Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore.
Department of Cornea and External Eye Disease, Singapore National Eye Centre, Singapore.
J Adv Res. 2020 Nov 5;29:67-81. doi: 10.1016/j.jare.2020.11.001. eCollection 2021 Mar.
The tear proteomics and neuromediators are associated with clinical dry eye parameters following refractive surgery.
To investigate and compare the tear proteomic and neuromediator profiles following small incision lenticule extraction (SMILE) versus laser-assisted in-situ keratomileusis (LASIK).
In this randomized controlled trial with paired-eye design, 70 patients were randomized to receive SMILE in one eye and LASIK in the other eye. Tear samples were collected preoperatively, and 1 week, 1, 3, 6 and 12 months postoperatively, and were examined for protein concentration changes using sequential window acquisition of all theoretical fragment ion mass spectrometry (SWATH-MS). The data were analyzed with DAVID Bioinformatics Resources for enriched gene ontology terms and over-represented pathways. Tear neuromediators levels were correlated with clinical parameters.
Post-SMILE eyes had significantly better Oxford staining scores and tear break-up time (TBUT) than post-LASIK eyes at 1 and 3 months, respectively. Tear substance P and nerve growth factor levels were significantly higher in the LASIK group for 3 months and 1 year, respectively. SMILE and LASIK shared some similar biological responses postoperatively, but there was significant up-regulation in leukocyte migration and wound healing at 1 week, humoral immune response and apoptosis at 1 month, negative regulation of endopeptidase activity at 3 to 6 months, and extracellular structure organization at 1 year in the post-LASIK eyes. Tear mucin-like protein 1 and substance P levels were significantly correlated with TBUT ( = -0.47, = -0.49, respectively).
Significant differences in the tear neuromediators and proteomics were observed between SMILE and LASIK, even though clinical dry eye signs have subsided and became comparable between 2 procedures.
泪液蛋白质组学和神经递质与屈光手术后的临床干眼参数有关。
研究和比较小切口透镜切除术（SMILE）与准分子激光原位角膜磨镶术（LASIK）后泪液蛋白质组学和神经递质谱。
在这项随机对照、配对眼设计的临床试验中，70 名患者随机接受一只眼的 SMILE 和另一只眼的 LASIK。在术前和术后 1 周、1 个月、3 个月、6 个月和 12 个月收集泪液样本，使用序贯窗口采集所有理论片段离子质谱（SWATH-MS）检测蛋白浓度变化。使用 DAVID 生物信息学资源分析数据，以富集基因本体论术语和过度表达的途径。泪液神经递质水平与临床参数相关。
术后 SMILE 眼的牛津染色评分和泪膜破裂时间（TBUT）分别在 1 个月和 3 个月时明显优于 LASIK 眼。LASIK 组术后 3 个月和 1 年泪液 P 物质和神经生长因子水平明显升高。SMILE 和 LASIK 术后有一些相似的生物学反应，但在术后 1 周时白细胞迁移和伤口愈合显著上调，术后 1 个月时体液免疫反应和细胞凋亡显著上调，术后 3 至 6 个月时内肽酶活性负调节显著上调，术后 1 年时细胞外结构组织显著上调LASIK 眼。泪液黏蛋白 1 和 P 物质水平与 TBUT 显著相关（r = -0.47，r = -0.49）。
即使在 2 种手术的临床干眼迹象消退并变得相似后，SMILE 和 LASIK 之间的泪液神经递质和蛋白质组学仍存在显著差异。
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