Chronic blepharitis is one of the most common conditions seen in the ophthalmologists office but is difficult to treat effectively. The disease is an extremely complex condition that manifests several different and overlapping arrays of signs and symptoms. Symptoms can include crusting of the lid margin, itching and burning eyelids, or lid inflammation and swelling, but signs can also include conjunctival inflammation and localized corneal damage. There is substantial evidence involving meibomian glands in several forms of this disease, especially the glandular lipid secretions. Because the meibomian gland lipid secretions form the outer layer of the tear film, the applicant's research has focused on certain unique characteristics of these lipids.This research project focuses on human subjects rather than animal models. This laboratory is the only one in the world doing lipid biochemical analysis of these secretions in health and disease. Patients with all types of chronic blepharitis are being thoroughly evaluated from a clinical and laboratory standpoint. This has led to the development of a classification system that is based not only on signs and symptoms but also on biochemical and microbial parameters. Evidence to date indicates lipid-lipid, lipid- bacterial, and bacterial exoenzyme-lipid interactions. The basic premise underlying this research is that certain biochemical changes of meibomian gland lipids cause many signs directly, while lipid composition itself predisposes secretions to other changes resulting from microbial activity or other factors. Thus, meibomian secretions are being evaluated biochemically and biophysically to determine the composition and properties of these secretions in normal individuals and in patients with chronic blepharitis. Because samples are small and the lipids are complex, gas chromatography - mass spectrometry is now being employed for analytical purposes. High pressure liquid chromatography is also used in order to achieve effective initial characterizations. Biophysical evaluations will utilize a microscope hot stage as well as techniques to characterize lipid layer film properties. In addition, isolated bacteria have been tested for production of specific exoenzymes such as lipases and esterases which could produce secondary lipid changes. Finally, secondary effects related to drugs and drug therapy will be evaluated since lipid analyses and microbial assays suggest that these may be quite important. Clinical trials will eventually be performed, based on these evaluations, thus permitting the ophthalmologist to select specific therapeutic treatments based on clinical signs and simple biochemical or microbial assays.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY003650-13
Application #
2158885
Study Section
Visual Sciences C Study Section (VISC)
Project Start
1980-08-01
Project End
1997-06-30
Budget Start
1995-07-01
Budget End
1996-06-30
Support Year
13
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of Texas Sw Medical Center Dallas
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
City
Dallas
State
TX
Country
United States
Zip Code
75390
McCulley, James P; Shine, Ward E (2003) Eyelid disorders: the meibomian gland, blepharitis, and contact lenses. Eye Contact Lens 29:S93-5; discussion S115-8, S192-
Ta, Christopher N; Shine, Ward E; McCulley, James P et al. (2003) Effects of minocycline on the ocular flora of patients with acne rosacea or seborrheic blepharitis. Cornea 22:545-8
Shine, W E; McCulley, J P (2000) Association of meibum oleic acid with meibomian seborrhea. Cornea 19:72-4
Shine, W E; McCulley, J P (1998) Keratoconjunctivitis sicca associated with meibomian secretion polar lipid abnormality. Arch Ophthalmol 116:849-52
McCulley, J P; Shine, W (1997) A compositional based model for the tear film lipid layer. Trans Am Ophthalmol Soc 95:79-88; discussion 88-93
Shine, W E; McCulley, J P (1996) Meibomian gland triglyceride fatty acid differences in chronic blepharitis patients. Cornea 15:340-6
Shine, W E; McCulley, J P (1993) Role of wax ester fatty alcohols in chronic blepharitis. Invest Ophthalmol Vis Sci 34:3515-21
Shine, W E; Silvany, R; McCulley, J P (1993) Relation of cholesterol-stimulated Staphylococcus aureus growth to chronic blepharitis. Invest Ophthalmol Vis Sci 34:2291-6
Dougherty, J M; Osgood, J K; McCulley, J P (1991) The role of wax and sterol ester fatty acids in chronic blepharitis. Invest Ophthalmol Vis Sci 32:1932-7
Dougherty, J M; McCulley, J P; Silvany, R E et al. (1991) The role of tetracycline in chronic blepharitis. Inhibition of lipase production in staphylococci. Invest Ophthalmol Vis Sci 32:2970-5

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