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David A. Sullivan - One of the best experts on this subject based on the ideXlab platform.
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Androgen influence on gene expression in the Meibomian Gland.
Advances in Experimental Medicine and Biology, 2020Co-Authors: H Yamagami, F Schirra, Benjamin D Sullivan, Stephen M Richards, David A. SullivanAbstract:Our previous research has demonstrated that the Meibomian Gland is an androgen target organ.1 This tissue contains androgen receptor mRNA, androgen receptor protein within acinar epithelial cell nuclei and the mRNAs for both Types 1 and 2 5±-reductase, an enzyme that converts testosterone and dehydroepiandrosterone into the potent androgen, 5a-dihydrotestosterone.2,3 Our studies also indicate that androgens, as well as gender, may influence gene expression in the rabbit and/or mouse Meibomian Glands.4,5 The purpose of this study was to identify androgen-regulated genes that may depend upon the presence of functional androgen receptors, and that may mediate the gender-related differences in gene expression in the Meibomian Gland.
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Androgen control of gene expression in the rabbit Meibomian Gland.
Advances in Experimental Medicine and Biology, 2020Co-Authors: Rebecca J. Steagall, H Yamagami, L. Alexandra Wickham, David A. SullivanAbstract:Meibomian Gland function is extremely important in promoting the health and integrity of the ocular surface.1–5 This Gland, through its synthesis and secretion of lipids, enhances the stability and prevents the evaporation of the tear film.1–5 Meibomian Gland dysfunction, in turn, leads to lipid insufficiency, tear film instability and evaporative dry eye.1–5 In fact, Meibomian Gland dysfunction is thought to be the primary cause of dry eye syndromes throughout the world.6 However, despite the importance of the Meibomian Gland in maintaining the well-being of the eye, very little research has been published concerning the physiological regulation of this tissue.
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Meibomian Gland dysfunction in primary and secondary sjogren syndrome
Ophthalmic Research, 2018Co-Authors: Reza Dana, David A. Sullivan, R M Sullivan, Kathleen L Krenzer, Afsun Sahin, Beril Arica, Athena PapasAbstract:Purpose We hypothesized that women with primary (pSS) and secondary Sjogren syndrome (sSS; with systemic lupus erythematosus [SLE] or rheumatoid arthritis [RA]) have Meibomian Gland dysfunction (MGD). We sought to test our hypothesis. Methods Subjects with pSS, sSS + SLE, sSS + RA, and non-SS-related MGD were recruited from the Sjogren's Syndrome Foundation or outpatient clinics at Tufts University School of Dental Medicine or Brigham and Women's Hospital. The control population was recruited from the Greater Boston area. After providing written informed consent, the subjects underwent an eye examination and/or completed two questionnaires that assess symptoms of dry eye disease (DED). Results Our results demonstrate that pSS and sSS patients have MGD. These subjects had Meibomian Gland orifice metaplasia, an increased number of occluded Meibomian Gland orifices, and a reduced quality of Meibomian Gland secretions. Further, patients with pSS, sSS + SLE, sSS + RA, and MGD had significant alterations in their tear film, lid margin, cornea, and conjunctiva. Symptoms of DED were increased ∼10-fold in all pSS, sSS, and MGD groups relative to controls. Conclusions Our findings support our hypothesis and show that individuals with pSS, sSS + SLE, and sSS + RA have MGD. In addition, our study indicates that patients with pSS and sSS have both aqueous-deficient and evaporative DED.
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serum induced differentiation of human Meibomian Gland epithelial cells
Investigative Ophthalmology & Visual Science, 2014Co-Authors: David A. Sullivan, Juan Ding, Karin M Green, Scott A Shaffer, Mark P HattonAbstract:Purpose. We hypothesize that culturing immortalized human Meibomian Gland epithelial cells in serum-containing medium will induce their differentiation. The purpose of this investigation was to begin to test our hypothesis, and explore the impact of serum on gene expression and lipid accumulation in human Meibomian Gland epithelial cells.
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Neurotransmitter Influence on Human Meibomian Gland Epithelial Cells
Investigative Ophthalmology & Visual Science, 2011Co-Authors: David A. SullivanAbstract:Optimal Meibomian Gland function is essential for protecting the health and integrity of the ocular surface.1–4 This Gland, through its synthesis and secretion of lipids, promotes stability and prevents evaporation of the tear film.1–4 Conversely, Meibomian Gland dysfunction (MGD), and the resulting lipid insufficiency, destabilizes the tear film, heightens its evaporation and osmolarity,3–9 and is very likely the most frequent cause of evaporative dry eye disease throughout the world.4,10–14 One of the most striking characteristics of the Meibomian Gland is its rich sensory, sympathetic, and parasympathetic innervation.15 Indeed, this tissue is the only human sebaceous Gland that has such innervation, with adjacent nerve fibers reactive for acetylcholinesterase, substance P, vasoactive intestinal peptide (VIP), dopamine β-hydroxylase, nitric oxide synthase, tyrosine hydroxylase, somatostatin, neuropeptide Y (NPY), and calcitonin gene-related peptide (CGRP).16–32 Furthermore, as recently reported,4,33 the mouse Meibomian Gland contains mRNAs of receptors for serotonin, adrenergic, CGRP, cholinergic, dopamine, γ-aminobutyric acid, glutamate, NPY, neurotensin, and somatostatin. It is quite possible that these nerves and, if translated, neurotransmitter receptors play a significant role in the regulation of the Meibomian Gland. However, this possibility is completely speculative. It is unknown whether neurotransmitters are released into the vicinity of the Meibomian Gland, act on Glandular receptors, or induce a physiological effect. We hypothesize that neurotransmitters are released in the vicinity of the Gland; act on Glandular receptors; and influence the production, secretion, and/or delivery of Meibomian Gland secretions to the ocular surface. If correct, this would indicate an important role for the nervous system in maintaining the tear film lipid layer and, thus, the health of the ocular surface. Our goal in this study was to begin to determine whether neurotransmitters do influence the Meibomian Gland. Toward that end, we focused on the role of VIPergic and cholinergic neurotransmitters, because innervation of the Meibomian Gland appears to be largely parasympathetic in origin.18,19,30 We investigated whether VIPergic and cholinergic receptors are transcribed and translated in human Meibomian Gland epithelial cells and whether corresponding ligands induce cellular physiological responses.
Reza Dana - One of the best experts on this subject based on the ideXlab platform.
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management of Meibomian Gland dysfunction a review
Survey of Ophthalmology, 2020Co-Authors: Saama Sabeti, Ahmad Kheirkhah, Reza DanaAbstract:Abstract Meibomian Gland dysfunction is the leading cause of evaporative dry eye disease and is one of the most common conditions encountered by eye care providers. The disorder is characterized by obstruction of the Meibomian Gland terminal ducts and/or changes in their Glandular secretion, resulting in changes in tear film stability, inflammation, and symptoms of irritation. There is no gold standard treatment for Meibomian Gland dysfunction, but rather a diversity of options. Conservative measures include warm compresses and lid hygiene, but there is growing interest and need for medical treatments and procedures. Potential medical treatments include antibiotics, nonsteroidal and steroidal anti-inflammatory agents, essential fatty acid supplementation, hormone therapy, and control of Demodex infestation. Procedures include intraductal Meibomian Gland probing, the use of electronic heating devices, intense pulsed light therapy, and intranasal neurostimulation. We provide an update on Meibomian Gland dysfunction treatments based on recent studies.
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Meibomian Gland dysfunction in primary and secondary sjogren syndrome
Ophthalmic Research, 2018Co-Authors: Reza Dana, David A. Sullivan, R M Sullivan, Kathleen L Krenzer, Afsun Sahin, Beril Arica, Athena PapasAbstract:Purpose We hypothesized that women with primary (pSS) and secondary Sjogren syndrome (sSS; with systemic lupus erythematosus [SLE] or rheumatoid arthritis [RA]) have Meibomian Gland dysfunction (MGD). We sought to test our hypothesis. Methods Subjects with pSS, sSS + SLE, sSS + RA, and non-SS-related MGD were recruited from the Sjogren's Syndrome Foundation or outpatient clinics at Tufts University School of Dental Medicine or Brigham and Women's Hospital. The control population was recruited from the Greater Boston area. After providing written informed consent, the subjects underwent an eye examination and/or completed two questionnaires that assess symptoms of dry eye disease (DED). Results Our results demonstrate that pSS and sSS patients have MGD. These subjects had Meibomian Gland orifice metaplasia, an increased number of occluded Meibomian Gland orifices, and a reduced quality of Meibomian Gland secretions. Further, patients with pSS, sSS + SLE, sSS + RA, and MGD had significant alterations in their tear film, lid margin, cornea, and conjunctiva. Symptoms of DED were increased ∼10-fold in all pSS, sSS, and MGD groups relative to controls. Conclusions Our findings support our hypothesis and show that individuals with pSS, sSS + SLE, and sSS + RA have MGD. In addition, our study indicates that patients with pSS and sSS have both aqueous-deficient and evaporative DED.
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influence of aging on the polar and neutral lipid profiles in human Meibomian Gland secretions
Archives of Ophthalmology, 2006Co-Authors: Benjamin D Sullivan, Reza Dana, James E Evans, David A. SullivanAbstract:Objective To determine whether aging is associated with significant alterations in the polar and neutral lipid profiles in human Meibomian Gland secretions. Methods Meibomian Gland secretions were collected from both eyes of younger and older men and women. Samples were processed for high-performance liquid chromatography or mass spectrometry and for the analysis of associated spectra of fragment ions. Subjects also underwent slitlamp evaluations of the eyelid. Results Aging is associated with numerous significant alterations in the lipid profiles of human Meibomian Gland secretions. Analysis of polar and neutral lipid patterns identified ions that were significantly different in secretions of younger vs older men and women, as well as ions that varied significantly only between men and women. Correlation coefficients within, but not between, groups were high. Aging was accompanied by increased opacity of Meibomian Gland secretions and by eyelid and eyelid margin changes. Conclusion Aging is associated with significant sex-related alterations in the polar and neutral lipid profiles of human Meibomian Gland secretions. Clinical Relevance The observed changes may contribute to the age-related increase in the prevalence of dry eye syndromes.
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complete androgen insensitivity syndrome effect on human Meibomian Gland secretions
Archives of Ophthalmology, 2002Co-Authors: Benjamin D Sullivan, Reza Dana, James E Evans, Kathleen L Krenzer, Jennifer M Cermak, David A. SullivanAbstract:Objective To determine whether androgen receptors affect the fatty acid profiles of neutral and polar lipids in human Meibomian Gland secretions. Methods Meibomian Gland secretion samples were obtained from both eyes of (1) women with complete androgen insensitivity syndrome, a condition characterized by dysfunctional androgen receptors, and (2) age-matched female and male controls. Samples were processed for high-performance liquid chromatography, mass spectrometry, or both and for analysis of the mass spectra of neutral and polar lipid fatty acid fragment ions by 3 different methods. Results Androgen receptor dysfunction is associated with significant alterations in the appearance of numerous molecular species in the neutral and polar lipid fractions of Meibomian Gland secretions. The ability to detect these differences, and to assess their nature and extent, was facilitated by the use of several analytic approaches. Sex-related differences exist in the expression of a variety of neutral and, especially, polar fatty acid products in Meibomian Gland secretions. Conclusions Androgens exert a significant effect on neutral and polar lipids in human Meibomian Gland secretions, and these hormonal effects may be mediated through androgen receptors.
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effect of androgen deficiency on the human Meibomian Gland and ocular surface
The Journal of Clinical Endocrinology and Metabolism, 2000Co-Authors: Kathleen L Krenzer, Reza Dana, James E Evans, David M Ullman, Jennifer M Cermak, Dorothy Bazzinotti Tolls, David A. SullivanAbstract:The purpose of this study was to determine whether the chronic use of antiandrogen medications leads to Meibomian Gland dysfunction, altered lipid profiles in Meibomian Gland secretions, decreased tear film stability, and evaporative dry eye. Subjects taking antiandrogen therapy for prostatic indications, as well as age-related controls, were asked to complete a questionnaire that assessed dry eye symptoms and then were given a complete anterior segment examination. Moreover, Meibomian Gland secretions were obtained from each eye and analyzed by high-performance liquid chromatography/mass spectrometry for the relative content of cholesterol, cholesterol esters, wax esters, diglycerides, triglycerides, and specific molecular species in the diglyceride fraction. Our results demonstrate that patients taking antiandrogen treatment, compared with age-related controls, had a: 1) significant increase in the frequency of appearance of tear film debris, an abnormal tear film meniscus, irregular posterior lid margins, conjunctival tarsal injection, and orifice metaplasia of the Meibomian Glands; 2) significant increase in the degree of ocular surface vital dye staining; 3) significant decrease in the tear film breakup time and quality of Meibomian Gland secretions; and 4) significant increase in the frequency of light sensitivity, painful eyes, and blurred vision. In addition, the use of antiandrogen pharmaceuticals was associated with significant changes in the relative amounts of lipids in Meibomian Gland secretions. Our findings indicate that chronic androgen deficiency is associated with Meibomian Gland dysfunction and dry eye.
Shiro Amano - One of the best experts on this subject based on the ideXlab platform.
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objective image analysis of the Meibomian Gland area
British Journal of Ophthalmology, 2014Co-Authors: Reiko Arita, Tsuyoshi Haraguchi, Hideaki Tokoro, Jun Suehiro, Rika Shirakawa, Shiro AmanoAbstract:Aims To evaluate objectively the Meibomian Gland area using newly developed software for non-invasive meibography. Methods Eighty eyelids of 42 patients without Meibomian Gland loss (meiboscore=0), 105 eyelids of 57 patients with loss of less than one-third total Meibomian Gland area (meiboscore=1), 13 eyelids of 11 patients with between one-third and two-thirds loss of Meibomian Gland area (meiboscore=2) and 20 eyelids of 14 patients with two-thirds loss of Meibomian Gland area (meiboscore=3) were studied. Lid borders were automatically determined. The software evaluated the distribution of the luminance and, by enhancing the contrast and reducing image noise, the Meibomian Gland area was automatically discriminated. The software calculated the ratio of the total Meibomian Gland area relative to the total analysis area in all subjects. Repeatability of the software was also evaluated. Results The mean ratio of the Meibomian Gland area to the total analysis area in the upper/lower eyelids was 51.9±5.7%/54.7±5.4% in subjects with a meiboscore of 0, 47.7±6.0%/51.5±5.4% in those with a meiboscore of 1, 32.0±4.4%/37.2±3.5% in those with a meiboscore of 2 and 16.7±6.4%/19.5±5.8% in subjects with a meiboscore of 3. Conclusions The Meibomian Gland area was objectively evaluated using the developed software. This system could be useful for objectively evaluating the effect of treatment on Meibomian Gland dysfunction.
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topical diquafosol for patients with obstructive Meibomian Gland dysfunction
British Journal of Ophthalmology, 2013Co-Authors: Tsuyoshi Haraguchi, Shuji Maeda, Koshi Maeda, Hideaki Tokoro, Jun Suehiro, Reiko Arita, Shiro AmanoAbstract:Aims To evaluate the effect of topical diquafosol in patients with Meibomian Gland dysfunction (MGD) using tear film parameters and quantitatively analyse the Meibomian Gland morphology. Subjects and Methods The subjects were 19 eyes of 10 patients diagnosed with obstructive MGD. All subjects were given 3% diquafosol ophthalmic solution with instructions to use one drop four times a day. Ocular symptoms were scored from 0 to 14. Lid margin abnormalities were scored from 0 to 4. Changes in the Meibomian Glands were scored using non-contact meibography (meiboscore). Superficial punctate keratopathy (SPK) was scored from 0 to 3. Meibum was graded from 0 to 3. Tear film production was evaluated by Schirmer’s test. Quantitative image analysis of the Meibomian Glands was performed using the original software. Results 10 patients completed more than 4 months of therapy. Ocular symptoms, lid margin abnormalities, SPK score and meibum grade were decreased. Break-up time and tear film meniscus were increased. Mean ratio of the Meibomian Gland area was significantly increased after treatment (p<0.0001). Conclusions Quantitative image analysis was useful for evaluating the morphological changes of the Meibomian Glands. Topical diquafosol therapy was effective for patients with obstructive MGD.
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Topical diquafosol for patients with obstructive Meibomian Gland dysfunction
British Journal of Ophthalmology, 2013Co-Authors: Reiko Arita, Tsuyoshi Haraguchi, Shuji Maeda, Koshi Maeda, Hideaki Tokoro, Jun Suehiro, Shiro AmanoAbstract:Aims To evaluate the effect of topical diquafosol in patients with Meibomian Gland dysfunction (MGD) using tear film parameters and quantitatively analyse the Meibomian Gland morphology. Subjects and Methods The subjects were 19 eyes of 10 patients diagnosed with obstructive MGD. All subjects were given 3% diquafosol ophthalmic solution with instructions to use one drop four times a day. Ocular symptoms were scored from 0 to 14. Lid margin abnormalities were scored from 0 to 4. Changes in the Meibomian Glands were scored using non-contact meibography (meiboscore). Superficial punctate keratopathy (SPK) was scored from 0 to 3. Meibum was graded from 0 to 3. Tear film production was evaluated by Schirmer’s test. Quantitative image analysis of the Meibomian Glands was performed using the original software. Results 10 patients completed more than 4 months of therapy. Ocular symptoms, lid margin abnormalities, SPK score and meibum grade were decreased. Break-up time and tear film meniscus were increased. Mean ratio of the Meibomian Gland area was significantly increased after treatment (p
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Meibomian Gland duct distortion in patients with perennial allergic conjunctivitis
Cornea, 2010Co-Authors: Reiko Arita, Shuji Maeda, Koshi Maeda, Kouzo Itoh, Ayumu Furuta, Atsuo Tomidokoro, Shiro AmanoAbstract:PURPOSE: To observe morphologic changes of Meibomian Glands in patients with and without perennial allergic conjunctivitis (AC) and to assess the relation between morphologic changes of the Meibomian Glands of both eyelids and tear film parameters. METHODS: In this study, 55 eyes of 55 patients with perennial AC and 47 eyes of 47 healthy volunteers as controls were included. The following tests were performed: a slit-lamp examination, measurement of tear film breakup time, grading of Meibomian Gland morphologic changes (meibography score) assessed with a noncontact meibography, Meibomian Gland duct distortion in meibography, tear production by the Schirmer I test, and grading of meibum expression. RESULTS: The frequency of Meibomian Gland duct distortion was significantly greater in patients with AC (45%) than that in controls (8.5%; P < 0.0001). The meibum (P = 0.049) and superficial punctate keratopathy scores (P = 0.0076) were significantly higher in patients with AC than those in controls. There was no significant difference in meibography score, breakup time, or Schirmer value between the 2 groups. The Meibomian expression score was significantly higher in patients with AC with Meibomian Gland duct distortion than in patients with AC without Meibomian Gland duct distortion (P = 0.0012). CONCLUSION: Perennial AC is associated with increased Meibomian Gland duct distortion.
Reiko Arita - One of the best experts on this subject based on the ideXlab platform.
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Meibomian Gland Dysfunction and Contact Lens Discomfort
Eye & Contact Lens-science and Clinical Practice, 2020Co-Authors: Reiko Arita, Shima Fukuoka, Naoyuki MorishigeAbstract:Abstract Meibomian Glands are located in the eyelids and secrete meibum, which gives rise to the lipid layer of the tear film. Changes to these Glands can lead to the development of Meibomian Gland dysfunction (MGD), which is associated with various ocular symptoms such as fatigue, dryness, burning sensation, and heavy sensation. The diagnosis of MGD thus relies on evaluation of ocular symptoms, meibum condition, and lid margin abnormalities. The recent development of noninvasive meibography and tear interferometry has provided important insight into Meibomian Gland structure and function, respectively. Wearers of contact lenses complain of ocular symptoms that are thought to be attributable to a variety of causes, such as a diminished aqueous or mucin layer of the tear film, changes in tear protein concentration, and altered Meibomian Gland structure or function. Many studies have examined the relation between contact lens wear and Meibomian Gland changes. Such studies have found that lens wear is associated with adverse changes in Meibomian Gland morphology and in the condition of the lid margin and meibum, suggesting that contact lenses negatively affect Meibomian Glands. Meibomian Gland dysfunction-like changes in Meibomian Glands induced by contact lens wear may thus be responsible for at least some of the ocular symptoms in lens wearers.
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Analysis of Meibum before and after Intraductal Meibomian Gland Probing in Eyes with Obstructive Meibomian Gland Dysfunction
Cornea, 2015Co-Authors: Naohiko Nakayama, Reiko Arita, Motoko Kawashima, Minako Kaido, Kazuo TsubotaAbstract:PURPOSE: To evaluate whether the amount of meibum and its viscosity change after intraductal Meibomian Gland probing in patients with refractory obstructive Meibomian Gland dysfunction (o-MGD). METHODS: Six lid margins of 3 patients with refractory o-MGD underwent intraductal Meibomian Gland probing. Meibum and the clinical outcome were evaluated before the procedure and at a 1-month postoperative visit. Meibum was quantified with a Meibometer, and its viscosity (Shimazaki grade) was assessed simultaneously. The tear film condition was evaluated by lipid layer interferometry (DR1, Kowa, Nagoya, Japan), and Meibomian Gland loss was analyzed by noncontact infrared meibography. Lid margin findings, tear break-up time, fluorescein score, and ocular symptoms were also assessed. RESULTS: At the postoperative visits, all cases showed improvements in meibum lipid levels (446-1376, 757-802, and 396-571 meibometer units) and meibum viscosity (grade 3-0, 3-1, and 3-2). Two cases showed an improvement in tear break-up time (2-5 and 0-6 seconds). No morphological changes in the Meibomian Gland were observed in any cases. CONCLUSIONS: Intraductal Meibomian Gland probing seems to improve Meibomian Gland lipid levels, and it may be a good treatment option for cases of o-MGD that are resistant to conventional treatment.
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objective image analysis of the Meibomian Gland area
British Journal of Ophthalmology, 2014Co-Authors: Reiko Arita, Tsuyoshi Haraguchi, Hideaki Tokoro, Jun Suehiro, Rika Shirakawa, Shiro AmanoAbstract:Aims To evaluate objectively the Meibomian Gland area using newly developed software for non-invasive meibography. Methods Eighty eyelids of 42 patients without Meibomian Gland loss (meiboscore=0), 105 eyelids of 57 patients with loss of less than one-third total Meibomian Gland area (meiboscore=1), 13 eyelids of 11 patients with between one-third and two-thirds loss of Meibomian Gland area (meiboscore=2) and 20 eyelids of 14 patients with two-thirds loss of Meibomian Gland area (meiboscore=3) were studied. Lid borders were automatically determined. The software evaluated the distribution of the luminance and, by enhancing the contrast and reducing image noise, the Meibomian Gland area was automatically discriminated. The software calculated the ratio of the total Meibomian Gland area relative to the total analysis area in all subjects. Repeatability of the software was also evaluated. Results The mean ratio of the Meibomian Gland area to the total analysis area in the upper/lower eyelids was 51.9±5.7%/54.7±5.4% in subjects with a meiboscore of 0, 47.7±6.0%/51.5±5.4% in those with a meiboscore of 1, 32.0±4.4%/37.2±3.5% in those with a meiboscore of 2 and 16.7±6.4%/19.5±5.8% in subjects with a meiboscore of 3. Conclusions The Meibomian Gland area was objectively evaluated using the developed software. This system could be useful for objectively evaluating the effect of treatment on Meibomian Gland dysfunction.
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topical diquafosol for patients with obstructive Meibomian Gland dysfunction
British Journal of Ophthalmology, 2013Co-Authors: Tsuyoshi Haraguchi, Shuji Maeda, Koshi Maeda, Hideaki Tokoro, Jun Suehiro, Reiko Arita, Shiro AmanoAbstract:Aims To evaluate the effect of topical diquafosol in patients with Meibomian Gland dysfunction (MGD) using tear film parameters and quantitatively analyse the Meibomian Gland morphology. Subjects and Methods The subjects were 19 eyes of 10 patients diagnosed with obstructive MGD. All subjects were given 3% diquafosol ophthalmic solution with instructions to use one drop four times a day. Ocular symptoms were scored from 0 to 14. Lid margin abnormalities were scored from 0 to 4. Changes in the Meibomian Glands were scored using non-contact meibography (meiboscore). Superficial punctate keratopathy (SPK) was scored from 0 to 3. Meibum was graded from 0 to 3. Tear film production was evaluated by Schirmer’s test. Quantitative image analysis of the Meibomian Glands was performed using the original software. Results 10 patients completed more than 4 months of therapy. Ocular symptoms, lid margin abnormalities, SPK score and meibum grade were decreased. Break-up time and tear film meniscus were increased. Mean ratio of the Meibomian Gland area was significantly increased after treatment (p<0.0001). Conclusions Quantitative image analysis was useful for evaluating the morphological changes of the Meibomian Glands. Topical diquafosol therapy was effective for patients with obstructive MGD.
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Topical diquafosol for patients with obstructive Meibomian Gland dysfunction
British Journal of Ophthalmology, 2013Co-Authors: Reiko Arita, Tsuyoshi Haraguchi, Shuji Maeda, Koshi Maeda, Hideaki Tokoro, Jun Suehiro, Shiro AmanoAbstract:Aims To evaluate the effect of topical diquafosol in patients with Meibomian Gland dysfunction (MGD) using tear film parameters and quantitatively analyse the Meibomian Gland morphology. Subjects and Methods The subjects were 19 eyes of 10 patients diagnosed with obstructive MGD. All subjects were given 3% diquafosol ophthalmic solution with instructions to use one drop four times a day. Ocular symptoms were scored from 0 to 14. Lid margin abnormalities were scored from 0 to 4. Changes in the Meibomian Glands were scored using non-contact meibography (meiboscore). Superficial punctate keratopathy (SPK) was scored from 0 to 3. Meibum was graded from 0 to 3. Tear film production was evaluated by Schirmer’s test. Quantitative image analysis of the Meibomian Glands was performed using the original software. Results 10 patients completed more than 4 months of therapy. Ocular symptoms, lid margin abnormalities, SPK score and meibum grade were decreased. Break-up time and tear film meniscus were increased. Mean ratio of the Meibomian Gland area was significantly increased after treatment (p
James E Evans - One of the best experts on this subject based on the ideXlab platform.
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influence of aging on the polar and neutral lipid profiles in human Meibomian Gland secretions
Archives of Ophthalmology, 2006Co-Authors: Benjamin D Sullivan, Reza Dana, James E Evans, David A. SullivanAbstract:Objective To determine whether aging is associated with significant alterations in the polar and neutral lipid profiles in human Meibomian Gland secretions. Methods Meibomian Gland secretions were collected from both eyes of younger and older men and women. Samples were processed for high-performance liquid chromatography or mass spectrometry and for the analysis of associated spectra of fragment ions. Subjects also underwent slitlamp evaluations of the eyelid. Results Aging is associated with numerous significant alterations in the lipid profiles of human Meibomian Gland secretions. Analysis of polar and neutral lipid patterns identified ions that were significantly different in secretions of younger vs older men and women, as well as ions that varied significantly only between men and women. Correlation coefficients within, but not between, groups were high. Aging was accompanied by increased opacity of Meibomian Gland secretions and by eyelid and eyelid margin changes. Conclusion Aging is associated with significant sex-related alterations in the polar and neutral lipid profiles of human Meibomian Gland secretions. Clinical Relevance The observed changes may contribute to the age-related increase in the prevalence of dry eye syndromes.
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proteomic analysis of human Meibomian Gland secretions
British Journal of Ophthalmology, 2006Co-Authors: P S Tsai, James E Evans, Stephen M Richards, Debra A Schaumberg, R M Sullivan, Karin M Green, M R Dana, David A. SullivanAbstract:Background/aim: Human tears contain hundreds of proteins that may exert a significant influence on tear film stability, ocular surface integrity, and visual function. The authors hypothesise that many of these proteins originate from the Meibomian Gland. This study’s aim was to begin to develop the proteomic methodology to permit the testing of their hypothesis. Methods: Meibomian Gland secretions were collected from the lower eyelids of adult volunteers and placed in a chloroform-methanol mixture. Samples were partitioned in a biphasic system and non-lipid phase materials were reduced, alkylated, and trypsin digested to obtain peptides for protein identification. This peptide mixture was separated by µ-capillary reverse phase chromatography and the effluent examined by nano-electrospray MS and data dependent MS/MS. SEQUEST software was used to identify proteins from the MS/MS spectra. Results: The methodological approach to date has permitted the identification of more than 90 proteins in human Meibomian Gland secretions. Proteins include the α2-macroglobulin receptor, IgA α chain, farnesoid X activated receptor, interferon regulatory factor 3, lacritin precursor, lactotransferrin, lipocalin 1, lysozyme C precursor, potential phospholipid transporting ATPase IK, seven transmembrane helix receptor (also termed somatostatin receptor type 4), testes development related NYD-SP21 (also termed high affinity IgE receptor β subunit), and TrkC tyrosine kinase. Conclusions: These findings indicate that the Meibomian Gland secretes a number of proteins into the tear film. It is quite possible that these proteins contribute to the dynamics of the tear film in both health and disease.
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complete androgen insensitivity syndrome effect on human Meibomian Gland secretions
Archives of Ophthalmology, 2002Co-Authors: Benjamin D Sullivan, Reza Dana, James E Evans, Kathleen L Krenzer, Jennifer M Cermak, David A. SullivanAbstract:Objective To determine whether androgen receptors affect the fatty acid profiles of neutral and polar lipids in human Meibomian Gland secretions. Methods Meibomian Gland secretion samples were obtained from both eyes of (1) women with complete androgen insensitivity syndrome, a condition characterized by dysfunctional androgen receptors, and (2) age-matched female and male controls. Samples were processed for high-performance liquid chromatography, mass spectrometry, or both and for analysis of the mass spectra of neutral and polar lipid fatty acid fragment ions by 3 different methods. Results Androgen receptor dysfunction is associated with significant alterations in the appearance of numerous molecular species in the neutral and polar lipid fractions of Meibomian Gland secretions. The ability to detect these differences, and to assess their nature and extent, was facilitated by the use of several analytic approaches. Sex-related differences exist in the expression of a variety of neutral and, especially, polar fatty acid products in Meibomian Gland secretions. Conclusions Androgens exert a significant effect on neutral and polar lipids in human Meibomian Gland secretions, and these hormonal effects may be mediated through androgen receptors.
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androgen deficiency Meibomian Gland dysfunction and evaporative dry eye
Annals of the New York Academy of Sciences, 2002Co-Authors: David A. Sullivan, Benjamin D Sullivan, James E Evans, F Schirra, H Yamagami, Stephen M Richards, Tomo Suzuki, Debra A Schaumberg, R M SullivanAbstract:Abstract: Objective. We have recently discovered that women with primary and secondary Sjogren's syndrome are androgen-deficient. We hypothesize that this hormone insufficiency contributes to the Meibomian Gland dysfunction, tear film instability, and evaporative dry eye that are characteristic of this autoimmune disorder. If our hypothesis is correct, we predict: (1) that androgens regulate Meibomian Gland function, control the quality and/or quantity of lipids produced by this tissue, and promote the formation of the tear film's lipid layer; and (2) that androgen deficiency, due to an attenuation in androgen synthesis (e.g., during Sjogren's syndrome, menopause, aging, complete androgen-insensitivity syndrome [CAIS] and anti-androgen use), will lead to Meibomian Gland dysfunction and evaporative dry eye. The following studies were designed to test these predictions. Methods. Experimental procedures included clinical studies, animal models, and histological, biochemical, molecular biological, and biomedical engineering techniques. Results. Our results demonstrate that: (1) androgens regulate the Meibomian Gland. This tissue contains androgen receptor mRNA, androgen receptor protein within acinar epithelial cell nuclei, and Types 1 and 2 5α-reductase mRNAs. Moreover, androgens appear to modulate lipid production and gene expression in mouse and/or rabbit Meibomian Glands; and (2) androgen deficiency may lead to Meibomian Gland dysfunction, altered lipid profiles in Meibomian Gland secretions, tear film instability, and evaporative dry eye. Thus, we have found that anti-androgen therapy in men is associated with Meibomian Gland disease, a decreased tear film breakup time, and functional dry eye. Furthermore, we have discovered that androgen receptor dysfunction in women with CAIS is associated with Meibomian Gland changes and a significant increase in the signs and symptoms of dry eye. Of interest, we have also found that androgen deficiency is associated with significant and striking alterations in the neutral and polar lipid patterns of human Meibomian Gland secretions. Conclusions. Our findings show that the Meibomian Gland is an androgen target organ and that androgen deficiency may promote Meibomian Gland dysfunction and evaporative dry eye. Overall, these results support our hypothesis that androgen deficiency may be an important etiologic factor in the pathogenesis of evaporative dry eye in women with Sjogren's syndrome.
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impact of androgen deficiency on the lipid profiles in human Meibomian Gland secretions
Advances in Experimental Medicine and Biology, 2002Co-Authors: Benjamin D Sullivan, James E Evans, M R Dana, David A. SullivanAbstract:Our previous research has indicated that androgen deficiency may be a critical etiologic factor in the pathogenesis of Meibomian Gland dysfunction, tear film instability and evaporative dry eye.1–3 We hypothesize that this may be due, at least in part, to significant alterations in the lipid profile of Meibomian Gland secretions.3 To test this hypothesis, we examined whether androgen deficiency, such as that occurring during aging in both sexes, complete androgen insensitivity syndrome (CAIS), the use of anti-androgen therapy and Sjogren’s syndrome (SS),4–7 is associated with significant changes in the fatty acid (FA) patterns of neutral and polar lipids in Meibomian Gland secretions. In addition, we determined whether lipid profiles could be used to separate individuals into clinically identifiable groups.
