Department of Ophthalmology, University of Florida Shands Hospital, Gainesville, FL, USA.
University of Florida College of Medicine, Gainesville, FL, USA.
Transl Vis Sci Technol. 2023 Aug 1;12(8):5. doi: 10.1167/tvst.12.8.5.
Carboxymethylcellulose is an artificial tear ingredient known to decrease gut microbiome diversity when ingested. This study examines the effect of carboxymethylcellulose on ocular surface microbiome diversity and composition.
Healthy adult participants without significant ophthalmic disease or concurrent carboxymethylcellulose artificial tear use were allocated randomly to take carboxymethylcellulose or control polyethylene glycol artificial tears for seven days. Conjunctival swabs were collected before and after artificial tear treatment. This trial is registered at clinicaltrials.gov (NCT05292755). Primary outcomes included abundance of bacterial taxa and microbiome diversity as measured by the Chao-1 richness estimate, Shannon's phylogenetic diversity index, and UniFrac analysis. Secondary outcomes included Ocular Surface Disease Index scores and artificial tear compliance.
Of the 80 enrolled participants, 66 completed the trial. Neither intervention affected Chao-1 richness (analysis of variance [ANOVA], P = 0.231) or Shannon's diversity index (ANOVA, P = 0.224). Microbiome samples did not separate by time point (permutation multivariate analysis of variance [PERMANOVA], P = 0.223) or intervention group (PERMANOVA, P = 0.668). LEfSe taxonomic analysis revealed that carboxymethylcellulose depleted several taxa including Bacteroides and Lachnoclostridium, but enriched Enterobacteriaceae, Citrobacter, and Gordonia. Both interventions decreased OSDI scores (Wilcoxon signed rank test, P < 0.05), but there was no significant difference between interventions (Mann-Whitney U, P = 0.54).
Carboxymethylcellulose artificial tears increased Actinobacteriota but decreased Bacteroides and Firmicutes bacteria. Carboxymethylcellulose artificial tears do not affect ocular surface microbiome diversity and are not significantly more effective than polyethylene glycol artificial tears for dry eye treatment.
The 16S microbiome analysis has revealed small changes in the ocular surface microbiome associated with artificial tear use.
羧甲基纤维素是一种人工泪液成分，已知摄入后会降低肠道微生物组的多样性。本研究旨在研究羧甲基纤维素对眼表微生物组多样性和组成的影响。
健康的成年参与者没有明显的眼部疾病或同时使用羧甲基纤维素人工泪液，随机分配使用羧甲基纤维素或对照聚乙二醇人工泪液治疗七天。在使用人工泪液治疗前后采集结膜拭子。该试验在 clinicaltrials.gov 注册（NCT05292755）。主要结局包括细菌分类群的丰度和微生物多样性，用 Chao-1 丰富度估计、Shannon 的系统发育多样性指数和 UniFrac 分析来衡量。次要结局包括眼表面疾病指数评分和人工泪液的依从性。
在 80 名入组的参与者中，有 66 名完成了试验。两种干预措施均未影响 Chao-1 丰富度（方差分析，P = 0.231）或 Shannon 的多样性指数（方差分析，P = 0.224）。微生物组样本未按时间点（置换多元方差分析，P = 0.223）或干预组（PERMANOVA，P = 0.668）分离。LEfSe 分类分析表明，羧甲基纤维素消耗了包括拟杆菌属和lachnoclostridium 在内的几种属，但富集了肠杆菌科、柠檬酸杆菌和戈登氏菌。两种干预措施都降低了 OSDI 评分（Wilcoxon 符号秩检验，P < 0.05），但干预措施之间无显著差异（Mann-Whitney U，P = 0.54）。
羧甲基纤维素人工泪液增加了放线菌门，但减少了拟杆菌属和厚壁菌门细菌。羧甲基纤维素人工泪液不会影响眼表微生物组多样性，在治疗干眼症方面并不比聚乙二醇人工泪液更有效。
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