Abstract

Trehalose is a natural disaccharide synthesized in various life forms, but not found in vertebrates. An increasing body of evidence demonstrates exceptional bioprotective characteristics of trehalose. This review discusses the scientific findings on potential functions of trehalose in oxidative stress, protein clearance, and inflammation, with an emphasis on animal models and clinical trials in ophthalmology. The main objective is to help understand the beneficial effects of trehalose in clinical trials and practice, especially in patients suffering from ocular surface disease. The discussion is supplemented with an overview of patents for the use of trehalose in dry eye and with prospects for the 2020s.

Highlights

  • Trehalose is a disaccharide occurring naturally in various life forms, but not found in vertebrates

  • The focus of the present review is to discuss the scientific evidence on the functions of trehalose in oxidative stress, protein clearance, and inflammation, and in animal models related to dry eye

  • Considering the proceedings reviewed in the preceding chapters, all indicators suggest that trehalose will continue to be a topic of intensive research in ophthalmology and other fields of science, maintaining the exponential trend in the number of medical publications (Figure 1) for the 2020s

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Summary

Introduction

Trehalose is a disaccharide occurring naturally in various life forms, but not found in vertebrates. Trehalose is raising increasing interest for the development of various applications in food, cosmetic, and pharmaceutical industries, as reflected by almost an exponential growth in the accumulation of scientific publications (Figure 1). This interest may be explained by the proliferating body of evidence on the bioprotective characteristics of trehalose, its low toxicity, and proceedings in the development of more affordable production technologies. Epithelial surfaces such as the cornea and the conjunctiva of the eye protect the underlying tissues against exogenous threats. The discussion is supplemented with patent data for the use of trehalose in dry eye and with some future prospects

Chemistry and Sources of Trehalose
Trehalose as a Bioprotectant
Inflammatory and Oxidative Stress Signaling
Trehalose in Ocular Surface Physiology
Trehalose in Oxidative Stress Signaling
Trehalose in Autophagy and Inflammation Signaling
Animal Models
Clinical Pilot Studies in Human Subjects
Randomized Controlled Trials
Main Findings for Trehalose
Clinical Trials on Dry Eye
Clinical Trials on Ocular Surgery
Clinical Trials on Tear Film Dynamics
Do We Know the Optimum Concentration?
Trehalose Patents in Dry Eye
Conclusions and an Outlook for Tomorrow
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