glazmagThe EYE ГЛАЗThe EYE GLAZ2222-44082686-8083Академия медицинской оптики и оптометрии10.33791/2222-4408-2025-2-140-147glazmag-664Research ArticleОБЗОРНЫЕ СТАТЬИREVIEWSИзменение состава слезной жидкости при синдроме сухого глаза (обзор литературы)Changes in tear fluid composition in dry eye disease: a literature reviewhttps://orcid.org/0000-0002-7856-8005ЧесноковаН. Б.ChesnokovaN. B.

Чеснокова Наталья Борисовна, доктор биологических наук, профессор, главный специалист отдела патофизиологии и биохимии

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Natalia B. Chesnokova, Dr. Sci. (Biol.), Professor, Сhief Specialist, Department of Pathophysiology and Biochemistry

14/19, Sadovaya-Chernogryazskaya Str., Moscow, 105062

nchesnokova2012@yandex.ruhttps://orcid.org/0000-0001-8032-4248ПавленкоТ. А.PavlenkoT. A.

Павленко Татьяна Аркадьевна, кандидат медицинских наук, начальник отдела патофизиологии и биохимии

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Tatyana A. Pavlenko, Cand. Sci. (Med.), Head of the Department Pathophysiology and Biochemistry

14/19, Sadovaya-Chernogryazskaya Str., Moscow, 105062

tanya1975_@inbox.ruhttps://orcid.org/0000-0001-7557-4955БезносО. В.BeznosO. V.

Безнос Ольга Валерьевна, врач отдела патофизиологии и биохимии

105062, Москва, ул. Садовая-Черногрязская, д. 14/19

Olga V. Beznos, Physician, Department of Pathophysiology and Biochemistry

14/19, Sadovaya-Chernogryazskaya Str., Moscow, 105062

olval2011@mail.ruФГБУ «Национальный медицинский исследовательский центр глазных болезней имени Гельмгольца»РоссияHelmholtz National Medical Center of Eye DiseasesRussian Federation202504072025272140147Copyright © Академия медицинской оптики и оптометрии, 20252025Академия медицинской оптики и оптометрииАкадемия медицинской оптики и оптометрииhttps://www.theeyeglaz.com/jour/about/submissions#copyrightNoticehttps://www.theeyeglaz.com/jour/article/view/664

Актуальность. Распространенность синдрома сухого глаза (ССГ) нарастает во всем мире. Нарушение состава слезной пленки является основной причиной развития этого заболевания. В  последние годы появилось много новых данных о механизмах, участвующих в патогенезе ССГ, что связано с возросшим интересом к слезе как материалу для проведения клинико-диагностических исследований. Цель: представить основные направления исследований биомаркеров ССГ в слезе, их роль в прогнозе, разработке новых методов лечения и мониторинге эффективности терапии ССГ. Материалы и методы. Проведен поиск статей в PubMed с 2000 по 2024 г. Публикации отбирались методом сплошной выборки с использованием ключевых слов: слеза, синдром сухого глаза, синдром Шегрена, биомаркеры, цитокины, окислительный стресс, ферменты, экстраклеточные везикулы, микроРНК, нетоз. В обзор вошло 60 статей. Результаты. Литературные данные об изменении состава слезы при ССГ свидетельствуют о том, что наряду с изменениями, характерными для воспалительного процесса любой этиологии, имеются и специфические особенности. В обзоре представлены сведения об изменениях содержания в слезе маркеров окислительного стресса, апоптоза, протеиназ и их ингибиторов, цитокинов, липидов и нуклеиновых кислот. Характерной чертой ССГ является гиперосмолярность слезы, которая способствует усилению воспаления, активизирует миграцию в слезу нейтрофилов и образование нейтрофильных внеклеточных ловушек. На тяжесть заболевания указывает повышение уровня таких маркеров воспаления, как металлопротеиназа‑9, лактоферрин, миелопероксидаза, эластаза. Есть различия в составе слезы при ССГ, сопровождающем синдром Шергена и без него, которые могут быть использованы для дифференциальной диагностики. Представлены данные о перспективности определения микроРНК в слезе в качестве маркеров тяжести ССГ и с целью дифференциальной диагностики. Заключение. Литературные данные объективно свидетельствуют о том, что компоненты слезы могут быть использованы в качестве биомаркеров в диагностических, прогностических целях и для мониторинга эффективности терапии синдрома сухого глаза. Исследование биомаркеров ССГ позволит осуществлять персонализированный подход к лечению этого заболевания.

Background. The global prevalence of dry eye disease (DED) continues to rise. Alterations in the composition of the tear film are a key factor in the development of this condition. In recent years, a growing body of evidence has emerged on the underlying mechanisms of DED pathogenesis, driven by increasing interest in tear fluid as a material for clinical and diagnostic studies. Purpose: to outline the main research directions concerning tear biomarkers of DED, as well as their role in prognosis, development of novel treatment approaches, and monitoring therapeutic effectiveness. Materials and methods. A literature search was conducted in PubMed for articles published from 2000 to 2024. The selection was carried out using a comprehensive sampling method with the following keywords: tear, dry eye disease, Sjögren’s syndrome, biomarkers, cytokines, oxidative stress, enzymes, extracellular vesicles, microRNAs, NETosis. A total of 60 articles were included in the review. Results. Literature data on tear composition changes in DED indicate the presence of both general inflammatory alterations and disease-specific features. The review summarizes findings on tear content changes involving oxidative stress markers, apoptosis-related factors, proteases and their inhibitors, cytokines, lipids, and nucleic acids. Tear hyperosmolarity is a hallmark of DED, contributing to the enhancement of inflammation, recruitment of neutrophils into the tear film, and the formation of neutrophil extracellular traps (NETs). Elevated levels of inflammation markers such as matrix metalloproteinase-9, lactoferrin, myeloperoxidase, and elastase are indicative of disease severity. Differences in tear composition between Sjögren-related and non-Sjögren DED have diagnostic potential. Furthermore, tear microRNAs show promise as severity markers and differential diagnostic tools in DED. Conclusion. Available literature convincingly demonstrates that tear components can serve as biomarkers for diagnostic, prognostic, and therapeutic monitoring purposes in dry eye disease. The investigation of DED biomarkers paves the way for personalized approaches to the treatment of this condition.

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The authors declare that there are no conflicts of interest present.