Dry Eye and Microenvironment

项目概述：干眼症（DE），其特征在于无数的体征（例如泪液分泌减少， 蒸发增加和炎症）和症状（例如疼痛，视力模糊和干燥），是一种使人衰弱的 影响生活质量的疾病。许多患者有持续的症状，因为可用的临床 治疗不足以管理DE。因此，管理DE需要解决方案（即超越个人- 临床干预）。一项新的文献表明，环境条件可能有助于 DE的发作和持续性。我们的微环境是一个复杂的混合物颗粒物（PM），气体 空气污染物和过敏原。然而，没有关于微环境的个体特定数据。的 该项目将测试两个新的假设：1）临床表现，通过类型和严重程度来衡量 DE的不同措施，在空气污染物，过敏原， 湿度和温度，特别是暴露于PM，生物气溶胶和气态污染物是相关的 分别伴有上皮破裂（艾德）、炎症和蒸发性泪液缺乏（ETD）; 2）DE征 相对于室外空气污染， 我们的室内暴露在微环境条件的总暴露中占主导地位。测试这些 假设，我们提出了一个前瞻性的病例对照设计。我们将从巴斯科姆招募360名受试者 帕尔默眼科研究所（BPEI），在过去的12年里连续被评为美国第一眼科研究所。 年，和马里兰州大学眼科-红木（UMOR）诊所。180例， 性别和种族/民族匹配的180名对照将在临床检查后确定。的受试者 符合入选标准，并且具有DE的三个指标中的至少一个，即艾德、炎症和 ETD将作为病例，对照将无这些DE体征，并符合入选标准。每个 受试者将接受四次临床检查，四季各一次，以及为期一周的强烈空气污染 在临床检查之前，在家中和家中进行监测。PRECISE（precise.ccs.miami.edu），我们的 便携式电池的直接读取传感器，将测量空气污染在每个受试者的家中整整一年。 在同一周内，参与者将通过网络或电话记录DE症状。我们会计算时间- 加权室内和室外暴露，并使用以下模型模拟暴露对DE体征和症状的影响 空间计量经济模型我们的跨学科团队拥有最先进的实验室设施， 评估DE和暴露评估以及四年来的合作跟踪记录。这 项目将产生的知识，将有可能提供一个新的路线，以家庭为基础的环境处理 管理DE。这项研究符合“眼部感染，炎症和免疫学”的优先顺序 国家眼科研究所（NEI）

Project Summary: Dry eye (DE), characterized by a myriad of signs (e.g. decreased tear production, increased evaporation, and inflammation) and symptoms (e.g. pain, blurry vision and dryness), is a debilitating disease that affects quality of life. Many patients have persistent symptoms, because the available clinical therapies are not adequate to manage DE. Thus, managing DE requires solutions (i.e. beyond individual- level clinical interventions). An emerging literature suggests that environmental conditions can contribute to the onset and persistence of DE. Our microenvironment is a complex mixture of particulate matter (PM), gaseous air pollutants and allergens. However, individual specific data on microenvironment are not available. The project will test two novel hypotheses: 1) the clinical manifestations, measured by the types and severity of different measures of DE, vary with respect to types, levels and sources of air pollutants, allergens, humidity and temperature, specifically, exposure to PM, bioaerosols and gaseous pollutants is associated with epithelial disruption (ED), inflammation and evaporative tear deficiency (ETD), respectively; 2) DE signs are more strongly associated with indoor relative to outdoor air pollution, as we spend more time indoors and our indoor exposure dominates our total exposure to microenvironmental conditions. To test these hypotheses, we propose a prospective case-control design. We will recruit 360 subjects from Bascom Palmer Eye Institute (BPEI), ranked as the number 1 eye institute in the US consecutively for the past 12 years, and University of Maryland Ophthalmology – Redwood (UMOR) clinics. 180 cases and age-, gender- and race/ethnicity-matched 180 controls will be determined after their clinical exams. Subjects who meet the inclusion criteria and have at least one of the three measures of DE, namely ED, inflammation, and ETD, will serve as cases, and controls will be free from these DE signs, and will meet inclusion criteria. Each subject will undergo four clinical exams one in each of the four seasons, and a weeklong intensive air pollution monitoring inside and outside their homes before the clinical exam. PRECISE (precise.ccs.miami.edu), our portable battery of direct-reading sensors, will measure air pollution in each subject's home for one full year. Over the same week, participants will record DE symptoms through web or phone. We will calculate time- weighted indoor and outdoor exposures, and model the effects of exposure on DE signs and symptoms using spatial econometric models. Our interdisciplinary team has the state-of-the-art laboratory facilities for clinical assessment of DE and exposure assessment as well as a collaborative track-record over four years. This project will generate knowledge that will potentially provide a new line of home-based environmental treatment to manage DE. This research aligns with the “ocular infection, inflammation and immunology” priority areas of the National Eye Institute (NEI).