Navel Valentin, Malecaze Jean, Pereira Bruno, Baker Julien S, Malecaze François, Sapin Vincent, Chiambaretta Frédéric, Dutheil Frédéric
Ophthalmology, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
Genetic Reproduction and Development Laboratory (GReD), Translational Approach to Epithelial Injury and Repair Team, CNRS UMR 6293, INSERM U1103, Université Clermont Auvergne, Clermont-Ferrand, France.
Acta Ophthalmol. 2021 Sep;99(6):e777-e794. doi: 10.1111/aos.14714. Epub 2020 Dec 23.
To conduct a systematic review and meta-analysis on the levels of oxidative stress markers and antioxidants in keratoconus compared to healthy subject.
The PubMed, Cochrane Library, Embase, Science Direct and Google Scholar databases were searched on 1st June 2020 for studies reporting oxidative and antioxidative stress markers in keratoconus and healthy controls. Main meta-analysis was stratified by type of biomarkers, type of samples (tears, cornea, aqueous humour and blood) and type of corneal samples (stromal cells, epithelium and endothelium).
We included 36 articles, for a total of 1328 keratoconus patients and 1208 healthy controls. There is an overall increase in oxidative stress markers in keratoconus compared with healthy controls (standard mean deviation (SMD) = 0.94, 95% confidence interval (95% CI) 0.55-1.33), with a significant increase in reactive oxygen and nitrogen species (1.09, 0.41-1.78) and malondialdehyde (1.78, 0.83-2.73). There is an overall decrease in antioxidants in keratoconus compared with healthy controls (-0.63, -0.89 to -0.36), with a significant decrease in total antioxidant capacity/status (-1.65, -2.88 to -0.43), aldehyde/NADPH dehydrogenase (-0.77, -1.38 to -0.17), lactoferrin/transferrin/albumin (-1.92, -2.96 to -0.89) and selenium/zinc (-1.42, -2.23 to -0.61). Oxidative stress markers were higher in tears and in cornea of keratoconus than in aqueous humour, and antioxidants were decreased in tears, aqueous humour and blood without difference between sample type. Oxidative stress markers increased in stromal cells and antioxidants decreased in endothelium.
Oxidative stress markers and antioxidants were dysregulated in keratoconus, involving an imbalance of redox homeostasis in tears, cornea, aqueous humour and blood.
对圆锥角膜患者与健康受试者的氧化应激标志物和抗氧化剂水平进行系统评价和荟萃分析。
于2020年6月1日检索PubMed、Cochrane图书馆、Embase、Science Direct和谷歌学术数据库，以查找报告圆锥角膜和健康对照中氧化和抗氧化应激标志物的研究。主要荟萃分析按生物标志物类型、样本类型（泪液、角膜、房水和血液）以及角膜样本类型（基质细胞、上皮细胞和内皮细胞）进行分层。
我们纳入了36篇文章，共1328例圆锥角膜患者和1208例健康对照。与健康对照相比，圆锥角膜患者的氧化应激标志物总体增加（标准均数差（SMD）=0.94，95%置信区间（95%CI）0.55 - 1.33），活性氧和氮物种（1.09，0.41 - 1.78）和丙二醛（1.78，0.83 - 2.73）显著增加。与健康对照相比，圆锥角膜患者的抗氧化剂总体减少（-0.63，-0.89至-0.36），总抗氧化能力/状态（-1.65，-2.88至-0.43）、醛/NADPH脱氢酶（-0.77，-1.38至-0.17）、乳铁蛋白/转铁蛋白/白蛋白（-1.92，-2.96至-0.89）和硒/锌（-1.42，-2.23至-0.61）显著减少。圆锥角膜患者泪液和角膜中的氧化应激标志物高于房水，泪液、房水和血液中的抗氧化剂减少，样本类型之间无差异。基质细胞中的氧化应激标志物增加，内皮细胞中的抗氧化剂减少。
圆锥角膜患者的氧化应激标志物和抗氧化剂失调，涉及泪液、角膜、房水和血液中氧化还原稳态的失衡。
