Dry Eye and Microenvironment

干眼与微环境

• 批准号: 9176495
• 负责人: Anat Galor
• 金额: $ 38.03万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9176495
• 关键词: Address; Affect; Age; Air Pollutants; Air Pollution; Allergens; American; Antioxidants; Area; Cellular Phone; Characteristics; Cities; Climate; Clinic; Clinical; Clinical assessments; Comorbidity; Complex Mixtures; Data; Development; Diet; Disease; Dryness; Econometric Models; Environmental Risk Factor; Epithelial; Epithelium; Ethnic Origin; Exclusion Criteria; Exposure to; Eye; Eye Infections; Fatty Acids; Frequencies; Gases; Gender; Goals; Home environment; Hormonal Change; Humidity; Immunology; Individual; Indoor Air Pollution; Indoor environment; Inflammation; Institutes; Internet; Intervention; Knowledge; Life Style; Light; Literature; Location; Maryland; Measurement; Measures; Modeling; Monitor; Morbidity - disease rate; National Eye Institute; Ophthalmology; Pain; Participant; Particulate Matter; Patients; Pattern; Plant Roots; Production; Public Health; Publishing; Quality of life; Race; Reading; Recruitment Activity; Redwood; Reporting; Research; Role; Seasons; Severities; Signs and Symptoms; Smoking; Source; Swimming; Symptoms; Temperature; Testing; Time; Universities; Vision; Visit; Water; Weight; Work; ambient air pollution; base; case control; cost effective; design; environmental intervention; evaporation; eye dryness; food consumption; hormone therapy; improved; inclusion criteria; indoor exposure; laboratory facility; meetings; novel; ocular pain; persistent symptom; pollutant; prevent; prospective; public health relevance; reduce symptoms; sensor; spatiotemporal; volatile organic compound

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).

项目摘要：干眼 (DE)，其特征为多种症状（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），是一种使人衰弱的疾病 许多患者有持续的症状，因为现有的临床症状。 治疗不足以控制 DE，因此，管理 DE 需要解决方案（即超越个体）。 临床干预水平）。一项新兴文献表明，环境条件可能会导致 DE 的发生和持续存在 我们的微环境是颗粒物 (PM)、气体的复杂混合物。 然而，尚无关于微环境的具体数据。 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 的不同测量方法因空气污染物、过敏原的类型、水平和来源而异， 湿度和温度，特别是与 PM、生物气溶胶和气态污染物的接触有关 分别伴有上皮破坏 (ED)、炎症和泪液蒸发缺乏 (ETD) 2) DE 体征； 相对于室外空气污染，与室内空气污染的相关性更强，因为我们在室内呆的时间更多 我们的室内暴露主导了我们对微环境条件的总暴露，以测试这些。 假设，我们提出前瞻性病例对照设计，我们将从 Bascom 招募 360 名受试者。 帕默眼科研究所（BPEI），连续12年排名美国第一眼科研究所 年，和马里兰大学眼科 - 雷德伍德 (UMOR) 诊所 180 例和年龄， 性别和种族/民族匹配的 180 名对照将在临床检查后确定。 符合纳入标准，并且至少具有 DE 的三种测量指标之一，即 ED、炎症和 ETD 将作为案例，并且控件将不受这些 DE 标志的影响，并且将满足包含标准。 受试者将接受四次临床检查，四个季节各进行一次，以及为期一周的密集空气污染 在临床检查前对他们的家内外进行监控（precise.ccs.miami.edu），我们的。 直读传感器的便携式电池，将测量每个受试者家中一整年的空气污染情况。 在同一周内，参与者将通过网络或电话记录 DE 症状，我们将计算时间-。 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 我们的跨学科团队拥有最先进的临床实验室设施。 DE 评估和暴露评估以及四年来的合作记录。 该项目将产生知识，有可能提供新的家庭环境处理系列 这项研究符合“眼部感染、炎症和免疫学”的优先重点。 国家眼科研究所 (NEI) 的领域。