Evaluation of point-of-care test for elevated tear matrix metalloproteinase 9 in post-LASIK dry eyes

Chan, Tak‐Mao; Ye, Cong; Chan, Kwok Ping; Chu, Kai On; Jhanji, Vishal

doi:10.1136/bjophthalmol-2015-307607

Cited by 25 publications

(28 citation statements)

References 27 publications

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“…A much expanded understanding of the tear proteome [405,406] has been achieved over the past decade and this section will concentrate on research conducted within this time frame. Techniques that have been used for proteomic analysis include unbiased tandem mass spectrometric (MS/MS) sequencing [19,268,269,407–414], candidate immunocapture [368,415–421] and other approaches (Table 5), from which a select group of putative disease biomarkers have emerged (Tables 6 and 7). …”

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

“…For this reason, candidate immunological approaches have been explored (Table 6) [270,368,415,417,420,421,423–436]. These include antibody array (16 inflammatory cytokines [437]), sandwich ELISA (for MMP-9 [415,418,421], MUC5AC [368], IL-1β and IL-6 [415]), direct ELISA (lacritin [416,438]), and bead adsorption [439] (13 inflammatory cytokines, EGF, vascular endothelial growth factor (VEGF) [417,419], TGFβ1 and 2 [420]). An expanded selection of quantitative immunoassays built on validated biomarkers (Tables 6 and 7) should be the way of the future.…”

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

“…Capture of tears by microcapillary tubes is most common in proteomic studies [268,269,408,409,418–421,432,437,450], although others collect tears onto Schirmer strips [269,407,410–412,442], using sponges [409,415,429] or via micropipette tip [368,417,450]. Posa et al [456] and Grus et al [442] note that microcapillary tubes and Schirmer strips are equally effective, whereas Green-Church et al [269] suggest that the tear film collection method impacts proteins present in the sample.…”

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

“…Not detected by MS/MS, but apparent by candidate immuno-screening or activity assays (Table 6) [415,417,420,421,423,424,426, 427,429,432,433,449,450] were several growth factors and cytokines. VEGF levels were increased in MGD [417].…”

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

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TFOS DEWS II Tear Film Report

et al. 2017

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The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED). The Subcommittee reviewed biophysical and biochemical aspects of tears and how these change in DED. Clinically, DED is characterized by loss of tear volume, more rapid breakup of the tear film and increased evaporation of tears from the ocular surface. The tear film is composed of many substances including lipids, proteins, mucins and electrolytes. All of these contribute to the integrity of the tear film but exactly how they interact is still an area of active research. Tear film osmolarity increases in DED. Changes to other components such as proteins and mucins can be used as biomarkers for DED. The Subcommittee recommended areas for future research to advance our understanding of the tear film and how this changes with DED. The final report was written after review by all Subcommittee members and the entire TFOS DEWS II membership.

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Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

Section: Biochemical Properties Of Tearsmentioning

confidence: 99%

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TFOS DEWS II Tear Film Report

et al. 2017

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“…26, 43–45 A point-of-care MMP-9 detection system (InflammaDry®, RPS, Sarasota, FL) is approved for detecting elevated levels of MMP-9 in tears of dry eye patients. 46–50 Increased tear MMP-9 has also been detected in other ocular surface diseases, such as atopic and vernal keratoconjunctivitis, corneal ulceration, recurrent corneal erosions and ocular burns that also have corneal barrier disruption. 51–63 Detection of elevated tear MMP-9 provides a rationale for use of anti-inflammatory/protease therapies in these conditions.…”

Section: Dry Eye – a Multifactorial And Self-perpetuating Inflammatormentioning

confidence: 99%

The Pathophysiology of Dry Eye Disease

2017

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Clinical and laboratory studies performed over the past few decades have discovered that dry eye is a chronic inflammatory disease that can be initiated by numerous extrinsic or intrinsic factors that promote an unstable and hyperosmolar tear film. These changes in tear composition, in some cases combined with systemic factors, lead to an inflammatory cycle that causes ocular surface epithelial disease and neural stimulation. Acute desiccation activates stress signaling pathways in the ocular surface epithelium and resident immune cells. This triggers production of innate inflammatory mediators that stimulate the production of matrix metalloprotease, inflammatory cell recruitment, and dendritic cell maturation. These mediators combined with exposure of autoantigens can lead to an adaptive T-cell mediated response. Cornea barrier disruption develops by protease-mediated lysis of epithelial tight junctions leading to accelerated cell death, desquamation, an irregular poorly lubricated cornea surface and exposure and sensitization of epithelial nociceptors. Conjunctival goblet cell dysfunction and death are promoted by the T helper 1 cytokine interferon gamma (IFN-γ). These epithelial changes further destabilize the tear film, amplify inflammation and create a vicious cycle. Cyclosporine and lifitegrast, the two FDA-approved therapies inhibit T cell activation and cytokine production. While these therapies represent a major advance in dry eye therapy, they are not effective in improving discomfort and corneal epithelial disease in all patients. Preclinical studies have identified other potential therapeutic targets, biomarkers and strategies to bolster endogenous immunoregulatory pathways. These discoveries will hopefully lead to further advances in diagnostic classification and treatment.

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Association of Ramadan daytime fasting with ocular surface inflammation and dry eye

et al. 2019

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Purpose Despite the widespread practice of fasting, there are no studies looking at ocular surface inflammation, specifically matrix metalloproteinase 9 (MMP-9) testing, during fasting. In this prospective study, we wanted to evaluate the effect of Ramadan fasting on the level of tear film MMP-9 as well as other standard indicators of dry eye disease. Methods Forty healthy patients without history of ocular disease were tested before and toward the end of Ramadan. Each patient was assessed at each timepoint for tear film MMP-9 positivity as measured by a commercially available test (InflammaDry; Quidel Corp., San Diego, CA, USA) which detects MMP-9 levels of more than 40 ng/ml. Ocular surface disease index (OSDI) scores, tear breakup time (TBUT), Schirmer I test (S1T) and corneal fluorescein staining (CFS) were also evaluated at each timepoint. Results InflammaDry was positive in 10 patients (25%) prior to Ramadan and 21 patients (52.5%) during Ramadan fasting, and this change was statistically significant (p = 0.02). Mean TBUT decreased from 7 s prior to Ramadan to 5.3 s during Ramadan fasting, and this change was statistically significant (p = 0.01). OSDI, CFS and S1T did not show any statistically significant changes (p [ 0.05 for all). Conclusion Ramadan fasting has a significant impact on TBUT and ocular surface inflammation detected by Inflamma Dry testing. Patients who suffer from dry eye disease and those who develop symptoms during Ramadan are advised to consult with a physician before or during Ramadan fasting.

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Evaluation of point-of-care test for elevated tear matrix metalloproteinase 9 in post-LASIK dry eyes

Cited by 25 publications

References 27 publications

TFOS DEWS II Tear Film Report

TFOS DEWS II Tear Film Report

The Pathophysiology of Dry Eye Disease

Association of Ramadan daytime fasting with ocular surface inflammation and dry eye

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