College of Optometry, University of Houston, USA.
College of Optometry, University of Houston, USA; Department of Zoology, Deen Dayal Upadhyaya College, University of Delhi, Delhi, India.
Ocul Surf. 2023 Oct;30:298-306. doi: 10.1016/j.jtos.2023.11.003. Epub 2023 Nov 17.
Meibomian glands (MGs), located within the tarsal plate of the eyelid, secrete meibum which is the lipid-rich secretion necessary for stabilizing the tear film and preventing tear evaporation. Changes in the quality and quantity of meibum produced causes MG dysfunction (MGD), the leading cause of evaporative dry eye disease (EDED). MGD is an underdiagnosed disease and it is estimated that, in the US, approximately 70 % of the population over 60 have MGD. Three forms of MGD occur based on their meibum secretion: hyposecretory, obstructive, and hypersecretory MGD. The pathophysiology of MGD remains poorly understood, however aging is the primary risk factor. With age, MGs undergo various age-related changes, including decreased acinar basal cell proliferation, hyperkeratinization, MG atrophy, and eventual MG drop-out, leading to age-related MGD (ARMGD). Additionally, studies have suggested that MGs can suffer inflammatory cell infiltration and changes innervation patterns with aging, which could also contribute towards ARMGD. This review focuses on how the aging process affects the MG, and more importantly, how age-related changes to the MG can lead to MG atrophy and MG drop-out, ultimately leading to ARMGD. This review also highlights the most recent developments in potential therapeutic interventions for ARMGD.
睑板腺（MGs）位于眼睑的睑板内，分泌的睑脂是稳定泪膜和防止泪液蒸发所必需的富含脂质的分泌物。睑脂的质量和数量发生变化会导致 MG 功能障碍（MGD），这是蒸发性干眼症（EDED）的主要原因。MGD 是一种未被充分诊断的疾病，据估计，在美国，60 岁以上的人群中约有 70%患有 MGD。根据其睑脂分泌情况，MGD 分为三种类型：分泌不足型、阻塞型和分泌过多型 MGD。MGD 的病理生理学仍不清楚，但衰老是主要的危险因素。随着年龄的增长，MGs 会发生各种与年龄相关的变化，包括腺泡基底细胞增殖减少、过度角化、MG 萎缩和最终的 MG 脱落，导致与年龄相关的 MGD（ARMGD）。此外，研究表明，MGs 可能会受到炎症细胞浸润和衰老时神经支配模式的改变，这也可能导致 ARMGD。这篇综述重点讨论了衰老过程如何影响 MG，更重要的是，MG 的年龄相关性变化如何导致 MG 萎缩和 MG 脱落，最终导致 ARMGD。这篇综述还强调了 ARMGD 潜在治疗干预措施的最新进展。
