The role of lacritin in dry eye disease: a novel human tear glycoprotein

Abstract

INTRODUCTION: The ocular surface condition known as dry eye disease is characterized by a breakdown in the tear film’s homeostasis. Among the tear protein secretion factors is lacritin, a glycoprotein secreted by the lacrimal gland. It functions as a mitogen, encouraging the formation of tears and promoting cell proliferation.EVIDENCE ACQUISITION: A literature search was conducted using four online databases (SpringerLink, ProQuest, ScienceDirect, and PubMed). The search terms consisted of the MeSH term “dry eye disease” and the main key word “lacritin.”EVIDENCE SYNTHESIS: A total of six articles were included. One reported on the homeostatic regulation of surface epithelia by lacritin with prosecretory mitogens that stimulate FOXO1-ATG7 and FOXO3-ATG101 autophagy, promote basal tearing, restore metabolism, and inhibit inflammatory cytokine stress. Another article reported reduced lacritin levels in dry eye disease. One study reported that the C-terminus of lacritin acts as a natural mechanism for delayed release and is crucial in preventing the collapse of the tear film, which helps restore the homeostasis of the epithelial cells. Finally, the first human study showed the efficacy and safety of topical treatment with a commercial lacritin preparation, Lacripep, in patients with primary Sjögren syndrome.CONCLUSIONS: Lacritin has a wide range of effects, including prosecretory, homeostatic, and promitogenic functions; maintaining hyperosmolarity; and inhibiting inflammation in dry eye disease.

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