Abstract：
Different types of refractive surgeries often exhibit differences in wound healing responses. The current study investigated post-operative tear protein profiles in subjects who underwent LASIK and SMILE to elucidate global changes to the proteomic profile during the period the patient cornea undergoes healing. In this study, 10 patients underwent LASIK and SMILE surgery with a contralateral paired eye design. Tear samples were collected using Schirmer\'s strips preoperatively, at 1 month, 3 months and 6 months postoperatively. Quantitative ITRAQ labeled proteomics was performed and the tear protein ratios were normalized to pre-operative protein levels for each subject. Whole proteomics identified 1345 proteins in tears from LASIK and 1584 proteins in SMILE across time points. About 67 proteins were common in LASIK and SMILE tears across all the time points. Wound healing responses were differentially regulated between two refractive surgeries (SMILE and LASIK). The proteins Ceruloplasmin, Clusterin, Serotransferrin were upregulated at 1 month and 3 months and downregulated at 6 months post operatively in LASIK surgery where as in SMILE these were downregulated. Galectin 3 binding protein showed upregulation at 1 month and the levels decreased at 3 months and 6 months postop in LASIK tears whereas the levels increased at 3 months and 6 months post-op in SMILE tears. The levels of proteins that protect from oxidative stress were higher in SMILE as compared to LASIK postoperatively. The extracellular matrix proteins showed an increase in expression at 6 months in SMILE tears and was stabilized at 6 months in LASIK tears post operatively. Different refractive surgeries induce distinct wound healing responses as identified in tears. This study has implications in targeting key proteins for improving the clinical outcome postrefractive surgery.
摘要：
不同类型的屈光手术通常表现出伤口愈合反应的差异。当前的研究调查了接受LASIK和SMILE的受试者的术后泪液蛋白质谱，以阐明在患者角膜愈合期间蛋白质组学谱的整体变化。在这项研究中,10例患者接受了LASIK和SMILE手术，对侧配对眼睛设计。术前使用Schirmer`s条收集泪液样本，在1个月，术后3个月和6个月。进行定量ITRAQ标记的蛋白质组学,并将泪液蛋白比率标准化为每个受试者的术前蛋白水平。全蛋白质组学鉴定了LASIK泪液中的1345种蛋白质和跨时间点SMILE中的1584种蛋白质。在所有时间点，LASIK和SMILE泪液中约有67种蛋白质是常见的。两种屈光手术（SMILE和LASIK）之间的伤口愈合反应受到差异调节。铜蓝蛋白，Clusterin,在LASIK手术中，血清转铁蛋白在术后1个月和3个月时上调，在术后6个月时下调，而在SMILE中这些下调。LASIK泪液中半乳糖凝集素3结合蛋白在1个月时显示上调，在术后3个月和6个月时水平降低，而在SMILE泪液中，在术后3个月和6个月时水平升高。与LASIK术后相比，SMILE中保护免受氧化应激的蛋白质水平更高。细胞外基质蛋白在术后6个月时在SMILE泪液中表达增加，在术后6个月时在LASIK泪液中稳定。不同的屈光手术诱导不同的伤口愈合反应，如在眼泪中所鉴定的。这项研究对靶向关键蛋白质以改善手术后的临床结果具有重要意义。
