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    Substance P: Dry eye and allergy’s mixed signal or missing link?

     

    Conclusion

    Succinctly, inflammation may lead to heightened peripheral sensitization and stimulation through a developing concept in which neuroimmune cross-talk causes the confounding interplay of both signs and symptoms in dry eye and allergic disease.

    Furthermore, this cascading response may propagate a neurogenic amplification of the inflammatory responses in a vicious loop that could have both protective and detrimental effects depending on the levels of a single neuropeptide entity.

    Therefore, it can be hypothesized that by peering into the mechanisms behind neurogenic inflammation this will hopefully soon dispel the ocular version of Lucy vs. Ardi in order to yield better treatment and stabilization of the disease activity through appropriate modulation of specific neuropeptides.

    References

    1. Shreeve J. Oldest Skeleton of Human Ancestor Found. Nat Geo. 2009 Oct 01. Available at: http://news.nationalgeographic.com/news/2009/10/091001-oldest-human-skeleton-ardi-missing-link-chimps-ardipithecus-ramidus.html. Accessed 7/30/17.

    2. Clark, G, Henneberg M. Ardipithecus ramidus and the evolution of language and singing: An early origin for hominin vocal capability. Homo. 2017 Mar;68(2):101-121.

    3. Müller LJ, Marfurt CF, Kruse F, Tervo TM. Corneal nerves: structure, contents and function. Exp Eye Res. 2003 May;76(5):521-42.

    4. Richardson JD, Vasko MR. Cellular Mechanisms of Neurogenic Inflammation. J Pharmacol Exp Ther. 2002 Sep;302(3):839-45.

    5. Bonini S, Lambiase A, Bonini S, Levi-Schaffer F, Aloe L. Nerve growth factor: An important molecule in allergic inflammation and tissue remodelling. Int Arch Allergy Immunol. 1999 Feb-Apr;118(2-4):159-62.

    6. Lai JP, Douglas SD, Wang YJ, Ho WZ. Real-Time Reverse Transcription-PCR Quantitation of Substance P Receptor (NK-1R) mRNA. Clin Diagn Lab Immunol. 2005 Apr;12(4):537-41.

    7. DeVane CL. Substance P: A new era, a new role. Pharmacotherapy. 2001 Sep;21(9):1061-9.

    8. Farris RL, Stuchell RN, Mandel ID. Tear osmolarity variation in the dry eye. Trans Am Ophthalmol Soc. 1986;84:250-68.

    9. Tomlinson A, Khanal S, Ramaesh K, Diaper C, McFadyen A. Tear film osmolarity: determination of a referent for dry eye diagnosis. Invest Ophthalmol Vis Sci. 2006 Oct;47(10):4309-15.

    10. Beuerman RW, Stern ME. Neurogenic inflammation: a first line of defense for the ocular surface. Ocul Surf 2005; 3(4 Suppl):S203–S206.  

    Michael S. Cooper, OD
    Michael S. Cooper, OD, is in private practice in Willimantic, CT. He is a consultant to Allergan, BioTissue, Johnson & Johnson Vision ...

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