title: Diquafosol sodium ophthalmic solution for the treatment of dry eye: clinical evaluation and biochemical analysis of tear composition.
abstract: OBJECTIVE
  To evaluate the clinical efficacy of 3% diquafosol sodium ophthalmic solution for dry eye, and to analyze the concentration of tear proteins and mucin-like substances after the treatment.
  
  
  METHODS
  Fifty eyes of 25 patients with dry eye syndrome were prospectively enrolled. The patients were treated with diquafosol solution at a dose of 1 drop in each eye 6 times daily for 4 weeks. The parameters of clinical efficacy were tear osmolarity, tear breakup time (BUT), fluorescein staining scores for the cornea and conjunctiva, Schirmer test values, and subjective symptoms evaluated using the ocular surface disease index (OSDI). Tears collected with Schirmer test strips were analyzed by high-performance liquid chromatography, and the concentrations of the total protein and the 4 major tear proteins, namely, secretory IgA, lactoferrin, lipocalin-1, lysozyme, and N-acetyl-neuraminic acid (Neu5Ac), were measured. Neu5Ac is a major sialic acid, a marker of secretory mucins.
  
  
  RESULTS
  The BUT, keratoconjunctival staining scores, and Schirmer test values were improved with statistical significance after the treatment with diquafosol solution, while changes in the other parameters, including tear osmolarity, corneal staining scores, and OSDI scores were not significant. The Neu5Ac concentration was significantly increased, which was not accompanied by changes in tear proteins.
  
  
  CONCLUSIONS
  Topical application of diquafosol significantly improved the clinical parameters of the BUT, keratoconjunctival staining scores, and Schirmer test values and was accompanied by increased sialic acid content in the tears of patients with dry eye.
authors: Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan. shigeyasu@eye-center.org.|Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. shigeyasu@eye-center.org.|Division for Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8982, Japan. shigeyasu@eye-center.org.
authors: Chika
authors: C
authors: Shigeyasu
authors: Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
authors: Masakazu
authors: M
authors: Yamada
authors: Division for Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8982, Japan.
authors: Yoko
authors: Y
authors: Akune
authors: Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors: Kazuo
authors: K
authors: Tsubota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002851:Chromatography, High Pressure Liquid; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000378:metabolism; D007781:Lactoferrin / Q000378:metabolism; D054835:Lipocalin 1 / Q000378:metabolism; D008875:Middle Aged; D009113:Muramidase / Q000378:metabolism; D019158:N-Acetylneuraminic Acid / Q000378:metabolism; D009883:Ophthalmic Solutions; D009994:Osmolar Concentration; D011122:Polyphosphates / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D058912:Purinergic P2Y Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D013666:Tears / Q000737:chemistry* / Q000378:metabolism*; D014500:Uracil Nucleotides / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D005136:Eye Proteins; D007071:Immunoglobulin A, Secretory; C490098:LTF protein, human; D054835:Lipocalin 1; D009883:Ophthalmic Solutions; D011122:Polyphosphates; D058912:Purinergic P2Y Receptor Agonists; D014500:Uracil Nucleotides; C042434:tear proteins; C403315:diquafosol; D009113:Muramidase; D007781:Lactoferrin; D019158:N-Acetylneuraminic Acid
keywords: Diquafosol ophthalmic solution; Dry eye syndrome; Mucins; Sialic acid; Tears