ABSTRACT
Over the last two decades, a large number of non-communicable/chronic disorders reached an epidemic level on a global scale such as diabetes mellitus type 2, cardio-vascular disease, several types of malignancies, neurological and eye pathologies-all exerted system's enormous socio-economic burden to primary, secondary, and tertiary healthcare. The paradigm change from reactive to predictive, preventive, and personalized medicine (3PM/PPPM) has been declared as an essential transformation of the overall healthcare approach to benefit the patient and society at large. To this end, specific biomarker panels are instrumental for a cost-effective predictive approach of individualized prevention and treatments tailored to the person. The source of biomarkers is crucial for specificity and reliability of diagnostic tests and treatment targets. Furthermore, any diagnostic approach preferentially should be noninvasive to increase availability of the biomaterial, and to decrease risks of potential complications as well as concomitant costs. These requirements are clearly fulfilled by tear fluid, which represents a precious source of biomarker panels. The well-justified principle of a "sick eye in a sick body" makes comprehensive tear fluid biomarker profiling highly relevant not only for diagnostics of eye pathologies but also for prediction, prognosis, and treatment monitoring of systemic diseases. One prominent example is the Sicca syndrome linked to a cascade of severe complications that include dry eye, neurologic, and oncologic diseases. In this review, protein profiles in tear fluid are highlighted and corresponding biomarkers are exemplified for several relevant pathologies, including dry eye disease, diabetic retinopathy, cancers, and neurological disorders. Corresponding analytical approaches such as sample pre-processing, differential proteomics, electrophoretic techniques, high-performance liquid chromatography (HPLC), enzyme-linked immuno-sorbent assay (ELISA), microarrays, and mass spectrometry (MS) methodology are detailed. Consequently, we proposed the overall strategies based on the tear fluid biomarkers application for 3P medicine practice. In the context of 3P medicine, tear fluid analytical pathways are considered to predict disease development, to target preventive measures, and to create treatment algorithms tailored to individual patient profiles.
ABSTRACT
Introduction The conjunctiva is one of the most frequently damaged targets for inflammatory responses induced by allergic immunological hypersensitivity reactions. Allergic conjunctivitis (AC) typically manifests as a spectrum of potential severity, ranging from mild symptoms to severe troublesome symptoms that might interfere significantly with daily activities and overall quality of life. Aim This study aimed to evaluate impact of the quarantine during the COVID-19 pandemic on the quality of life of allergic conjunctivitis patients. Methodology This is a cross-sectional study conducted among confirmed patients with allergic conjunctivitis in Saudi Arabia from the period of July 2020 to September 2020. An electronic validated structured-questionnaire explored the participants' demography, symptoms, known allergen and risk factors, and patient psychological and functional domains of life using Eye Allergy Patient Impact Questionnaire (EAPIQ). Data were gathered in MS Excel and all statistical analyses were performed using SPSS version 21. Results The most common symptoms of AC was itching (79.9%) and redness of the eye (38.8%), while the most common causes was dust (46.9%) and pollens (46.9%). With regards to the assessment of EAPIQ, the mean score was higher in the impact of eye allergy symptoms domain (mean 12.6 ± 4.84 SD.), while it was lower in the impact of AC on the psychological and emotional domain (mean 10.7 ± 5.62 SD.). Statistical analysis revealed that previous history of AC and a visit to healthcare provider were the significant factors associated with the increased risk of eye allergy symptoms, troubled daily activities and bothered psychological and emotional life. Conclusion This study demonstrated that a patients' eye allergy symptoms affect many aspects of patients' daily activities. In addition to affecting functionality, these symptoms also affect patients' emotional state. Although the impact of daily activities and emotions due to eye allergy were minimal, the impact of eye allergy symptoms during quarantine period was still found to be moderate. We found the severity of AC & its impact over a patients' quality of life was moderate which suggests there was no major effect found on AC severity during the COVID-19 pandemic quarantine period. Further studies with detailed analysis of triggering factors might lead to a better understanding of the disease and its relation to the patients' activities & lifestyle which can directly affect the AC management & quality of life.