Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye

Eilidh Martin, Katherine M. Oliver, E. Ian Pearce, Alan Tomlinson, Peter Simmons, Suzanne Hagan

Research output: Contribution to journalArticle

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Abstract

Purpose

Three tear supplements were compared for their effects on the signs, symptoms and inflammatory status of subjects with dry eye disease. Assessments were made before and after both 2 and 4¿weeks of treatment.

Methods

In this masked, randomized, 3-way crossover trial, eighteen dry eye subjects were recruited. At each visit, symptoms, tear evaporation rate, stability and osmolarity were measured and tear samples were analyzed for 7 inflammatory markers, using multiplex immunoassays. The 3 treatments included carboxymethylcellulose-glycerine-castor oil (CGC), carboxymethylcellulose (CMC) and hydroxypropyl guar (HPG). The CGC and HPG drops are emulsified lipids; CGC also contains osmoprotectants. The CMC drop is a standard aqueous polymeric supplement.

Results

Significant improvements were seen in symptoms (OSDI) and tear stability (NITBUT) with all 3 treatments at 4¿weeks. At 4¿weeks post-CGC, 6 out of 7 biomarkers demonstrated a >25% reduction (in 40% of subjects). The same reduction (>25%) was seen in 10% of the subjects for CMC and in none of the subjects for HPG. No significantly different change to either evaporation rate or tear osmolarity was found following any of the three treatments.

Conclusions

In this study, the CGC treatment resulted in the greatest reduction in ocular biomarkers of inflammation, while all 3 treatments reduced symptoms and improved tear stability. These results indicate that subject-perceived symptomatic improvements are not necessarily associated with a reduction in objective measures of inflammation.

Original languageEnglish
Pages (from-to)37-44
Number of pages8
JournalCytokine
Volume105
Early online date14 Feb 2018
DOIs
Publication statusPublished - May 2018

Fingerprint

Carboxymethylcellulose Sodium
Tears
Signs and Symptoms
Castor Oil
Glycerol
Biomarkers
Osmolar Concentration
Evaporation
Inflammation
Eye Diseases
Immunoassay
Cross-Over Studies
Lipids

Keywords

  • dry eye disease
  • cytokines
  • biomarkers
  • tears
  • inflammation

Cite this

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title = "Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye",
abstract = "PurposeThree tear supplements were compared for their effects on the signs, symptoms and inflammatory status of subjects with dry eye disease. Assessments were made before and after both 2 and 4¿weeks of treatment.MethodsIn this masked, randomized, 3-way crossover trial, eighteen dry eye subjects were recruited. At each visit, symptoms, tear evaporation rate, stability and osmolarity were measured and tear samples were analyzed for 7 inflammatory markers, using multiplex immunoassays. The 3 treatments included carboxymethylcellulose-glycerine-castor oil (CGC), carboxymethylcellulose (CMC) and hydroxypropyl guar (HPG). The CGC and HPG drops are emulsified lipids; CGC also contains osmoprotectants. The CMC drop is a standard aqueous polymeric supplement.ResultsSignificant improvements were seen in symptoms (OSDI) and tear stability (NITBUT) with all 3 treatments at 4¿weeks. At 4¿weeks post-CGC, 6 out of 7 biomarkers demonstrated a >25{\%} reduction (in 40{\%} of subjects). The same reduction (>25{\%}) was seen in 10{\%} of the subjects for CMC and in none of the subjects for HPG. No significantly different change to either evaporation rate or tear osmolarity was found following any of the three treatments.ConclusionsIn this study, the CGC treatment resulted in the greatest reduction in ocular biomarkers of inflammation, while all 3 treatments reduced symptoms and improved tear stability. These results indicate that subject-perceived symptomatic improvements are not necessarily associated with a reduction in objective measures of inflammation.",
keywords = "dry eye disease, cytokines, biomarkers, tears, inflammation",
author = "Eilidh Martin and Oliver, {Katherine M.} and Pearce, {E. Ian} and Alan Tomlinson and Peter Simmons and Suzanne Hagan",
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Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye. / Martin, Eilidh; Oliver, Katherine M.; Pearce, E. Ian; Tomlinson, Alan; Simmons, Peter; Hagan, Suzanne.

In: Cytokine, Vol. 105, 05.2018, p. 37-44.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye

AU - Martin, Eilidh

AU - Oliver, Katherine M.

AU - Pearce, E. Ian

AU - Tomlinson, Alan

AU - Simmons, Peter

AU - Hagan, Suzanne

N1 - Acceptance: see webpage OA article

PY - 2018/5

Y1 - 2018/5

N2 - PurposeThree tear supplements were compared for their effects on the signs, symptoms and inflammatory status of subjects with dry eye disease. Assessments were made before and after both 2 and 4¿weeks of treatment.MethodsIn this masked, randomized, 3-way crossover trial, eighteen dry eye subjects were recruited. At each visit, symptoms, tear evaporation rate, stability and osmolarity were measured and tear samples were analyzed for 7 inflammatory markers, using multiplex immunoassays. The 3 treatments included carboxymethylcellulose-glycerine-castor oil (CGC), carboxymethylcellulose (CMC) and hydroxypropyl guar (HPG). The CGC and HPG drops are emulsified lipids; CGC also contains osmoprotectants. The CMC drop is a standard aqueous polymeric supplement.ResultsSignificant improvements were seen in symptoms (OSDI) and tear stability (NITBUT) with all 3 treatments at 4¿weeks. At 4¿weeks post-CGC, 6 out of 7 biomarkers demonstrated a >25% reduction (in 40% of subjects). The same reduction (>25%) was seen in 10% of the subjects for CMC and in none of the subjects for HPG. No significantly different change to either evaporation rate or tear osmolarity was found following any of the three treatments.ConclusionsIn this study, the CGC treatment resulted in the greatest reduction in ocular biomarkers of inflammation, while all 3 treatments reduced symptoms and improved tear stability. These results indicate that subject-perceived symptomatic improvements are not necessarily associated with a reduction in objective measures of inflammation.

AB - PurposeThree tear supplements were compared for their effects on the signs, symptoms and inflammatory status of subjects with dry eye disease. Assessments were made before and after both 2 and 4¿weeks of treatment.MethodsIn this masked, randomized, 3-way crossover trial, eighteen dry eye subjects were recruited. At each visit, symptoms, tear evaporation rate, stability and osmolarity were measured and tear samples were analyzed for 7 inflammatory markers, using multiplex immunoassays. The 3 treatments included carboxymethylcellulose-glycerine-castor oil (CGC), carboxymethylcellulose (CMC) and hydroxypropyl guar (HPG). The CGC and HPG drops are emulsified lipids; CGC also contains osmoprotectants. The CMC drop is a standard aqueous polymeric supplement.ResultsSignificant improvements were seen in symptoms (OSDI) and tear stability (NITBUT) with all 3 treatments at 4¿weeks. At 4¿weeks post-CGC, 6 out of 7 biomarkers demonstrated a >25% reduction (in 40% of subjects). The same reduction (>25%) was seen in 10% of the subjects for CMC and in none of the subjects for HPG. No significantly different change to either evaporation rate or tear osmolarity was found following any of the three treatments.ConclusionsIn this study, the CGC treatment resulted in the greatest reduction in ocular biomarkers of inflammation, while all 3 treatments reduced symptoms and improved tear stability. These results indicate that subject-perceived symptomatic improvements are not necessarily associated with a reduction in objective measures of inflammation.

KW - dry eye disease

KW - cytokines

KW - biomarkers

KW - tears

KW - inflammation

U2 - 10.1016/j.cyto.2018.02.009

DO - 10.1016/j.cyto.2018.02.009

M3 - Article

VL - 105

SP - 37

EP - 44

JO - Cytokine

JF - Cytokine

SN - 1043-4666

ER -