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R. W. Beuerman, L. Zhou, C. Chan, X. Li, L. Tong, S. Zhao; Comparison of Tear Biomarkers for Dry Eye in Patients From Singapore and China. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6253.
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We previously identified 10 tear biomarker candidates (alpha-enolase, alpha-1-acid glycoprotein 1, S100 A8, S100 A9, S100 A4, S100 A11, prolactin-inducible protein (PIP), lipocalin-1, lactoferrin and lysozyme) which are associated with dry eye patients in Singapore. In this study, we performed a quantitative proteomic analysis to evaluate these tear biomarker candidates using samples obtained from an independent site, Tianjin, China.
Patients with dry eye (28 in total, 3 Indian, 2 Malay and 23 Chinese) were recruited from Singapore and another 28 patients with dry eye and 20 controls were also recruited from Tianjin, China for the whole study. Tears were eluted into PBS after a type I Schirmer’s test. Tear proteins were analyzed using iTRAQ-based quantitative proteomics technology combined with 2D nanoLC-MS/MS. Ten potential tear biomarkers identified from an earlier Singapore study were compared with those from patients in Tianjin, China. Two potential biomarkers, alpha-enolase and S100 A4 were also verified using ELISA.
Changes of tear proteins associated with dry eye were found to be very similar in two different locations (Singapore and Tianjin, China). 9 out of 10 biomarker candidates (except alpha-1-acid glycoprotein 1) showed significant changes (p< 0.05) between the dry eye group and control group from Tianjin, China as they were found in discovery phase using patient samples from Singapore. ELISA (Tianjin patients) results showed that the tear concentrations of alpha-enolase (t-test, p<0.038) and S100 A4 (t-test, p<0.027) were significantly higher in the dry eye group compared to controls.
This study has successfully verified 9 potential tear biomarkers for dry eye using an independent sample set obtained from two different location, one genetically diverse (Singapore) and the other all Chinese (Tianjin). Our results suggest these tear proteins should be useful clinically in different countries for the objective diagnosis of dry eye.
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