Mateos-Olivares Milagros, Pastor-Idoate Salvador, Martín-Vallejo Javier, García-Vazquez Cristina, Pastor José Carlos, Usategui-Martín Ricardo, Sobas Eva María
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
Department of Ophthalmology, Clinical University Hospital of Valladolid, Valladolid, Spain.
PLoS One. 2024 Jun 13;19(6):e0304261. doi: 10.1371/journal.pone.0304261. eCollection 2024.
Patients with Retinitis Pigmentosa (RP) commonly experience sleep-related issues and are susceptible to stress. Moreover, variatiaons in their vision are often linked to anxiety, stress and drowsiness, indicating that stress and sleep deprivation lead to a decline in vision, and vision improves when both are mitigated. The objective of this study was to investigate the utility of salivary biomarkers as biochemical indicators of anxiety and sleep deprivation in RP patients.
Seventy-eight RP patients and 34 healthy controls were included in this observational study. Anxiety and sleep-quality questionnaires, a complete ophthalmological exam for severity grading and, the collection of salivary samples from participants were assessed for participants. The activity of biomarkers was estimated by ELISA, and statistical analysis was performed to determine associations between the parameters. Associations between underlying psychological factors, grade of disease severity, and biomarkers activity were also examined.
Fifty-two (67%) of patients had a severe RP, and 26 (33%) had a mild-moderate grade. Fifty-eight (58,9%) patients reported severe levels of anxiety and 18 (23.,1%) a high level. Forty-six (59%) patients obtained pathological values in sleep-quality questionaries and 43 (55.1%) in sleepiness. Patients with RP exhibited significant differences in testosterone, cortisol, sTNFαRII, sIgA and melatonin as compared to controls and patients with a mild-moderate and advanced stage of disease showed greater differences. In covariate analysis, patients with a severe anxiety level also showed greater differences in mean salivary cortisol, sTNFαRII and melatonin and male patients showed lower IgA levels than female.
The present findings suggest that salivary biomarkers could be suitable non-invasive biochemical markers for the objective assessment of sleep deprivation and anxiety in RP patients. Further research is needed to characterize the effects of untreated negative psychological states and sleep deprivation on increased variability of vision and disease progression, if any.
视网膜色素变性（RP）患者通常会经历与睡眠相关的问题，并且容易受到压力影响。此外，他们视力的变化往往与焦虑、压力和嗜睡有关，这表明压力和睡眠剥夺会导致视力下降，而当两者都得到缓解时视力会改善。本研究的目的是调查唾液生物标志物作为RP患者焦虑和睡眠剥夺生化指标的效用。
本观察性研究纳入了78名RP患者和34名健康对照。对参与者进行焦虑和睡眠质量问卷、全面的眼科检查以进行严重程度分级，并收集唾液样本。通过酶联免疫吸附测定（ELISA）评估生物标志物的活性，并进行统计分析以确定参数之间的关联。还检查了潜在心理因素、疾病严重程度分级与生物标志物活性之间的关联。
52名（67%）患者患有严重的RP，26名（33%）患有轻度至中度RP。58名（58.9%）患者报告有严重程度的焦虑，18名（23.1%）报告有高水平焦虑。46名（59%）患者在睡眠质量问卷中获得病理值，43名（55.1%）在嗜睡方面获得病理值。与对照组相比，RP患者在睾酮、皮质醇、可溶性肿瘤坏死因子α受体II（sTNFαRII）、分泌型免疫球蛋白A（sIgA）和褪黑素方面表现出显著差异，疾病轻度至中度和晚期患者表现出更大差异。在协变量分析中，焦虑水平严重的患者在唾液皮质醇、sTNFαRII和褪黑素的平均值方面也表现出更大差异，男性患者的IgA水平低于女性。
目前的研究结果表明，唾液生物标志物可能是用于客观评估RP患者睡眠剥夺和焦虑的合适非侵入性生化标志物。如果存在的话，需要进一步研究来确定未经治疗的负面心理状态和睡眠剥夺对视力变异性增加和疾病进展的影响。
