Lipidomics Profiles Revealed Alterations in Patients With Meibomian Gland Dysfunction After Exposure to Intense Pulsed Light

Abstract

So far, intense pulsed light (IPL) has been widely used in the treatment of meibomian gland dysfunction (MGD), but there was still a lack of research on its specific mechanism. Determining whether there was a correlation between liposome changes and remission of clinical signs in patients with MGD treated with IPL was of great significance in the clinical evaluation of efficacy in patients with MGD. Our study enrolled the 10 healthy subjects and 26 adult patients, who were diagnosed with MGD and had not received any alternative treatments for at least 3 months. Each patient received a series of three treatments at 3-week intervals. The meibum was collected before the first treatment (T0) and the third treatment (T2). The significant changes in ocular surface parameters before and after IPL treatment were analyzed. The results showed that IPL significantly improved the symptoms of MGD, including ocular surface disease index (OSDI), tear breakup time (TBUT), redness of conjunctival (CR), corneal fluorescein staining (CF), the meibomian gland expressibility (MGE), and meibum quality (all p < 0.05). Lipidomics analysis of the meibum characterized the changes in lipid profiles induced by IPL. A total of 323 lipid species compounds were identified in the spectrum. A total of 41 lipid species were significantly different in patients with MGD (T0) vs. healthy controls. Following IPL treatment (T2), 24 lipid species were significantly different compared with T0: TG (10 lipid species), LPC (6 lipid species), OAHFA (4 lipid species), Cer (2 lipid species), SM (1 lipid species), and PE (1 lipid specie). Among these lipids, 4 of the lipids was a high correlation with TBUT, 5 was TH, 6 was CR, and 11 was meibum quality. In a ward, IPL treatment can achieve the therapeutic effect by changing the alternations of tear film lipids in patients with MGD. The changes in lipid expression profiles are potential indexes to evaluate the therapeutic effectiveness of IPL treatment or other treatments on MGD.

Intense pulsed light treatment in meibomian gland dysfunction: Past, present, and future

“…Several authors have promoted this as a contributary mechanism of IPL (Dell et al, 2017; Gupta et al, 2016), though others voice scepticism due to the short duration and limited effect on temperature (Albietz & Schmid, 2018; Craig et al, 2015). However, recent publications describe alterations of the lipidomic profile of DED patients following IPL treatment, thus theoretically lowering the phase‐transition temperature back towards the physiological range and promoting a more lasting expressibility (Ahmed et al, 2019; Zhao et al, 2022). More extensive, prospective studies employing lipidomic analysis at several time points during treatment are warranted and currently underway by our group. Telangiectatic thrombosis: eyelid telangiectasia is a hallmark of MGD, and it is hypothesised that these abnormal vascular structures may work as an inducer, propagator and reservoir for pro‐inflammatory mediators (Bron et al, 2017; Dell et al, 2017; Schaumberg et al, 2011).…”

“…A later study employed liquid chromatography tandem mass spectrometry to analyse and compare the lipidomic profiles of 10 healthy controls and 26 MGD patients before and after IPL treatment (Zhao et al, 2022). In total, 323 lipid species were identified, 41 of which differed between subjects and controls at baseline, and 24 lipid species altered following treatment.…”

Dry Eye Disease Associated with Meibomian Gland Dysfunction: Focus on Tear Film Characteristics and the Therapeutic Landscape

“…The potential mechanism of action of IPL in MGD management is poorly understood but may involve warming (although observed eyelid temperature change is minimal [ 113 ]), thrombosis of abnormal blood vessels, inhibition of bacterial growth, and/or photomodulation effects on the meibomian glands [ 114 ]. It is possible that IPL may alter tear film lipids [ 115 , 116 ] and tear cytokines [ 114 , 117 ]. The efficacy of IPL for the treatment of MGD was evaluated in a meta-analysis that included nine studies (539 patients in total) and found that IPL combined with meibomian gland expression was superior to meibomian gland expression alone based on TFBUT and OSDI scores, but not SPEED scores [ 118 ].…”

The ILux® compared to the mechanical meibomian gland expression for the treatment of moderate and severe meibomian gland dysfunction

“…Finally, atrophy and dropout of MGs in some cases could appear [6][7] . MGD is a prevalent dry eye disorder (DED) with an estimated prevalence range between 3.5% and 70% [1,[8][9][10] , it constitutes the primary underlying pathology within the EDE subtype [11][12] . In addition, it is known that MGD is a chronic and progressive condition [2,13] , so it is crucial to identify clinical approaches that can successfully address this underlying condition.…”