Dry eye mediators investigation through tear proteomic and metabolomic evaluation

Abstract

Dry eye is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Dry eye is a heterogeneous group of conditions related to tear film abnormalities of multiple causes such as water deficiency, abnormalities of lipid layers and / or eyelid disorders and inflammation of the ocular surface. Symptoms of dry eye has a strong impact on their quality of life of patients Moreover, changes in the homeostasis of the ocular surface related dry eye increases the risk of potentially serious complications for ocular health and visual acuity. Possible mediators of dry eye such as apoptosis, hormonal disorders, autoantibody production, changes in cellular signaling, nerve dysfunction and increased proinflammatory cytokines represent a broad field of research and research and are directed through analysis of proteomics and metabolomics tear and correlated with clinical findings. tear samples will be collected for proteomic studies and metabolomics in conditions associated with graft versus host disease or GVHD. Objectives: This project aims to assess possible pathophysiological pathways related to related to dry eye in GVHD patients. The study of proteomics and metabolomics will enable new understandings and lacrimal dysfunction pathways and ocular surface. Methods: Patients will be instructed as to the purposes and procedures related to research and informed consent, will then be evaluated for collection of clinical data described below: a. History and eye examination: symptoms, history, visual acuity, ocular findings. B. Evaluation of the ocular surface will be in a standardized way that allows comparison of our data with literature and consist of: - survey administered to the ocular surface changes, - Schirmer I test (with anesthetic) - Staining with fluorescein (2%) topical: quantifying areas of irregularities and scarify the corneal-conjunctival surface, ranging from 0 to 15 and evaluation of the tear film breakup time, in seconds, - Staining with green lissamine (1%) topical: After instillation of drop in the conjunctival fornix, the conjunctiva and the cornea will be examined in the light and quantified changes from 0 to 9. c. Ocular Surface Evaluation and tear film (Surveyor oculus 5M): examination permits evaluation and documentation of the corneal curvature of the lipid layer and study the stability of the tear film film, meibomiografia and quantification conjunctival hyperemia. Faced with the parameters obtained, the classification for missing dry eye, mild, moderate or severe will be made according to criteria established in the Dry Eye Workshop (DEWS)Expected results: This study will identify the association of new mediators and mechanisms related to dry eye and ocular surface dysfunction related to GVHD. (AU)