Tear biomarkers and corneal sensitivity as an indicator of neuropathy in type 2 diabetes

Iyengar, Meera; Soto, L; Requena, David; Ruíz-Alejos, Andrea; Huaylinos, Yvonne; Velasquez, Ricardo; Bernabé‐Ortiz, Antonio; Gilman, Robert H.

doi:10.1016/j.diabres.2020.108143

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…Basal tear flow (Schirmer test II) and TBUT were found to be unaffected. These data are consistent with the observation that diabetic neuropathy most often involves the ophthalmic nerve, thus triggering a corneal neuropathy with loss of sensitivity [39,40], which in turn results in decreased tear secretion and altered composition of tear proteins [41,42].…”

Section: Discussionsupporting

confidence: 92%

Effects of the Topical Use of the Natural Antioxidant Alpha-Lipoic Acid on the Ocular Surface of Diabetic Patients with Dry Eye Symptoms

Roszkowska¹,

Spinella²,

Oliverio³

et al. 2022

Front. Biosci. (Landmark Ed)

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Purpose:The purpose of this study is to investigate the effects of the treatment with eye-drops based on a combination of antioxidant and mucomimetic molecules, namely 0.1% alpha-lipoic acid (ALA) and 0.3% hydroxy-propyl-methylcellulose (HPMC) on the ocular surface of diabetic patients with dry eye symptoms. Methods: Seventy patients, 42 M and 28 F, aged from 50 to79 years (mean 62.1 ± 10.5), affected by type II diabetes mellitus, were enrolled and divided in two groups treated for 2 months as follows: Group 1 (35 patients), received topical ALA/HPMC three times a day, Group 2 (35 patients) received topical HPMC (0.3%) alone, three times a day. The main outcome measures were: Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), corneal fluorescein staining, Schirmer I test, corneal sensitivity. An examination of tear film morphology with confocal microscopy was carried out in a subset of patients of each group at baseline and after two months. Statistical analysis was performed with t-test for the parametric data and Mann-Whitney U-test or chi-squared test for the nonparametric data. Results: Both treatments resulted in significant improvements of BUT, OSDI and tear film morphology, although the improvements observed in group 1 showed a higher trend than what observed for group 2. Moreover, only in group 1 a significant improvement was visible for corneal staining, and no significant improvements were observed in any group for Schirmer I and sensitivity. Conclusions: These results confirmed the efficacy of HPMC in the treatment of diabetic dry eye and indicated that the addition of a strong self-regenerating antioxidant like ALA may give a distinctive advantage for the healing of corneal defects (as evidenced by corneal staining), beside improving HPMC efficacy on three other parameters (BUT, OSDI score, tear morphology). Therefore, the addition of a strong antioxidant like ALA can be helpful in preventing or treating ocular surface defects in diabetic patients, in which the oxidative damage is predominant.

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Section: Discussionsupporting

confidence: 92%

Effects of the Topical Use of the Natural Antioxidant Alpha-Lipoic Acid on the Ocular Surface of Diabetic Patients with Dry Eye Symptoms

Roszkowska¹,

Spinella²,

Oliverio³

et al. 2022

Front. Biosci. (Landmark Ed)

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“…The authors concluded that inflammatory tear biomarkers were regarded as suboptimal standalone tools for detecting DPN as the AUC was only 65%. However, combining tear analysis (MMP-9 and TNF-α) with corneal esthesiometry measurement (cut off 5.8 mm) could improve the AUC to 84% [126].…”

Section: Inflammatory Tear Biomarkersmentioning

confidence: 99%

Diabetic Corneal Neuropathy

Mansoor¹,

Tan

Lin

et al. 2020

JCM

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Diabetic keratopathy (DK) is a common, but underdiagnosed, ocular complication of diabetes mellitus (DM) that has a significant economic burden. It is characterised by progressive damage of corneal nerves, due to DM-induced chronic hyperglycaemia and its associated metabolic changes. With advances in corneal nerve imaging and quantitative analytic tools, studies have shown that the severity of diabetic corneal neuropathy correlates with the status of diabetic peripheral neuropathy. The corneal nerve plexus is, therefore, considered as an important surrogate marker of diabetic peripheral neuropathy and helps in the evaluation of interventional efficacy in the management of DM. The clinical manifestations of DK depend on the disease severity and vary from decreased corneal sensitivity to sight-threatening corneal infections and neurotrophic ulcers. The severity of diabetic corneal neuropathy and resultant DK determines its management plan, and a step-wise approach is generally suggested. Future work would focus on the exploration of biomarkers for diabetic corneal neuropathy, the development of new treatment for corneal nerve protection, and the improvement in the clinical assessment, as well as current imaging technique and analysis, to help clinicians detect diabetic corneal neuropathy earlier and monitor the sub-clinical progression more reliably.

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“…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].…”

Section: Emerging Body Fluid Biomarkersmentioning

confidence: 99%

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

2020

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Neurodegeneration is a highly complex process which is associated with a variety of molecular mechanisms related to ageing. Among neurodegenerative disorders, Alzheimer’s disease (AD) is the most common, affecting more than 45 million individuals. The underlying mechanisms involve amyloid plaques and neurofibrillary tangles (NFTs) deposition, which will subsequently lead to oxidative stress, chronic neuroinflammation, neuron dysfunction, and neurodegeneration. The current diagnosis methods are still limited in regard to the possibility of the accurate and early detection of the diseases. Therefore, research has shifted towards the identification of novel biomarkers and matrices as biomarker sources, beyond amyloid-β and tau protein levels within the cerebrospinal fluid (CSF), that could improve AD diagnosis. In this context, the aim of this paper is to provide an overview of both conventional and novel biomarkers for AD found within body fluids, including CSF, blood, saliva, urine, tears, and olfactory fluids.

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Tear biomarkers and corneal sensitivity as an indicator of neuropathy in type 2 diabetes

Cited by 11 publications

References 36 publications

Effects of the Topical Use of the Natural Antioxidant Alpha-Lipoic Acid on the Ocular Surface of Diabetic Patients with Dry Eye Symptoms

Effects of the Topical Use of the Natural Antioxidant Alpha-Lipoic Acid on the Ocular Surface of Diabetic Patients with Dry Eye Symptoms

Diabetic Corneal Neuropathy

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

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