Change of tear lipid mediators in a post-trabeculectomy cohort.,The Ocular Surface

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Change of tear lipid mediators in a post-trabeculectomy cohort.
The Ocular Surface ( IF 5.9 ) Pub Date : 2020-07-03 , DOI: 10.1016/j.jtos.2020.06.004
Yohannes Abere Ambaw ₁ , Tina Wong ₂ , Rachel Chong ₃ , Hou Ah ₄ , Shanshan Ji ₅ , Manfred Raida ₅ , Federico Torta ₆ , Markus R Wenk ₇ , Louis Tong ₈

Affiliation

Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore; Department of Molecular Metabolism, Harvard T.H Chan School of Public Health, Harvard Univeristy, USA.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cornea and External Eye Disease, Singapore National Eye Center, Singapore; Ocular Surface Research Group, Singapore Eye Research Institute, Singapore; Eye-Academic Clinical Program, Duke-NUS Medical School, Singapore; School of Material Science and Engineering, Nanyang Technological University, Singapore.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Glaucoma, Singapore National Eye Center, Singapore.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ocular Surface Research Group, Singapore Eye Research Institute, Singapore.
Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore.
Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore.
Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cornea and External Eye Disease, Singapore National Eye Center, Singapore; Ocular Surface Research Group, Singapore Eye Research Institute, Singapore; Eye-Academic Clinical Program, Duke-NUS Medical School, Singapore.

Purpose

Trabeculectomy surgery could affect ocular surface disease (OSD) in several ways, through cessation of long term glaucoma eyedrops, exposure to operative mitomycin C and post-operative eyedrops including corticosteroids and aminoglycosides and reduction in eyelid hygiene measures. Previously we showed the relevance of tear lipid mediators (also referred oxylipins) in OSD. Here, we aim to evaluate changes of these lipids in a post-trabeculectomy cohort.

Methods

Patients undergoing trabeculectomy were prospectively evaluated and had tear collected using Schirmer's strips, preoperatively and postoperatively at 0.5, 1.0 and 3.0 years. Lipid mediators were analyzed using liquid chromatography mass spectrometry.

Results

The normalized concentrations of 40 lipid mediators were between 0.1 and 8.0 ng/mL, whereas docosahexaenoic acid (DHA), Arachidonic acid (AA) and eicosapentaenoic acid (EPA) ranged up to a few hundred ng/mL. The concentrations of lipid mediators, except DHA, EPA, and thromboxane (TXB₁), showed reduction after surgery. At the last visit, these lipids were significantly reduced by ¹/₃ to ½, compared to pre-operative values: 8-HETE, 15-HETE, 15-oxoETE, 11-HDoHE, 17-HDoHE, and 20-OH-LTB₄. To examine collective changes of lipids, clustering analysis revealed 10 groups of lipids consistent with known metabolic pathways.

Results

An increase in the level of 2,3-dinor-8-isoPGF_2α between 0 and 0.5 year was associated with inferior corneal staining at 0.5 year. In 14 patients who required post-operative needling, six lipid mediators were found to be significantly higher at 1.0 year compared to non-needled patients.

Conclusions

In this 3-years study, trabeculectomy reduced the tear level of pro-inflammatory lipid mediators. Patients who required needling of the bleb to maintain surgical success may have a chronic underlying inflammatory process associated with fibrosis.

中文翻译：

小梁切除术后队列中泪脂介质的变化。

目的

小梁切除术可以通过停止长期青光眼滴眼液，暴露于手术性丝裂霉素C和术后滴眼剂（包括糖皮质激素和氨基糖苷类）以及减少眼睑卫生措施，以多种方式影响眼表疾病（OSD）。以前，我们在OSD中显示了泪脂介体（也称为oxylipins）的相关性。在这里，我们旨在评估小梁切除术后队列中这些脂质的变化。

方法

对接受小梁切除术的患者进行前瞻性评估，并在术前和术后0.5、1.0和3.0岁时使用Schirmer试纸收集泪液。使用液相色谱质谱法分析脂质介体。

结果

40种脂质介体的归一化浓度在0.1至8.0 ng / mL之间，而二十二碳六烯酸（DHA），花生四烯酸（AA）和二十碳五烯酸（EPA）的范围高达几百ng / mL。除DHA，EPA和血栓烷（TXB ₁）外，脂质介体的浓度在手术后降低。在最后的访问，这些脂质显著通过降低¹ / ₃至1/2相比手术前给的值：8-HETE，15-HETE，15-oxoETE，11- HDoHE，17-HDoHE，和20-OH-LTB ₄。为了检查脂质的集体变化，聚类分析揭示了与已知代谢途径一致的10组脂质。