Abstract
Purpose :
Proteomic analysis of tears plays a major role understanding the pathogenesis and management of dry eye disease (DED), however limited data is available for young adults. The study aimed to identify key tear proteins in DED in young adults and characterise longitudinal changes in tear proteome.
Methods :
A prospective, longitudinal, observational study was conducted on participants with or without DED (TFOS DEWS II criteria) and followed for 1 year. Participants with recent history of allergy or use of medications known to affect the eyes were excluded. A battery of clinical tests was conducted to assess DED, followed by tear protein analysis. Briefly, basal tears (>4 µL) were collected using glass microcapillary tubes and processed for a panel of proteins (14-230 kDa) using a quantitative microfluidic system (Protein230 LabChip; Agilent 2100 Bioanalyzer). Corelations with clinical findings of DED in young adults with individual tear proteins were established.
Results :
Participants’ mean age was 19.9±1.6 yr, 72% were female. Protein profiles were obtained for 25 DED (25) and 20 non-DED (14) participants (at 1 year). Lysozyme, lipocalin, albumin, lactoferrin, secretory immunoglobulin-A-light chain(slgA), zinc-α2 glycoprotein(ZAG) and a few unidentified proteins in 47kDa, 100kDa, 147kDa and 167 kDa were found. Total protein concentration initially and after 1 year was 4.50±2.45 and 4.93±2.70 mg/ml (p=0.518) respectively. DED participants had a significantly higher concentration (p<0.001) and percentage (p=0.003) of albumin, lower percentage lactoferrin (p=0.009) and ZAG (p=0.080) compared to non-DED participants. Initially, ZAG percentage concentration was significantly (P<0.05) negatively correlated with key DED signs: corneal staining (r=-0.360), meibum quality (r=-0.334), upper / lower lid gland loss (r=-0.296 / -0.297) and after 1 year with NIKBUT (r=-0.396). Lipocalin initially showed similar correlation (P<0.05) with corneal staining (r=-0.341) and horizontal lid wiper epitheliopathy (r=0.300), and after 1 year with NIKBUT (r=-0.377).
Conclusions :
The results underpin the importance of monitoring the kinetics of five key tear proteins in DED progression: ZAG, lipocalin, lactoferrin, albumin and lysozyme. Progression of DED signs were specifically associated with upregulation of albumin and downregulation of lactoferrin and ZAG in young adults.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.