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Demographics, clinical signs and symptoms of DED and clinical data of T2D among groups. Data are expressed as Median (IQR).
Source publication
Dry eye disease (DED) can be extremely distressing and is common in type 2 diabetes (T2D). To investigate potential biomarkers of DED in T2D, panels of proteins in tears, alongside clinical signs and symptoms of DED, were assessed. Patients were classified into four groups: T2D + DED (n = 47), T2D-only (n = 41), DED-only (n = 17) and healthy contro...
Contexts in source publication
Context 1
... total, 122 subjects were enrolled, with n = 17 in the healthy controls, n = 17 in the DED-only group, n = 41 in the T2D-only group and n = 47 in the T2D + DED group. The demographics, clinical signs and symptoms of DED and clinical data of T2D in each group are summarized in Table 1. Comparisons (p-values) of these characteristics are detailed in Table 2. Note: a p value of ≤0.05 was considered a statistically significant difference (shown in italics). ...Context 2
... sex of each group was matched (p = 0.14, Table 1). The patients in the T2D + DED group were older than the healthy controls and the patients in the DED-only group (p = 0.001 and p = 0.03, respectively, Table 2). ...Context 3
... addition, the patients in the T2D-only group were older than the healthy controls (p = 0.003, Table 2). No differences were found for the duration of T2D, HbA 1C , total Cholesterol and HDL levels between the T2D-only and T2D + DED groups (p = 0.21, p = 0.45, p = 0.45 and p = 0.28, respectively; Table 1). ...Context 4
... TER, there were no differences between the four groups (p = 0.44, Table 1). The results of the other comparison tests, however, showed that the fTBUT, CFS, Schirmer 1 values, OSDI and DEQS scores were significantly different across the study groups (p < 0.001, p = 0.002, p < 0.001, p < 0.001 and p < 0.001, respectively; Table 1). ...Context 5
... TER, there were no differences between the four groups (p = 0.44, Table 1). The results of the other comparison tests, however, showed that the fTBUT, CFS, Schirmer 1 values, OSDI and DEQS scores were significantly different across the study groups (p < 0.001, p = 0.002, p < 0.001, p < 0.001 and p < 0.001, respectively; Table 1). In more detail, the T2D + DED and the DED-only groups had significantly lower fTBUT values compared to the healthy controls (p = 0.004 and p = 0.01, respectively, Table 2) and the T2D-only group (p < 0.001 and p = 0.003, respectively). ...Context 6
... relationships between the biomarkers and clinical signs of DED were calculated for the DED-only group and for the T2D + DED group. The significance levels of these variables and their clinical interpretation in the DED-only and T2D + DED groups are detailed in Supplementary Materials (Table S1 and Table S2, respectively). In addition, the relationships between the biomarkers and symptoms of DED were calculated for the DED-only group and for the T2D + DED group. ...Context 7
... relationships were found for EGF versus TER (r s = −0.50, p = 0.05), IL-6 versus Schirmer 1 values (r s = −0.5, p = 0.05) and Leptin versus Schirmer 1 values (r s = −0.5, p = 0.03) in the DED-only group (Table S1). Positive relationships were shown for IL-6 versus TER (r s = 0.6, p = 0.02) and for Leptin versus TER (r s = 0.5, p = 0.02) in the DED-only group (Table S1). ...Context 8
... = 0.05), IL-6 versus Schirmer 1 values (r s = −0.5, p = 0.05) and Leptin versus Schirmer 1 values (r s = −0.5, p = 0.03) in the DED-only group (Table S1). Positive relationships were shown for IL-6 versus TER (r s = 0.6, p = 0.02) and for Leptin versus TER (r s = 0.5, p = 0.02) in the DED-only group (Table S1). In the T2D + DED group, there were negative relationships between IL-10 versus TER (r s = −0.3, ...Context 9
... determination of the relationship between DED severity and QoL was undertaken to detect if there was an effect of DED-related symptoms on patient QoL. It was noted that there was a significant positive relationship between DED severity (as measured by OSDI) and impact on QoL (as measured by DEQS) in the DED-only group (p < 0.001, r s = 0.79; Figure 1a) and the T2D + DED group (p < 0.001, r s = 0.73; Figure 1b (Table S1 and Table S2, (Table S3 and Table S4, respectively). ...Context 10
... relationships were found for EGF versus TER (rs = −0.50, p = 0.05), IL-6 versus Schirmer 1 values (rs = −0.5, p = 0.05) and Leptin versus Schirmer 1 values (rs = −0.5, p = 0.03) in the DED-only group (Table S1). Positive relationships were shown for IL-6 versus TER (rs = 0.6, p = 0.02) and for Leptin versus TER (rs = 0.5, p = 0.02) in the DED-only group (Table S1). ...Context 11
... = 0.05), IL-6 versus Schirmer 1 values (rs = −0.5, p = 0.05) and Leptin versus Schirmer 1 values (rs = −0.5, p = 0.03) in the DED-only group (Table S1). Positive relationships were shown for IL-6 versus TER (rs = 0.6, p = 0.02) and for Leptin versus TER (rs = 0.5, p = 0.02) in the DED-only group (Table S1). In the T2D + DED group, there were negative relationships between IL-10 versus TER (rs = −0.3, ...Context 12
... Materials: The following supporting information can be downloaded at: https:// www.mdpi.com/article/10.3390/metabo13060733/s1, Table S1: Relationships of biomarkers and ocular surface parameters in the DED-only group. R s and p values are shown, as well as the clinical interpretation of these correlations. ...Similar publications
Purpose:
The purpose of this study was to determine if there are significant differences in the concentrations of tear proteins in Sjögren's syndrome keratoconjunctivitis sicca (SS KCS) compared to healthy controls.
Methods:
Tear samples were collected with unmarked Schirmer strips from 15 patients with SS KCS and 21 healthy controls. Tear prote...
Citations
... The study by Bradley et al. is the only study that investigated human serum VEGF levels (68.76 ± 38.70 pg/mL) in DED patients [33]. Byambjav et al. found tear VEGF levels to be similar between groups of participants: healthy controls, DED only, diabetics, and diabetics with DED (p > 0.5) [34]. ...
... Two studies were age/gender-matched due to the limited number of samples. Figure 5. "Traffic light" plots of the domain-level assessments for each individual result [29][30][31][32][33][34][35][36][37][38][39][40][41][42] using the ROBINS-E tool [43]. ...
... In a similar study performed in the UK by Byambajav et al. [34], patients were classified into four groups, and it was found that tear fluid IL-6 and IL-8 concentrations correlated with various clinical signs of dry eye in Type 2 diabetes mellitus with DED. The study also concluded that inflammation is an important cause and influences the progression of DED, with the concomitant occurrence of cytokine production [34]. ...
We aim to summarize the current evidence of Vascular endothelial growth factors (VEGF)s in external eye diseases and determine whether serum and plasma VEGF levels are associated with tear and ocular surface tissues. A systematic search of PUBMED and EMBASE was conducted using PRISMA guidelines between October 2022 and November 2023, with no restriction on language or publication date. Search terms included relevant MESH terms. These studies were evaluated for quality, and an assessment of the risk of bias was also carried out. Extracted data were then visually represented through relevant tables or figures. The initial literature search yielded 777 studies from PUBMED, 944 studies from EMBASE, and 10 studies from manual searches. Fourteen eligible studies were identified from 289 articles published from 2000 to 2023 in the English language or with English translations, including rabbit models, murine models, and human-derived samples. Most studies were retrospective in nature and case–control studies. Various common external eye diseases, such as dry eye disease (DED) and allergic eye disease were investigated. Despite limitations and small sample sizes, researchers have found elevated tissue levels of the VEGF in the vascularized cornea, especially in animal models, but there is no evidence of clear changes in the tear concentrations of VEGF in DED and allergic eye disease. Tear VEGF is associated with corneal vascularization. Anti-VEGF therapies may have the potential to manage such conditions.
... Dry eye disease is of high prevalence in persons with type 2 diabetes [30]. Ocular surface inflammation plays a huge role in the pathogenesis of dry eye disease and ocular surface discomfort [31]. Inflammation has a significant impact on how dry eye disease in people with type 2 diabetes develops [31]. ...
... Ocular surface inflammation plays a huge role in the pathogenesis of dry eye disease and ocular surface discomfort [31]. Inflammation has a significant impact on how dry eye disease in people with type 2 diabetes develops [31]. In laser-assisted in situ keratomileusis (LASIK), corneal nerve loss is accompanied by more severe ocular surface discomfort [32]; however, loss of corneal nerve fibers in LASIK is distinctively different from type 2 diabetes. ...
Purpose:
The study aimed to ascertain the potential effects of chronic kidney disease (CKD) on substance P concentration in the tear film of people with type 2 diabetes.
Methods:
Participants were classified into two groups: type 2 diabetes with concurrent chronic kidney disease (T2DM-CKD (n = 25)) and type 2 diabetes without chronic kidney disease (T2DM-no CKD (n = 25)). Ocular surface discomfort assessment, flush tear collection, in-vivo corneal confocal microscopy, and peripheral neuropathy assessment were conducted. Enzyme-linked immunosorbent assays were utilized to ascertain the levels of tear film substance P in collected flush tears. Correlation analysis, hierarchical multiple linear regression analysis, and t-tests or Mann-Whitney U tests were used in the analysis of data for two-group comparisons.
Results:
There was no substantial difference between the T2DM-CKD and T2DM-no CKD groups for tear film substance P concentration (4.4 (0.2-50.4) and 5.9 (0.2-47.2) ng/mL, respectively; p = 0.54). No difference was observed in tear film substance P concentration between the low-severity peripheral neuropathy and high-severity peripheral neuropathy groups (4.4 (0.2-50.4) and 3.3 (0.3-40.7) ng/mL, respectively; p = 0.80). Corneal nerve fiber length (9.8 ± 4.6 and 12.4 ± 3.8 mm/mm2, respectively; p = 0.04) and corneal nerve fiber density (14.7 ± 8.5 and 21.1 ± 7.0 no/mm2, respectively; p < 0.01) were reduced significantly in the T2DM-CKD group compared to the T2DM-no CKD group. There were significant differences in corneal nerve fiber density (21.0 ± 8.1 and 15.8 ± 7.7 no/mm2, respectively; p = 0.04) and corneal nerve fiber length (12.9 ± 4.2 and 9.7 ± 3.8 mm/mm2, respectively; p = 0.03) between the low- and high-severity peripheral neuropathy groups.
Conclusion:
In conclusion, no significant difference in tear film substance P concentration was observed between type 2 diabetes with and without CKD. Corneal nerve loss, however, was more significant in type 2 diabetes with chronic kidney disease compared to type 2 diabetes alone, indicating that corneal nerve morphological measures could serve greater utility as a tool to detect neuropathy and nephropathy-related corneal nerve changes.
Dry eye disease (DED) can arise from a variety of factors, including inflammation, meibomian gland dysfunction (MGD), and neurosensory abnormalities. Individuals with DED may exhibit a range of clinical signs, including tear instability, reduced tear production, and epithelial disruption, that are driven by different pathophysiological contributors. Those affected often report a spectrum of pain and visual symptoms that can impact physical and mental aspects of health, placing an overall burden on an individual’s well-being. This cumulative impact of DED on an individual’s activities and on society underscores the importance of finding diverse and effective management strategies. Such management strategies necessitate an understanding of the underlying pathophysiological mechanisms that contribute to DED in the individual patient. Presently, the majority of approved therapies for DED address T cell-mediated inflammation, with their tolerability and effectiveness varying across different studies. However, there is an emergence of treatments that target additional aspects of the disease, including novel inflammatory pathways, abnormalities of the eyelid margin, and neuronal function. These developments may allow for a more nuanced and precise management strategy for DED. This review highlights the recent pharmacological advancements in DED therapy in the United States. It discusses the mechanisms of action of these new treatments, presents key findings from clinical trials, discusses their current stage of development, and explores their potential applicability to different sub-types of DED. By providing a comprehensive overview of products in development, this review aims to contribute valuable insights to the ongoing efforts in enhancing the therapeutic options available to individuals suffering from DED.
