Dry eye and human tear lipid compositional, conformational and functional relationships using spectroscopy

Abstract

Abstract Purpose Knowledge of the relationships among composition, conformation and function of tear film lipids could facilitate the development of therapies to alleviate symptoms related to meibomian gland dysfunction (MGD) and to diagnose the disease. Toward this goal, we used spectroscopic approaches to assess tear lipid composition and conformation relationships with age, sex and meibomian gland dysfunction. Methods Spectra of meibum from 41 patients diagnosed with MGD (Md) and 27 normal donors (Mn) were acquired. Results 1H‐NMR spectra showed cholesterol esters were found to decrease by 21% with MGD. The number of double bonds/ester increased with age and MGD which indirectly relates to tear film stability. With age, the amount of CH2 groups increased twice as much as the C=C moieties and the C=C/CH2 and CH3/CH2 ratios were related to lipid order and indirectly related to meibum delivery. With the use of MALDI‐TOF MS, we quantified and identified lipid components in Mn and Md such as cholesterol, hydrocarbons and wax esters with a sensitivity of 9 pmoles for each analyte. Sixty‐nine of the 189 resolved peaks were unique to Md spectra compared to Mn spectra and were not due to waxes. Extra peaks in Md spectra may arise from increased lipid synthesis, bacteria or cellular debris. Conclusion It is reasonable that as the lipids become more ordered and more viscous with Md, less lipid flows out of the meibomian gland orifice and more casual lipid is present on the lid margin. The age‐ and disease‐related changes in the physical and chemical characteristics of meibum lipids suggest that the C=C/CH2 and CH3/CH2 ratios may be more important than quantity in relation to tear film stability.