Regeneration of Lacrimal Gland Function to Maintain the Health of the Ocular Surface

Kawakita, Tetsuya

doi:10.1167/iovs.17-23576

Cited by 16 publications

(10 citation statements)

References 39 publications

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“…Although the blockage was released, the weight of lacrimal gland could not recover to normal stage if the ligation was released after five days. Although it was reported that the lacrimal gland has a powerful regenerative capacity after inflammation or injury, 28 our results suggest that long-term ligation induces irreversible atrophy of the lacrimal gland within 21 days. Whether a longer period can allow lacrimal gland injury to repair still needs more exploration in future study.…”

Section: Discussioncontrasting

confidence: 81%

Lacrimal Gland Microenvironment Changes After Obstruction of Lacrimal Gland Ducts

Sun

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose To investigate microenvironment changes of the lacrimal gland after obstruction of lacrimal gland ducts. Methods The ducts of rat exorbital lacrimal gland were ligated by sutures for different durations. After that, the sutures in some animals were released, and they were observed for 21 days to evaluate the recovery of the lacrimal gland. Slit lamp and tear secretion test was performed to evaluate ocular surface and lacrimal gland function. The lacrimal gland and cornea were harvested and processed for hematoxylin and eosin staining, oil red O staining, LipidTOX staining, Masson staining, quantitative real time polymerase chain reaction, and immunofluorescence staining. Results After the lacrimal gland ducts were blocked, tear secretion and the weight of the lacrimal gland were reduced. Incidence of corneal neovascularization increased after seven days. Intraglandular ducts dilated and acini destroyed. Long-term ligation induced fibrosis and lipid accumulation of the lacrimal glands. Inflammatory cell infiltrated and inflammatory factors upregulated. Proliferative and apoptotic cells increased. Structure of myoepithelial cells and basement membrane was destroyed. The p63 expression increased whereas Pax6 expression decreased. After suture release, tear secretion and structure of acini could recover in less than seven days after ligation, with a decrease in inflammatory cell infiltration and fibrosis relief. Apoptotic cells and proliferative cells increased at five days thereafter. The structure of the myoepithelial cells and basement membrane could not recover three days after ligation, and the number of mesenchymal cells increased in ligation after five to 14 days. Conclusions Blockage of the lacrimal gland ducts results in dystrophy of lacrimal gland acini cells, inflammation, and lipid accumulation of the lacrimal gland microenvironment. Long-term duct blockage will cause irreversible lacrimal gland failure.

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Section: Discussioncontrasting

confidence: 81%

Lacrimal Gland Microenvironment Changes After Obstruction of Lacrimal Gland Ducts

Sun

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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“…Lacrimal gland hypofunction, or low production and secretion of tears, is a common cause of ATD, and can occur in isolation or co-morbid with a systemic disease (Sjögren's, graft-versus-host disease) [15]. Lacrimal gland hypofunction can manifest secondary to glandular inflammation, destruction, or denervation, among other causes [16]. Mainstay treatments for ATD include artificial tears and antiinflammatories, [15] however several alternative therapies are being explored that have been shown to be effective in improving gland output.…”

Section: Therapies For Lacrimal Gland Hypofunctionmentioning

confidence: 99%

Alternative therapies for dry eye disease

Mittal

Patel

Galor

2021

Current Opinion in Ophthalmology

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Purpose of reviewDry eye disease (DED) is a multifactorial disease affecting approximately 5-50% of individuals in various populations. Contributors to DED include, but are not limited to, lacrimal gland hypofunction, meibomian gland dysfunction (MGD), ocular surface inflammation, and corneal nerve dysfunction. Current DED treatments target some facets of the disease, such as ocular surface inflammation, but not all individuals experience adequate symptom relief. As such, this review focuses on alternative and adjunct approaches that are being explored to target underlying contributors to DED. Recent findingsNeuromodulation, stem cell treatments, and oral royal jelly have all been studied in individuals with DED and lacrimal gland hypofunction, with promising results. In individuals with MGD, devices that provide eyelid warming or intense pulsed light therapy may reduce DED symptoms and signs, as may topical Manuka honey. For those with ocular surface inflammation, naturally derived anti-inflammatory agents may be helpful, with the compound trehalose being farthest along in the process of investigation. Nerve growth factor, blood-derived products, corneal neurotization, and to a lesser degree, fatty acids have been studied in individuals with DED and neurotrophic keratitis (i.e. corneal nerve hyposensitivity). Various adjuvant therapies have been investigated in individuals with DED with neuropathic pain (i.e. corneal nerve hypersensitivity) including nerve blocks, neurostimulation, botulinum toxin, and acupuncture, although study numbers and design are generally weaker than for the other DED sub-types. SummarySeveral alternatives and adjunct DED therapies are being investigated that target various aspects of disease. For many, more robust studies are required to assess their sustainability and applicability.

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“…The main lacrimal glands secrete a large fraction of the aqueous component of tears and are responsible for basal and reflex tearing. The extent of the contribution of accessory lacrimal glands to tear secretion at the ocular surface still remains unclear, and research regarding lacrimal gland function and pathology remains inadequate [24]. There is a limited understanding of the mechanism underlying lacrimal gland inflammation and damage, and case reports of DES complications after lacrimal gland surgery are similarly limited.…”

Section: Discussionmentioning

confidence: 99%

Refractory Dry Eye Syndrome after Transconjunctival Excision of the Palpebral Lobe of the Lacrimal Gland

et al. 2021

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The aim of the present study was to report two cases of refractory dry eye syndrome (DES) after transconjunctival excision of the palpebral lobe of the lacrimal gland. A 25-year-old female patient with a chief complaint of a palpable mass in both upper eyelids visited our medical center. Preoperative orbital computer tomography showed high-attenuation lesions in both lacrimal glands. Incisional biopsy of the lacrimal gland palpebral lobe via transconjunctival incision was performed in January 2019. At 1 month after the biopsy, a lack of tears and persistent corneal erosions were found in both eyes. Artificial tears, punctal occlusion, autologous serum eye drops, and therapeutic contact lenses were applied in an attempt to control the dry eye symptoms. The patient continues to suffer from intractable DES at 2.5 years after the procedure. The second case involved a 52-year-old female patient who visited our medical center with a chief complaint of a palpable mass in both upper eyelids. Bilateral orbital tumors were diagnosed with preoperative magnetic resonance imaging. An incisional biopsy of the lacrimal gland was performed. Immunoglobulin G4-related dacryoadenitis was confirmed through lacrimal palpebral lobe incisional biopsy. Intractable DES and corneal erosion of her left eye persisted thereafter. A transconjunctival incision is an effective approach for minimizing postoperative scars and is suitable for the biopsy of tumors that are visible through the conjunctiva. After a biopsy of the palpebral lobe of the main lacrimal glands, the secretion of reflex tears decreases due to damage to the secreting ducts of the main lacrimal glands. However, total tear secretion can be maintained by basal tear secretion from the accessory lacrimal glands. In this report, we describe two cases of refractory DES due to decreased total tear secretion, although only the palpebral lobes of the main lacrimal glands were biopsied.

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Regeneration of Lacrimal Gland Function to Maintain the Health of the Ocular Surface

Cited by 16 publications

References 39 publications

Lacrimal Gland Microenvironment Changes After Obstruction of Lacrimal Gland Ducts

Lacrimal Gland Microenvironment Changes After Obstruction of Lacrimal Gland Ducts

Alternative therapies for dry eye disease

Refractory Dry Eye Syndrome after Transconjunctival Excision of the Palpebral Lobe of the Lacrimal Gland

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