PDF(Pubmed)
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.
摘要：
在过去的二十年里，大量非传染性/慢性疾病在全球范围内达到流行水平，例如2型糖尿病，心血管疾病，几种类型的恶性肿瘤，神经和眼病-所有施加系统的巨大社会经济负担，次要,和三级医疗保健。范式从反应性转变为预测性，预防性,个性化医疗（3PM/PPPM）已被宣布为整体医疗保健方法的重要转变，以造福患者和整个社会。为此,特定的生物标志物小组有助于为患者量身定制的个性化预防和治疗的具有成本效益的预测方法.生物标志物的来源对于诊断测试和治疗目标的特异性和可靠性至关重要。此外，任何诊断方法优先应该是非侵入性的，以增加生物材料的可用性，并降低潜在并发症的风险以及伴随的成本。泪液显然满足了这些要求，这代表了生物标志物面板的宝贵来源。“病态眼”的合理原则使全面的泪液生物标志物分析不仅与眼部病理的诊断高度相关，而且与预测高度相关。预后,和全身性疾病的治疗监测。一个突出的例子是与一系列严重并发症相关的Sicca综合征，包括干眼，神经学，和肿瘤疾病。在这次审查中,突出了泪液中的蛋白质谱，并举例说明了几种相关病理的相应生物标志物，包括干眼症,糖尿病视网膜病变，癌症,和神经系统疾病。相应的分析方法，如样品预处理，差异蛋白质组学，电泳技术,高效液相色谱(HPLC),酶联免疫吸附测定(ELISA),微阵列,和质谱（MS）的方法是详细的。因此,我们提出了基于泪液生物标志物应用于3P医学实践的总体策略。在3P医学的背景下，泪液分析途径被认为是预测疾病发展，以预防措施为目标，并创建针对个人患者特征的治疗算法。
