Sensitivity and Specificity of a Point-of-Care Matrix Metalloproteinase 9 Immunoassay for Diagnosing Inflammation Related to Dry Eye

Sambursky, Robert; Davitt, William F.; Latkany, Robert; Tauber, Shachar; Starr, Chauncey; Friedberg, Murray; Dirks, Monte S.; McDonald, Marguerite B.

doi:10.1001/jamaophthalmol.2013.561

Cited by 171 publications

(129 citation statements)

References 32 publications

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“…13,25 This tear molecule has gained popularity in relation to dry eye, as some authors have indicated its potential utility as a biomarker to diagnose dry eye disease using a MMP-9 based point-of-care device. 46 Additionally, other authors have shown in-vivo benefits of using MMP-9 inhibitors for restoring tear production. 47 In the present study we also found consistent associations between the increase in IL-1RA tear levels and the worsening of the corneal staining, in addition to the relationship between the decrease in Schirmer test and the increase of IL-6, IL-8 and MMP-9 tear levels.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Inflammatory Response in Sjögren Syndrome–Associated Dry Eye Patients Under Desiccating Stress

López-Miguel

Tesón

Martín-Montañéz

et al. 2016

American Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Clinical and Molecular Inflammatory Response in Sjögren Syndrome–Associated Dry Eye Patients Under Desiccating Stress

López-Miguel

Tesón

Martín-Montañéz

et al. 2016

American Journal of Ophthalmology

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“…Using a point-of-care lateral flow immunoassay (InflammaDry ® ; Rapid Pathogen Screening, Sarasota, FL, USA), which detects both pro-and active MMP-9 at tear concentrations ≥40 ng/mL, elevated tear MMP-9 was found to have high sensitivity and specificity with clinical diagnosis of dry eye in two studies, and in another study, a positive result was significantly correlated with severity of irritation symptoms and ocular surface dye staining, tear break-up time and systemic autoimmune disease, particularly SS. [67][68][69] Using the same assay, Lanza et al found only 39% of subjects with symptoms of dry eye had a positive MMP-9 assay and there was no difference in the profile of signs and symptoms between MMP-9-positive and …”

Section: Correlations Between Mmp-9 and Severitymentioning

confidence: 99%

“…When Sambursky et al evaluated 206 patients with dry eye, they reported a sensitivity of 85%, specificity of 94%, negative predictive value of 73% and positive predictive value of 97% using the InflammaDry test. 68 The clinical trials summarized in Table 1 show conflicting results regarding the diagnostic utility of the InflammaDry tear MMP-9 immunoassay. This may be due to the design of this test that detects a threshold MMP-9 concentration.…”

Section: Mmp-9 As a Diagnostic Biomarkermentioning

confidence: 99%

Matrix metalloproteinase-9 in the pathophysiology and diagnosis of dry eye syndrome

Pflugfelder¹,

Bian²,

Paiva³

2017

MNM

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Dry eye and tear dysfunction are common ocular disorders that cause cornea barrier disruption resulting in a poorly lubricated and irregular cornea epithelium, eye irritation and blurred vision. Increased levels and activities of matrix metalloproteinases (MMPs), particularly MMP-9, have been detected in the tears and ocular surface epithelial and inflammatory cells in dry eye. MMPs have been found to participate in disruption of tight junctions in the apical cornea epithelium leading to their accelerated desquamation and barrier disruption. This review summarizes evidence showing the contribution of MMPs to dry eye pathogenesis and their roles as biomarkers and therapeutic targets. Keywords: matrix metalloproteinase, dry eye, keratitis sicca, cornea, barrier function, Sjögren syndrome Dry eye overviewDry eye and tear dysfunction are common ocular disorders that cause cornea barrier disruption resulting in a poorly lubricated and irregular cornea epithelium, eye irritation and blurred vision. It affects millions of people worldwide and is one of the most frequent conditions for which patients seek eye care.1 Aging and female sex are significant risk factors for dry eye which increases in prevalence around the fifth decade, with further increase every decade thereafter.2-13 Prevalence of dry eye varies from 2% to 50%, depending on the population studied and the diagnostic criteria for dry eye (symptom questionnaire vs. objective signs). [1][2][3]6,7,[9][10][11][14][15][16][17][18][19][20][21][22][23] There is scarce information about the natural history of dry eye, but there is a recognized disconnection between signs and symptoms; patients tend to be more symptomatic at early stages.24,25 Dry eye causes corneal irregularity [26][27][28] and decreases functional vision by altering contrast sensitivity [29][30][31] and, therefore, decreases quality of life with a significant burden on the individual as well as the society. 23,[32][33][34][35] A meta-analysis of 22 published studies showed increased odds ratio for depression and anxiety in patients with ocular Sjögren syndrome (SS). 36 There is increased evidence that dry eye is an inflammatory disease, and this review will focus on matrix metalloproteinases (MMPs) and their role in the pathogenesis of dry eye. Cornea barrier disruption is a feature of dry eyeAs the principal lens of the eye, the cornea has unique features to maintain its transparency and smooth surface that include a lack of blood vessels and a multilayered stratified, non-cornifying epithelium. The differentiated apical epithelial cells produce

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“…[55][56][57] Finally, MMP-9 levels have been shown to increase in the tears of dry eye patients. 58,59 In addition to pro-inflammatory mediators, there are anti-inflammatory mediators, such as those derived from omega 3 and 6 fatty acids (ie, resolvins and 60 ), and the presence of both pro-and antiinflammatory mediators are likely important in regulating the signs and symptoms in dry eye.…”

Section: Inflammationmentioning

confidence: 99%

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

Galor

Levitt

Felix

et al. 2014

Eye

182

187

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Dry eye has gained recognition as a public health problem given its prevalence, morbidity, and cost implications. Dry eye can have a variety of symptoms including blurred vision, irritation, and ocular pain. Within dry eyeassociated ocular pain, some patients report transient pain whereas others complain of chronic pain. In this review, we will summarize the evidence that chronicity is more likely to occur in patients with dysfunction in their ocular sensory apparatus (ie, neuropathic ocular pain). Clinical evidence of dysfunction includes the presence of spontaneous dysesthesias, allodynia, hyperalgesia, and corneal nerve morphologic and functional abnormalities. Both peripheral and central sensitizations likely play a role in generating the noted clinical characteristics. We will further discuss how evaluating for neuropathic ocular pain may affect the treatment of dry eye-associated chronic pain.

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Sensitivity and Specificity of a Point-of-Care Matrix Metalloproteinase 9 Immunoassay for Diagnosing Inflammation Related to Dry Eye

Cited by 171 publications

References 32 publications

Clinical and Molecular Inflammatory Response in Sjögren Syndrome–Associated Dry Eye Patients Under Desiccating Stress

Clinical and Molecular Inflammatory Response in Sjögren Syndrome–Associated Dry Eye Patients Under Desiccating Stress

Matrix metalloproteinase-9 in the pathophysiology and diagnosis of dry eye syndrome

Neuropathic ocular pain: an important yet underevaluated feature of dry eye

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