Journal of Ophthalmology (Feb 2023)
Lactoferrin concentration in tears of patients with chronic conjunctivitis and effect of Lacto eyedrops in the multicomponent treatment for this disorder
Abstract
Background: Lactoferrin (LF) is a non-heme iron-binding glycoprotein of the transferrin family. It is a natural component of the tear film, has bacteriostatic, bactericidal, fungicidal, antiviral, and antioxidant properties, and thus plays an important role in the protection of the ocular surface from infections. A low tear LF concentration has been found in some ocular disorders, but there have been no reports on the determination of LF concentration in tears of patients with chronic conjunctivitis (CC). Purpose: To determine LF concentration in tears of patients with CC, and to assess the effect of LACTO eye drops in the multicomponent treatment for the disorder. Material and Methods: Eleven patients (17 eyes) with CC were included in the study. Patient age ranged from 27 to 68 years, and the duration of CC, from 3.5 to 7 months. The ophthalmological examination included biomicroscopy of the bulbar conjunctiva and cornea, fluorescein examination, determination of corneal sensation and basal tear production (Schirmer’s II test), and microbiological examination of the conjunctiva. Corneal and conjunctival xerosis was assessed using the method of van Bijsterveld. Patients were administered a topical antiseptic four times daily, preservative-free hyaluronic acid artificial tears four times daily, and Lacto eye drops twice daily over a month. Concentration of LF in the tear samples was determined by a human LF enzyme-linked immunosorbent assay kit before treatment and at day 30 of treatment. Results: Seven patients (11 eyes) underwent an examination after the completion of a one-month treatment with Lacto eye drops. Tear LF concentration (mean ± standard deviation (SD)) in patients with CC was 1.37 ± 0.4 mg/ml (95% confidence interval, 1.16–1.58). The examination found no microbial growth in all these 11 eyes, with 6/7 patients presenting no complaints after treatment. There was no statistically significant change in Schirmer II test values from baseline. Corneal sensation was found to be improved in 6/11 eyes. After a one-month treatment with Lacto eye drops, tear LF concentration (a) decreased from a relatively high (mean ± SD, 1.65 ± 0.45 mg/ml) value at baseline to 1.05 ± 0.33 mg/ml (р = 0.04) in four eyes (eyes nos. 1-4), (b) increased from 1.52 ± 0.21 to 2.03 ± 0.41 gm/ml in other four eyes (eyes nos. 6-8, 11), and (c) increased from a low value (0.85 ± 0.17 mg/ml) to 1.18 ± 0.27 (р = 0.07) in eyes nos. 5, 9, and 11. Conclusion: Lacto eye drops were found to have an immune modulating effect, with any low tear LF at baseline increased in an amount required for normalization of the conjunctival microbiota after treatment. In addition, our microbiological study after one-month administration of Lacto eye drops as a component of therapy for CC demonstrated that the medication provided a sanitizing effect, with no conjunctival microbiota growth but subjective improvement in complaints in all patients.
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