Meibomian gland triglyceride fatty acid differences in chronic blepharitis patients.

In this study, we analyzed the triglyceride fraction of human meibomian gland secretions to determine whether specific fatty acids were significantly associated with specific chronic blepharitis disease groups. Triglycerides, isolated from the lipid component of human meibomian secretions by thin-layer chromatography, were transmethylated with sodium methoxide/methanol. Samples from individuals were then analyzed by gas chromatography-mass spectroscopy (GC-MS). Significant fatty acid differences were determined by nonparametric analyses, utilizing Kruskal-Wallis analysis of between group differences and Student-Newman-Keuls multiple comparisons. The analyses showed that the triglyceride samples contained the expected normal, iso, and anteiso fatty acids; disease group differences (from normals) in some of these fatty acid types were significant only with a Bonferroni adjustment. The triglycerides also contained previously unreported polyunsaturated fatty acids as well as two four-member families of fatty acids that had mass spectra and retention times consistent with dimethylated carbon chains. Additionally, some members of the meibomian keratoconjunctivitis (MKC) group contained an unusual pattern of normal 20-carbon fatty acids, including a higher level of saturated and lower levels of unsaturated fatty acids. An important exception was the presence of a monosaturated fatty acid whose GC retention time and mass spectrum were consistent with the uncommon cis-10-20:1 isomer. This pattern was associated with the presence of patient posterior hordeola. Thus, the association of triglyceride fatty acid composition with chronic blepharitis disease signs could be much more important than previously thought. Furthermore, this is the first example of the association of specific fatty acids with a specific chronic blepharitis disease sign.