In May 2021 a team of researchers from the Ophthalmology Department and the Clinical Research Centre, Medical University of Bialystok, published an article entitled: Metabolomics reveals differences in aqueous humor composition in patients with and without pseudoexfoliation syndrome, in the journal Frontiers in Molecular Biosciences (https://doi.org/10.3389/fmolb.2021.682600). This is the first ever paper in the world focusing on metabolomics of the aqueous humour in the course of the pseudoexfoliation syndrome (XFS). This syndrome is a complex, progressive systemic condition mainly associated with the accumulation of a pathological, microfibrillar material within various parts of the eye. 60-70 millions of people worldwide are affected by XFS, and as far as ophthalmological perspective is concerned, it is a factor predisposing to glaucoma (untreated glaucoma may lead to blindness) and increasing the risk of intra- and postoperative complications related to the cataract surgery. Currently, there are no methods of preventing and treating the XFS, but investigating the pathogenesis of the disease may lead to their development. Authors used metabolomics, which has been gaining popularity recently, in order to learn more about this condition. Metabolomics is an area of science devoted to analysing small molecular compounds (metabolites) and their derivates. These compounds include amino acids, lipids or carbohydrates. The research focused on aqueous humour, which fills the anterior and posterior chamber of the eye. The role of this fluid in the eye resembles the role that blood plays in our organism, since it provides nutrients and eliminates waste products from the cornea and the lens.
The publication demonstrates the differences in the composition of the aqueous humour in patients with and without exfoliation syndrome. The research has shown L-arginine and ascorbic acid, which pose antioxidative and anti-inflammatory properties. Their lowered level in patients with the XFS suggests an increased oxidative stress and inflammation. The impaired metabolic pathways of acylcarnitines, along with their lowered levels in patients with XFS, indicate an improper mitochondrial function. On the other hand, the increased level of indole acetaldehyde may be associated with impaired intestinal microflora.
This publication stands as a continuation of the pioneer cycle concerning the metabolomic analysis of the human aqueous humour. Previously, in 2018, the same team, also as the first team in the world, published a paper devoted to metabolomics of the aqueous humour in patients with type 2 diabetes (https://doi.org/10.1002/elps.201700411). Future plans regard the determination of the profile of metabolites in aqueous humour characterising the short-term and long-term retinal detachment, as well as in patients with high myopia.