Importance Age‐related cataract is the leading cause of blindness worldwide. The pathological mechanisms causing this disease remain elusive. Background To examine the involvement of uric acid (UA) in the pathogenesis of posterior subcapsular cataract (PSC). Design Retrospective study and experimental investigation. Participants A total of 180 patients with PSC or non‐PSC were included. Methods Samples obtained from the patients were used to analyse content of UA and for histochemical examinations. The effects of UA on human lens epithelial cells were also investigated. Main Outcome Measures Aqueous humour UA and urate deposits. Results The results showed a significant increase of aqueous humour UA in patients with PSC. After adjustment for potential confounders, elevated aqueous humour UA (odds ratio [OR] = 1.45) showed a stronger association with PSC than serum UA (OR = 1.10). Gomori methenamine silver staining revealed in PSC an intense deposit of urates in the lens fibres in equatorial regions, and in subcapsular fibres in posterior regions of the lens. Such staining was not detected in the lens with non‐PSC. Treatment with UA‐induced senescence and apoptosis in human lens epithelial cells in a dose dependent manner. Our results suggest that the elevated level of UA in aqueous humour causes a deposition of urates in human lens epithelium, which could possibly lead to dysfunction of these cells that generates opacification in PSC. Conclusions and Relevance These findings indicate the local action of excessive UA in the pathogenesis of PSC. Control of serum UA level could delay the progression of PSC.
Background Several studies have shown that the use of antibiotics early in life significantly increases the risk of asthma in children. It is unclear whether antibiotics are more commonly used in patients with allergy-related diseases. Methods A multistage, clustered and random sampling with a field-interviewer-administrated survey study was performed to investigate if there was multiple use of antibiotics (MUA) in patients with allergic rhinitis (AR), conjunctivitis, chronic urticaria (CU), and asthma in the grasslands of northern China. MUA was defined as antibiotic usage for at least 3 days and for more than 3 times a year in the past 2 years. Results A total of 5,787 subjects completed the study, with 1,079 subjects (18.6%) identified as MUA. MUA was more common in patients with AR (23.7% vs 16.2%, P <0.001), conjunctivitis (22.5% vs 17.1%, P <0.001), asthma (31.8% vs 17.7%, P <0.001), and CU (25.9% vs 18.3%, P <0.01) than in subjects without allergic diseases. There is an increasing percentage of MUA in patients with a single, two, and three or more diseases both in children (20.1%, 25.0%, and 31.4%, respectively, P =0.014) and in adults (19.1%, 23.4%, and 32.9%, respectively, P <0.001). MUA is significantly associated with AR (OR=1.7, 95% CI: 1.3–2.1, P <0.001), conjunctivitis (OR=1.6, 95% CI: 1.2–2.1, P =0.001), asthma (OR=2.3, 95% CI:1.6–3.3, P <0.001) and CU (OR=2.1, 95% CI: 1.2–3.6, P =0.006) in children aged 2–17 years; and in adults (≥18 years old) for AR (OR=1.7, 95% CI: 1.4–2.1, P <0.001), conjunctivitis (OR=1.3, 95% CI:1.1–1.6, P =0.002), and asthma (OR=2.0, 95% CI: 1.5–2.7, P <0.001). Conclusion Antibiotic overuse might be associated with increased risk of allergy-related disease. It is important that implementation of the evidence-based international guidelines for the management of allergy-related diseases needs to be improved, in order to avoid unnecessary use of antibiotics.
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