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Area of Science:

  • Microbiome Research
  • Immunology
  • Ophthalmology

Background:

  • Intestinal microbiota are increasingly implicated in triggering distant autoimmune conditions.
  • Sjögren's syndrome (SS) is an autoimmune disease impacting the ocular surface, often with unmet needs in dry eye management.
  • A potential link between autoimmune dry eye and gut microbiota composition is emerging.

Purpose of the Study:

  • To review the interplay between gut microbiota, the immune system, and autoimmune diseases, specifically comparing with SS.
  • To explore rodent and human studies on gut microbiota in SS and environmental dry eye.
  • To discuss the therapeutic potential of prebiotics and probiotics for dry eye.

Main Methods:

  • Literature review of metagenomic, rodent, and human studies.
  • Analysis of gut microbiota composition in SS and environmental dry eye.
  • Exploration of proposed mechanisms linking gut dysbiosis to ocular surface and lacrimal gland function.

Main Results:

  • A correlation between gut dysbiosis and clinical SS manifestations is frequently observed.
  • Environmental dry eye shows intermediate characteristics between healthy and autoimmune states.
  • SS subjects commonly exhibit a decreased Firmicutes/Bacteroidetes ratio and reduced Faecalibacterium genus.

Conclusions:

  • The "gut dysbiosis-ocular surface-lacrimal gland axis" is a plausible pathway in autoimmune dry eye pathogenesis.
  • Understanding the gut microbiome's role can enhance insights into autoimmune dry eye.
  • This knowledge may guide the development of novel therapeutic interventions for dry eye.