Download Lacrimal Gland, Tear Film, and Dry Eye Syndromes 3: Basic Science and Clinical Relevance Part B PDF

TitleLacrimal Gland, Tear Film, and Dry Eye Syndromes 3: Basic Science and Clinical Relevance Part B
Author
LanguageEnglish
File Size38.1 MB
Total Pages620
Document Text Contents
Page 2

Lacrimal Gland, Tear Film,
and Dry Eye Syndromes 3

Basic Science and Clinical Relevance
PartB

Lacrimal Gland, Tear Film,
and Dry Eye Syndromes 3

Basic Science and Clinical Relevance
PartB

Page 310

1054

4 '
I

3.5 •,-, I..,
3;.Q

...."
2.5 'fIJ

:=
:= 2
ca
'" 1.5 -
~

I

0.5 :

0'

D. Welch et al.

Untreated Claritin QD, 4 days

Treatment

Claritin BID, 4 days

Figure 1. Mean keratitis, measured on a standardized O-to-4-point scale, after 45 min CAE exposure. Results

are based on the average of both eyes. n = 14 for the untreated group (baseline) and n = 7 for QD- and BID-
treated groups.

4; -
I

3.5 I·
f
3 . ----- ---

:r_~-~.···-- ..
0.5~ ---
O· ~ -- -

Untreated Claritin QD, 4 days

Treatment

Claritin BID, 4 days

Figure 2. Mean conjunctival staining, graded on a standardized O-to-4-point scale, after 45-min CAE

exposure. Results are based on the average of both eyes. n = 14 for the untreated group (baseline) and n = 7

for QD- and BID-treated groups.

6

-- 4c.i
Ql
fIJ


......
Ql

e 2
E:::

I l _.~
oj

Untreated Claritin QD, 4 days Claritin BID, 4 days

Treatment

Figure 3. Mean TFBUT after 45-min CAE exposure. Results are based on the average of both eyes.n = 14
for the untreated group (baseline) and n = 7 for QD- and BID-treated groups.

Page 311

Ocular Drying Associated with Oral Antihistamines (Loratadine) 1055

4,------·---·---------------------,

4530

--_Clarilin (QD, 4 days)

.- - Claritin (BID, 4 days

1- Untreated
IS10

2

OL------------------------l
o

3

CAE Exposure Time (min)

Figure 4. Mean ocular discomfort, graded on a 0-to-4 standardized scale, during 45 min CAE exposure.

Results are based on the average of both eyes. n = 14 for the untreated group (baseline) and n = 7 for QD-

and BID-treated groups.

4. CONCLUSIONS

Signs and symptoms consistent with ocular dryness, including an increase in corneal

and conjunctival staining, a decrease in TFBUT, an increase in ocular discomfort and a

decrease in the Schirmer's test, were induced by CAE exposure in normal subjects after

taking Claritin® (loratadine, 10 mg) for 4 days, compared to baseline values. Mean

differences in QD and BID treatment groups indicate a dose effect. Therefore, Claritin®

may cause clinically meaningful damage to the ocular surface as a result of anti-muscarinic

activity on the M) muscarinic receptors that causes a decrease in the aqueous and mucous

layers of the tear film.

REFERENCES

1. D.C. Crandall, 1.H. Leopold.The influence of systemic drugs on tear film constituents. Ophthalmology

86: 115-25 (1979).

2. B.C.P. Polak.Side effects of drugs and tear secretion. Documental Ophthalmology 67: 115-117 (1987)

3. S.D. Jaanus.Ocular side effects of selected systemic drugs. Opthom Clin. 2(4): 73-96 (1992).

4. B.G. Katzung. 1998.Basic & Clinical Pharmacology, Appleton & Lange, Stamford.

5. B.H. Koffler, M.A. Lemp.The effect of an antihistamine (chlorpheniramine maleate) on tear production

in humans. Ann Ophthalmol. 12: 217 (1980).

6. M.B. Abelson, G.W. Gusler, L.A. Nally, K. Krenzer,Alternative reference values for tear film breakup

time in normal and dry eye populations. Abstract. Cornea: Supplement 2 19(6): s72 (2000).

7. G.W. Gusler., M.B. Abelson, L.A. Nally, D. We1chAn evaluation of time to "natural compensation" or

improved ocular discomfort during exposure to a controlled adverse environment (CAE) in normal and

dry eye populations. Abstract. Cornea: Supplement 2 19(6): sill (2000).

Page 619

Tear proteins (cant d)
mass spectrometry, 602-4
mass spectrometry of, 601-4
ocular surface interactions, 412-13, 415
pattern analysis, in diagnosis of dry eye, 1213-15
purification of, 568
sorting, 208
in tears and autologous serum, 7, 9

Tears
acid-activated, 8
biotribology of, 594-95
collection of, 581-82, 588,608,611-12
critical nitric oxide (NO) concentration in, 691
deficiency, 13, 71, 72, 73, 390, 632, 645
distribution, 1088
diurnal distribution patterns, 539-45
in dry eye syndrome, 992, 1013, 1074
dynamic surface characteristics, 595-96
familial dysautonomia and, 73
flow, 861,1088-89
fluorescein clearance, 648
functions of, 405
lacrimal drainage system and, 861
lipophilin in, 571, 573-78
as lubricants, 593-94
meniscus, 1088, 1263-68
menopause and, 1029-33
MMP-9 expression in, 741-42
mucolytic-agent-treated, 8
non-Newtonian viscosity, 583-85
parasympathetic nerve denervation and, 65-69,

225-29
physical properties of, 581-85
physiology measurements, 1097-1104
salt concentration, 612
surface tension, 557
thickness mapping, 1130-32
tonicity, 1091
velocity profiles, 1202-4
viscosity of, 583-85, 587

Tearscope, 935
Tear secretion
acetylcholine (ACh) and, 109
aging and, 103-7
botulinum toxin treatment for, 1241-45
defecti ve, 13
mechanisms governing, 199-204
nitric oxide and, 94-95
tear clearance and, 1072

Tear spreading rates, 1201-4
Tear supplements. See artificial tears
Tear turnover
atelocollagen treatment and, 1278
lacrimal gland functioning and, 1070, 1074
LASIK treatment and, 714

1384

Tear volume
atelocollagen treatment and, 1278
botulinum toxin treatment for, 1244
in dry eye syndrome, 1093
LASIK treatment and, 714
tear flow and, 1088-89

Teleopsis, 1205-7
Temperature
eyelid, inflammation and, 1227-31
thermally cooling stimulus effects, 719-21

Testosterone, 391
androgen receptor expression and, 137
dry eye syndrome and, 1017
gene expression and, 145, 148
meibomian gene expression and, 472, 473, 477-78

TFBUT. See breakup time (BUT)
TFF-peptides, 313-15
defined,313-14
functions of, 314-15
synthesis of, 314
TFFI,313-14
TFF2,313-14
TFF3,313-15

T helper cells
inflammatory ocular surface diseases and, 841
lacrimal gland disease and, 771-74
nerve growth factor (NGF) and, 532
Sj gren's syndrome and, 100 I

Thermal corneal injury model, 635
Thermally cooling stimulus sensitivity, 719-21
Threonine, 618, 6 I9
Time to natural compensation (TNC), 1057-63
T lymphocytes. See T cells
TNF-a. See tumor necrosis factor-a (TNF-a)
A-tocopherol (vitamin E)
tear lipocalins and, 567-71

Tolerance
immune, 816-17, 835, 840
mucosal, 835
mucosal lymphocytes and, 840

Tolypocladium inflatum. 805
Topical insulin therapy, 607
Topical medicine hypersensitivity, 73
Transcription factor UBF, 148
Transdermal scopolamine (Scop) patches, 649-53
Transferrin, 8, 148
Transforming growth factor-~ family, 19

TGF-~, 1001
TGF-~ 1, 8,9, 790-93
TGF-~ receptor type I, 148

Transglutaminase 1 (TGase 1), 641-45
Trans-Golgi network, 54
high-density (hd-tgns), 207, 209-10, 215-16
low-density (Id-tgns), 207, 209-10, 215-17

Trans-membrane tyrosinekinase Ret, 20-24

Page 620

Transmission electron microscopy (TEM), 160
Trantas dots, 805
Trefoil factors. See TFF-peptides
Triacylglycerol Iipases, 115-18
Tricyclic antidepressants, 1108
Trigeminal nerve hypersensitivity, 1049
Triglycerides (TG)
in meibomian gland, 489
in tear film, 374, 376

Triple A syndrome, 167-68
Triple A syndrome region, 168-73
Tryptic peptides, 602
Tryptophan, 559, 578

~-structure, 559
TRP17,559

Tryptophanyl residues, 559
Tubular glands, 867. See also crypts
r-tubulin, 202
Tumor necrosis factor (TNF), 790-93
apoptosis and, 825
lacrimal gland disease and, 771

Tumor necrosis factor-a (TNF-a), 731, 746, 766-67,
841,1247

apoptosis and, 825, 828
CD95L-mediated death and, 817-18
lacrimal gland secretion and, 784
neurotransmission and, 1026
in non-SS (Sj gren's syndrome)

keratoconjunctivitis, 801-3
Remicadeo and, 1336, 1339
secretion regulation by, 1108
Sj gren 's syndrome and, 100 I

Two-dimensional electrophoresis, 623-26
Tyrosine, 27, 578, 618, 619
Tyrosine kinase, 28

Ultrasonography, of salivary glands, 1217-20
Ultraviolet spectrophotometry (UV), 963
Upgaze, 1088
Uric acid, 570
Uridine 5'-triphosphate (UTP), 250-53, 255-59
Uteroglobins, 573-74, 578

VAChT,91-94
VAChT immunoreactivity (VAChT-IR), 92-93
Vascular endothelial cells (VEC), 730-31
Vascular endothelial growth factor (VEGF), 852
Vascular endothelial growth factor receptors

(VEGFR), 852
VEGF-C, 852, 856, 858
VEGF-D, 852, 856-58
VEGFR-l, 852
VEGFR-2,852
VEGFR-3,851-58
VEGFR-3 mRNA, 852

Vasoactive intestinal polypeptide (VIP), 193
Vernal keratoconjunctivitis (VKC), 532, 805-11
Vesicle transport, 200
Vesicular acetylcholine transporter (VAChT), 91-94
Video-photographic analysis, of tear film thickness,

1201--4
Viral infection, 745--48
Viral vectors, 1297, 1298, 1310-13
Virus/retroviros-mediated gene transfer, 1298
Viscometry, 582
Viscosity, of tears, 583-85, 587
Vision
contact lens protein deposits and, 957
dry eye syndrome and, 808, 809, 1011, 1013, 1015
near vision accommodation in horizontality,

1205-10
patient-reported vs. doctor diagnosed, I 191-93
tear film breakup time and, 1122-24, 1141--46

Visual analogue scale (VAS), 1238
Visual display terminals (VDTs). See also computer

use
eye discomfort and, 501-5, 513-16
near vision accommodation in horizontality,

1205-10
Vitamins
A, 6, 8, 9,1249
8 6,443--46
C, 8, 9,570
D,443--46
E,567-71

Von Eben's gland protein, 555.See also tear
lipocalins (TL)

Warm compression, tear film stability and, 1149-52
Water channels, 13, 191. 195
Wax esters, 376,489
Western blotting, tear protein profiling with. 967,

970-71
Wistar rats, 28
Women. See also gender
dry eye syndrome in, 1017-21
meibomian gland polar lipid profiles, 441--46
quality of life impacts of Sj gren's syndrome,

1183-88
Sj gren's syndrome in, 57, 137

Xerophthalmia, 249
Xeroscope, 1071, 1074
Xerostomia, 663

Zwitterionic neutral phospholipid (ZNP), 496-99
Zymography, 540--45

1385

Similer Documents