DRY EYE DIAGNOSIS AND MANAGEMENT

“We are seeking to validate the potential protein biomarkers present in the tear film for the spectrum of dry eye diseases using a targeted proteomics strategy,” Franz Grus MD told the 6th EuCornea Congress in Barcelona.   “This would allow us to identify a cluster of proteins and employ this to distinguish between different dry eye subgroups based on their expression levels,” added Dr Grus, of the University Medical Center Mainz, Germany.

Dr Grus emphasised the poor correlation between clinical parameters and disease severity, suggesting that more advanced and objective indicators of abnormalities are needed.

“Protein and peptide expressions reflect the current state of disease or health, a ‘snapshot’ of body functions at any given time,” said Dr Grus. “This might help with both diagnosis and prognosis of this varied and complex condition.”

Protein microarrays are used to detect upregulation of proteins such as calgranulin, an inflammatory marker that is elevated in all dry eye subgroups. Microarrays can also detect downregulation of proline-rich protein 4 (PRP4), a protective marker thought to play a role in tissue coating that is decreased in dry eye subgroups.

“Besides looking for the proteins themselves, we also try to discover post-translational modifications, which may largely determine the ultimate cell regulation function of these proteins, as well as their resistance against degradation,” said Dr Grus.“This is a promising approach for diagnosis and better understanding of the disease pathomechanisms within the dry eye spectrum, as well as personalised medicine based on the biomarkers present in each patient,” he concluded.