New Testing Options for Diagnosing and Grading Dry Eye Disease

Foulks, Gary N.; Pflugfelder, Stephen C.

doi:10.1016/j.ajo.2014.03.002

Cited by 39 publications

(39 citation statements)

References 57 publications

(68 reference statements)

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“…In addition, tear stability has been traditionally measured using TBUT 23 . Dry eye in pSS can damage the ocular surface, and the range and severity of KCS is assessed using ocular stain score systems.…”

Section: Discussionmentioning

confidence: 99%

Relation of Autoimmune Cytopenia to Glandular and Systemic Manifestations in Primary Sjögren Syndrome: Analysis of 113 Korean Patients

Koh

Lee²,

Chung³

et al. 2015

J Rheumatol

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Section: Discussionmentioning

confidence: 99%

Relation of Autoimmune Cytopenia to Glandular and Systemic Manifestations in Primary Sjögren Syndrome: Analysis of 113 Korean Patients

Koh

Lee²,

Chung³

et al. 2015

J Rheumatol

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“…It is hoped that these new methods would be integrated into clinical practice for diagnosis, classification, and severity grading of DEDs in the near future. 24,32,33 Furthermore, symptoms alone are not enough to diagnose and manage DED. A consensus of clinical signs that better captures the totality of DED is needed.…”

Section: Discussionmentioning

confidence: 97%

“…Recent research has shown the validity of tear osmolarity as one of the best objective measures of dry eye. [23][24][25] The observed variability in tear osmolarity between eyes or multiple measurements in the same eye has established a means of identifying patients with mild tear dysfunction, given that such variability is not observed in normal tears. Hence, measuring tear osmolarity may be useful in diagnosing and grading DED severity.…”

Section: Discussionmentioning

confidence: 99%

Concordance Between Patient and Clinician Assessment of Dry Eye Severity and Treatment Response in Taiwan

Yeh

Chien

et al. 2015

Cornea

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“…This initiates the vicious circle of dry eye pathology in a final common pathway. Hyperosmolarity induces inflammatory cascade activation [135][136][137], increases apoptosis [138][139][140], and stimulates expression and activity of MMPs [141,142], causing ocular surface barrier disruption [143,144]. In severe cases, dry eye also leads to squamous metaplasia involving ocular surface epithelial cell transdifferentiation from a wet mucosal phenotype to a keratinized skin-like phenotype [145].…”

Section: Ocular Surface Barrier Function In Dry Eye Diseasementioning

confidence: 99%

Clusterin in the eye: An old dog with new tricks at the ocular surface

Fini

Bauskar

Jeong

et al. 2016

Experimental Eye Research

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, M. R. (2016). Clusterin in the eye: an old dog with new tricks at the ocular surface. Experimental Eye Research, Clusterin in the eye: an old dog with new tricks at the ocular surface AbstractThe multifunctional protein clusterin (CLU) was first described in 1983 as a secreted glycoprotein present in ram rete testis fluid that enhanced aggregation ('clustering') of a variety of cells in vitro. It was also independently discovered in a number of other systems. By the early 1990s, CLU was known under many names and its expression had been demonstrated throughout the body, including in the eye. Its homeostatic activities in proteostasis, cytoprotection, and anti-inflammation have been well documented, however its roles in health and disease are still not well understood. CLU is prominent at fluid-tissue interfaces, and in 1996 it was demonstrated to be the most highly expressed transcript in the human cornea, the protein product being localized to the apical layers of the mucosal epithelia of the cornea and conjunctiva. CLU protein is also present in human tears. Using a preclinical mouse model for desiccating stress that mimics human dry eye disease, the authors recently demonstrated that CLU prevents and ameliorates ocular surface barrier disruption by a remarkable sealing mechanism dependent on attainment of a critical all-or-none concentration in the tears. When the CLU level drops below the critical all-or-none threshold, the barrier becomes vulnerable to desiccating stress. CLU binds selectively to the ocular surface subjected to desiccating stress in vivo, and in vitro to LGALS3 (galectin-3), a key barrier component. Positioned in this way, CLU not only physically seals the ocular surface barrier, but it also protects the barrier cells and prevents further damage to barrier structure. CLU depletion from the ocular surface epithelia is seen in a variety of inflammatory conditions in humans and mice that lead to squamous metaplasia and a keratinized epithelium. This suggests that CLU might have a specific role in maintaining mucosal epithelial differentiation, an idea that can now be tested using the mouse model for desiccating stress. Most excitingly, the new findings suggest that CLU could serve as a novel biotherapeutic for dry eye disease. Competing Interests: US patent 9,241,974 B2 entitled "Clusterin pharmaceuticals and treatment methods using the same" (inventors: MEF and SJ), assigned to the University of Southern California, is connected with this work. MEF holds a management position with Proteris Biotech, Inc., Pasadena, CA, which is developing Protearin for dry eye based on clusterin. MRW declares that he has no competing interests. Page 3 of 65 AbstractThe multifunctional protein clusterin (CLU) was first described in 1983 as a secreted glycoprotein present in ram rete testis fluid that enhanced aggregation ('clustering') of a variety of cells in vitro. It was also independently discovered in a number of other systems. By the early 1990s, CLU was known under many names and its expression had bee...

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New Testing Options for Diagnosing and Grading Dry Eye Disease

Cited by 39 publications

References 57 publications

Relation of Autoimmune Cytopenia to Glandular and Systemic Manifestations in Primary Sjögren Syndrome: Analysis of 113 Korean Patients

Relation of Autoimmune Cytopenia to Glandular and Systemic Manifestations in Primary Sjögren Syndrome: Analysis of 113 Korean Patients

Concordance Between Patient and Clinician Assessment of Dry Eye Severity and Treatment Response in Taiwan

Clusterin in the eye: An old dog with new tricks at the ocular surface

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