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Ocular Reactions During Aspirin Challenge in Aspirin–Exacerbated Respiratory Disease

^A Ophthalmology, ^B Allergy, ¹ Scripps Clinic, La Jolla, CA
² Mass Spectrometry Laboratory, The Scripps Research Institute, La Jolla, CA

Commercial Relationships: M.H. Friedlaender, None; P.K. Mehra, None; G. Siuzdak, None; D.D. Stevenson, None.

Support: None.

Abstract

Purpose: Clinical grading of ocular reactions during aspirin challenges is problematic. We attempted to objectively evaluate these reactions using new methodology.

Methods: Six patients with aspirin–exacerbated respiratory disease (AERD) were studied at baseline and at the time of aspirin challenge using a symptom score, photography, and measurement of conjunctival erythema with spectroradiometry. Tear samples were collected on Schirmer strips and labeled using Prolytica^TM reagent (Stratagene) with either heavy (O18) or light (O16) isotopic tags. LC separation was performed on a laser pulled 100 um ID C₁₈ column. The MS/MS analysis was performed on an Agilent LC/MSD Trap ion mass spectrometer.

Results: The ocular rating score showed that from baseline to aspirin reaction, symptoms of itching, burning, and tearing were highly variable and independent of each other. Spectroradiometer measurements in 3/6 patients demonstrated a significant increase in conjunctival erythema. Data obtained from mass spectrometry of tears was searched with Mascot using the NCBInr data base. this resulted in the identification of 10 proteins such as lacrimal proline–rich protein 4, lactoferrin, and prolactin–inducible protein. This proteomics profiling strategy helped identify several proteins that were expressed differentially at baseline and at the time of aspirin challenge.

Conclusions: The ocular reactions during aspirin challenge are clinically variable and molecularly complex. Protein profiling of tears provides quantitative characterization of protein expression in AERD.

Keywords: proteomics • inflammation • conjunctivitis

© 2005, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. For permission to reproduce any part of this abstract, contact the ARVO Office at arvo{at}arvo.org.