氧化应激因素在干眼中的临床研究
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摘要
干眼是由于泪液的量或质的异常引起的泪膜不稳定和眼表面的损害,从而导致眼不适症状的一类疾病。干眼与多种因素相关。本文主要探讨氧化应激因素对干眼的影响及临床治疗。针对氧化应激因素,干眼周期概念、干眼的眼表炎症和蛋白质组学相关研究证明了两者的相关性,有利于进行针对性临床治疗。针对氧化应激因素的治疗是干眼的潜在治疗方式,无防腐剂眼药水的使用、碘离子电渗疗法及其他蛋白质组学方法的临床试验证明了其合理性与有效性。随着近年来对抗老化药物、预防性整体健康以及环境科学作用的重视,对眼表氧化应激的研究可能会在未来几年产生越来越大的影响。
Dry eye is due to the amount of tear or quality abnormalities caused by tear film instability and damage to the ocular surface,resulting in eye irritation symptoms of a class of diseases. Dry eye is associated with many factors. This article mainly discusses the impact of oxidative stress on dry eye and clinical treatment. In view of the factors of oxidative stress,the concept of dry eye cycle,dry eye ocular inflammation and proteomics related studies have proved the correlation between the two,which is conducive to targeted clinical treatment. The treatment of oxidative stress factors is a potential therapeutic strategy for dry eye. The use of preservative-free eye drops,iodine iontophoresis and other proteomics studies have proved its rationality and effectiveness. With the recent attention to anti-aging drugs,preventive holistic health and the role of environmental science,the study of ocular oxidative stress may have an increasing impact in the coming years.
Dry eye is due to the amount of tear or quality abnormalities caused by tear film instability and damage to the ocular surface,resulting in eye irritation symptoms of a class of diseases. Dry eye is associated with many factors. This article mainly discusses the impact of oxidative stress on dry eye and clinical treatment. In view of the factors of oxidative stress,the concept of dry eye cycle,dry eye ocular inflammation and proteomics related studies have proved the correlation between the two,which is conducive to targeted clinical treatment. The treatment of oxidative stress factors is a potential therapeutic strategy for dry eye. The use of preservative-free eye drops,iodine iontophoresis and other proteomics studies have proved its rationality and effectiveness. With the recent attention to anti-aging drugs,preventive holistic health and the role of environmental science,the study of ocular oxidative stress may have an increasing impact in the coming years.
引文
[1]SHAO Y.Interpretation of TFOS DEWSⅡ[J].Res Adv Ophthalmol,2018,38(1):1-12.邵毅.国际干眼新共识(TFOS DEWSⅡ)解读[J].眼科新进展,2018,38(1):1-12.
[2]SHI C H,YU J M,WANG J W,GONG X H,SUN L,ZHANG Q Y,et al.The epidemiological investigation of dry eye ophthalmic clinic in China[J].Chin Prim Heal Car,2014,28(7):119-122.石常宏,余金明,王继伟,宫霄欢,孙丽,张庆云等.中国眼科门诊干眼的流行病学调查[J].中国初级卫生保健,2014,28(7):119-122.
[3]KRUK J,KUBASIKKLADNA K,ABOULEINEIN H Y.The role oxidative stress in the pathogenesis of eye diseases:current status and a dual role of physical activity[J].Mini Rev Med Chem,2015,16(3):241-257.
[4]LI J,DING X Y,WANG Y H,YE L H,YE L,JIANG N,et al.Effects of PM2.5on tear film function and corneal epithelial structure in mice[J].Rec Adv Ophthalmol,2017,37(3):201-204.李娟,丁小艳,王亚虹,叶鳞泓,叶蕾,姜楠,等.PM2.5对小鼠泪膜功能和角膜上皮组织结构的影响[J].眼科新进展,2017,37(3):201-204.
[5]HU J D,LIU X Q.Adverse environmental factors and dry eye disease[J].Chin J Ophthalmol Otorhinolaryngol,2017,17(4):283-287.胡锦东,刘新泉.不利环境因素与干眼[J].中国眼耳鼻喉科杂志,2017,17(4):283-287.
[6]HWANG S H,CHOI Y H,PAIK H J,WEE W R,KIM M K,KIM DH.Potential importance of ozone in the association between outdoor air pollution and dry eye disease in South Korea[J].Jama Ophthalmology,2016,134(5):503-510.
[7]ZHU Y.Effects of different preservatives in topical medications on glaucoma patients with dry eye[J].Chin J Ophthalmol Otorhinolaryngol,2016,16(6):402-405.朱研.局部药物中不同防腐剂对青光眼患者干眼的影响差异[J].中国眼耳鼻喉科杂志,2016,16(6):402-405.
[8]BAUDOUIN C.The pathology of dry eye[J].Sur Ophthalmol,2001,45(Suppl 2):S211-S220.
[9]HAGAN S,MARTIN E,ENRIQUEZDESALAMANCA A.Tear fluid biomarkers in ocular and systemic disease:potential use for predictive,preventive and personalised medicine[J].Epma J,2016,7(1):1-20.
[10]CEJKOVA J,ARDAN T,SIMONOVA Z,CEJKA C,MALEC J,DOTRELOVA D,et al.Decreased expression of antioxidant enzymes in the conjunctival epithelium of dry eye(Sj9gren’s syndrome)and its possible contribution to the development of ocular surface oxidative injuries[J].Histol Histopathol,2008,23(12):1477-1483.
[11]CHOI W,LIAN C,YING L,KIM G E,YOU I C,PARK S H,et al.Expression of lipid peroxidation markers in the tear film and ocular surface of patients with non-sj9gren syndrome:potential biomarkers for dry eye disease[J].Curr Eye Res,2016,41(9):1143-1149.
[12]WAKAMATSU T H,MURAT D,YUKIHIRO M,KOJIMA T,KAI-DO M,IBRAHIM O M,et al.Evaluation of lipid oxidative stress status in Sj9gren syndrome patients[J].Inv Ophthalmol Vis Sci,2013,54(1):201-210.
[13]LI B,SHENG M,LI J,YAN G,LIN A,LI M,et al.Tear proteomic analysis of Sjogren syndrome patients with dry eye syndrome by two-dimensional-nano-liquid chromatography coupled with tandem mass spectrometry[J].Sci Rep,2014,4:5772.
[14]LIU Z Y,LI C R.Treatment of dry eye caused by meibomian gland dysfunction[J].Int Eye Sci,2014,14(2):270-272.刘泽源,李才锐.睑板腺功能障碍所致干眼的治疗[J].国际眼科杂志,2014,14(2):270-272.
[15]LIM S Y,RAFTERY M J,GOYETTE J,HSU K,GECZY C L.Oxidative modifications of S100 proteins:functional regulation by redox[J].J Leuk Biol,2009,86(3):577-587.
[16]GUTTERIDGE J M.Lipid Peroxidation and Antioxidants as Biomarkers of Tissue Damage[J].Clin Chem,1995,41(2):1819-1828.
[17]HITOE S,TANAKA J,SHIMODA H.MaquiBright standardized maqui berry extract significantly increases tear fluid production and ameliorates dry eye-related symptoms in a clinical pilot trial[J].Panm Med,2014,56:1-6.
[18]ZHU T W,LI H P.Advances in research on dry eye after phacoemulsification[J].Mod J Int Trad Chin West Med,2016,25(3):336-339.朱天文,黎海平.白内障超声乳化术后干眼的研究进展[J].现代中西医结合杂志,2016,25(3):336-339.
[19]SITOMPUL R,SANCOYO G S,HUTAURUK J A,GONDHO-WIARDJO T D.Sensitivity change in cornea and tear layer due to incision difierence on cataract surgery with either manual small-incision cataract surgery or phacoemulsification[J].Cornea,2008,27(Suppl 1):S13-S18.
[20]PARK Y,HWANG H B,KIM H S.Observation of influence of cataract surgery on the ocular surface[J].PLoS ONE,2016,11:e0152460.
[21]JEE D,PARK M,LEE H J,KIM M S,KIME C.Comparison of treatment with preservative-free versus preserved sodium hyaluronate 0.1%and fluorometholone 0.1%eyedrops after cataract surgery in patients with preexisting dry-eye syndrome[J].Cataract Refract Surg,2015,41:756-763.
[22]MACRI A,SCANAROTTI C,BASSI A M,GIUFFRIDAS,SANGALLI G,TRAVERSO C E,et al.Evaluation of oxidative stress levels in the conjunctival epithelium of patients with or without dry eye,and dry eye patients treated with preservative-free hyaluronic acid 0.1 5%and vitamin B1 2eye drops[J].Graefes Arch Clin Exp Ophthalmol,2 0 1 5,2 5 3:4 2 5-4 3 0.
[23]HORWATH W J,SCHMUT O,HALLERSCHOBER E M,GRU-BER A,RIEGER G.Iodide iontophoresis as a treatment for dry eye syndrome[J].British Journal of Ophthalmology,2005,89(1):40-44.
[24]RIEGER G,KLIEBER M,SCHIMETTA W,POLZ W,GRIEBE-NOW S,WINKLER R,et al.The effect of iodide iontophoresis on the antioxidative capacity of the tear fluid[J].Graefes Arch Clin Exp Ophthalmol,2010,248:1639-1646.
[25]PASTORI V,TAVAZZI S,LECCHI M.Lactoferrin-loaded contact lenses:eye protection against oxidative stress[J].Cornea,2015,34(6).
[26]LIU Z Z.Correlation between changes of meibomian glands and dry eye in contact lens wearers[D].Tianjin Medical University,2016.刘珠珠.角膜接触镜配戴者睑板腺变化与干眼的相关性研究[D].天津医科大学,2016.
[27]JONES L,DOWNIE L E,KORB D,BENITEZ-DEL-CASTILLO JM,DANA R,DENG S X et al.TFOS DEWSⅡmanagement and therapy report[J].Ocul Sur,2017,15(3):575.
[2]SHI C H,YU J M,WANG J W,GONG X H,SUN L,ZHANG Q Y,et al.The epidemiological investigation of dry eye ophthalmic clinic in China[J].Chin Prim Heal Car,2014,28(7):119-122.石常宏,余金明,王继伟,宫霄欢,孙丽,张庆云等.中国眼科门诊干眼的流行病学调查[J].中国初级卫生保健,2014,28(7):119-122.
[3]KRUK J,KUBASIKKLADNA K,ABOULEINEIN H Y.The role oxidative stress in the pathogenesis of eye diseases:current status and a dual role of physical activity[J].Mini Rev Med Chem,2015,16(3):241-257.
[4]LI J,DING X Y,WANG Y H,YE L H,YE L,JIANG N,et al.Effects of PM2.5on tear film function and corneal epithelial structure in mice[J].Rec Adv Ophthalmol,2017,37(3):201-204.李娟,丁小艳,王亚虹,叶鳞泓,叶蕾,姜楠,等.PM2.5对小鼠泪膜功能和角膜上皮组织结构的影响[J].眼科新进展,2017,37(3):201-204.
[5]HU J D,LIU X Q.Adverse environmental factors and dry eye disease[J].Chin J Ophthalmol Otorhinolaryngol,2017,17(4):283-287.胡锦东,刘新泉.不利环境因素与干眼[J].中国眼耳鼻喉科杂志,2017,17(4):283-287.
[6]HWANG S H,CHOI Y H,PAIK H J,WEE W R,KIM M K,KIM DH.Potential importance of ozone in the association between outdoor air pollution and dry eye disease in South Korea[J].Jama Ophthalmology,2016,134(5):503-510.
[7]ZHU Y.Effects of different preservatives in topical medications on glaucoma patients with dry eye[J].Chin J Ophthalmol Otorhinolaryngol,2016,16(6):402-405.朱研.局部药物中不同防腐剂对青光眼患者干眼的影响差异[J].中国眼耳鼻喉科杂志,2016,16(6):402-405.
[8]BAUDOUIN C.The pathology of dry eye[J].Sur Ophthalmol,2001,45(Suppl 2):S211-S220.
[9]HAGAN S,MARTIN E,ENRIQUEZDESALAMANCA A.Tear fluid biomarkers in ocular and systemic disease:potential use for predictive,preventive and personalised medicine[J].Epma J,2016,7(1):1-20.
[10]CEJKOVA J,ARDAN T,SIMONOVA Z,CEJKA C,MALEC J,DOTRELOVA D,et al.Decreased expression of antioxidant enzymes in the conjunctival epithelium of dry eye(Sj9gren’s syndrome)and its possible contribution to the development of ocular surface oxidative injuries[J].Histol Histopathol,2008,23(12):1477-1483.
[11]CHOI W,LIAN C,YING L,KIM G E,YOU I C,PARK S H,et al.Expression of lipid peroxidation markers in the tear film and ocular surface of patients with non-sj9gren syndrome:potential biomarkers for dry eye disease[J].Curr Eye Res,2016,41(9):1143-1149.
[12]WAKAMATSU T H,MURAT D,YUKIHIRO M,KOJIMA T,KAI-DO M,IBRAHIM O M,et al.Evaluation of lipid oxidative stress status in Sj9gren syndrome patients[J].Inv Ophthalmol Vis Sci,2013,54(1):201-210.
[13]LI B,SHENG M,LI J,YAN G,LIN A,LI M,et al.Tear proteomic analysis of Sjogren syndrome patients with dry eye syndrome by two-dimensional-nano-liquid chromatography coupled with tandem mass spectrometry[J].Sci Rep,2014,4:5772.
[14]LIU Z Y,LI C R.Treatment of dry eye caused by meibomian gland dysfunction[J].Int Eye Sci,2014,14(2):270-272.刘泽源,李才锐.睑板腺功能障碍所致干眼的治疗[J].国际眼科杂志,2014,14(2):270-272.
[15]LIM S Y,RAFTERY M J,GOYETTE J,HSU K,GECZY C L.Oxidative modifications of S100 proteins:functional regulation by redox[J].J Leuk Biol,2009,86(3):577-587.
[16]GUTTERIDGE J M.Lipid Peroxidation and Antioxidants as Biomarkers of Tissue Damage[J].Clin Chem,1995,41(2):1819-1828.
[17]HITOE S,TANAKA J,SHIMODA H.MaquiBright standardized maqui berry extract significantly increases tear fluid production and ameliorates dry eye-related symptoms in a clinical pilot trial[J].Panm Med,2014,56:1-6.
[18]ZHU T W,LI H P.Advances in research on dry eye after phacoemulsification[J].Mod J Int Trad Chin West Med,2016,25(3):336-339.朱天文,黎海平.白内障超声乳化术后干眼的研究进展[J].现代中西医结合杂志,2016,25(3):336-339.
[19]SITOMPUL R,SANCOYO G S,HUTAURUK J A,GONDHO-WIARDJO T D.Sensitivity change in cornea and tear layer due to incision difierence on cataract surgery with either manual small-incision cataract surgery or phacoemulsification[J].Cornea,2008,27(Suppl 1):S13-S18.
[20]PARK Y,HWANG H B,KIM H S.Observation of influence of cataract surgery on the ocular surface[J].PLoS ONE,2016,11:e0152460.
[21]JEE D,PARK M,LEE H J,KIM M S,KIME C.Comparison of treatment with preservative-free versus preserved sodium hyaluronate 0.1%and fluorometholone 0.1%eyedrops after cataract surgery in patients with preexisting dry-eye syndrome[J].Cataract Refract Surg,2015,41:756-763.
[22]MACRI A,SCANAROTTI C,BASSI A M,GIUFFRIDAS,SANGALLI G,TRAVERSO C E,et al.Evaluation of oxidative stress levels in the conjunctival epithelium of patients with or without dry eye,and dry eye patients treated with preservative-free hyaluronic acid 0.1 5%and vitamin B1 2eye drops[J].Graefes Arch Clin Exp Ophthalmol,2 0 1 5,2 5 3:4 2 5-4 3 0.
[23]HORWATH W J,SCHMUT O,HALLERSCHOBER E M,GRU-BER A,RIEGER G.Iodide iontophoresis as a treatment for dry eye syndrome[J].British Journal of Ophthalmology,2005,89(1):40-44.
[24]RIEGER G,KLIEBER M,SCHIMETTA W,POLZ W,GRIEBE-NOW S,WINKLER R,et al.The effect of iodide iontophoresis on the antioxidative capacity of the tear fluid[J].Graefes Arch Clin Exp Ophthalmol,2010,248:1639-1646.
[25]PASTORI V,TAVAZZI S,LECCHI M.Lactoferrin-loaded contact lenses:eye protection against oxidative stress[J].Cornea,2015,34(6).
[26]LIU Z Z.Correlation between changes of meibomian glands and dry eye in contact lens wearers[D].Tianjin Medical University,2016.刘珠珠.角膜接触镜配戴者睑板腺变化与干眼的相关性研究[D].天津医科大学,2016.
[27]JONES L,DOWNIE L E,KORB D,BENITEZ-DEL-CASTILLO JM,DANA R,DENG S X et al.TFOS DEWSⅡmanagement and therapy report[J].Ocul Sur,2017,15(3):575.