Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry

Abstract

Background The purpose of this study was to investigate whether acupuncture is effective at treating dry eye disease among postmenopausal women and to identify the possible mechanisms. Methods Twenty-eight postmenopausal women with dry eye disease were randomly divided into two groups: an acupuncture plus artificial tears (AC + AT) group and an artificial tears (AT) only group. After baseline examination of clinical parameters and tear sample collection, each patient received the designated modality of topical therapy for 2 months. Post-treatment documentation of clinical parameters was recorded, and tear samples were collected. Tear samples from the AC + AT group were subjected to two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry (2D nano-LC-MS/MS). Western blot analysis was also performed on tear samples from both groups. Results After treatment, the Ocular Surface Disease Index scores, symptom assessment scores, scores of sign assessment, and tear break-up time were significantly improved in both groups ( P =0.000). Symptom assessment scores were significantly improved in the AC + AT group ( P =0.000) compared with the AT group. 2D nano-LC-MS/MS identified 2,411 proteins, among which 142 were downregulated and 169 were upregulated. After combined AC + AT treatment, the abundance of secreted proteins was increased, whereas that of cytoplasmic proteins decreased (Pearson’s χ 2 test, P =0.000, P =0.000, respectively). Proteins involved in immunity and regulation were also more abundant (Pearson’s χ 2 test, P =0.040, P =0.016, respectively), while components and proliferation-related proteins were downregulated (Pearson’s χ 2 test, P =0.003, P =0.011, respectively). Conclusion AC + AT treatment increased protein synthesis and secretion, and improved clinical symptoms. These results indicate that acupuncture may be a complimentary therapy for treating postmenopausal dry eye disease.

Acupoint selection for the treatment of dry eye: A systematic review and meta‑analysis of randomized controlled trials

“…A total of 12 studies with 900 participants were included in this review. A majority of the studies compared manual acupuncture with AT (33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). An applied form of acupuncture was used in 4 of the studies, including 1 study using silver spike point electro-therapy (35), 1 study using electroacupuncture (44) and 2 studies using combined acupuncture at the phenomaxillary ganglia with acupoints (41,42).…”

“…Participants in the study by Zeng et al (40) were patients who experienced DED for >1 month after LASIK. Furthermore, 2 studies focused on DED in post-menopausal or peri-menopausal females (38,43). Regarding the sensation of acupoints, 4 studies reported on de-qi (soreness, numbness, sensation of heaviness or swelling) associated with the needling (35,37,40,44).…”

“…Regarding the sensation of acupoints, 4 studies reported on de-qi (soreness, numbness, sensation of heaviness or swelling) associated with the needling (35,37,40,44). A total of 10 of the studies were performed in China (34)(35)(36)(38)(39)(40)(41)(42)(43)(44). Detailed descriptions of the studies and the acupuncture treatments are provided in Tables I and II. Risk-of-bias assessment.…”

“…Furthermore, 9 studies described the method of random sequence generation (using a random number table or a computerized random-number generator) (34,(36)(37)(38)(39)(40)(41)(42)44). Clear and adequate allocation concealment was performed in only two studies (35,37) and assessor blinding was used in six studies (33,36,37,(41)(42)(43). Sufficient details of drop-out rates and reasons were described in six studies (35)(36)(37)(38)(39)41).…”

“…For the results of the SIT, 10 studies were used to compare the effect of periocular acupoints or periocular acupoints plus body acupoints with those of AT in patients with DED (34)(35)(36)(37)(38)(39)(40)(42)(43)(44). Compared with the AT group, significant improvement was determined among the acupuncture groups (n=1,107, WMD=1.98, 95% CI: 0.44-3.34, P=0.01).…”