Humor Of Patients Research Articles

Proteomic analysis of the aqueous humor in patients with wet age‐related macular degeneration

A number of studies have shown that the levels of some proteins in the aqueous humor (AH) are altered and correlate with the mechanisms or prognosis of many eye diseases. To identify the possible mechanisms that lead to the development of wet age-related macular degeneration (AMD), a proteomic analysis of the AH composition from wet AMD patients was performed and compared with that from non-AMD cataract patients. Six wet AMD and six non-AMD cataract patients were enrolled. A proteomic approach which included two-dimensional electrophoresis coupled with MS and bioinformatics methods were used to identify AH proteins with altered expression in wet AMD compared with non-AMD patients. An ELISA was used to validate the proteomic results. We separated 78 protein spots and identified 68 that were differently expressed in the wet AMD group and controls. Numerous proteins identified in this study are implicated in inflammation, apoptosis, angiogenesis, and oxidative stress. The AH protein composition was significantly different between wet AMD and non-AMD patients. The proteins identified in this study may be potential biomarkers of wet AMD development and might play a role in the mechanisms of wet AMD.

The Use of Humor in Patients With Recurrent Ovarian Cancer

Humor has been shown to decrease the use of pain medicine, improve mood, and decrease stress. However, the timing and setting for using humor can be perceived differently depending on the patient and the context. Our objective was to better understand how patients with recurrent ovarian cancer experience humor to gain insight into the feasibility of using humor as a therapeutic adjunct. We conducted structured patient interviews with women being treated for recurrent ovarian cancer. The phenomenological method of Colaizzi was used to gain an in-depth understanding of how women with recurrent ovarian cancer use and view humor in relation to their diagnosis. Most patients used humor to cope with cancer and felt that humor alleviated their anxiety. The use of humor by physicians and nurses was perceived as appropriate and positive. A previous relationship with a physician was often felt necessary before the use of humor. Humor was often perceived not only in traditional jokes but was also found in humorous anecdotes from the caregiver's life outside of medicine. This study revealed that humor is an often used coping mechanism for women with recurrent ovarian cancer and subjectively helps alleviate anxiety. The use of humor by physicians was found to be universally perceived as appropriate and positive. The waiting area seems to be a place where humorous experiences would be welcomed. These findings provide additional insight into the role that humor plays in the lives of patients with recurrent ovarian cancer.

Asymmetric Dimethyloarginin (ADMA) Concentration in the Aqueous Humor of Patients with Exfoliation Syndrome or Exfoliative Glaucoma

Background: Asymmetric dimethyloarginin or dimethylarginin (ADMA) is a marker and maker of oxidative stress. It is elevated in several pathological conditions, such as hyperhomocysteinemia and endothelial dysfunction, which have also been reported in patients with exfoliation syndrome (XFS), or exfoliative glaucoma (XFG). We evaluated ADMA levels in the aqueous humor of XFS and XFG patients.Methods: This study included 48 aqueous samples; 16 from cataract patients with XFS, 16 from cataract patients with XFG and 16 from age-matched cataract control patients. ADMA levels were determined employing a commercial ELISA kit. Results: ADMA concentration was significantly greater in XFG patients (0.398 ± 0.026 μM) compared to either XFS (0.168 ± 0.028 μM; p < 0.0001) or normal cataract controls (0.245 ± 0.025 μM; p = 0.0002). In contrast, no significant difference was detected for ADMA levels in the aqueous of XFS patients as compared to normal controls (p = 0.0477).Conclusions: Aqueous humor ADMA concentration is significantly elevated in XFG patients supporting the view that oxidative stress plays a key role in XFG pathobiology. The lower level of this marker in XFS suggests that the development of XFG is a prerequisite for ADMA elevation.

Simultaneous increases in multiple proinflammatory cytokines in the aqueous humor in pseudophakic glaucomatous eyes

To evaluate cytokine and growth factor levels in the aqueous humor in patients with open-angle glaucoma (OAG). Kumamoto University Hospital, Kumamoto, Japan. Cross-sectional cohort study. Aqueous humor samples were collected from cataract cases and OAG cases. Aqueous levels of cytokines and growth factors were determined by multiplex immunoassay. The data were analyzed using the Tukey-Kramer honestly-significant-difference test and multiple regression analyses. The study evaluated 52 cataract cases and 73 OAG cases. In the cataract cases, the mean interleukin (IL)-6, IL-8, monocyte chemotactic protein (MCP)-1, tumor necrosis factor-α, epidermal growth factor, vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-AA, PDGF-AB/BB, and VEGF levels (all pg/mL) were 21.4, 4.6, 829.4, 0.8, 0.5, 33.8, 1.6, and 77.9, respectively. In 23 phakic primary OAG (POAG) and 26 phakic exfoliation glaucoma cases, the corresponding values were 15.1 and 8.3, 15.2 and 12.3, 1142.5 and 1253.9, 0.3 and 0.5, 1.5 and 1.4, 57.7 and 58.0, 2.5 and 3.3, 37.4 and 59.7, respectively. In pseudophakic OAG cases, the IL-8 levels for exfoliation glaucoma (P=.0002) and MCP-1 for POAG (P=.0008) and exfoliation glaucoma (P<.0001) were significantly different compared with phakic OAG. Interleukin-6, IL-8, and MCP-1 levels were correlated (P<.0001). Multiple regression analyses showed the highest association of pseudophakic status with IL-8 and MCP-1 levels (P=.0002 and P<.0001, respectively). The OAG patients, especially those with pseudophakic eyes, had simultaneous cytokine level increases, suggesting the aqueous humor microenvironment is altered in pseudophakic glaucomatous eyes. No author has a financial or proprietary interest in any material or method mentioned.

Serotonin and hydroxyindolacetic acid levels in aqueous humor of patients with primary open-angle glaucoma

AbstractPurposeTo investigate the levels of 5-HT (serotonin, 5-hydroxytryptamine) and 5-HIAA (5-hydroxyindolacetic acid) in the aqueous humor and plasma of subjects with primary open-angle glaucoma (POAG) and to correlate their concentrations with the severity of glaucoma.MethodsThirty-five patients with POAG and 30 patients with senile cataract (control group) of matched age and gender were included in the study prospectively. Aqueous humor samples were obtained by paracentesis from glaucoma and cataract patients who were undergoing elective surgery. Aqueous humor and corresponding plasma samples were analyzed for 5-HT and 5-HIAA levels by high performance liquid chromatography with electrochemical detection.Results5-HT and 5-HIAA levels were significantly higher in the aqueous humor of POAG patients than in that of the comparative group of cataract patients. There was no significant difference in the 5-HT and 5-HIAA levels in plasma of POAG and cataract patients. A positive correlation was found between 5-HT and 5-HIAA in the aqueous humor of POAG patients. The 5-HT turnover (5-HIAA/5-HT) was higher in POAG than in cataract patients, but the difference was not significant. No significant correlation was found between levels and severity of visual field loss.ConclusionIncreased levels of 5-HT and 5-HIAA aqueous humor may be associated with POAG.

Matrix metalloproteinases and inhibitors in aqueous humor of patients with open angle neovascular glaucoma

Matrix metalloproteinases and inhibitors in aqueous humor of patients with open angle neovascular glaucoma

Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis

Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis

Increased levels of vascular endothelial growth factor in aqueous humor of patients with diabetic retinopathy: Is it the whole truth?

Increased levels of vascular endothelial growth factor in aqueous humor of patients with diabetic retinopathy: Is it the whole truth?

Surface Tension of Aqueous Humor

To measure and compare the surface tension of aqueous humor in patients with and without glaucoma. The surface tension of aqueous humor was measured using a commercially available instrument and software that were validated by using a known fluid (deionized water and methanol). Analysis of aqueous and vitreous samples obtained from 20 rabbit eyes showed that the system could be used successfully for small amounts of ocular fluid. The effect of glaucoma drugs on the surface tension of aqueous humor was then studied in a rabbit model. Comparison of aqueous humor from 66 patients with glaucoma and 53 patients with cataracts but no glaucoma was carried out. The surface tension of rabbit aqueous humor was 65.9 ± 1.2; vitreous, 60.6 ± 2.6; and balanced salt solution, 70.7 ± 0.9. Timolol and latanoprost did not alter the surface tension of the aqueous humor in the rabbit model. The average surface tension of human aqueous humor was 63.33 ± 4.0 (glaucomatous eyes) and 66.19 ± 2.64 (nonglaucomatous eyes with cataracts) (P=0.0001). A technique of measuring the surface tension from small quantities of aqueous humor is validated. Surface tension of the aqueous humor in glaucoma patients was less than that of cataract patients.

Aqueous humor redox potential in pseudoexfoliation syndrome

Abstract Purpose To determine the overall oxidative status of the aqueous humor in patients with pseudoexfoliation syndrome, by measuring the reduction‐oxidation (redox) potential in the aqueous samples. Methods Samples were collected during cataract extraction from 13 patients with pseudoexfoliation syndrome and 22 normal patients. A platinum electrode together with a reference electrode Ag/AgCl/KCl was used for the measurement of the apparent redox potential in the aqueous humor. Ten measurements were taken every five minutes from the acquisition of the sample and the average value of the measurements was recorded. The independent samples t‐test was used to compare aqueous redox potential between the study and control group. Statistical significance was set at 0.05. Results The redox potential was found significantly higher in patients with pseudoexfoliation syndrome than in normal patients (p&lt;0.05). Conclusion Measurements of redox potential is an accurate, easy, time‐saving method for evaluating the oxidative situation in the aqueous humor. Redox potential was found significantly higher in the aqueous humor of the study group. These results support the role of increased oxidative stress in the development of pseudoexfoliation syndrome and suggest for the first time in the field of Ophthalmology a direct and convenient technique for the determination of the oxidative status in aqueous humor.

Plasma and Aqueous Humor Angiotensin-Converting Enzyme Levels in Patients with Diabetic Retinopathy

Purpose: To assess angiotensin-converting enzyme (ACE) levels in aqueous humor and plasma of patients with nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) as another potent ischemia-induced angiogenic factor.Methods: The clinical comparative study included 40 patients with diabetic retinopathy and 16 healthy subjects. For all patients, aqueous humors were collected during the cataract surgery or intravitreal injection of triamcinolone acetonide. ACE levels were measured using a solid-phase chemiluminescence immunoassay.Results: We observed significantly elevated ACE level in aqueous humor of patients with PDR compared with the patients with NPDR and normal subjects (P = 0.023), but no significant difference was detected between nonproliferative diabetics and control group (P = 0.239). There was no significant difference in plasma ACE levels among diabetic and control groups (P = 0.816).Conclusion: Elevated ACE level may induce retinal angiogenesis and proliferative retinopathy in patients with DM. We consider that high levels of ACE in aqueous humor can reflect the association between retinal angiogenesis and DM serve as predictor in the progression of diabetic retinopathy.

Lactate dehydrogenase and oxidative stress activity in primary open-angle glaucoma aqueous humour.

Lactate dehydrogenase (LDH) and lactate are some of the hypoxy biochemical parameters. Extracellular activity of this enzyme increases under the condition of oxidative stress, since the cell integrity can be disrupted during the lipid peroxidation process. Subsequently that leads to the increase level of the lactic acid and lactic acid salts. The objective of this investigation is establishing the level of LDH, LDH1 (HBDH) and the lactate concentration in aqueous humour in patients with primary open-angle glaucoma. Biochemical analysis have been made by enzymatic-colometric method (lactate) and UV-kinetic method (LDH and HBDH) in aqueous humour of 30 patients (42 eyes) with primary open-angle glaucoma (POAG) and 30 patients (40 eyes) with cataract (the control group). The increased values of lactate and the activity of LDH and HBDH enzyme in aqueous humour of POAG patients in correlation with the control group are the results not only of oxidative stress but also of hypoxy and the mitochondry oxidative function (p<0,001). The increased activity of the examined biochemical parameters in the aqueous humour of the POAG patients points to the fact that other mechanisms, besides IOP, have a role in glaucoma pathogenesis.

Antioxidant Status Modifications by Topical Administration of Dorzolamide in Primary Open-Angle Glaucoma

This study deals with the role of the topical administration of dorzolamide eyedrops on the oxidative/antioxidant status of aqueous humor in patients with primary open angle glaucoma (POAG). A case-control study including 130 patients distributed into three groups was carried out: 1) patients with POAG without dorzolamide instillation administration (GG; n=34); 2) patients with POAG with dorzolamide (DG; n=36); and 3) subjects with cataracts (comparative group, CG; n=60). Oxidative activity was measured in the aqueous humor by malondialdehyde determination by the thiobarbituric acid reactive substances assay. Antioxidant status was assessed in the aqueous humor samples by measuring the superoxide dismutase activity and the total antioxidant status. Oxidative activity was significantly higher in both glaucoma groups than in the cataracts group (GG vs CG, p=3.68 E-34; DG vs CG, p=5.11 E-45) and was significantly higher in GG than in DG (p=0.0034). SOD activity was significantly higher in both glaucoma groups than in the cataracts group (GG vs CG, p=1.08 E-14; DG vs CG, p=3.70 E-22), and was significantly higher in GG than in DG (p=0.018). Finally, total antioxidant status was significantly decreased in both glaucoma groups compared with the cataracts group (GG vs CG, p=2.51 E-12; DG vs CG, p=5.06 E-05), and was more significantly decreased in GG than in DG (p=9.23 E-07). Topical administration of dorzolamide colirium diminishes oxidative stress in patients with glaucoma.

Differences in retinal neovascular tissue and vitreous humour in patients with type 1 and type 2 diabetes

Aims:The aim of the study was to evaluate the histopathology of neovascular tufts and vitreous samples collected from patients with diabetes.Methods:Vitreous samples and neovascular tufts were collected from patients with...

Oxidative Stress Markers in Aqueous Humor of Patients with Senile Cataracts

Purpose: To investigate the levels of oxidative stress markers in human eyes with senile cataracts. Methods: We conducted a retrospective, case-controlled study of 57 patients with senile cataracts. To assess oxidative stress markers in the eye, we measured the enzymatic activities of superoxide dismutase (SOD) and catalase (CAT) as well as the total protein levels in aqueous humor. Results: In aqueous humor, SOD and CAT activity levels were 0.133 ± 0.020 and 1.223 ± 0.081 U/ml, respectively; protein levels were 2.372 ± 0.166 mg/ml (means ± SEM). We observed a significant increase in SOD activity and the protein level in progressed nuclear cataracts. No significant age-associated difference in antioxidant enzyme levels was detected. Conclusion: Significant increases in the levels of SOD activity and total protein correlated with the severity of the cataract but not with patient age, suggesting that progressed cataract is associated with molecules leaking from the lens capsule.

Association of varicella zoster virus load in the aqueous humor with clinical manifestations of anterior uveitis in herpes zoster ophthalmicus and zoster sine herpete

Aim:To investigative whether clinical manifestations of anterior uveitis are associated with the viral load of varicella zoster virus (VZV) in the aqueous humor in patients with herpes zoster ophthalmicus (HZO)...

Infectious Uveitis in Immunocompromised Patients and the Diagnostic Value of Polymerase Chain Reaction and Goldmann-Witmer Coefficient in Aqueous Analysis

To establish the causes of uveitis in immunocompromised patients and to determine the contribution of polymerase chain reaction (PCR) and Goldmann-Witmer coefficient (GWC) analysis of aqueous humor in patients with an infectious etiology. Retrospective case series of 56 consecutive immunocompromised patients with uveitis. All patients underwent full ophthalmologic examination and laboratory blood analysis for uveitis. Aqueous humor analyses were performed using PCR and GWC for cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), and Toxoplasma gondii. Of 56 immunocompromised patients, 43 (77%), all posterior and panuveitis, had intraocular infections. Twenty-one (49%) had CMV, three (7%) had VZV, 11 (26%) had T. gondii, six (14%) had Treponema pallidum, and one (2%) each had Aspergillus and Candida. In AIDS patients, CMV was the most common cause. A strong correlation between AIDS and ocular syphilis was also observed (P = .007). In nonAIDS immunocompromised patients, T. gondii was most frequently detected. Twenty-seven patients were examined by both PCR and GWC; five (18.5%) were positive by both assays, 15 (55.5%) were positive by PCR alone and seven (26%) by GWC alone. Viral infections were detected by PCR in 16 of 17 (94%) cases; T. gondii in four of 10 (40%) patients. Using GWC, a viral infection was diagnosed in three of 17 (18%) and T. gondii in nine of 10 (90%) cases. In immunocompromised patients, PCR is superior in diagnosing viral infections. Analysis of intraocular antibody production played a decisive role in the diagnosis of ocular toxoplasmosis.

Endothelin-1-Mediated Signaling in the Expression of Matrix Metalloproteinases and Tissue Inhibitors of Metalloproteinases in Astrocytes

Endothelin (ET)-1 levels are increased in aqueous and vitreous humor in patients with glaucoma and animal models of glaucoma. Whether the elevated ET-1 induces extracellular matrix (ECM) remodeling in the optic nerve head is still unknown. In the present study, the regulation of matrix metalloproteinases/tissue inhibitors of matrix metalloproteinases (MMPs/TIMPs) and ECM remodeling in ET-1-activated human optic nerve head astrocytes (hONAs) were determined. Primary hONAs were exposed to ET-1 for 1 day and 4 days. Incubation media were subjected to zymography and Western blot to detect activity and expression of MMPs and TIMPs. Fibronectin (FN) was monitored by Western blot and immunofluorescent staining. ET-1 increased the activity of MMP-2 and the expression of TIMP-1 and -2 in hONAs. The expression of TIMP-1 and -2 induced by ET-1 was abolished by application of inhibitors of mitogen-activated protein kinase (MAPK) or PKC, leading to enhanced activity of MMP-2. Knockdown of MMP-2, by using small interfering (si)RNA, not only decreased the activity of MMP-2 but also decreased the expression of TIMP-1 and -2. ET-1 increased the soluble (s)FN expression as well as FN matrix formation. However, the accumulation of sFN did not enhance FN matrix formation. Unlike ET-1's effects on MMP-2, blockade of MAPK and PKC did not alter the expression and deposition pattern of FN in hONAs. ET-1 increased the expression and activity of MMP-2 and TIMP-1 and -2. The ERK-MAPK and PKC pathways are involved in the regulation of expression of MMP-2 and TIMP-1 and -2. ET-1's effects on MMPs/TIMPs may be important, not only in regulating the expression of MMPs and TIMPs, but also in influencing ECM remodeling.

Detection of Herpes Simplex virus DNA and Varicella Zoster virus DNA in aqueous humor of patients with corneal endothelitis by polymerase chain reaction

目的 评价聚合酶链反应技术(PCR)对角膜内皮炎的诊断价值,并以此解释病因,指导临床治疗.方法对临床诊断为角膜内皮炎的患者12例(12眼)及临床诊断为年龄相关性白内障的患者15例(15眼)分别用PCR方法进行房水中单纯疱疹病毒Ⅰ型(HSV-Ⅰ)DNA及带状疱疹病毒(VZV)DNA的检测,结果采用分类变量资料两样本率比较的四格表确切概率比较.结果共扩增角膜内皮炎患者12例(12眼),HSV-Ⅰ阳性者5例(5眼),阳性率为41.67%,共扩增对照组15例(15眼),HSV-Ⅰ阳性者0例,阳性率为0%,二者差异有显著性.结论PCR技术检测角膜内皮炎患者房水中的HSV-Ⅰ,可在分子水平上建立一种快速准确的诊断方法,为临床治疗提供可靠的依据。

This issue of Acta

This issue of Acta