A multi-organ map of the human immune system across age, sex and ethnicity.

Understanding tissue biology's heterogeneity is crucial for advancing precision medicine. Despite the centrality of the immune system in tissue homeostasis, a detailed and comprehensive map of immune cell distribution and interactions across human tissues and demographics remains elusive. To fill this gap, we harmonised data from 12,981 single-cell RNA sequencing samples and curated 29 million cells from 45 anatomical sites to create a comprehensive compositional and transcriptional healthy map of the healthy immune system. We used this resource and a novel multilevel modelling approach to track immune ageing and test differences across sex and ethnicity. We uncovered conserved and tissue-specific immune-ageing programs, resolved sex-dependent differential ageing and identified ethnic diversity in clinically critical immune checkpoints. This study provides a quantitative baseline of the immune system, facilitating advances in precision medicine. By sharing our immune map, we hope to catalyse further breakthroughs in cancer, infectious disease, immunology and precision medicine.

Pilocarpine HCl 1.25% for treatment of presbyopia after laser vision correction: pooled analysis of two phase 3 randomized trials (GEMINI 1 and 2).

PURPOSE: To evaluate the efficacy of topical pilocarpine HCl 1.25% (Pilo) in treating presbyopia in individuals with or without a history of laser vision correction (laser-assisted in situ keratomileusis [LASIK] or photorefractive keratectomy [PRK]). SETTING: Multiple clinical sites. DESIGN: Pooled analysis of 2 identically designed prospective, randomized, vehicle-controlled studies (GEMINI 1 and 2). METHODS: Adults aged 40 to 55 years with presbyopia received once-daily Pilo or vehicle bilaterally for 30 days. Responder rates for ≥3-line improvement in mesopic, high-contrast, binocular distance-corrected near visual acuity (DCNVA) were determined on day 30. RESULTS: Among participants with a history of LASIK/PRK (n = 39 in the Pilo group, n = 41 in the vehicle group), responder rates for ≥3-line improvement in DCNVA on day 30 at hours 0.25, 0.5, 1, 3, 6, 8, and 10, respectively, were 16.7%, 38.9%, 41.7%, 37.8%, 16.2%, 13.9%, and 8.3% with Pilo and 0.0%, 2.6%, 10.5%, 5.1%, 7.7%, 2.6%, and 0.0% with vehicle. Responder rates in the LASIK/PRK subgroup were significantly higher with Pilo than vehicle at hours 0.25 ( P = .0087), 0.5 ( P = .0001), 1 ( P = .0022), and 3 ( P = .0005). In contrast, there were no significant differences in responder rates between Pilo-treated participants with and without LASIK/PRK. Among non-LASIK/PRK participants in the Pilo group (n = 336), responder rates for ≥3-line improvement in DCNVA on day 30 at hours 0.25, 0.5, 1, 3, 6, 8, and 10, respectively, were 16.8%, 32.7%, 39.0%, 28.0%, 17.4%, 12.6%, and 10.5%. CONCLUSIONS: Pilo treatment effectively and similarly improved DCNVA in presbyopes with or without a history of laser vision correction.

Exploring the bioactive potential leaves of Sphaeranthus indicus: Targeting immature stages of Aedes aegypti and Culex quinquefasciatus mosquito vectors through bioassay-guided screening and fraction isolation.

Mosquito control is vital for combating mosquito-borne diseases, but concerns exist regarding the use of synthetic insecticides. This study aimed to explore eco-friendly alternatives derived from natural sources. The larvicidal, pupicidal, and ovicidal activities of various fractions obtained from the hexane leaf extract of Sphaeranthus indicus were investigated against two important mosquito vectors, Aedes aegypti and Culex quinquefasciatus. S. indicus leaves were extracted with hexane and column chromatography was performed with hexane, ethyl acetate, methanol, and their mixtures as eluents. Among the ten fractions (F1-F10) evaluated, fraction 'F-4' exhibited significant activity against third instar larvae, pupae, and eggs of both mosquito species, closely followed by 'F-5' . At a concentration of 10 ppm, 'F-4' achieved 100% mortality in larvae and displayed LC50 values of 5.08 ppm and 5.03 ppm for Ae. aegypti and Cx. quinquefasciatus larvae, respectively. The LC50 values for pupae were 6.12 ppm and 5.83 ppm for Ae. aegypti and Cx. quinquefasciatus, respectively. Regarding ovicidal activity, 'F-4' demonstrated percentages ranging from 63.2% to 64.8% against Ae. aegypti and Cx. quinquefasciatus eggs, respectively. These findings underscore the potent larvicidal, pupicidal, and ovicidal effects of fraction 'F-4' from S. indicus against the targeted mosquito species. Further research is warranted to identify the active compounds responsible for these effects and explore practical applications for sustainable mosquito control strategies.

Mosquito larvicidal, pupicidal and ovicidal effects of the extracts of Peltophorum pterocarpum flowers on Aedes aegypti and Culex quinquefasciatus.

Mosquitoes are the vectors of several diseases like dengue, chikungunya, malaria etc. The three important mosquito species in India are Aedes aegypti, Culex quinquefasciatus and Anopheles stephensi. Several plant extracts have been tested for their anti-mosquito activity. In this dissertation, the larvicidal, pupicidal and ovicidal activities of the successive hexane, chloroform and methanol extracts of Peltophorum pterocarpum (Fabaceae) on mosquitoes are reported. The larvicidal activity of those extracts on both Aedes aegypti and Culex quinquefasciatus mosquitoes was found to be in a decreasing order of hexane, methanol and chloroform - the LC50 values for these extracts were 111.81 and 104.84 ppm, 121.92 and 121.56 ppm, 357.2 and 352.0 ppm respectively. Their pupicidal activity on both mosquitoes was found in the order of methanol, chloroform and hexane - the LC50 values for these extracts being 172.8 and 162.35 ppm, 425.8 respectively. Their ovicidal activity on both mosquitoes was found to be very low, even at the higher concentration of 500 ppm. This is the first report on the effect of the extracts of Peltophorum pterocarpum flowers on the two mosquito species of Aedes aegypti, Culex quinquefasciatus. In the present work, the results showed that the hexane extract had the highest larvicidal activity, while methanol showed the highest pupicidal activity besides larvicidal activity. Hence, the methanol extract holds promise to be used as mosquitocidal agent against the above two vectors.

Evaluating the Effectiveness of Pisonia alba Leaf Extracts in Managing Aedes aegypti and Culex quinquefasciatus Populations via Larvicidal, Pupicidal and Ovicidal Actions.

PURPOSE: The purpose of this study was to evaluate the effectiveness of Pisonia alba Span commonly known as lettuce tree or bird catcher tree leaf extracts in controlling Aedes aegypti and Culex quinquefasciatus mosquitoes, which transmit several severe illnesses, such as dengue, Zika, chikungunya, yellow fever, West Nile virus, lymphatic filariasis and Japanese encephalitis. METHODS: Sequential extraction of P. alba leaves was done using n-hexane, chloroform, and methanol. The larvicidal, pupicidal, and ovicidal activities of the extracts were evaluated against both mosquito species using standard bioassays. The concentrations of the extracts required to kill 50% of the mosquito larvae, pupae, and ova (LC50) were determined. RESULTS: The results showed that the methanol extract of P. alba had significant potential in killing the larvae, pupae, and ova of both mosquito species, with LC50 values of 65.0 and 54.5 ppm for larvicidal activity, 73.7 and 69.7 ppm for pupicidal activity, and 78.4 and 80.0 ppm for ovicidal activity against Ae. aegypti and Cx. quinquefasciatus, respectively. The n-hexane extract demonstrated moderate larvicidal activity, while the n-hexane and chloroform extracts lacked ovicidal activity. CONCLUSION: The methanol extract from Pisonia alba could be a natural and eco-friendly alternative for controlling mosquito populations responsible for transmitting vector-borne diseases. Further research is warranted to determine their practical applications in controlling mosquito populations in the field.

Optimization of biogas production from anaerobic co-digestion of fish waste and water hyacinth.

Many fresh water bodies face a great challenge of an invasive weed called water hyacinth (WH) which has great impacts on the environment, ecology, and society. Food and Agriculture Organization (FAO) estimates that over nine million tons of Fish wastes (FW) are thrown away each year. The fish waste generated poses environmental and health hazards because in most cases it is either disposed into pits or discarded onto the open grounds. Both WH and FW are potential substrates for biogas production. However, utilization of FW substrate alone has a limitation of producing a lot of amounts of volatile fatty acids (VFAs) and ammonia. Their accumulation in the digester inhibits substrate digestion. Consequently, as stand-alone it is not suitable for anaerobic digestion (AD). This can be overcome by co-digestion with a substrate like WH which has high carbon to nitrogen (C/N) ratio prior to biodigestion. Experimental variable levels for biogas were substrate ratio (WH:FW, 25-75 g), inoculum concentration (IC, 5-15 g/250 mL), and dilution (85-95 mL). Design-Expert 13 was used for optimization and results analysis. Response surface methodology (RSM) was used to examine the effects of operating parameters and identify optimum values for biogas yield. Optimum values for maximum biogas with the highest methane yield of 68% were found to be WH:FW ratio, 25:75 g, 15 g of IC, and 95 mL for dilution. The yield was 16% and 32% greater than FW and WH mono-digestion, respectively. The biogas yield was expressed as a function of operating variables using a quadratic equation. The model was significant (P < 0.05). All factors had significant linear and quadratic effects on biogas while only the interaction effects of the two factors were significant. The coefficient of determination (R2) of 99.9% confirmed the good fit of the model with experimental variables.

DNA methylation in regulatory elements of the FKBP5 and NR3C1 gene in mother-child binomials with depression.

BACKGROUND: The FKBP5 and NR3C1 genes play an important role in stress response, thus impacting mental health. Stress factor exposure in early life, such as maternal depression, may contribute to epigenetic modifications in stress response genes, increasing the susceptibility to different psychopathologies. The present study aimed to evaluate the DNA methylation profile in maternal-infant depression in regulatory regions of the FKBP5 gene and the alternative promoter of the NR3C1 gene. METHODS: We evaluated 60 mother-infant pairs. The levels of DNA methylation were analyzed by the MSRED-qPCR technique. RESULTS: We observed an increased DNA methylation profile in the NR3C1 gene promoter in children with depression and children exposed to maternal depression (p < 0.05). In addition, we observed a correlation of DNA methylation between mothers and offspring exposed to maternal depression. This correlation shows a possible intergenerational effect of maternal MDD exposure on the offspring. For FKBP5, we found a decrease in DNA methylation at intron 7 in children exposed to maternal MDD during pregnancy and a correlation of DNA methylation between mothers and children exposed to maternal MDD (p < 0.05). LIMITATIONS: Although the individuals of this study are a rare group, the sample size of the study was small, and we evaluated the DNA methylation of only one CpG site for each region. CONCLUSION: These results indicate changes in DNA methylation levels in regulatory regions of FKBP5 and NR3C1 in the mother-child MDD context and represent a potential target of studies to understand the depression etiology and how it occurs between generations.

Building National Health Security Through a Rapid Self-Assessment and Annual Operational Plan in Uganda, May to September 2021.

Uganda established a National Action Plan for Health Security in 2019, following a Joint External Evaluation (JEE) of International Health Regulations (2005) capacities in 2017. The action plan enhanced national health security awareness, but implementation efforts were affected by limited funding, excess of activities, and challenges related to monitoring and evaluation. To improve implementation, Uganda conducted a multisectoral health security self-assessment in 2021 using the second edition of the JEE tool and developed a 1-year operational plan. From 2017 to 2021, Uganda's composite ReadyScore improved by 20%, with improvement in 13 of the 19 technical areas. Indicator scores showing limited capacity declined from 30% to 20%, and indicators with no capacity declined from 10% to 2%. More indicators had developed (47% vs 40%), demonstrated (29% vs 20%), and sustained (2% vs 0%) capacities in 2021 compared with 2017. Using the self-assessment JEE scores, 72 specific activities from the International Health Regulations (2005) benchmarks tool were selected for inclusion in a 1-year operational plan (2021-2022). In contrast to the 264 broad activities in the 5-year national action plan, the operational plan prioritized a small number of activities to enable sectors to focus limited resources on implementation. While certain capacities improved before and during implementation of the action plan, countries may benefit from using short-term operational planning to develop realistic and actionable health security plans to improve health security capacities.

Uganda's experience in establishing an electronic compendium for public health emergencies.

Uganda has implemented several interventions that have contributed to prevention, early detection, and effective response to Public Health Emergencies (PHEs). However, there are gaps in collecting and documenting data on the overall response to these PHEs. We set out to establish a comprehensive electronic database of PHEs that occurred in Uganda since 2000. We constituted a core development team, developed a data dictionary, and worked with Health Information Systems Program (HISP)-Uganda to develop and customize a compendium of PHEs using the electronic Integrated Disease Surveillance and Response (eIDSR) module on the District Health Information Software version 2 (DHIS2) platform. We reviewed literature for retrospective data on PHEs for the compendium. Working with the Uganda Public Health Emergency Operations Center (PHEOC), we prospectively updated the compendium with real-time data on reported PHEs. We developed a user's guide to support future data entry teams. An operational compendium was developed within the eIDSR module of the DHIS2 platform. The variables for PHEs data collection include those that identify the type, location, nature and time to response of each PHE. The compendium has been updated with retrospective PHE data and real-time prospective data collection is ongoing. Data within this compendium is being used to generate information that can guide future outbreak response and management. The compendium development highlights the importance of documenting outbreak detection and response data in a central location for future reference. This data provides an opportunity to evaluate and inform improvements in PHEs response.

Asymmetric growth-limiting development of the female conceptus.

Introduction: Sex differences in prenatal growth may contribute to sex-dependent programming effects on postnatal phenotype. Methods: We integrated for the first time phenotypic, histomorphological, clinico-chemical, endocrine and gene expression analyses in a single species, the bovine conceptus at mid-gestation. Results: We demonstrate that by mid-gestation, before the onset of accelerated growth, the female conceptus displays asymmetric lower growth compared to males. Female fetuses were smaller with lower ponderal index and organ weights than males. However, their brain:body weight, brain:liver weight and heart:body weight ratios were higher than in males, indicating brain and heart 'sparing'. The female placenta weighed less and had lower volumes of trophoblast and fetal connective tissue than the male placenta. Female umbilical cord vessel diameters were smaller, and female-specific relationships of body weight and brain:liver weight ratios with cord vessel diameters indicated that the umbilico-placental vascular system creates a growth-limiting environment where blood flow is redistributed to protect brain and heart growth. Clinico-chemical indicators of liver perfusion support this female-specific growth-limiting phenotype, while lower insulin-like growth factor 2 (IGF2) gene expression in brain and heart, and lower circulating IGF2, implicate female-specific modulation of key endocrine mediators by nutrient supply. Conclusion: This mode of female development may increase resilience to environmental perturbations in utero and contribute to sex-bias in programming outcomes including susceptibility to non-communicable diseases.

Establishing a Public Health Emergency Operations Center in an Outbreak-Prone Country: Lessons Learned in Uganda, January 2014 to December 2021.

Uganda is highly vulnerable to public health emergencies (PHEs) due to its geographic location next to the Congo Basin epidemic hot spot, placement within multiple epidemic belts, high population growth rates, and refugee influx. In view of this, Uganda's Ministry of Health established the Public Health Emergency Operations Center (PHEOC) in September 2013, as a central coordination unit for all PHEs in the country. Uganda followed the World Health Organization's framework to establish the PHEOC, including establishing a steering committee, acquiring legal authority, developing emergency response plans, and developing a concept of operations. The same framework governs the PHEOC's daily activities. Between January 2014 and December 2021, Uganda's PHEOC coordinated response to 271 PHEs, hosted 207 emergency coordination meetings, trained all core staff in public health emergency management principles, participated in 21 simulation exercises, coordinated Uganda's Global Health Security Agenda activities, established 6 subnational PHEOCs, and strengthened the capacity of 7 countries in public health emergency management. In this article, we discuss the following lessons learned: PHEOCs are key in PHE coordination and thus mitigate the associated adverse impacts; although the functions of a PHEOC may be legalized by the existence of a National Institute of Public Health, their establishment may precede formally securing the legal framework; staff may learn public health emergency management principles on the job; involvement of leaders and health partners is crucial to the success of a public health emergency management program; subnational PHEOCs are resourceful in mounting regional responses to PHEs; and service on the PHE Strategic Committee may be voluntary.

Performance comparison of homologous and heterologous Newcastle disease virus in vaccines and antibody tests.

Antigenic differences between commercial Newcastle Disease Virus (NDV) vaccine and circulating field virus reduce vaccine efficacy. Fifty-layer chickens were divided into five groups: three vaccinated chicken groups using killed LaSota (Genotype II/GII), Mega, or VD (Genotype VII/GVII) viral strains, negative, and positive control groups. On day 28, Hemagglutination Inhibition (HI) serology of vaccinated chickens was performed using whole virus antigens of RIVS, LaSota, Mega, and VD strains. Sera were also tested with an alternative antigen, using an ELISA to detect antibody for the cleavage site F protein peptide from GII and GVII NDV strains. Vaccinated and unvaccinated positive control birds underwent infectious challenges using VD and Mega strains. HI testing showed that antibody titers were higher when tested using homologous antigens than heterologous antigens. ELISA performed with alternative antigens did not perform as well as the established HI test using homologous strains. Viral shedding was reduced by vaccination that was homologous to the infectious challenge in comparison with vaccination using the LaSota strain virus. We conclude that superior results are obtained when serological testing, vaccinations, and vaccine challenge experiments all use circulating strains of ND virus. Implementation of this recommendation would likely reduce viral shedding by vaccinated chickens and be more effective in preventing outbreaks of virulent NDV.

Experimental Neospora caninum Infection in Pregnant Cattle: Different Outcomes Between Inoculation With Tachyzoites and Oocysts.

Neospora caninum is a globally distributed abortifacient protozoan of cattle. Experimental infections with N. caninum in cattle have provided valuable information on host-parasite interaction and immunopathogenesis. Experimental infection of pregnant cows has been reported in about 20 articles, with most studies using cultured parasite tachyzoites as the inoculum. Only three experimental studies have been conducted in pregnant cows using the parasite's oocysts which are shed by dogs, in large part because transmission experiments using oocysts take more time and are more complex and expensive than experiments using tachyzoites. In this minireview, we discuss differences between N. caninum tachyzoites and oocysts as inocula for experimental infection of pregnant cows, as well as the route animals are inoculated.

Message in a Bottle-Metabarcoding enables biodiversity comparisons across ecoregions.

BACKGROUND: Traditional biomonitoring approaches have delivered a basic understanding of biodiversity, but they cannot support the large-scale assessments required to manage and protect entire ecosystems. This study used DNA metabarcoding to assess spatial and temporal variation in species richness and diversity in arthropod communities from 52 protected areas spanning 3 Canadian ecoregions. RESULTS: This study revealed the presence of 26,263 arthropod species in the 3 ecoregions and indicated that at least another 3,000-5,000 await detection. Results further demonstrate that communities are more similar within than between ecoregions, even after controlling for geographical distance. Overall α-diversity declined from east to west, reflecting a gradient in habitat disturbance. Shifts in species composition were high at every site, with turnover greater than nestedness, suggesting the presence of many transient species. CONCLUSIONS: Differences in species composition among their arthropod communities confirm that ecoregions are a useful synoptic for biogeographic patterns and for structuring conservation efforts. The present results also demonstrate that metabarcoding enables large-scale monitoring of shifts in species composition, making it possible to move beyond the biomass measurements that have been the key metric used in prior efforts to track change in arthropod communities.

A GRA2 minimal promoter improves the efficiency of TATi / Tet-Off conditional regulation of gene expression in Toxoplasma gondii.

A tetracycline-responsive transcription system (Tet-Off) adapted for use in Toxoplasma gondii (nicknamed TATi) is useful for molecular biological studies of this organism. Previous studies using TATi incorporated minimal promoters derived from the gene promoters for TgSAG1 or TgSAG4. The present study achieves improved activation and suppression of an integrated reporter gene in the absence and presence of anhydrotetracycline, respectively (p < 0.0001), by use of a newly derived minimal promoter based on the core promoter of TgGRA2. In comparison with the SAG1 minimal promoter, use of the GRA2 minimal promoter in stable transfectants has a 23-fold higher Signal to Noise Ratio for EYFP fluorescence in the absence or presence of anhydrotetracycline. We conclude that the performance of TATi for both activation and suppression of transcription can be markedly enhanced by incorporating a GRA2 minimal promoter.

Antitumor activity via apoptotic cell death pathway of water soluble copper(II) complexes: effect of the diamino unit on selectivity against lung cancer NCI-H460 cell line.

The cytotoxicity against five human tumor cell lines (THP-1, U937, Molt-4, Colo-205 and NCI-H460) of three water soluble copper(II) coordination compounds containing the ligands 3,3'-(ethane-1,2-diylbis(azanediyl))dipropanamide (BCEN), 3,3'-(piperazine-1,4-diyl)dipropanamide (BPAP) or 3,3'-and (1,4-diazepane-1,4-diyl)dipropanamide (BPAH) are reported in this work. The ligands contain different diamine units (ethylenediamine, piperazine or homopiperazine) and two propanamide units attached to the diamine centers, resulting in N2O2 donor sets. The complex containing homopiperazine unit presented the best antiproliferative effect and selectivity against lung cancer cell line NCI-H460, showing inhibitory concentration (IC50) of 58 µmol dm-3 and Selectivity Index (SI) > 3.4. The mechanism of cell death promoted by the complex was investigated by Sub-G1 cell population analysis and annexin V and propidium iodide (PI) labeling techniques, suggesting that the complex promotes death by apoptosis. Transmission electron microscopy investigations are in agreement with the results presented by mitochondrial membrane potential analysis and also show the impairment of other organelles, including endoplasmic reticulum.

Appraising the impact of air transport on the environment: Lessons from the COVID-19 pandemic.

The spread of the COVID-19 disease caused by the respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in unpredicted measures restricting daily flights. Although passenger demand for travel has considerably reduced, the pre-existing impacts of gases generated by aeroplane engines on the environment are still substantial. This paper uses a modelling-based scenario analysis to assess the restriction policies relating to air transport in Argentina, Brazil and Colombia during and after the pandemic and their effects on the environment. The simulation results highlight the need to reduce the negative environmental impact produced by the aviation sector and suggest that policymakers should try to focus on creating ways to reduce the impact made by the aviation industry on the environment, through a coordinated environmental policy between countries, including the three that are the subject of the present case study in order to highlight these issues.

Effect of the hydroxamate group in the antitumoral activity and toxicity toward normal cells of new copper(II) complexes.

The synthesis, physico-chemical characterization and cytotoxicity of four copper(II) coordination complexes, i.e. [Cu(HBPA)Cl2] (1), [Cu(BHA)2] (2), [Cu(HBPA)(BHA)Cl] CH3OH (3) and [Cu(HBPA)2]Cl2·4H2O (4), are reported. HBPA is the tridentate ligand N-(2-hydroxybenzyl)-N-(2-pyridylmethyl)amine and HBHA is the benzohydroxamic acid. The reaction between the HBHA and CuCl2.2H2O has resulted in the new complex (2) and the reaction between complex (1) and HBHA has resulted in the new complex (3). X-ray diffraction studies for complex (3) indicated the effective coordination of HBHA as BHA-. Their cytotoxicity was evaluated against three human tumoral cell lines (Colo-205, NCI-H460 and U937) and PBMC (peripheral blood mononuclear cells), using the MTT cytotoxic assay. The results toward PBMC reveal that the new copper(II) complex (2) presents lower toxicity toward normal cells. Furthermore, complex (2) presents IC50 values lower than cisplatin toward NCI-H460 and the best selectivity index obtained towards NCI-H460 (SI = 2.2) and U937 cell lines (SI = 2.0), as a result of the presence of two molecules of HBHA in its structure. Complex (3) presents IC50 values lower than cisplatin toward NCI-H460, Colo-205 and comparable to cisplatin toward U937. The evaluation of the cell death type promoted by complexes (2) and (4) was investigated toward NCI-H460 revealing better results than the standard drug cisplatin, according to the Annexin V and propidium iodide (PI) labeling experiment. Based on the studies here performed, HBHA seems to be related to lower toxicity toward PBMC and HBPA is improving directly the cytotoxity.

Associations Between Systemic Omega-3 Fatty Acid Levels With Moderate-to-Severe Dry Eye Disease Signs and Symptoms at Baseline in the Dry Eye Assessment and Management Study.

PURPOSE: Omega-3 (n-3) fatty acid supplementation is used to treat systemic inflammatory diseases, but the role of n-3 in the pathophysiology and therapy of dry eye disease (DED) is not definitive. We evaluated the relationship of systemic n-3 levels with signs and symptoms at baseline in the Dry Eye Assessment and Management (DREAM) Study. METHODS: Blood samples from participants at baseline were analyzed for n-3 and n-6, measured as relative percentage by weight among all fatty acids in erythrocytes. Symptoms were evaluated using the Ocular Surface Disease Index. Signs including conjunctival staining, corneal staining, tear breakup time (TBUT), and Schirmer's test with anesthesia were also evaluated. RESULTS: There was no correlation between the systemic n-3 levels and DED symptoms. When the associations with signs of DED were assessed, lower DHA levels were associated with higher conjunctival staining, with mean scores of 3.31, 2.96, and 2.82 for low, medium, and high levels of DHA, respectively (linear trend P=0.007). None of the other signs were associated with DHA or the other measures of n-3. CONCLUSION: Previous studies have found varying results on the role of n-3 supplementation with the signs and symptoms of DED. Among patients with DED enrolled in the DREAM Study, lower systemic n-3 levels were not associated with worse symptoms and most signs of DED.

The spectrum of allergic ocular diseases.

OBJECTIVE: The purpose of this article is to review the pathophysiologic mechanisms, differential diagnosis, evaluation, and treatment of the various manifestations of ocular allergy, with an especial focus on immunoglobulin E (IgE)-mediated disease. DATA SOURCES: A PubMed search was performed to include articles, using the search terms ocular allergy and allergic conjunctivitis. STUDY SELECTIONS: Recent and relevant human studies in the English language pertaining to our topic of study were selected. Animal studies pertaining to pathophysiology of ocular allergy were also reviewed. We focused on clinical trials, practice guidelines, reviews, and systematic reviews. In addition, case reports were reviewed if they described rare clinical presentations, disease mechanisms, or novel therapies. RESULTS: Ocular allergy encompasses both IgE- and non-IgE-mediated disease, and the clinical severity may range from mild to sight-threatening inflammation. A comprehensive treatment regimen including education, lifestyle measures, topical therapies, and even systemic interventions may be necessary for the effective management of ocular allergies, tailored according to symptom severity. CONCLUSION: Ocular allergy is frequently encountered by allergists and eye-care specialists, and despite progressively increasing incidence, it often remains underdiagnosed and, hence, untreated.