2.6 Conclusions
As described, the human nasolacrimal ducts must be included in the considerations concerning dry eye. Areas of interest include analyses of normal tear components, such as mucins, TFF peptides, and freely water-soluble small molecules (e.g., urea or amino acids), or perhaps smaller molecular tear proteins such as lysozyme. Moreover, analysis of such molecules in certain diseases, such as dacryostenosis, are of interest. Such investigations would be useful for extrapolation to the human situation, as the exact mechanism of absorption and regulation of these processes at the mucosa of the lacrimal passage is still not understood. Current investigations of epithelial transporter systems of the human nasolacrimal ducts will give deeper insights into possible routes of absorption and also the substances that are able to be absorbed. Possibly, some of these transporters are regulated by hormones in the efferent tear ducts, similar to the action of the water transporter aquaporine (AQP) 2 in the kidney, where AQP 2 is only present in the apical membrane of collecting duct main cells under the influence of adiuretic hormone. Moreover, current analysis of TALT and also conjunctiva-associated lymphoid tissue (CALT), as well as different epithelial cells of the lacrimal passage, are interesting with regard to the induction of tolerance in the nasolacrimal system and at the ocular surface.
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References
Adenis JP, Loubet A, Leboutet MJ, Robin A, Loubet R (1980) Morphologie ultrastructurale de la muqueuse des voies lacrymalesà ses différents niveaux. Arch Anat Cytol Pathol 28:371–375
Allen JC (1968) Congenital absence of the lacrimal punctum. J Pediatr Ophthalmol 5:176–178
Argüeso P, Balaram M, SpurrMichaud S, Keutmann HT, Dana MR, Gipson IK (2002) Decreased levels of the goblet cell mucin MUC5AC in tears of patients with Sjögren syndrome. Invest Ophthalmol Vis Sci 43:1004–1011
Busse H, Müller KM (1977) Zur Entstehung der idiopathischen Dakryostenose. Klin Monatsbl Augenheilkd 170: 627–632
Dalgleish R (1964) Incidence of idiopathic acquired obstructions in the lacrimal drainage apparatus. Br J Ophthalmol 48:373–376
Danjo Y, Watanabe H, Tisdale AS, George M, Tsumura T, Abelson MB, Gipson IK (1998) Alterations of mucin in human conjunctival epithelia in dry eye. Invest Ophthalmol Vis Sci 39:2602–2609
François J, Neetens A (1973) Tear flow in man. Am J Ophthalmol 75:351–358
Paulsen F (2006) Cell and molecular biology of human lacrimal gland and nasolacrimal duct mucins. Int Rev Cytol 249:229–279
Jones DT, Ji A, Monroy D, Ji Z, Pflugfelder SC (1998) Alterations of ocular surface gene expression in Sjogren’s syndrome. Adv Exp Med Biol 438:533–536
Kheterpal S, Chan SY, Batch A, Kirkby GR (1994) Previously undiagnosed lymphoma presenting as recurrent dacryocystitis. Arch Ophthalmol 112:519–520
Lew H, Lee S-Y, Yun Y-S (2004) Measurement of pH, electrolytes and electrophoretic studies of tear proteins in tears of patients with dacryoliths: a novel concept for dacryoliths. Ophthalmologica 218:130–135
Linberg JV (2001) Discussion of lacrimal sac dacryoliths. Ophthalmology 108:1312
Linberg JV, McCormick SA (1986) Primary acquired nasolacrimal duct obstruction. A clinical pathologic report and biopsy technique. Ophthalmology 93:1055–1063
Mauriello JA, Palydowycz S, DeLuca J (1992) Clinicopathologic study of lacrimal sac and nasal mucosa in 44 patients with complete acquired nasolacrimal duct obstruction. Ophthalmic Plast Reconstr Surg 8:13–21
McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR (1998) The epidemiology of dry eye in Melbourne, Australia. Ophthalmology 105:1114–1119
Mishima S (1965) Some physiological aspects of the precorneal tear film. Arch Ophthalmol 73:233–241
Norn MS (1966) Tear secretion in diseased eyes. Acta Ophthalmol 44:25–32
Orhan M, Onerci M, Dayanir V, Orhan D, Irkec T, Irkec M (1996) Lacrimal sac dacryolith: a study with atomic absorption spectrophotometry and scanning electron microscopy. Eur J Ophthalmol 6:478–480
Paulsen F, Paulsen J, Thale A, Tillmann B (2000) Mucosa-associated lymphoid tissue (MALT) in the human efferent tear ducts. Virchows Arch 437:185–189
Paulsen F, Schaudig U, Fabian A, Ehrich D, Sel S (in press) Production of TFF peptides and single mucins is augmented in dacryolithiasis. Graefe’s Arch Clin Exp Ophthalmol
Paulsen F, Schaudig U, Maune S, Thale AB (2003) Loss of tear duct-associated lymphoid tissue (TALT) in association with the scarring of symptomatic dacryostenosis. Ophthalmology 110:85–92
Paulsen F, Schaudig U, Thale A (2003) Drainage of tears: impact on the ocular surface and lacrimal system. Ocular Surface 1:180–191
Paulsen F, Thale A, Hallmann U, Schaudig U, Tillmann B (2000) The cavernous body of the human efferent tear ducts: function in tear outflow mechanism. Invest Ophthalmol Vis Sci 41:965–970
Paulsen F, Thale A, Kohla G, Schauer R, Rochels R, Parwaresch R, Tillmann B (1998) Functional anatomy of human duct epithelium. Anat Embryol 198:1–12
Paulsen F, Thale A, Maune S, Tillmann B (2001) Primary acquired dacryostenosis: histopathology and pathophysiology. Ophthalmology 108:2329–2336
Pflugfelder SC, Tseng SC, Yoshino K, Monroy D, Felix C, Reis BL (1997) Correlation of goblet cell density and mucosal epithelial membrane mucin expression with rose bengal staining in patients with ocular irritations. Ophthalmology 104:223–235
Radnot M (1970) Die Flimmerhaare des Tränensackepithels. Klin Monatsbl Augenheilkd 170:428–432
Tucker N, Chow D, Stockl F, Codere F, Burnier M (1997) Clinically suspected primary acquired nasolacrimal duct obstruction. Ophthalmology 104:1882–1886
White WL, Ferry JA, Harris NL, Grove AS Jr (1995) Ocular adnexal lymphoma. Ophthalmology 102:1994–2006
Yen MT, Pflugfelder SC, Feuer WJ (2001) The effect of punctal occlusion on tear production, tear clearance, and ocular surface sensation in normal subjects. Am J Ophthalmol 131:314–323
Paulsen F, Berry M (2006) Mucins and TFF peptides of the tear film and lacrimal apparatus. Prog Histochem Cytochem 41:1–53
Paulsen FP, Schandig U, Fabian A, Ehrich D, Sels (2006) TFF peptides and mucins are major components of dacryoliths. Graefes Arch Clin Exp Ophthalmol 244:1160–1170
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Paulsen, F. (2007). Pathophysiological Aspects of PANDO, Dacryolithiasis, Dry Eye, and Punctum Plugs. In: Weber, R.K., Keerl, R., Schaefer, S.D., Della Rocca, R.C. (eds) Atlas of Lacrimal Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68215-8_2
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