Wang Zuo, Guo Siqi, He Chong, Chen Lingling, Wang Jinxia, Xiu Wenbo, Zhang Gao, Chen Yang, Li An, Zhu Xiong, Xiao Xiao, Yu Ling, Lu Fang
Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
J Inflamm Res. 2024 Sep 30;17:6895-6904. doi: 10.2147/JIR.S480809. eCollection 2024.
Evidence suggests that dysbiosis of the gut microbiota plays a pivotal role in the development of glaucoma. This dysbiosis is commonly associated with chronic intestinal inflammation and increased intestinal permeability. However, the understanding of intestinal inflammation and permeability in glaucoma remains insufficient. This study aims to investigate the potential relationship between fecal inflammation and permeability markers and glaucoma.
We recruited 114 glaucoma patients and 75 healthy controls. Levels of fecal lactoferrin (Lf) and alpha-1 antitrypsin (AAT) were quantified using enzyme linked immunosorbent assay (ELISA) to compare both biomarkers between groups and across different severity grades of glaucoma. Logistic regression analysis was used to assess the association between these fecal biomarkers and glaucoma. The severity of glaucoma was assessed based on the mean deviation (MD) in the visual field.
In this study, we observed elevated levels of fecal Lf and AAT in glaucoma patients. The proportion of glaucoma patients with abnormal fecal Lf levels (≥ 7.25 µg/g) was significantly higher than that of the controls ( = 0.012). A positive correlation was noted between fecal Lf and AAT (rho = 0.20, = 0.006). After adjusting for age and sex, multivariable logistic regression analysis indicated that both fecal Lf (OR = 1.11, 95% CI: 1.01-1.21, = 0.026) and AAT (OR = 1.01, 95% CI: 1.01-1.02, < 0.001) positively correlated with glaucoma. These biomarkers might reflect glaucoma severity, with significant differences in fecal Lf levels observed between moderate and severe stages, but not in the early stage. Furthermore, increasing levels of fecal AAT correlated with greater severity of glaucomatous injury and a larger vertical cup-to-disc ratio (VCDR) ( < 0.05).
This study suggests an increase in intestinal inflammation and permeability in glaucoma, further indicating the importance of the 'gut-retina axis' in the pathogenesis of the disease and potentially offering new therapeutic avenues.
有证据表明肠道微生物群失调在青光眼的发展中起关键作用。这种失调通常与慢性肠道炎症和肠道通透性增加有关。然而，对青光眼患者肠道炎症和通透性的了解仍然不足。本研究旨在探讨粪便炎症和通透性标志物与青光眼之间的潜在关系。
我们招募了114例青光眼患者和75名健康对照者。采用酶联免疫吸附测定（ELISA）对粪便乳铁蛋白（Lf）和α-1抗胰蛋白酶（AAT）水平进行定量，以比较两组之间以及不同严重程度等级青光眼患者的这两种生物标志物。采用逻辑回归分析评估这些粪便生物标志物与青光眼之间的关联。根据视野中的平均偏差（MD）评估青光眼的严重程度。
在本研究中，我们观察到青光眼患者粪便Lf和AAT水平升高。粪便Lf水平异常（≥7.25µg/g）的青光眼患者比例显著高于对照组（P = 0.012）。粪便Lf与AAT之间存在正相关（rho = 0.20，P = 0.006）。在调整年龄和性别后进行多变量逻辑回归分析表明，粪便Lf（OR = 1.11，95%CI：1.01 - 1.21，P = 0.026）和AAT（OR = 1.01，95%CI：1.01 - 1.02，P < 0.001）均与青光眼呈正相关。这些生物标志物可能反映青光眼的严重程度，在中度和重度阶段观察到粪便Lf水平存在显著差异，但在早期阶段没有。此外，粪便AAT水平升高与青光眼性损伤的严重程度增加和更大的垂直杯盘比（VCDR）相关（P < 0.05）。
本研究表明青光眼患者肠道炎症和通透性增加，进一步表明“肠 - 视网膜轴”在该疾病发病机制中的重要性，并可能提供新的治疗途径。
