be involved in the mechanisms of post-LASIK dry eye. Post-LASIK ocular surface pain is a type of postoperative chronic pain and discomfort, and is thought to be a different clinical entity from dry eye, possibly induced by abnormal reinnervation or neural sensitization of peripheral nerves and the central nervous system after LASIK. Treatments include tear supplements, anti-inflammatory agents, meibomian gland dysfunction management, ointment and eye patches, punctal plugs, and autologous serum eye drops. For patients with preoperative dry eye, careful patient selection, and preoperative ocular surface management are mandatory.
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Fu R, Jiang Y, Zhou J, Zhang J. Rebamipide ophthalmic solution modulates the ratio of T helper cell 17/regulatory T cells in dry eye disease mice. Mol Med Rep 2019; 19:4011-4018. [PMID: 30896815 PMCID: PMC6472194 DOI: 10.3892/mmr.2019.10068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/15/2018] [Indexed: 01/09/2023] Open
Abstract
The aim of the present study was to confirm the effect of 2% rebamipide ophthalmic solution on a scopolamine‑induced dry eye (DE) mouse model, and to investigate its effect on the ratio of T helper cell 17 (Th17)/regulatory T cell (Treg) numbers. C57BL/6 mice received subcutaneous injections of scopolamine and were exposed to a low‑humidity environment in order to establish a DE model. Rebamipide eye drops (2%) administered four times daily for 2 weeks, significantly reduced the corneal staining scores and increased the tear film breakup time and tear production in the DE mice. Pathologically, the rebamipide restored the histological changes induced by DE in the cornea, conjunctiva and lacrimal gland. At a molecular level, it downregulated pro‑inflammatory and upregulated anti‑inflammatory cytokines in the conjunctiva and lacrimal gland. Furthermore, the increased Th17 and Treg levels were restored following treatment with rebamipide. In conclusion, the anti‑inflammatory and Th17/Treg balance‑preserving effects of rebamipide may contribute to the treatment of DE in mice.
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Affiliation(s)
- Rongrong Fu
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, P.R. China
- Department of Ophthalmology, Shenyang Fourth People's Hospital, Shenyang, Liaoning 110031, P.R. China
| | - Yanhua Jiang
- Department of Ophthalmology, Shenyang Fourth People's Hospital, Shenyang, Liaoning 110031, P.R. China
| | - Jing Zhou
- Department of Ophthalmology, Shenyang Fourth People's Hospital, Shenyang, Liaoning 110031, P.R. China
| | - Jinsong Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, P.R. China
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Maruoka S, Inaba M, Ogata N. Activation of Dendritic Cells in Dry Eye Mouse Model. Invest Ophthalmol Vis Sci 2019; 59:3269-3277. [PMID: 29971446 DOI: 10.1167/iovs.17-22550] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The immune system plays a major role in the pathogenesis of dry eye diseases (DED), and dendritic cells (DCs) are known to be important initiators of acquired immunity. Thus, the purpose of this study was to determine the contribution of DCs to the development of DED. Methods Mouse dry eye model was induced by subcutaneous injections of scopolamine and was euthanized at the baseline, and 2, 4, and 7 days postinjection. The activation of the DCs was determined by the mixed leukocyte reaction (MLR), and the number of activated CD86+ DCs in the lymph nodes was determined by flow cytometry. Upregulation of cytokines in the culture supernatant of MLR was determined by ELISA. Results Significantly increased superficial corneal punctate lesions and decreased number of goblet cells in the conjunctiva were observed in scopolamine-injected mice. The number of activated CD86+ DCs was significantly increased in the cervical lymph nodes but not in the inguinal lymph nodes of the dry eye mice. The stimulatory activity of the DCs derived from the cervical lymph nodes of dry eye mice was significantly higher than that of control mice, and upregulations of IL-17, IL-2, and IL-4 were observed in the culture supernatant of MLR. These results indicate that the DCs of the cervical lymph nodes were activated by the scopolamine injections. Conclusions Our results indicate that DCs in our dry eye model were sufficiently activated to stimulate the T cells that participate in the onset and progression of DED.
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Affiliation(s)
- Shinji Maruoka
- Department of Ophthalmology, Nara Medical University, Nara, Japan
| | - Muneo Inaba
- Department of Ophthalmology, Nara Medical University, Nara, Japan.,Department of Internal Medicine I, Kansai Medical University, Osaka, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University, Nara, Japan
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21
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Coursey TG, Wassel RA, Quiambao AB, Farjo RA. Once-Daily Cyclosporine-A-MiDROPS for Treatment of Dry Eye Disease. Transl Vis Sci Technol 2018; 7:24. [PMID: 30323997 PMCID: PMC6181191 DOI: 10.1167/tvst.7.5.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/06/2018] [Indexed: 12/15/2022] Open
Abstract
Purpose To determine if a Microemulsion Drug Ocular Penetration System (MiDROPS) formulation of cyclosporine A (CsA) delivers more drug and is more efficacious for treatment of dry eye disease (DED) than the current clinical formulation. Methods Tissue distribution of CsA was quantified by liquid chromatography with tandem mass spectrometry (LC-MS/MS). To assess tolerability, CsA-MiDROPS (0.1%) was applied to the eyes of rabbits twice per day for 14 days and assessed using ophthalmoscopic examinations. Mice were exposed to desiccating stress for 10 days and received daily topical instillation of the vehicle or test agent. Cornea staining was done to quantify corneal permeability. Histologic quantification of goblet cell (GC) density and CD4+ T-cell infiltration in the conjunctiva was performed. Results Ophthalmic distribution studies indicate significantly increased drug concentration with CsA-MiDROPS compared with Restasis. CsA-MiDROPS is well tolerated with little toxicity in a 2-week tolerability study. In the DED model, both 0.05% and 0.1% CsA-MiDROPS conferred a significant effect and were more effective than Restasis for treating experimental DED when dosed twice per day. As compared with Restasis dosed twice per day, 0.1% CsA-MiDROPS dosed once per day demonstrated superiority. Conclusions CsA-MiDROPS showed superior drug delivery and efficacy compared with other clinical formulations. As this product is simple to produce and needs to be only applied once daily, the clinical development of CsA-MiDROPS will help to reduce societal and patient burdens by lowering drug costs and accelerating/improving the activity of CsA. Translational Relevance MiDROPS has broad application concerning the ophthalmic development of lipophilic small molecule therapeutics.
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Kim CE, Kleinman HK, Sosne G, Ousler GW, Kim K, Kang S, Yang J. RGN-259 (thymosin β4) improves clinically important dry eye efficacies in comparison with prescription drugs in a dry eye model. Sci Rep 2018; 8:10500. [PMID: 30002412 PMCID: PMC6043477 DOI: 10.1038/s41598-018-28861-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/02/2018] [Indexed: 12/17/2022] Open
Abstract
This study evaluated the clinical activity of RGN-259 (thymosin β4) in comparison with cyclosporine A (CsA), diquafosol (DQS), and lifitegrast (LFA) in a murine model of dry eye. The model was NOD.B10-H2b mice in a 30–40% humidified environment together with daily scopolamine hydrobromide injections for 10 days. After desiccation stress, all drugs were evaluated after 10 treatment days. RGN-259 increased tear production similar to that in the DQS- and LFA-treated mice while CsA was inactive. RGN-259 improved corneal smoothness and decreased fluorescein staining similar to that of LFA group while CsA and DQS were inactive. Corneal epithelial detachment was reduced by RGN-259, and DQS and LFA showed similar activity but the CsA was inactive. RGN-259 increased conjunctival goblet cells and mucin production comparable to that seen with CsA, while DQS and LFA were inactive. RGN-259 reduced the over-expression of inflammatory factors comparable to that with CsA and LFA, while DQS was inactive. RGN-259 increased mucin production comparable to that observed with CsA, while DQS and LFA were inactive. In conclusion, RGN-259 promoted recovery of mucins and goblet cells, improved corneal integrity, and reduced inflammation in a dry eye mouse model and was equal to or more effective than prescription treatments.
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Affiliation(s)
- Chae Eun Kim
- Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, 47392, Korea
| | - Hynda K Kleinman
- Department of Biochemistry and Molecular Biology, The George Washington University School of Medicine, Washington D.C, USA.,ReGenTree, LLC, 116 Village Boulevard, Suite 200, Princeton, NJ, USA
| | - Gabriel Sosne
- Departments of Ophthalmology and Anatomy/Cell Biology, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Kyeongsoon Kim
- Department of Pharmaceutical Engineering, Inje University, Gimhae, Republic of Korea.,ReGenTree, LLC, 116 Village Boulevard, Suite 200, Princeton, NJ, USA
| | - Sinwook Kang
- ReGenTree, LLC, 116 Village Boulevard, Suite 200, Princeton, NJ, USA
| | - Jaewook Yang
- Department of Ophthalmology, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, 47392, Korea. .,T2B infrastructure Center for Ocular Disease, Inje University Busan Paik Hospital, Busan, 47392, Korea.
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23
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Zou X, Lu L, Xu Y, Zhu J, He J, Zhang B, Zou H. Prevalence and clinical characteristics of dry eye disease in community-based type 2 diabetic patients: the Beixinjing eye study. BMC Ophthalmol 2018; 18:117. [PMID: 29747621 PMCID: PMC5946388 DOI: 10.1186/s12886-018-0781-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 04/30/2018] [Indexed: 02/07/2023] Open
Abstract
Background This study was performed to evaluate the prevalence and clinical characteristics of dry eye disease (DED) in community-based type 2 diabetic patients and to identify the associated factors related with DED. Methods A total of 1360 type 2 diabetic patients in the Beixinjing community were randomly selected. All participants were given a questionnaire that assessed basic information and subjective symptoms.DED was diagnosed using the revised Japanese DED diagnostic criteria. All subjects underwent a routine ophthalmic examination, corneal sensitivity test, tear film break-up time(BUT) test, Schirmer I test, fluorescein and lissamine green staining(FL) and fundus photography. Diabetic retinopathy (DR) was graded according to the International severity scale of diabetic retinopathy and diabetic macular edema. Results Of the 1360 subjects, 238 (17.5%) were diagnosed with DED. There was a significant association between the presence of DED and higher blood glucose (P < 0.001, OR1.240) as well as higher levels of glycosylated hemoglobin HbA1c (P < 0.001, OR1.108). Corneal sensitivity was negatively correlated with the prevalence of DED (P = 0.02, OR0.973). Conclusions The prevalence of DED in this community-based study was 17.5%, which was lower than that observed in hospital-based studies. Diabetic patients with poor metabolic control were more likely to present with DED. A dry eye examination should be added to the routine screening of diabetes.
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Affiliation(s)
- Xinrong Zou
- Shanghai General Hospital, Nanjing Medical University, No. 100, Haining Road, Hongkou District, Shanghai, 200080, China.,Department of Ophthalmology, Fengcheng Hospital, No.9983, Chuannanfeng Road, Fengxian District, Shanghai, 201411, China
| | - Lina Lu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China
| | - Yi Xu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China
| | - Jianfeng Zhu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China
| | - Jiangnan He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China
| | - Bo Zhang
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China
| | - Haidong Zou
- Shanghai General Hospital, Nanjing Medical University, No. 100, Haining Road, Hongkou District, Shanghai, 200080, China. .,Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, No. 380, Kangding Road, Jingan, Shanghai, 200040, China. .,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. .,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
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24
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Gilger BC. Immune Relevant Models for Ocular Inflammatory Diseases. ILAR J 2018; 59:352-362. [DOI: 10.1093/ilar/ily002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/18/2018] [Accepted: 01/27/2018] [Indexed: 02/03/2023] Open
Abstract
Abstract
Ocular inflammatory diseases, such as dry eye and uveitis, are common, painful, difficult to treat, and may result in vision loss or blindness. Ocular side effects from the use of antiinflammatory drugs (such as corticosteroids or nonsteroidal antiinflammatories) to treat ocular inflammation have prompted development of more specific and safer medications to treat inflammatory and immune-mediated diseases of the eye. To assess the efficacy and safety of these new therapeutics, appropriate immune-relevant animal models of ocular inflammation are needed. Both induced and naturally-occurring models have been described, but the most valuable for translating treatments to the human eye are the animal models of spontaneous, immunologic ocular disease, such as those with dry eye or uveitis. The purpose of this review is to describe common immune-relevant models of dry eye and uveitis with an overview of the immuno-pathogenesis of each disease and reported evaluation of models from small to large animals. We will also review a selected group of naturally-occurring large animal models, equine uveitis and canine dry eye, that have promise to translate into a better understanding and treatment of clinical immune-relevant ocular disease in man.
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Affiliation(s)
- Brian C Gilger
- Professor of Ophthalmology, Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA
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25
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Ji YW, Mittal SK, Hwang HS, Chang EJ, Lee JH, Seo Y, Yeo A, Noh H, Lee HS, Chauhan SK, Lee HK. Lacrimal gland-derived IL-22 regulates IL-17-mediated ocular mucosal inflammation. Mucosal Immunol 2017; 10:1202-1210. [PMID: 28051088 PMCID: PMC5496813 DOI: 10.1038/mi.2016.119] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 11/09/2016] [Indexed: 02/04/2023]
Abstract
Inflammatory damage of mucosal surface of the eye is a hallmark of dry eye disease (DED) and, in severe cases, can lead to significant discomfort, visual impairment, and blindness. DED is a multifactorial autoimmune disorder with a largely unknown pathogenesis. Using a cross-sectional patient study and a well-characterized murine model of DED, herein we investigated the immunoregulatory function of interleukin-22 (IL-22) in the pathogenesis of DED. We found that IL-22 levels were elevated in lacrimal fluids of DED patients and inversely correlated with severity of disease. Acinar cells of the lacrimal glands (LGs), not inflammatory immune cells, are the primary source of IL-22, which suppresses inflammation in ocular surface epithelial cells upon desiccating stress. Moreover, loss of function analyses using IL-22 knockout mice demonstrated that IL-22 is essential for suppression of ocular surface infiltration of Th17 cells and inhibition of DED induction. Our novel findings elucidate immunoregulatory function of LG-derived IL-22 in inhibiting IL-17-mediated ocular surface epitheliopathy in DED thus making IL-22 a new relevant therapeutic target.
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Affiliation(s)
- Yong Woo Ji
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Cornea Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Sharad K. Mittal
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Ho Sik Hwang
- Department of Ophthalmology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Gangwon-Do, Korea
| | - Eun-Ju Chang
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Joon H. Lee
- Myunggok Eye Research Institute, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Yuri Seo
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Areum Yeo
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyemi Noh
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul. Korea
| | - Sunil K. Chauhan
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Hyung Keun Lee
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
- Cornea Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, Knop E, Markoulli M, Ogawa Y, Perez V, Uchino Y, Yokoi N, Zoukhri D, Sullivan DA. TFOS DEWS II pathophysiology report. Ocul Surf 2017; 15:438-510. [PMID: 28736340 DOI: 10.1016/j.jtos.2017.05.011] [Citation(s) in RCA: 944] [Impact Index Per Article: 134.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/26/2017] [Indexed: 12/18/2022]
Abstract
The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease. Its central mechanism is evaporative water loss leading to hyperosmolar tissue damage. Research in human disease and in animal models has shown that this, either directly or by inducing inflammation, causes a loss of both epithelial and goblet cells. The consequent decrease in surface wettability leads to early tear film breakup and amplifies hyperosmolarity via a Vicious Circle. Pain in dry eye is caused by tear hyperosmolarity, loss of lubrication, inflammatory mediators and neurosensory factors, while visual symptoms arise from tear and ocular surface irregularity. Increased friction targets damage to the lids and ocular surface, resulting in characteristic punctate epithelial keratitis, superior limbic keratoconjunctivitis, filamentary keratitis, lid parallel conjunctival folds, and lid wiper epitheliopathy. Hybrid dry eye disease, with features of both aqueous deficiency and increased evaporation, is common and efforts should be made to determine the relative contribution of each form to the total picture. To this end, practical methods are needed to measure tear evaporation in the clinic, and similarly, methods are needed to measure osmolarity at the tissue level across the ocular surface, to better determine the severity of dry eye. Areas for future research include the role of genetic mechanisms in non-Sjögren syndrome dry eye, the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation.
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Affiliation(s)
- Anthony J Bron
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK.
| | - Cintia S de Paiva
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Sunil K Chauhan
- Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Stefano Bonini
- Department of Ophthalmology, University Campus Biomedico, Rome, Italy
| | - Eric E Gabison
- Department of Ophthalmology, Fondation Ophtalmologique Rothschild & Hôpital Bichat Claude Bernard, Paris, France
| | - Sandeep Jain
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Erich Knop
- Departments of Cell and Neurobiology and Ocular Surface Center Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Yoko Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Victor Perez
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Yuichi Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Driss Zoukhri
- Tufts University School of Dental Medicine, Boston, MA, USA
| | - David A Sullivan
- Schepens Eye Research Institute & Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Wang J, Zhou R, Gao W. The neural pathway for lacrimal gland tear secretion in New Zealand White rabbits. Neurosci Lett 2017; 649:14-19. [PMID: 28396281 DOI: 10.1016/j.neulet.2017.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/26/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We investigated the neural pathway for tear secretion from the lacrimal gland of New Zealand White rabbits. METHODS Nine healthy adult New Zealand White rabbits were randomly divided into three experimental groups, namely, an irritant-stimulated group, a non-stimulated group, and a saline-stimulated group. Sanitized dry cotton swabs with menthol were used to wipe both of the rabbits' eyelids in the irritant-stimulated group, and the non-stimulated group and saline- stimulated group were compared as controls. The animals in the three groups were killed 2h later and the expressions of c-Fos in the frontal cortex, hippocampus, hypothalamus, pons, and medulla oblongata of the rabbits were detected using immunofluorescence labeling. According to the distribution of c-Fos protein expression, 12 healthy adult New Zealand rabbits were similarly divided into three groups for retrograde tract tracing via pseudorabies virus (PRV) injection into the lacrimal gland. Immunofluorescence labeling was used to analyze PRV-infected neurons in the brains of rabbits after survival for 30h, 38h, and 46h. RESULTS The most c-Fos-positive immunolabeled cells were observed in the menthol-stimulated group, whereas fewer c-Fos-positive immunolabeled cells were observed in the saline-stimulated group.The non-treated group showed the least c-Fos-positive immunolabeled cells. At 30h after PRV injection, PRV-positive neurons were found only in the superior salivary nucleus of the pons (SSN). At 38h, PRV-infected neurons were observed in the lateral nucleus of the superior olive (LSO) and the medial nucleus of the superior olive (MSO). At 46h, PRV-infected neurons were found in the nucleus of the trapezoid body (Tz) and the hypothalamic paraventricular nucleus (PVN), and their distributions were dense in the LSO and MSO. CONCLUSIONS Menthol-induced c-Fos protein expression and PRV-mediated tract tracing suggest that in New Zealand White rabbits, the neural pathway that regulates tear secretion from the lacrimal gland proceeds from the PVN to the superior olivary complex of the pons to the SSN and finally to the lacrimal gland.
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Affiliation(s)
- Jiaojiao Wang
- Nanjing University of Traditional Chinese Medicine, Xianlin road no. 138, Qixia District, Nanjing City, Jiangsu Province 210023, China.
| | - Rongyi Zhou
- Nanjing University of Traditional Chinese Medicine, Xianlin road no. 138, Qixia District, Nanjing City, Jiangsu Province 210023, China.
| | - Weiping Gao
- Nanjing University of Traditional Chinese Medicine, Xianlin road no. 138, Qixia District, Nanjing City, Jiangsu Province 210023, China.
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Kobashi H, Kamiya K, Shimizu K. Randomized Comparison Between Rebamipide Ophthalmic Suspension and Diquafosol Ophthalmic Solution for Dry Eye After Penetrating Keratoplasty. J Ocul Pharmacol Ther 2017; 33:13-18. [DOI: 10.1089/jop.2016.0096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hidenaga Kobashi
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Kazutaka Kamiya
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
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29
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Martínez-Carrasco R, Sánchez-Abarca LI, Nieto-Gómez C, García EM, Ramos TL, Velasco A, Sánchez-Guijo F, Aijón J, Hernández-Galilea E. Assessment of dry eye in a GVHD murine model: Approximation through tear osmolarity measurement. Exp Eye Res 2017; 154:64-69. [DOI: 10.1016/j.exer.2016.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/19/2016] [Accepted: 11/02/2016] [Indexed: 01/11/2023]
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30
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Yu T, Shi WY, Song AP, Gao Y, Dang GF, Ding G. Changes of meibomian glands in patients with type 2 diabetes mellitus. Int J Ophthalmol 2016; 9:1740-1744. [PMID: 28003972 DOI: 10.18240/ijo.2016.12.06] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 08/19/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the morphological changes of meibomian glands in patients with type 2 diabetes mellitus (DM). METHODS Of 118 eyes (118 patients) with type 2 DM (DM group) and 100 eyes of 100 control subjects (control group) were enrolled. After completing an ocular surface disease index (OSDI) questionnaire, the non-invasive tear film break-up time (NI-BUT) and the structure of the meibomian glands (MGs, meibography) were assessed by the Keratograph 5M system. Partial or complete loss of MG was scored for each eyelid from grade 0 (no loss) to grade 3 (lost area was >2/3 of the total MG area), which were also examined by laser scanning confocal microscopy (LSCM). The primary outcomes were meibomian gland acinar unit density (MGAUD), meibomian gland acinar longest diameter (MGALD) and meibomian gland acinar shortest diameter (MGASD). RESULTS Compared with control group, the OSDI was significantly higher in DM group (Z=-5.916; P<0.001), while the NI-BUT was significantly lower (Z=-7.765; P<0.001). Keratograph showed that there were more MGs dropout in DM group than that in control group. The meiboscore was significantly higher in DM group compared with control group (Z=-3.937; P<0.001). LSCM revealed that there were cytological alterations of MGs in DM group compared with control group, which included enlargement of MG acinar units and decreased in density of MG acinar units. Specifically, there were lower MGAUD, larger MGALD and MGASD in DM group than control group (Z=-10.120, -9.4442, -7.771; P<0.001). CONCLUSION Compared with the normal control participants, the patients with type 2 DM had more unstable tear films and severe symptoms of dry eye. Using Keratograph 5M system and LSCM, we found that the patients with type 2 DM had more significant morphological and cytological changes and dysfunction in MGs.
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Affiliation(s)
- Tao Yu
- Qingdao University, Qingdao 266071, Shandong Province, China; Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Wei-Yun Shi
- Shandong Eye Hospital, Shandong Eye Institute, Jinan 250021, Shandong Province, China
| | - Ai-Ping Song
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Yang Gao
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Guang-Fu Dang
- Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China
| | - Gang Ding
- Jinan Second People's Hospital, Jinan 250012, Shandong Province, China
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Assessment of the Tear Meniscus Using Optical Coherence Tomography in Patients With Type 2 Diabetes Mellitus. Cornea 2016; 34:1534-40. [PMID: 26488630 DOI: 10.1097/ico.0000000000000651] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze tear meniscus dimensions with Fourier domain-optical coherence tomography (FD-OCT) in patients with type 2 diabetes mellitus. METHODS Patients with type 2 diabetes without diabetic retinopathy (DR) (n = 54), with nonproliferative DR (n = 45), with proliferative DR (PDR) (n = 25), and controls (n = 45) were enrolled. Hemoglobin A1c and Early Treatment Diabetic Retinopathy Study (ETDRS) stages of DR were evaluated. Schirmer test (ST), tear breakup time test, and fluorescein corneal staining were carried out. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained by FD-OCT. RESULTS TMH, TMD, and TMA in the diabetes and control groups were 233 ± 79 μm, 148 ± 53 μm, and 0.026 ± 0.015 mm, and 261 ± 67 μm, 167 ± 49 μm, and 0.032 ± 0.017 mm, respectively. All parameters were lower in diabetes (all P < 0.01). And the values in PDR were 185 ± 90 μm, 117 ± 50 μm, and 0.017 ± 0.010 mm which were lower than those in control and nonproliferative DR (227 ± 71 μm, 144 ± 50 μm, and 0.023 ± 0.010 mm) (all P < 0.01). TMH, TMD, and TMA correlated with ST (P < 0.01, P = 0.02, and P < 0.01, respectively) and the corneal staining score (all P < 0.01). Patients with longer diabetes duration and a history of panretinal photocoagulation showed significantly decreased TMH, TMD, and TMA (P < 0.01). CONCLUSIONS OCT, along with tear breakup time and ST, is an effective way to assess tear function in type 2 diabetes. Patients with PDR and a history of panretinal photocoagulation showed lower tear meniscus parameters. The decrease in tear meniscus parameters was correlated with diabetes duration.
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A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients. J Ophthalmol 2016; 2016:5465272. [PMID: 27034823 PMCID: PMC4789474 DOI: 10.1155/2016/5465272] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/02/2016] [Accepted: 02/10/2016] [Indexed: 11/26/2022] Open
Abstract
Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls. Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted. Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls. Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P = 0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability. Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.
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She Y, Li J, Xiao B, Lu H, Liu H, Simmons PA, Vehige JG, Chen W. Evaluation of a Novel Artificial Tear in the Prevention and Treatment of Dry Eye in an Animal Model. J Ocul Pharmacol Ther 2015; 31:525-30. [PMID: 26322539 PMCID: PMC4675178 DOI: 10.1089/jop.2015.0042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To evaluate effects of a novel multi-ingredient artificial tear formulation containing carboxymethylcellulose (CMC) and hyaluronic acid (HA) in a murine dry eye model. Methods: Dry eye was induced in mice (C57BL/6) using an intelligently controlled environmental system (ICES). CMC+HA (Optive Fusion™), CMC-only (Refresh Tears®), and HA-only (Hycosan®) artificial tears and control phosphate-buffered saline (PBS) were administered 4 times daily and compared with no treatment (n = 64 eyes per group). During regimen 1 (prevention regimen), mice were administered artificial tears or PBS for 14 days (starting day 0) while they were exposed to ICES, and assessed on days 0 and 14. During regimen 2 (treatment regimen), mice exposed to ICES for 14 days with no intervention were administered artificial tears or PBS for 14 days (starting day 14) while continuing exposure to ICES, and assessed on days 0, 14, and 28. Corneal fluorescein staining and conjunctival goblet cell density were measured. Results: Artificial tear-treated mice had significantly better outcomes than control groups on corneal staining and goblet cell density (P < 0.01). Mice administered CMC+HA also showed significantly lower corneal fluorescein staining and higher goblet cell density, compared with CMC (P < 0.01) and HA (P < 0.05) in both regimens 1 and 2. Conclusions: The artificial tear formulation containing CMC and HA was effective in preventing and treating environmentally induced dry eye. Improvements observed for corneal fluorescein staining and conjunctival goblet cell retention suggest that this combination may be a viable treatment option for dry eye disease.
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Affiliation(s)
- Yujing She
- 1 School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Jinyang Li
- 1 School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Bing Xiao
- 1 School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Huihui Lu
- 1 School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou, Zhejiang, China
| | - Haixia Liu
- 2 Allergan Clinical Research , Allergan, Inc., Irvine, California
| | - Peter A Simmons
- 2 Allergan Clinical Research , Allergan, Inc., Irvine, California
| | - Joseph G Vehige
- 2 Allergan Clinical Research , Allergan, Inc., Irvine, California
| | - Wei Chen
- 1 School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou, Zhejiang, China
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Exploring the role and diversity of mucins in health and disease with special insight into non-communicable diseases. Glycoconj J 2015; 32:575-613. [PMID: 26239922 DOI: 10.1007/s10719-015-9606-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 06/18/2015] [Indexed: 12/11/2022]
Abstract
Mucins are major glycoprotein components of the mucus that coats the surfaces of cells lining the respiratory, digestive, gastrointestinal and urogenital tracts. They function to protect epithelial cells from infection, dehydration and physical or chemical injury, as well as to aid the passage of materials through a tract i.e., lubrication. They are also implicated in the pathogenesis of benign and malignant diseases of secretory epithelial cells. In Human there are two types of mucins, membrane-bound and secreted that are originated from mucous producing goblet cells localized in the epithelial cell layer or in mucous producing glands and encoded by MUC gene. Mucins belong to a heterogeneous family of high molecular weight proteins composed of a long peptidic chain with a large number of tandem repeats that form the so-called mucin domain. The molecular weight is generally high, ranging between 0.2 and 10 million Dalton and all mucins contain one or more domains which are highly glycosylated. The size and number of repeats vary between mucins and the genetic polymorphism represents number of repeats (VNTR polymorphisms), which means the size of individual mucins can differ substantially between individuals which can be used as markers. In human it is only MUC1 and MUC7 that have mucin domains with less than 40% serine and threonine which in turn could reduce number of PTS domains. Mucins can be considered as powerful two-edged sword, as its normal function protects from unwanted substances and organisms at an arm's length while, malfunction of mucus may be an important factor in human diseases. In this review we have unearthed the current status of different mucin proteins in understanding its role and function in various non-communicable diseases in human with special reference to its organ specific locations. The findings described in this review may be of direct relevance to the major research area in biomedicine with reference to mucin and mucin associated diseases.
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Xiao W, Xu GT, Zhang J, Zhang J, Zhang Y, Ye W. FTY720 ameliorates Dry Eye Disease in NOD mice: Involvement of leukocytes inhibition and goblet cells regeneration in ocular surface tissue. Exp Eye Res 2015; 138:145-52. [PMID: 26187517 DOI: 10.1016/j.exer.2015.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/06/2015] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED FTY720 is a promising drug in attenuating multiple sclerosis, prolonging survival of organ allograft, and many other protective effects. Its mechanism of action is considered to be mediated by the internalization of sphingosine 1-phosphate receptors (S1PRs). In the current study, we investigated the efficacy of FTY720 in Non-Obese Diabetic (NOD) mice, serving as a model of Dry Eye Disease (DED). NOD mice were divided into six study groups, i.e., FTY720-treated groups with 3 concentrations of FTY720 (0.05%, 0.005%, and 0.001%), 0.05% Cyclosporin A (CsA) treated group, normal saline treated group, and no treatment control group. FTY720 was reconstituted with normal saline and prepared as eye drop. The stability and production of tear film was measured by Tear Break up Time test (TBUT) and phenol red cotton thread test (PRCTT), respectively. Tear fluid washings were collected and assessed by ELISA. Cytokines were detected in lacrimal glands by RT-PCR. Inflammation in conjunctiva was assessed by immunohistochemistry, goblet cells and conjunctival epithelia were examined and evaluated by impression cytology. Our results indicated that FTY720 had a significantly therapeutic effect in NOD mice. After FTY720 intervention, TBUT and PRCTT data were greatly improved (p < 0.01), the interleukin 1β (IL-1β) level was markedly decreased in tear fluid washings compared to control and normal saline groups after 2 weeks ( CONTROL 1.06 ± 0.12, Normal saline:0.97 ± 0.09 pg/ml, CsA:0.22 ± 0.02 pg/ml, 0.001% FTY720:0.23 ± 0.02 pg/ml, 0.005% FTY720:0.14 ± 0.03 pg/ml, 0.05% FTY720: 0.18 ± 0.03 pg/ml. CsA group and 3 FTY720 groups VS. control group and normal saline groups: p < 0.01). Proinflammatory factors were greatly decreased in lacrimal glands (p < 0.01). Leukocytes were identified and markedly decreased in conujnctiva (p < 0.01), inflammatory reaction of DED was greatly relieved. More importantly, the goblet cells were largely restored and ocular surface lesions were significantly ameliorated (p < 0.01). Thus, we observed FTY720 alleviated DED in NOD mice by inhibiting leukocytes, the function of ocular surface tissue in NOD mice was partially restored via inhibiting ocular surface inflammation and increasing the density of goblet cells and conjunctival epithelia. FTY720 may offer a novel strategy for the treatment of inflammatory disorders in the ocular surface.
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Affiliation(s)
- Weibao Xiao
- Department of Ophthalmology, Huashan Hospital Affiliated to Fudan University, 12 Middle Wulumuqi Road, Buiding 3, Room 802, Shanghai 200040, China
| | - Guo-Tong Xu
- Tongji Eye Institute and Department of Regenerative Medicine, Tongji University School of Medicine, 1239 Siping Road, Medical School Building, Room 521, Shanghai 200092, China
| | - Jingfa Zhang
- Tongji Eye Institute and Department of Regenerative Medicine, Tongji University School of Medicine, 1239 Siping Road, Medical School Building, Room 521, Shanghai 200092, China
| | - Jiaying Zhang
- Department of Ophthalmology, Huashan Hospital Affiliated to Fudan University, 12 Middle Wulumuqi Road, Buiding 3, Room 802, Shanghai 200040, China
| | - Yu Zhang
- Department of Ophthalmology, Huashan Hospital Affiliated to Fudan University, 12 Middle Wulumuqi Road, Buiding 3, Room 802, Shanghai 200040, China
| | - Wen Ye
- Department of Ophthalmology, Huashan Hospital Affiliated to Fudan University, 12 Middle Wulumuqi Road, Buiding 3, Room 802, Shanghai 200040, China.
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Abstract
PURPOSE The purpose of this article is to review the evidence for the hypothesis that the core mechanism of dry eye disease (DED) is inflammation, including evidence from recent basic, clinical, and translational research involving human patients, animal models, and cell cultures. METHODS Using the key words "dry eye + inflammation," the authors conducted a comprehensive search of the PubMed and Web of Science databases for scientific articles published in English between January 1, 1900 and August 30, 2013 on the role of inflammation in DED in cell cultures, animal models, and humans. The resulting articles were then categorized and reviewed. RESULTS The literature search revealed a total of 458 publications, almost all published after 1992. The percentages of original studies and review articles are 77.29% (354) and 22.71% (104), respectively. Among the original studies, the number of reports on human DED is 200 (43.7%), on animal models is 115 (25.1%), and cell cultures is 39 (8.5%). A yearly distributing plot revealed that 76% were published from 2003 to 2011, 53% from 2008 to 2012, and 11% during the first 9 months of 2013. This distribution signifies a rapidly growing awareness of the importance of inflammation in DED pathogenesis. CONCLUSIONS Inflammation plays a key role in the pathogenesis of DED as evidenced by research using tissue culture, animal models, and subjects with DED. Developing biomarkers for inflammation of the ocular surface will provide improved understanding of the mechanisms leading to DED, classification of the severity of DED, and objective metrics for outcome measures of treatment. The chronicity of the disease suggests that dysregulation of immune mechanisms leads to a cycle of continued inflammation, accompanied by alterations in both innate and adaptive immune responses. Given the underlying mechanism for DED, developing effective and safe anti-inflammatory treatments is likely to be beneficial for patients with DED.
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Extraorbital lacrimal gland excision: a reproducible model of severe aqueous tear-deficient dry eye disease. Cornea 2015; 33:1336-41. [PMID: 25255136 DOI: 10.1097/ico.0000000000000264] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE The aim of this study was to establish and characterize extraorbital lacrimal gland excision (LGE) as a model of aqueous tear-deficient dry eye disease in mice. METHODS Female C57BL/6 mice at 6 to 8 weeks of age were randomized to extraorbital LGE, sham surgery, or scopolamine groups. Mice that underwent extraorbital LGE or sham surgery were housed in the standard vivarium. Scopolamine-treated mice were housed in a controlled environment chamber that allowed for the continuous regulation of airflow (15 L/min), relative humidity (30%), and temperature (21-23°C). Clinical disease severity was assessed over the course of 14 days using the phenol red thread test and corneal fluorescein staining. Real-time polymerase chain reaction was performed to assess corneal mRNA expression of interleukin 1β, tumor necrosis factor α, and matrix metalloproteinase 9. Flow cytometry was used to assess T helper cell frequencies in the conjunctivae and draining lymph nodes. RESULTS Extraorbital LGE markedly reduced aqueous tear secretion as compared with the sham procedure and induced a more consistent decrease in aqueous tear secretion than was observed in mice that received scopolamine while housed in the controlled environment chamber. Extraorbital LGE significantly increased corneal fluorescein staining scores as compared with those of both the sham surgery and scopolamine-treated groups. Extraorbital LGE significantly increased the corneal expression of interleukin 1β, tumor necrosis factor α, and matrix metalloproteinase 9. Further, extraorbital LGE increased T helper 17-cell frequencies in the conjunctivae and draining lymph nodes. CONCLUSIONS Extraorbital LGE induces aqueous tear-deficient dry eye disease in mice as evidenced by decreased aqueous tear secretion, increased corneal epitheliopathy, and induced ocular surface inflammation and immunity.
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Efficacy and Safety of Topical 0.05% Cyclosporine Eye Drops in the Treatment of Dry Eye Syndrome: A Systematic Review and Meta-analysis. Ocul Surf 2015; 13:213-25. [PMID: 26045239 DOI: 10.1016/j.jtos.2014.12.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 02/05/2023]
Abstract
A systematic review was performed to evaluate the safety and efficacy of topical 0.05% cyclosporine in treating patients with dry eye syndrome (DES). Twelve qualified randomized-controlled trials incorporating 1367 patients were analyzed. In comparison to controls, patients who were on topical 0.05% cyclosporine eye drops had lower Ocular Surface Disease Index scores (mean difference [MD]=4.10, 95% CI: 0.25-7.96, P=.04), longer tear film breakup time (MD=2.30 seconds, 95% CI: 0.75-3.86, P=.004), improved Schirmer I scores (MD=2.77 mm/5min, 95% CI: 1.63-3.91, P=.00001), reduced corneal fluorescein staining (standardized mean difference [SMD]=0.61, 95% CI: 0.07-1.15, P=.03), and higher goblet cell densities (SMD=1.68, 95% CI: 0.54-2.81, P=.004). However, there were more adverse effects in the cyclosporine patient group (odds ratio=1.64, 95% CI: 1.17-2.30, P=.004). Topical 0.05% cyclosporine eye drops twice daily significantly improved both the objective and subjective outcomes in DES patients. The study limitations in the clinical, methodological and statistical heterogeneities are discussed.
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Mauffray M, Domingues O, Hentges F, Zimmer J, Hanau D, Michel T. Neurturin influences inflammatory responses and airway remodeling in different mouse asthma models. THE JOURNAL OF IMMUNOLOGY 2015; 194:1423-33. [PMID: 25595789 DOI: 10.4049/jimmunol.1402496] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurturin (NTN) was previously described for its neuronal activities, but recently, we have shown that this factor is also involved in asthma physiopathology. However, the underlying mechanisms of NTN are unclear. The aim of this study was to investigate NTN involvement in acute bronchial Th2 responses, to analyze its interaction with airway structural cells, and to study its implication in remodeling during acute and chronic bronchial inflammation in C57BL/6 mice. We analyzed the features of allergic airway inflammation in wild-type and NTN(-/-) mice after sensitization with two different allergens, OVA and house dust mite. We showed that NTN(-/-) dendritic cells and T cells had a stronger tendency to activate the Th2 pathway in vitro than similar wild-type cells. Furthermore, NTN(-/-) mice had significantly increased markers of airway remodeling like collagen deposition. NTN(-/-) lung tissues showed higher levels of neutrophils, cytokine-induced neutrophil chemoattractant, matrix metalloproteinase 9, TNF-α, and IL-6. Finally, NTN had the capacity to decrease IL-6 and TNF-α production by immune and epithelial cells, showing a direct anti-inflammatory activity on these cells. Our findings support the hypothesis that NTN could modulate the allergic inflammation in different mouse asthma models.
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Affiliation(s)
- Marion Mauffray
- Department of Infection and Immunity, Laboratory of Immunogenetics and Allergology, Public Research Center for Health, L-1526 Luxembourg, Luxembourg; and
| | - Olivia Domingues
- Department of Infection and Immunity, Laboratory of Immunogenetics and Allergology, Public Research Center for Health, L-1526 Luxembourg, Luxembourg; and
| | - François Hentges
- Department of Infection and Immunity, Laboratory of Immunogenetics and Allergology, Public Research Center for Health, L-1526 Luxembourg, Luxembourg; and
| | - Jacques Zimmer
- Department of Infection and Immunity, Laboratory of Immunogenetics and Allergology, Public Research Center for Health, L-1526 Luxembourg, Luxembourg; and
| | - Daniel Hanau
- Mixed Research Unit-S949, INSERM-University of Strasbourg, Biology and Pharmacology of Haemostasis and Thrombosis, Blood Transfusion Center-Alsace, 67065 Strasbourg, France
| | - Tatiana Michel
- Department of Infection and Immunity, Laboratory of Immunogenetics and Allergology, Public Research Center for Health, L-1526 Luxembourg, Luxembourg; and
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D’Souza S, Tong L. Practical issues concerning tear protein assays in dry eye. EYE AND VISION (LONDON, ENGLAND) 2014; 1:6. [PMID: 26605353 PMCID: PMC4604107 DOI: 10.1186/s40662-014-0006-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 10/09/2014] [Indexed: 12/20/2022]
Abstract
Dry eye is a common clinical condition diagnosed by cumulative evidence of symptoms and signs. Many new treatments in dry eye are either expensive, invasive, have potential for side effects, or are not easily accessible. In severe dry eye, the ideal modality of treatment to begin with is often not clear as specific molecular disturbances are not evident from just examination of clinical manifestations. Assessing the effects of ongoing treatment is not straight forward since there is lack of agreement between clinical signs and symptoms. There is a need to have more objective methods of selecting treatment for dry eye and monitoring the effect of treatment. Recently, there are many new technologies applied to the discovery of tear biomarkers, for e.g., mass spectrometry based proteomics techniques and multiplex assays such as the bead-based sandwich indirect immunofluorescent assays. Tear proteins assays have even been made available as point-of-care devices. This review focuses on the evidence for the involvements of tear proteins in dry eye, possible changes in tear concentrations with therapy and the strength of evidence regarding dry eye pathology. Much remains to be done in terms of developing office-based assays and ascertaining their reliability, but current evidence suggests that tear proteins have a role in the clinical practice of dry eye.
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Affiliation(s)
- Sharon D’Souza
- />Narayana Nethralaya Superspeciality Eye Hospital and Post Graduate Institute, Bangalore, Karnataka India
| | - Louis Tong
- />Singapore Eye Research Institute, 11, Third Hospital Avenue, Singapore, 168751 Singapore
- />Singapore National Eye Center, Singapore, Singapore
- />Duke-NUS Graduate Medical School, Singapore, Singapore
- />Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Plaza-Menacho I, Mologni L, McDonald NQ. Mechanisms of RET signaling in cancer: current and future implications for targeted therapy. Cell Signal 2014; 26:1743-52. [PMID: 24705026 DOI: 10.1016/j.cellsig.2014.03.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 03/30/2014] [Indexed: 11/15/2022]
Abstract
De-regulation of RET signaling by oncogenic mutation, gene rearrangement, overexpression or transcriptional up-regulation is implicated in several human cancers of neuroendocrine and epithelial origin (thyroid, breast, lung). Understanding how RET signaling mechanisms associated with these oncogenic events are deregulated, and their impact in the biological processes driving tumor formation and progression, as well as response to treatment, will be crucial to find and develop better targeted therapeutic strategies. In this review we emphasie the distinct mechanisms of RET signaling in cancer and summarise current knowledge on small molecule inhibitors targeting the tyrosine kinase domain of RET as therapeutic drugs in RET-positive cancers.
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Affiliation(s)
- I Plaza-Menacho
- Structural Biology Laboratory, London Research Institute, Cancer Research UK, London, UK.
| | - L Mologni
- Dept. of Health Sciences, University of Milano-Bicocca, Italy
| | - N Q McDonald
- Structural Biology Laboratory, London Research Institute, Cancer Research UK, London, UK
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Chen Y, Zhang X, Yang L, Li M, Li B, Wang W, Sheng M. Decreased PPAR-γ expression in the conjunctiva and increased expression of TNF-α and IL-1β in the conjunctiva and tear fluid of dry eye mice. Mol Med Rep 2014; 9:2015-23. [PMID: 24626526 DOI: 10.3892/mmr.2014.2041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 02/25/2014] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to investigate the expression of peroxisome proliferator-activated receptor γ (PPAR-γ), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the conjunctiva and the association between inflammatory cytokines and PPAR-γ in dry eye mice. Dry eye was induced in 6-week-old female C57 mice. mRNA expression of PPAR-γ, TNF-α and IL-1β were measured. PPAR-γ protein expression in the conjunctiva, and the contents of TNF-α and IL-1β in the conjunctiva and tear-wash fluid were determined. A PPAR-γ agonist, pioglitazone (PIO), was used to treat dry eye mice. Dry eye mice presented with similar manifestations as in humans. The PPAR-γ expression in the conjunctiva of dry eye mice was downregulated, accompanied by increased contents of TNF-α and IL-1β. PIO treatment markedly reduced the contents of TNF-α and IL-1β in tear fluid of dry eye mice. Following PIO treatment, the PPAR-γ expression increased markedly. PIO may activate PPAR-γ to inhibit the expression of the inflammatory cytokines TNF-α and IL-1β in dry eye mice. This suppresses the inflammatory progression, increases the tear fluid production, elevates the tear film stability and reduces the damage to the ocular surface, exerting a therapeutic effect on dry eye.
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Affiliation(s)
- Yihui Chen
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Xiaoyan Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Ling Yang
- Department of Ophthalmology, Luwan Branch of Ruijin Hospital, Shanghai Jiaotong University, Shanghai 200020, P.R. China
| | - Min Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Bing Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Weifang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Minjie Sheng
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, P.R. China
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Lv H, Li A, Zhang X, Xu M, Qiao Y, Zhang J, Yu L. Meta-analysis and review on the changes of tear function and corneal sensitivity in diabetic patients. Acta Ophthalmol 2014; 92:e96-e104. [PMID: 23782539 DOI: 10.1111/aos.12063] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To perform a comprehensive evaluation and comparison of tear function in diabetic and non-diabetic patients. Research related to tear function in diabetic and non-diabetic patients was gathered using PubMed, EBSCO, OVID. Two reviewers independently conducted the literature search. The quality assessment and the data extraction were performed in accordance with exclusion criteria and cross-checking. RevMan 5.1.7 software was used for the meta-analysis. The tear film break-up time was studied in eight articles with a total of 1449 samples. Through a random-effects model analysis, the combined weighted mean difference (WMD) was -4.44 [-5.87, -3.01]. The time in diabetic patients was shorter than that in the non-diabetic group (p < 0.00001). The basal tear secretion test was studied in seven articles with a total of 949 samples. The combined WMD was -3.96 [-5.70, -2.23], and the difference between the diabetic group and control group was statistically significant (p < 0.00001). The total tear secretion test was studied in five articles with a total of 921 samples. The combined WMD was -3.96 [-7.43, -0.50]. The difference between the diabetic and control groups was statistically significant (p = 0.03). The corneal sensitivity was compared in eight studies with a total of 976 samples. Through a random-effects model analysis, the standardized mean difference (SMD) was -5.14 [-6.99, -3.29]. The corneal sensitivity was lower in diabetic patients than the control group (p < 0.00001). Our study suggests that the tear functions are worse in diabetic patients compared with the control group. Moreover, patients with PDR are more predisposed to impaired tear functions.
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Affiliation(s)
- Hongbin Lv
- Department of Ophthalmology, Affiliated Hospital, Luzhou Medical College, Luzhou, ChinaSchool of Public Health of Luzhou Medical College, Luzhou, China
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Air exposure induced characteristics of dry eye in conjunctival tissue culture. PLoS One 2014; 9:e87368. [PMID: 24498087 PMCID: PMC3909183 DOI: 10.1371/journal.pone.0087368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 12/20/2013] [Indexed: 11/19/2022] Open
Abstract
There are several animal models illustrating dry eye pathophysiology. Current study would like to establish an ex vivo tissue culture model for characterizing dry eye. Human conjunctival explants were cultured under airlift or submerged conditions for up to 2 weeks, and only airlifted conjunctival cultures underwent increased epithelial stratification. Starting on day 4, the suprabasal cells displayed decreased K19 expression whereas K10 keratin became evident in airlift group. Pax6 nuclear expression attenuated already at 2 days, while its perinuclear and cytoplasmic expression gradually increased. MUC5AC and MUC19 expression dramatically decreased whereas the full thickness MUC4 and MUC16 expression pattern disappeared soon after initiating the airlift condition. Real time PCR showed K16, K10 and MUC16 gene up-regulated while K19, MUC5AC, MUC19 and MUC4 down-regulated on day 8 and day 14. On day 2 was the appearance of apoptotic epithelial and stromal cells appeared. The Wnt signaling pathway was transiently activated from day 2 to day 10. The inflammatory mediators IL-1β, TNF-α, and MMP-9 were detected in the conditioned media after 6 to 8 days. In conclusion, airlifted conjunctival tissue cultures demonstrated Wnt signaling pathway activation, coupled with squamous metaplasia, mucin pattern alteration, apoptosis and upregulation of proinflammatory cytokine expression. These changes mimic the pathohistological alterations described in dry eye. This correspondence suggests that insight into the pathophysiology of dry eye may be aided through the use of airlifted conjunctival tissue cultures.
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Deng R, Su Z, Lu F, Zhang L, Lin J, Zhang X, de Paiva CS, Pflugfelder SC, Li DQ. A potential link between bacterial pathogens and allergic conjunctivitis by dendritic cells. Exp Eye Res 2014; 120:118-26. [PMID: 24486456 DOI: 10.1016/j.exer.2014.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 01/15/2014] [Accepted: 01/19/2014] [Indexed: 01/22/2023]
Abstract
The association and mechanism of bacteria linking to the allergic inflammation have not been well elucidated. This study was to explore a potential link between bacterial pathogens and allergic conjunctivitis by dendritic cells (DCs). Bone marrow-derived DCs from BALB/c and MyD88 knockout mice were treated with or without bacterial pathogens or thymic stromal lymphopoietin (TSLP). Two murine models of the topical challenge with LPS or flagellin and experimental allergic conjunctivitis (EAC) were used for in vivo study. The mRNA expression was determined by reverse transcription and real time PCR, and protein production was evaluated by ELISA, Western blotting, immunofluorescent staining and flow cytometry. TSLP mRNA and protein were found to be largely induced by DCs challenged with microbial pathogens, highly by lipopolysaccharide (LPS) and flagellin. The expression of MyD88, NFκB1, NFκB2 and RelA accompanied by NFκB p65 nuclear translocation and TSLP induction were significantly stimulated by flagellin, but blocked by TLR5 antibody or NFκB inhibitor in DCs from MyD88(+/+) but not MyD88(-/-) mice. TSLP promoted the expression of CD40, CD80, OX40 ligand (OX40L), IL-13 and CCL17 by DCs. TSLP-producing DCs were identified in vivo in ocular surface conjunctiva and draining cervical lymph nodes from two murine models of topical challenge with LPS or flagellin, and EAC in BALB/c mice. TSLP/TSLPR/OX40L signaling was observed in DCs of EAC mice. Our findings demonstrate that DCs not only respond to TSLP, but also produce TSLP via TLR/MyD88/NFκB pathways in response to bacterial pathogens, suggesting a potential link between bacteria and allergic disease.
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Affiliation(s)
- Ruzhi Deng
- School of Optometry and Ophthalmology, Wenzhou Medical College, Wenzhou, China; Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Zhitao Su
- School of Optometry and Ophthalmology, Wenzhou Medical College, Wenzhou, China; Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Fan Lu
- School of Optometry and Ophthalmology, Wenzhou Medical College, Wenzhou, China.
| | - Lili Zhang
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; Department of Ophthalmology, the Affiliated Hospital of Qingdao University Medical College, Qingdao, China
| | - Jing Lin
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; Department of Ophthalmology, the Affiliated Hospital of Qingdao University Medical College, Qingdao, China
| | - Xiaobo Zhang
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Cintia S de Paiva
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Stephen C Pflugfelder
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - De-Quan Li
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA.
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Misra SL, Patel DV, McGhee CNJ, Pradhan M, Kilfoyle D, Braatvedt GD, Craig JP. Peripheral neuropathy and tear film dysfunction in type 1 diabetes mellitus. J Diabetes Res 2014; 2014:848659. [PMID: 25177708 PMCID: PMC4142275 DOI: 10.1155/2014/848659] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 07/23/2014] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To compare tear film metrics in patients with type 1 diabetes mellitus (DM) and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. METHODS Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. RESULTS Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P = 0.12 and P = 0.33, resp.). Tear lipid thickness (P = 0.02), stability (P < 0.0001), and quantity (P = 0.01) were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P < 0.001) and tear film stability was inversely associated with total neuropathy score (r = -0.29, P = 0.03). CONCLUSION The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.
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Affiliation(s)
- Stuti L. Misra
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Dipika V. Patel
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Charles N. J. McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Monika Pradhan
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Dean Kilfoyle
- Department of Neurology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Geoffrey D. Braatvedt
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Jennifer P. Craig
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- *Jennifer P. Craig:
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Chemokine receptors CCR6 and CXCR3 are necessary for CD4(+) T cell mediated ocular surface disease in experimental dry eye disease. PLoS One 2013; 8:e78508. [PMID: 24223818 PMCID: PMC3817213 DOI: 10.1371/journal.pone.0078508] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 09/13/2013] [Indexed: 11/19/2022] Open
Abstract
CD4(+) T cells are essential to pathogenesis of ocular surface disease in dry eye. Two subtypes of CD4(+) T cells, Th1 and Th17 cells, function concurrently in dry eye to mediate disease. This occurs in spite of the cross-regulation of IFN-γ and IL-17A, the prototypical cytokines Th1 and Th17 cells, respectively. Essential to an effective immune response are chemokines that direct and summon lymphocytes to specific tissues. T cell trafficking has been extensively studied in other models, but this is the first study to examine the role of chemokine receptors in ocular immune responses. Here, we demonstrate that the chemokine receptors, CCR6 and CXCR3, which are expressed on Th17 and Th1 cells, respectively, are required for the pathogenesis of dry eye disease, as CCR6KO and CXCR3KO mice do not develop disease under desiccating stress. CD4(+) T cells from CCR6KO and CXCR3KO mice exposed to desiccating stress (DS) do not migrate to the ocular surface, but remain in the superficial cervical lymph nodes. In agreement with this, CD4(+) T cells from CCR6 and CXCR3 deficient donors exposed to DS, when adoptively transferred to T cell deficient recipients manifest minimal signs of dry eye disease, including significantly less T cell infiltration, goblet cell loss, and expression of inflammatory cytokine and matrix metalloproteinase expression compared to wild-type donors. These findings highlight the important interaction of chemokine receptors on T cells and chemokine ligand expression on epithelial cells of the cornea and conjunctiva in dry eye pathogenesis and reveal potential new therapeutic targets for dry eye disease.
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Potential autocrine regulation of interleukin-33/ST2 signaling of dendritic cells in allergic inflammation. Mucosal Immunol 2013; 6:921-30. [PMID: 23299617 PMCID: PMC3904307 DOI: 10.1038/mi.2012.130] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 11/13/2012] [Indexed: 02/04/2023]
Abstract
This study identified a novel phenomenon that dendritic cells (DCs) produced interleukin (IL)-33 via Toll-like receptor (TLR)-mediated innate pathway. Mouse bone marrow-derived DCs were treated with or without microbial pathogens or recombinant murine IL-33. IL-33 mRNA and protein were found to be expressed by DCs and largely induced by several microbial pathogens, highly by lipopolysaccharide (LPS) and flagellin. Using two mouse models of topical challenge by LPS and flagellin and experimental allergic conjunctivitis, IL-33-producing DCs were observed in ocular mucosal surface and the draining cervical lymph nodes in vivo. The increased expression levels of myeloid differentiation primary-response protein 88 (MyD88), nuclear factor (NF)-κB1, NF-κB2, and RelA accompanied by NF-κB p65 nuclear translocation were observed in DCs exposed to flagellin. IL-33 induction by flagellin was significantly blocked by TLR5 antibody or NF-κB inhibitor quinazoline and diminished in DCs from MyD88 knockout mice. IL-33 stimulated the expression of DC maturation markers, CD40 and CD80, and proallergic cytokines and chemokines, OX40L, IL-4, IL-5, IL-13, CCL17 (C-C motif chemokine ligand 17), TNF-α (tumor necrosis factor-α), and IL-1β. This stimulatory effect of IL-33 in DCs was significantly blocked by ST2 antibody or soluble ST2. Our findings demonstrate that DCs produce IL-33 via TLR/NF-κB signaling pathways, suggesting a molecular mechanism by which local allergic inflammatory response may be amplified by DC-produced IL-33 through potential autocrine regulation.
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Spdef null mice lack conjunctival goblet cells and provide a model of dry eye. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 183:35-48. [PMID: 23665202 DOI: 10.1016/j.ajpath.2013.03.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 02/07/2013] [Accepted: 03/04/2013] [Indexed: 12/19/2022]
Abstract
Goblet cell numbers decrease within the conjunctival epithelium in drying and cicatrizing ocular surface diseases. Factors regulating goblet cell differentiation in conjunctival epithelium are unknown. Recent data indicate that the transcription factor SAM-pointed domain epithelial-specific transcription factor (Spdef) is essential for goblet cell differentiation in tracheobronchial and gastrointestinal epithelium of mice. Using Spdef(-/-) mice, we determined that Spdef is required for conjunctival goblet cell differentiation and that Spdef(-/-) mice, which lack conjunctival goblet cells, have significantly increased corneal surface fluorescein staining and tear volume, a phenotype consistent with dry eye. Microarray analysis of conjunctival epithelium in Spdef(-/-) mice revealed down-regulation of goblet cell-specific genes (Muc5ac, Tff1, Gcnt3). Up-regulated genes included epithelial cell differentiation/keratinization genes (Sprr2h, Tgm1) and proinflammatory genes (Il1-α, Il-1β, Tnf-α), all of which are up-regulated in dry eye. Interestingly, four Wnt pathway genes were down-regulated. SPDEF expression was significantly decreased in the conjunctival epithelium of Sjögren syndrome patients with dry eye and decreased goblet cell mucin expression. These data demonstrate that Spdef is required for conjunctival goblet cell differentiation and down-regulation of SPDEF may play a role in human dry eye with goblet cell loss. Spdef(-/-) mice have an ocular surface phenotype similar to that in moderate dry eye, providing a new, more convenient model for the disease.
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The Practical Detection of MMP-9 Diagnoses Ocular Surface Disease and May Help Prevent Its Complications. Cornea 2013; 32:211-6. [DOI: 10.1097/ico.0b013e3182541e9a] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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