Role of tear film biomarkers in the diagnosis and management of dry eye disease

Abstract

In recent years, there has been increasing scientific interest in the use of tear film biomarkers in the diagnosis and management of dry eye disease (DED), owing to their potential important roles in the pathogenesis of ocular surface damage, as well as the technical feasibility of tear sample collection techniques. An Entrez PubMed search was conducted on March 2, 2019, to include papers investigating the use of tear film biomarkers in DED, and the results were classified according to whether the DED is associated with systemic inflammatory disease or not and further classified within each section according to the molecular nature of the biomarker for further discussion. A total of 58 relevant articles were reviewed. Certain cytokines, including interleukin-6 (IL-6), tumor necrosis factor-alpha, IL-17, and IL-8, were found by a number of studies to consistently reflect disease severity well and had strong correlations with tear film metrics and tests for ocular surface damage in dry eye without systemic inflammatory disease. For dry eye with systemic inflammatory disease, IL-17, IL-8, and IL-1 receptor antagonists were shown to be consistently higher in affected eyes and correlated well with ocular surface disease severity in more than one type of inflammatory disease. With the advancement in technology and lowered costs in the future, tear film biomarker counts would allow better diagnosis and monitoring of DED, as well as facilitate personalized treatment strategies.

Development of Lactoferrin-Loaded Liposomes for the Management of Dry Eye Disease and Ocular Inflammation

“…Various authors have studied the influence of DED on the presence of different inflammation markers at ocular level. It has been reported that there is a significant increase of inflammation, doubling the concentration of IL-8 in patients with DED compared with healthy controls [ 2 , 81 ]. This high concentration of IL-8 at the tear level leads to the migration of different immune cells towards the eye, triggering the aggravation of the ocular inflammation symptoms present in the disease [ 15 ].…”

Body Fluid Biomarkers for Alzheimer’s Disease—An Up-To-Date Overview

“…While tears are available in considerably reduced volumes for sampling, they are a neglected key reservoir of biomarkers, with great potential in medical diagnostics [179,180]. Tears are complex protein, lipid, mucin, water and salt mixtures, and the development of novel proteomic, lipidomic and glycomic techniques has allowed for a complete understanding of these components and their changes associated with ocular or non-ocular disorders [171,181,182]. For example, proteomic techniques have revealed the presence of AD-related peptides within aqueous humor samples [183], while tear fluid has proven to be clinically relevant through the discovery of a combination of four tear proteins, namely lipocalin-1, dermicidin, lysozyme C and lactritin, with a sensitivity of 81% and a specificity of 77% for AD [184,185].…”

<p>Efficacy and Safety of VisuEvo® and Cationorm® for the Treatment of Evaporative and Non-Evaporative Dry Eye Disease: A Multicenter, Double-Blind, Cross-Over, Randomized Clinical Trial</p>

“…Tear samples were analyzed for pro-inflammatory cytokines IFN, IL-6, IL-8, by means of ELISA using a Luminex multiplex basis (which enables the quantification of the three proteins simultaneously in the same sample). 20 Lipid expression was evaluated by mass spectrometry. Four molecules were studied: ceramides, sphingomieline, sphingosine and sphingosine 1 phosphate.…”