title: Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry.
abstract: BACKGROUND
  The purpose of this study was to investigate whether acupuncture is effective at treating dry eye disease among postmenopausal women and to identify the possible mechanisms.
  
  
  METHODS
  Twenty-eight postmenopausal women with dry eye disease were randomly divided into two groups: an acupuncture plus artificial tears (AC + AT) group and an artificial tears (AT) only group. After baseline examination of clinical parameters and tear sample collection, each patient received the designated modality of topical therapy for 2 months. Post-treatment documentation of clinical parameters was recorded, and tear samples were collected. Tear samples from the AC + AT group were subjected to two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry (2D nano-LC-MS/MS). Western blot analysis was also performed on tear samples from both groups.
  
  
  RESULTS
  After treatment, the Ocular Surface Disease Index scores, symptom assessment scores, scores of sign assessment, and tear break-up time were significantly improved in both groups (P=0.000). Symptom assessment scores were significantly improved in the AC + AT group (P=0.000) compared with the AT group. 2D nano-LC-MS/MS identified 2,411 proteins, among which 142 were downregulated and 169 were upregulated. After combined AC + AT treatment, the abundance of secreted proteins was increased, whereas that of cytoplasmic proteins decreased (Pearson'sχ2test,P=0.000,P=0.000, respectively). Proteins involved in immunity and regulation were also more abundant (Pearson'sχ2test,P=0.040,P=0.016, respectively), while components and proliferation-related proteins were downregulated (Pearson'sχ2test,P=0.003,P=0.011, respectively).
  
  
  CONCLUSIONS
  AC + AT treatment increased protein synthesis and secretion, and improved clinical symptoms. These results indicate that acupuncture may be a complimentary therapy for treating postmenopausal dry eye disease.
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai.
authors.forename: Qingyu
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai.
authors.forename: Junling
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai.
authors.forename: Chengda
authors.initials: C
authors.lastname: Ren
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai.
authors.forename: Wenting
authors.initials: W
authors.lastname: Cai
authors.affiliation: Department of Ophthalmology, Nanchang University, Nanchang.
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Wei
authors.affiliation: Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai.
authors.forename: Jing
authors.initials: J
authors.lastname: Yu
mesh_terms: D015670:Acupuncture Therapy; D015153:Blotting, Western; D002853:Chromatography, Liquid / Q000379:methods*; D003710:Demography; D015352:Dry Eye Syndromes / Q000378:metabolism* / Q000628:therapy*; D005136:Eye Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D007553:Isotope Labeling; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D036103:Nanotechnology / Q000379:methods*; D020543:Proteome / Q000378:metabolism; D040901:Proteomics / Q000379:methods*; D015203:Reproducibility of Results; D053719:Tandem Mass Spectrometry / Q000379:methods*; D013666:Tears / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D005136:Eye Proteins; D020543:Proteome
keywords: acupuncture; menopausal dry eye; proteomics