title: Establishing the tolerability and performance of tamarind seed polysaccharide (TSP) in treating dry eye syndrome: results of a clinical study.
abstract: BACKGROUND
  One of the problems arising from available preparations for dry eye syndrome is the limited residence time of products on the ocular surface. In this paper, we look at an innovative new treatment for dry eye, tamarind seed polysaccharide (TSP). TSP possesses mucomimetic, mucoadhesive and pseudoplastic properties. The 'mucin-like' molecular structure of TSP is similar to corneal and conjunctival mucin 1 (MUC1), a transmembrane glycoprotein thought to play an essential role in protecting and wetting the corneal surface and may explain its increased retention on the eye surface.
  
  
  METHODS
  The activity of TSP and hyaluronic acid (HA) in the treatment of dry eye syndrome was compared in an open-label, randomised, single-centre clinical study. Thirty patients were randomised to receive three or more applications per day of either TSP 0.5%, TSP 1% or HA 0.2% (Hyalistiltrade mark) over a period of 90 days. The primary objective of tolerability was assessed by visual analogue scale (VAS), scoring of specific symptoms and the incidence of adverse events. Secondary objectives included improvement in stability of the precorneal tear film, subjective symptoms and corneal and conjunctival staining.
  
  
  RESULTS
  TSP 0.5% and 1% were comparable to HA 0.2% with regard to both primary and secondary objective parameters.TSP 1% showed benefits over HA 0.2% for the subjective symptoms; trouble blinking, ocular burning and foreign body sensation.
  
  
  CONCLUSIONS
  This study suggests that TSP 0.5% and 1% offer at least equivalent relief to HA 0.2% for dry eye syndrome. All treatments demonstrated optimal tolerability and are suitable for frequent use in the therapy of dry eye.TSP 1% produced promising results in terms of improvements in certain patient symptoms and suggests benefits of the TSP formulation. This study paves the way for a larger study to further establish the performance and safety of TSP compared with HA and highlights the need to expand this therapeutic agent to a wider dry eye population.
authors: Ocular Surface Unit, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Largo R, Benzi 10, 16132 Genoa, Italy. mrolando@unige.it
authors: Maurizio
authors: M
authors: Rolando
authors: Cristiana
authors: C
authors: Valente
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000473:pathology; D003315:Cornea / Q000473:pathology; D004334:Drug Administration Schedule; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D011134:Polysaccharides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D012639:Seeds / Q000737:chemistry*; D013194:Staining and Labeling; D029861:Tamarindus / Q000737:chemistry*; D013666:Tears / Q000378:metabolism
chemical_list: D011134:Polysaccharides; D006820:Hyaluronic Acid