Barbosa-Breda João, Himmelreich Uwe, Ghesquière Bart, Rocha-Sousa Amândio, Stalmans Ingeborg
Laboratory of Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Belgium.
Ophthalmic Res. 2018;59(1):1-6. doi: 10.1159/000479158. Epub 2017 Sep 1.
Glaucoma is one of the leading causes of irreversible blindness worldwide. However, there are no biomarkers that accurately help clinicians perform an early diagnosis or detect patients with a high risk of progression. Metabolomics is the study of all metabolites in an organism, and it has the potential to provide a biomarker. This review summarizes the findings of metabolomics in glaucoma patients and explains why this field is promising for new research. We identified published studies that focused on metabolomics and ophthalmology. After providing an overview of metabolomics in ophthalmology, we focused on human glaucoma studies. Five studies have been conducted in glaucoma patients and all compared patients to healthy controls. Using mass spectrometry, significant differences were found in blood plasma in the metabolic pathways that involve palmitoylcarnitine, sphingolipids, vitamin D-related compounds, and steroid precursors. For nuclear magnetic resonance spectroscopy, a high glutamine-glutamate/creatine ratio was found in the vitreous and lateral geniculate body; no differences were detected in the optic radiations, and a lower N-acetylaspartate/choline ratio was observed in the geniculocalcarine and striate areas. Metabolomics can move glaucoma care towards a personalized approach and provide new knowledge concerning the pathophysiology of glaucoma, which can lead to new therapeutic options.
青光眼是全球不可逆性失明的主要原因之一。然而，目前尚无能够准确帮助临床医生进行早期诊断或检测出具有高进展风险患者的生物标志物。代谢组学是对生物体中所有代谢物的研究，它有潜力提供一种生物标志物。本综述总结了青光眼患者代谢组学的研究结果，并解释了为何该领域在新研究方面前景广阔。我们检索了专注于代谢组学和眼科的已发表研究。在概述了眼科领域的代谢组学之后，我们重点关注了人类青光眼研究。目前已对青光眼患者开展了五项研究，所有研究均将患者与健康对照进行了比较。通过质谱分析，发现涉及棕榈酰肉碱、鞘脂、维生素D相关化合物和类固醇前体的代谢途径在血浆中存在显著差异。对于核磁共振波谱分析，在玻璃体和外侧膝状体中发现谷氨酰胺 - 谷氨酸/肌酸比值较高；在视辐射中未检测到差异，而在膝距束和纹状区观察到较低的N - 乙酰天门冬氨酸/胆碱比值。代谢组学可使青光眼治疗走向个性化，并提供有关青光眼病理生理学的新知识，从而带来新的治疗选择。
