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Protective effect of trans-resveratrol against excitotoxic retinal injury: Focus on renin-angiotensin system and adenosine interaction. 反式白藜芦醇对兴奋性视网膜损伤的保护作用:肾素-血管紧张素系统和腺苷的相互作用。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-17 DOI: 10.1016/j.exer.2026.110977
Mohammed Irfan Abdul Malick Sahib, Igor Iezhitsa, Purushotham Krishnappa, Norhafiza Razali, Renu Agarwal

NMDA-mediated excitotoxic retinal injury, altered renin-angiotensin system (RAS) expression and adenosine receptor (AR) signaling are associated with glaucomatous retinal ganglion cells loss. Trans-resveratrol protects against NMDA-induced retinal injury via adenosine receptors. It also alters RAS expressions in relation to cardiovascular functions. However, the mechanistic links among these pathways remain unclear. We hypothesized that the protective effect of trans-resveratrol against NMDA-induced retinal excitotoxicity involves AR mediated regulation of RAS expression. Using a oculonormotensive rat model of NMDA-induced retinal injury, we examined the retinal RAS expression following NMDA exposure with or without trans-resveratrol pre-treatment. To delineate the contribution of AR, effect of trans-resveratrol on retinal RAS expression was studied in the presence of selective adenosine A1 and A2A antagonists. The angiotensinogen, angiotensin II and angiotensin II type 1 receptor expressions were significantly lower in trans-resveratrol pre-treated compared to NMDA-treated group (p < 0.0001). However, the renin expression was significantly greater in trans-resveratrol pre-treated compared to NMDA-treated group (p < 0.05). The alternate RAS proteins including ACE2 and Ang (1-7) showed significantly greater expressions in trans-resveratrol pre-treated compared to NMDA-treated group (p < 0.0001). Overall, trans-resveratrol shifts RAS towards a more active alternate rather than the classical arm. In alignment with these observations, TUNEL staining showed a significantly reduced apoptotic cell count in the ganglion cell layer (GCL) in trans-resveratrol pre-treated compared to NMDA treated group (p < 0.01). Morphological observations showed that it protects against NMDA-induced loss of GCL thickness within inner retina and retinal cell density in GCL (p < 0.01). These effects of trans-resveratrol were abolished by pre-treatment with adenosine A1 but not by A2A receptor antagonist highlighting the role of adenosine-RAS interactions via adenosine A1 receptors in the neuroprotective effect of trans-resveratrol. This study not only clarifies mechanisms underlying the neuroprotective effects of trans-resveratrol but for the first time provides novel insight into adenosine-RAS interactions, which may be explored as potential targets for therapeutic intervention in neurodegenerative conditions.

nmda介导的兴奋性视网膜损伤、肾素血管紧张素系统(RAS)表达和腺苷受体(AR)信号的改变与青光眼视网膜神经节细胞损失有关。反式白藜芦醇通过腺苷受体保护nmda诱导的视网膜损伤。它还会改变与心血管功能相关的RAS表达。然而,机制上的联系仍不清楚。我们假设反式白藜芦醇对nmda诱导的视网膜兴奋性毒性的保护作用涉及AR介导的RAS表达调节。利用正常血压的NMDA诱导的视网膜损伤大鼠模型,我们检测了NMDA暴露后视网膜RAS表达与不含反式白藜芦醇。为了描述AR的作用,在选择性腺苷A1和A2A拮抗剂存在的情况下研究了RAS的表达。与nmda处理组相比,反式白藜芦醇预处理组血管紧张素原、血管紧张素II和血管紧张素II型1受体的表达明显降低(p
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引用次数: 0
Comment on "Sigma-2 receptor modulators alter low-density lipoprotein receptor-mediated lipid uptake in retinal pigment epithelial cells". 对“Sigma-2受体调节剂改变视网膜色素上皮细胞低密度脂蛋白受体介导的脂质摄取”的评论。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-17 DOI: 10.1016/j.exer.2026.110975
Anuradha Mokkapati, Rhushvi Thakkar, Anjna Rani, Dinesh Puri
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引用次数: 0
A Shared Mechanism in Eye Optical Development: Lens Nucleus Centralization in Xenopus laevis. 眼光学发育的共同机制:非洲爪蟾晶状体核集中。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-17 DOI: 10.1016/j.exer.2026.110974
Karla A Garcia, Kelly Ai-Sun Tseng, Irene Vorontsova

Developing eye optics, determined by the lens and cornea, must coordinate with the axial length of growing eyes to focus light onto the retina to form an image. It was found that the lens nucleus in zebrafish (Danio rerio)y initially localized anteriorly in the optical axis of larvae, then centralized at older stages. An anteriorly placed lens nucleus is thought to enable a functional optical system in larvae, where eye axial length is short. To determine if a similar mechanism occurs in other aquatic animals, we studied the clawed frog, Xenopus laevis, a fully aquatic species that similarly relies on vision for survival at stages where eyes are initially small. We found that the tadpole lens nucleus was initially located anteriorly in the optical axis. As development proceeded, it moved to a more centralized location by the prometamorphosis period. Similarly, in eyes regenerated after embryonic ablation, tadpole lens nuclei were anteriorly localized and then centralized before metamorphosis, recapitulating the same pattern as control developing eyes. Moreover, the localization of the lens nucleus in the optical axes in both the developing and regenerated Xenopus eyes correlate with axial eye length. Our findings suggest this could be a shared mechanism for eye optical development in at least two aquatic species. Future studies examining how nucleus centralization modulates lens optical power may reveal key mechanisms that coordinate optical development with axial eye growth. These insights could ultimately inform strategies to prevent or delay refractive errors that arise when these processes become mismatched.

由晶状体和角膜决定的发育中的眼睛光学系统必须与生长中的眼睛的轴向长度相协调,以便将光线聚焦到视网膜上形成图像。研究发现,斑马鱼的晶状体核最初位于幼虫的光轴前部,而在老年阶段晶状体核集中。在眼轴较短的幼虫中,晶状体核的前部被认为使其具有功能性的光学系统。为了确定其他水生动物是否也存在类似的机制,我们研究了爪蛙,非洲爪蟾,一种完全水生的物种,在眼睛最初很小的阶段同样依赖视觉生存。我们发现蝌蚪晶状体核最初位于光轴的前部。随着发育的进行,它在前变态期移到一个更集中的位置。同样,在胚胎消融后再生的眼睛中,蝌蚪晶状体核在变形前先定位,然后集中,与对照发育中的眼睛重复相同的模式。此外,在发育和再生的爪蟾眼中,晶状体核在光轴上的定位与眼轴长度相关。我们的研究结果表明,这可能是至少两种水生物种眼睛光学发育的共同机制。未来研究核集中如何调节晶状体光功率可能揭示协调眼轴发育的关键机制。这些见解最终可以为预防或延迟这些过程不匹配时出现的屈光不正提供策略。
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引用次数: 0
Targeting the cGAS-STING pathway in ophthalmology: from innate immunity to therapeutic innovation. 靶向cGAS-STING通路在眼科中的应用:从先天免疫到治疗创新。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-17 DOI: 10.1016/j.exer.2026.110978
Dan Yan, Weijie Ouyang, Kuanshu Li, Xuguang Sun

The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway is a key mediator of the innate immune response to cytosolic DNA, with growing implications beyond traditional host defense mechanisms. Recent research has linked the abnormal activation of this pathway to a wide range of ocular diseases, such as age-related macular degeneration, diabetic retinopathy, corneal injuries, glaucoma, and ocular tumors. This review examines the multifaceted roles of cGAS-STING signaling in ocular inflammation, tissue degeneration, fibrosis, angiogenesis, and immune surveillance. We emphasize the mechanistic basis through which the cGAS-STING pathway orchestrates various pathological processes across different ocular compartments, from the ocular surface to the retina. Additionally, we discuss its interactions with autophagy, cellular senescence, and cell death, exploring its potential as a therapeutic target in inflammatory and neoplastic eye conditions. Finally, we identify key unresolved questions and outline future research directions aimed at exploiting cGAS-STING modulation for precision therapies in vision-threatening diseases.

环GMP-AMP合成酶-干扰素基因刺激因子(cGAS-STING)途径是对细胞质DNA的先天免疫应答的关键介质,在传统宿主防御机制之外具有越来越多的意义。最近的研究将该通路的异常激活与广泛的眼部疾病联系起来,如年龄相关性黄斑变性、糖尿病视网膜病变、角膜损伤、青光眼和眼部肿瘤。本文综述了cGAS-STING信号在眼部炎症、组织变性、纤维化、血管生成和免疫监视中的多方面作用。我们强调通过cGAS-STING通路协调从眼表面到视网膜的不同眼室的各种病理过程的机制基础。此外,我们讨论了其与自噬、细胞衰老和细胞死亡的相互作用,探索其作为炎症和肿瘤性眼病治疗靶点的潜力。最后,我们确定了尚未解决的关键问题,并概述了未来的研究方向,旨在利用cGAS-STING调节来精确治疗视力威胁疾病。
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引用次数: 0
A Framework of Hybrid Deep Learning and Nature-Inspired algorithms for Accurate Multi-Class Fundus Disease Classification. 基于深度学习和自然启发算法的多类眼底疾病精确分类框架。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-16 DOI: 10.1016/j.exer.2026.110966
Anuj Kumar Parashar, Bambam Kumar

Fundus imaging is an essential technique for detecting anatomical changes indicative of various ophthalmological diseases. These alterations-including changes in the macula, optic disc, fovea, and blood vessels-can signal conditions such as diabetic retinopathy, glaucoma, age-related macular degeneration, cataracts, and myopia. In this paper, we propose a novel hybrid framework for classifying multi-class fundus images by combining deep learning feature extraction with nature-inspired algorithms. Pre-trained ResNet-18 and GoogLeNet architectures are employed to extract features, which are subsequently refined using nature-inspired algorithms including Particle Swarm Optimization, Grey Wolf Optimizer, Differential Evolution, Firefly Algorithm, and Genetic Algorithm. Finally, machine learning classifiers, such as K-Nearest Neighbor, Gaussian Naive Bayes, Support Vector Machine, and Logistic Regression, are applied to the optimized feature sets. Our extensive experiments on the ODIR and RFMiD datasets demonstrate that the proposed framework-specifically the combination of the Firefly Algorithm with K-Nearest Neighbor (FAKNN)-achieves state-of-the-art performance, reaching 100% accuracy, recall, precision, Kappa, F1 score, and Area Under the Curve. This approach not only improves diagnostic accuracy but also demonstrates significant potential for clinical application, facilitating early intervention and better patient outcomes.

眼底成像是检测各种眼科疾病解剖变化的重要技术。这些变化——包括黄斑、视盘、中央窝和血管的变化——可能是糖尿病视网膜病变、青光眼、年龄相关性黄斑变性、白内障和近视等疾病的信号。在本文中,我们提出了一种新的混合框架,将深度学习特征提取与自然启发算法相结合,用于多类眼底图像的分类。采用预训练的ResNet-18和GoogLeNet架构提取特征,随后使用受自然启发的算法进行细化,包括粒子群优化、灰狼优化器、差分进化、萤火虫算法和遗传算法。最后,将k近邻、高斯朴素贝叶斯、支持向量机和逻辑回归等机器学习分类器应用于优化的特征集。我们在ODIR和RFMiD数据集上的大量实验表明,所提出的框架-特别是萤火虫算法与k-最近邻(FAKNN)的结合-达到了最先进的性能,达到100%的准确率,召回率,精度,Kappa, F1分数和曲线下面积。这种方法不仅提高了诊断的准确性,而且显示了显著的临床应用潜力,促进了早期干预和更好的患者预后。
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引用次数: 0
Nrf2 attenuates epithelial-mesenchymal transition of lens epithelial cells in fibrotic cataract via PINK1-mediated mitophagy. Nrf2通过pink1介导的有丝分裂,减弱纤维化性白内障晶状体上皮细胞的上皮-间质转化。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-16 DOI: 10.1016/j.exer.2026.110976
Lijun Wang, Xin Hu, Bo Zhao, Yang Huang, Yao Zhang, Jianhao Bai, Wanru Zhou, Haiying Jin

Oxidative stress plays a critical role in lens fibrosis, and nuclear factor erthroid 2-related factor 2 (Nrf2) is a key antioxidant transcription factor. This study investigates the specific role and underlying mechanism of Nrf2 in fibrotic cataract using in vitro and in vivo models. An in vitro model of fibrotic cataract was established by treating lens epithelial cells (LECs) with TGF-β2 (10 ng/mL). We found that oxidative stress participated in epithelial-mesenchymal transition (EMT) in LECs, concomitant with reduced Nrf2 expression. Moreover, Nrf2 overexpression alleviated oxidative stress, suppressed cell migration, and inhibited EMT. The anterior capsule injury method was utilized to establish a murine model of anterior subcapsular cataract (ASC). In the ASC model, LECs displayed increased oxidative stress and reduced Nrf2 expression. Consistently, Nfe2l2-knockout mice exhibited exacerbated lens fibrosis and higher oxidative stress levels compared to wild-type controls. The mechanism of Nrf2 in lens fibrosis was then investigated by RNA sequencing and validated in LECs in vitro. Our data revealed that Nrf2 promoted PINK1-mediated mitophagy, through which it attenuated oxidative stress and suppressed EMT in LECs. To elucidate how Nrf2 regulates PINK1, the Nrf2 binding sites in the promoter region of PINK1 were predicted using the JASPAR database and subsequently confirmed by both chromatin immunoprecipitation and electrophoretic mobility shift assay. We found that Nrf2 directly binds to the PINK1 promoter to drive its transcription. Collectively, our study suggests that Nrf2 activation mitigates lens fibrosis by promoting PINK1-dependent mitophagy, identifying the Nrf2-PINK1 axis as a potential therapeutic target.

氧化应激在晶状体纤维化中起关键作用,核因子2相关因子2 (Nrf2)是关键的抗氧化转录因子。本研究通过体外和体内模型探讨Nrf2在纤维化性白内障中的具体作用及其机制。采用TGF-β2 (10 ng/mL)处理晶状体上皮细胞(LECs),建立体外纤维化白内障模型。我们发现氧化应激参与了上皮-间质转化(EMT),并伴有Nrf2表达降低。此外,Nrf2过表达可减轻氧化应激,抑制细胞迁移,抑制EMT。采用前囊损伤法建立小鼠前囊下白内障(ASC)模型。在ASC模型中,LECs表现出氧化应激升高和Nrf2表达降低。与野生型对照组相比,nfe2l2基因敲除小鼠表现出晶状体纤维化加剧和氧化应激水平升高。然后通过RNA测序研究Nrf2在晶状体纤维化中的作用机制,并在体外lec中进行验证。我们的数据显示Nrf2促进了pink1介导的线粒体自噬,从而减轻了lec中的氧化应激并抑制了EMT。为了阐明Nrf2是如何调控PINK1的,我们使用JASPAR数据库预测了PINK1启动子区域Nrf2的结合位点,随后通过染色质免疫沉淀和电泳迁移转移实验证实了Nrf2的结合位点。我们发现Nrf2直接与PINK1启动子结合以驱动其转录。总的来说,我们的研究表明Nrf2激活通过促进pink1依赖性的线粒体自噬来减轻晶状体纤维化,并将Nrf2- pink1轴确定为潜在的治疗靶点。
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引用次数: 0
Rapid detection of fluoroquinolone-resistant Staphylococcus epidermidis and its associated mutations in the quinolone resistance-determining region. 喹诺酮耐药区耐氟喹诺酮表皮葡萄球菌的快速检测及其相关突变
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-14 DOI: 10.1016/j.exer.2026.110973
Nobuhiro Kato, Masatoshi Haruta, Rikki Arai, Kazunori Sato, Kei Furushima, Miki Okuno, Takeshi Yamamoto, Yoshitoshi Ogura, Shigeo Yoshida

The purpose of this study was to investigate the relationship between amino acid mutations in the quinolone resistance-determining region (QRDR) of Staphylococcus epidermidis and its susceptibility to fluoroquinolones, as well as the potential of single nucleotide polymorphism (SNP) genotyping for rapid detection of resistant strains. Thirty-three S. epidermidis strains were analyzed (25 from preoperative patients, 8 from keratoconjunctivitis patients). Minimum inhibitory concentrations (MICs) of fluoroquinolones were determined using the broth microdilution method. The QRDR sequences of resistance-related genes (gyrA, gyrB, parC, parE) were analyzed by direct sequencing. SNP genotyping was performed using TaqMan probes targeting conserved regions and mutation sites. The correlation between fluoroquinolone use and mutation counts was analyzed using the Mann-Whitney U test and Spearman's rank correlation test. Fifteen strains showed resistance to fluoroquinolones. Mutations in gyrA, parC, and/or parE were detected in 15 fluoroquinolone-resistant strains. Double mutations in both gyrA and parC were associated with the strongest resistance. Among the 18 non-resistant strains, 17 had no mutations, while one strain had a mutation in parE (Asn404Ser). No mutations were found in gyrB. A significant difference in mutation presence was observed between fluoroquinolone-use and non-use groups (p = 0.026). Additionally, a positive correlation was found between fluoroquinolone use duration and mutation counts (p = 0.025). SNP genotyping was accurate for all strains and successfully identified mutations in gyrA, parC, and parE. The duration of fluoroquinolone use influences mutation counts in the QRDR sequences. Additionally, SNP genotyping is a rapid and effective method for identifying fluoroquinolone-resistant S. epidermidis strains.

本研究旨在探讨表皮葡萄球菌喹诺酮类药物耐药区(QRDR)氨基酸突变与其对氟喹诺酮类药物敏感性的关系,以及单核苷酸多态性(SNP)基因分型快速检测耐药菌株的潜力。分析33株表皮葡萄球菌(术前患者25株,角膜结膜炎患者8株)。采用微量肉汤稀释法测定了氟喹诺酮类药物的最低抑菌浓度。采用直接测序法分析抗性相关基因gyrA、gyrB、parC、parE的QRDR序列。使用TaqMan探针针对保守区域和突变位点进行SNP基因分型。采用Mann-Whitney U检验和Spearman秩相关检验分析氟喹诺酮类药物使用与突变计数的相关性。15株对氟喹诺酮类药物耐药。在15株氟喹诺酮耐药菌株中检测到gyrA、parC和/或parE突变。gyrA和parC的双突变与最强抗性相关。18株非耐药菌株中,17株无突变,1株parE突变(Asn404Ser)。gyrB未发现突变。使用氟喹诺酮和未使用氟喹诺酮组的突变存在显著差异(p = 0.026)。此外,氟喹诺酮类药物使用时间与突变数呈正相关(p = 0.025)。SNP基因分型对所有菌株都是准确的,并成功地鉴定了gyrA、parC和parE的突变。氟喹诺酮类药物使用的持续时间影响QRDR序列的突变计数。此外,SNP基因分型是鉴定耐氟喹诺酮类表皮葡萄球菌的一种快速有效的方法。
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引用次数: 0
Concurrent quantification of oxidized and reduced glutathione and cysteine by targeted mass spectrometry: Applications to ocular tissue biology. 同时定量氧化还原性谷胱甘肽和半胱氨酸通过靶向质谱:应用于眼组织生物学。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-14 DOI: 10.1016/j.exer.2026.110972
Lanpeng Jiang, Renita M Martis, Yongchuan Gu, Melody Tang, Paul J Donaldson, Julie C Lim, Angus C Grey

Glutathione (GSH) and cysteine (Cys) are crucial low-molecular-weight thiol antioxidants that protect ocular tissues from oxidative stress, a key driver of age-related eye diseases. The balance between their reduced (GSH/Cys) and oxidized (GSSG/CySS) forms reflect tissue oxidative status. Despite their importance, existing analytical methods typically quantify these analytes separately, requiring multiple assays. In this work, a robust liquid chromatography-tandem mass spectrometry method for the concurrent quantification of GSH, GSSG, Cys, and CySS in ocular tissues has been developed and validated. The workflow uses derivatization of reduced thiols with monobromobimane, followed by solid-phase extraction and separation using reversed-phase high-performance liquid chromatography with an 8-min gradient elution of acetonitrile and heptafluorobutyric acid. Analytes were detected by positive-ion mode multiple reaction monitoring on a triple quadrupole mass spectrometer and quantified using extracted ion chromatograms. The method demonstrated excellent linearity, precision, and accuracy, with all quality control samples meeting acceptance criteria. Method sensitivity and reproducibility were also validated. Application to human, rat, bovine, and rabbit lenses, as well as rat retina, cornea, aqueous humor, and vitreous humor revealed distinct tissue- and species-specific redox profiles. Rat ocular tissues were found to be in a predominantly reduced state, with reduced thiols at higher concentrations than their oxidized counterparts. Rabbit lenses exhibited the highest GSH concentrations, while human lenses showed lower levels, a finding potentially related to donor age. This method has broad applicability in studies investigating the role of oxidative stress in ocular health and the development of novel treatments to prevent ocular disease.

谷胱甘肽(GSH)和半胱氨酸(Cys)是至关重要的低分子量硫醇抗氧化剂,可保护眼组织免受氧化应激的影响,而氧化应激是与年龄相关的眼病的关键驱动因素。它们的还原(GSH/Cys)和氧化(GSSG/CySS)形式之间的平衡反映了组织的氧化状态。尽管它们很重要,但现有的分析方法通常是单独量化这些分析物,需要多次测定。在这项工作中,建立了一种可靠的液相色谱-串联质谱法,用于同时定量眼部组织中GSH、GSSG、Cys和CySS。该流程使用单溴化烷衍生化还原硫醇,然后使用反相高效液相色谱进行固相萃取和分离,乙腈和七氟丁酸梯度洗脱8分钟。分析物在三重四极杆质谱仪上进行正离子模式多重反应监测,并使用提取的离子色谱进行定量。该方法具有良好的线性度、精密度和准确度,所有质控样品均符合验收标准。验证了方法的灵敏度和重复性。应用于人类、大鼠、牛和兔晶状体,以及大鼠视网膜、角膜、房水和玻璃体,显示出不同组织和物种特异性的氧化还原谱。发现大鼠眼组织处于主要还原状态,还原的硫醇浓度高于氧化的硫醇浓度。兔晶状体的GSH浓度最高,而人晶状体的GSH浓度较低,这一发现可能与供体年龄有关。这种方法在研究氧化应激在眼健康中的作用以及开发新的眼病预防方法方面具有广泛的适用性。
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引用次数: 0
In Memoriam Peter Sol Reinach (1943-2025). 纪念彼得·索尔·莱纳赫(1943-2025)。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-14 DOI: 10.1016/j.exer.2026.110971
Shizuya Saika, Xiangtian Zhou
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引用次数: 0
Molecular mechanisms and pathophysiology of meibomian gland dysfunction. 睑板腺功能障碍的分子机制和病理生理。
IF 2.7 2区 医学 Q1 OPHTHALMOLOGY Pub Date : 2026-03-12 DOI: 10.1016/j.exer.2026.110970
Liu Yang, Zhijie Li

Meibomian gland dysfunction (MGD) is the leading cause of evaporative dry eye disease and arises from failure of a coordinated molecular network that normally maintains meibomian gland homeostasis. In health, endocrine-lipidogenic signaling via peroxisome proliferator-activated receptor-γ (PPARγ) and androgen receptor (AR), trophic pathways such as epidermal growth factor and Hedgehog, a circadian-metabolic axis coupling nicotinamide adenine dinucleotide (NAD+)-dependent steroidogenesis to lipid output, and neuroimmune circuits involving Toll-like receptors and nuclear factor-κB (NF-κB) act together to regulate stem/progenitor maintenance, meibocyte differentiation and lipid secretion. In MGD these axes become progressively uncoupled: hormonal and metabolic stress reduce NAD+ and intracrine androgen production, dampening AR-PPARγ activity; loss of trophic support exhausts basal progenitor pools; and chronic NF-κB-driven inflammation with Th17 and interleukin-33 (IL-33) signaling promotes ductal hyperkeratinization, acinar loss and fibrosis. Lipidomic studies show a shift from cholesteryl esters (CEs) toward free fatty acids, along with remodeling of O-acyl-ω-hydroxy fatty acid (OAHFA) profiles, oxidized lipids and eicosanoids, which stiffen meibum, destabilize the tear film lipid layer and fuel inflammation. Recent single-cell and organoid studies further map cellular heterogeneity and disease-linked lineage changes. Biomarkers such as cholesteryl ester/wax ester ratios, OAHFA profiles, eicosanoids, cytokines and imaging metrics offer read-outs of axis-specific dysfunction. Therapeutically, emerging strategies seek to correct these defects by enhancing AR-PPARγ signaling and NAD+-dependent steroidogenesis, re-engaging trophic pathways, normalizing ductal keratinization with "soft" keratolytics and inhibiting inflammatory circuits. This review integrates these mechanisms, disease networks, biomarker signatures and interventions into a unified model to support mechanism-based, biomarker guided precision care in MGD.

睑板腺功能障碍(MGD)是蒸发性干眼病的主要原因,是由正常维持睑板腺稳态的协调分子网络失效引起的。在健康中,通过过氧化物酶体增殖物激活受体-γ (PPARγ)和雄激素受体(AR)的内分泌-脂质信号,如表皮生长因子和Hedgehog等营养通路,结合烟酰胺腺嘌呤二核苷酸(NAD+)依赖的类固醇生成和脂质输出的生理代谢轴,以及涉及toll样受体和核因子-κB (NF-κB)的神经免疫回路共同作用,调节干细胞/祖细胞维持,代谢细胞分化和脂质分泌。在MGD中,这些轴逐渐不耦合:激素和代谢应激减少NAD+和分泌内雄激素,抑制AR-PPARγ活性;营养支持的丧失耗尽了基底祖细胞池;慢性NF-κ b驱动的炎症与Th17和白细胞介素-33 (IL-33)信号传导促进导管角化过度、腺泡丢失和纤维化。脂质组学研究表明,随着o -酰基ω-羟基脂肪酸(OAHFA)谱的重塑,氧化脂质和二十烷类物质从胆固醇酯(CEs)向游离脂肪酸转变,这些物质使代谢硬化,使撕裂膜脂质层不稳定并加剧炎症。最近的单细胞和类器官研究进一步绘制了细胞异质性和疾病相关谱系变化。生物标志物如胆固醇酯/蜡酯比率、OAHFA谱、类二十烷、细胞因子和成像指标提供了轴特异性功能障碍的读数。在治疗上,新兴的策略试图通过增强AR-PPARγ信号和NAD+依赖性甾体生成,重新参与营养通路,用“软”角化剂使导管角化正常化和抑制炎症回路来纠正这些缺陷。本综述将这些机制、疾病网络、生物标志物特征和干预措施整合到一个统一的模型中,以支持基于机制的、生物标志物引导的MGD精确护理。
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引用次数: 0
期刊
Experimental eye research
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