Tear fluid biomarkers in ocular and systemic disease: potential use for predictive, preventive and personalised medicine

Abstract

In the field of predictive, preventive and personalised medicine, researchers are keen to identify novel and reliable ways to predict and diagnose disease, as well as to monitor patient response to therapeutic agents. In the last decade alone, the sensitivity of profiling technologies has undergone huge improvements in detection sensitivity, thus allowing quantification of minute samples, for example body fluids that were previously difficult to assay. As a consequence, there has been a huge increase in tear fluid investigation, predominantly in the field of ocular surface disease. As tears are a more accessible and less complex body fluid (than serum or plasma) and sampling is much less invasive, research is starting to focus on how disease processes affect the proteomic, lipidomic and metabolomic composition of the tear film. By determining compositional changes to tear profiles, crucial pathways in disease progression may be identified, allowing for more predictive and personalised therapy of the individual.This article will provide an overview of the various putative tear fluid biomarkers that have been identified to date, ranging from ocular surface disease and retinopathies to cancer and multiple sclerosis. Putative tear fluid biomarkers of ocular disorders, as well as the more recent field of systemic disease biomarkers, will be shown.

Pathogenesis of Keratoconus: The intriguing therapeutic potential of Prolactin-inducible protein

“…Complex array of biomolecules are secreted within the tear fluid, which are potential targets of prognostic value in ocular diseases. Tear fluid as a pool of biomarkers, in ocular and systemic conditions, has been well studied and shown to have translational potential (Hagan et al, 2016; von Thun Und Hohenstein-Blaul et al, 2013). Tear fluid can be collected in a painless, non-invasive fashion, making it an optimal biological fluid to analyse with minimal discomfort to the patient.…”

Identification and Profiling of Specialized Pro-Resolving Mediators in Human Tears by Lipid Mediator Metabolomics

“…Tear fluid can serve as a means to identify and monitor novel biomarkers in ocular and systemic disease that can also be used in personalized medicine and for prevention [23]. The omega-3 (DHA and EPA) and omega-6 (arachidonic acid) fatty acid precursors are present in human tears and have been shown to correlate with clinical measures of dry eye systems in humans [24].…”

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

“…Combination of DTI with other advanced MR parameters (i.e., atrophy measurement, MTR, MRS) may enable early classification of distinct neuroimmunological CNS diseases and identification of patients with more severe inflammation or patients with progressive axonal damage. This MR-based classification might foster the use of more tailored treatments in the sense of a "personalized neuroimmunology.^Therefore, the next step will be to combine the information of DTI and other advanced MR technologies to generate patient profiles with regard to localization, quantification, functional impairment, and possible future development of visual pathway damage analogous to other biomarker profiles used in PPPM [120]. These profiles may serve as individual outcome predictors and as additive biomarkers within personalized treatment algorithms in MS and other CNS autoimmune diseases and help explain heterogeneous symptom presentations and associations, such as the association between MS and Flammer syndrome [121].…”