Making Tears Part 6
Regulation is the key to running an efficient, effective realm, no matter what era or place is involved. In the case of dry eye disease, this is especially true, as this is where regulation has often gone amiss of our healthy aim. Cortisol (a messenger from the adrenal glands) is responsible for helping us in coping with stress. I see it as the emissary sent to warn of an impending enemy “siege,” and sets in motion the ability to free up energy and promote the “S” camp to “protect the realm” from the “attacking Huns,” with its emergency rations and protective reflexes. The problem is that we can only stay on this level of “high alert” for so long, before we begin to literally “break down.” This is another way of saying that reducing stress levels and the cortisol levels related to it, is important for restoring “normalcy” to the daily functions of the castle and protect the general health of its populace. Other ways we raise our cortisol levels is with alcohol. As little as 2 ounces of alcohol can raise this level and set us on this “S” pathway for days. Illness will also activate cortisol production, so staying physically healthy is key to eye health as well as general health. (Often easier said than done.)
Caffeine is a powerful “S” camp activator as well. It sends a message to prepare for “Flight or Fright,” where our heart rate, blood pressure and breathing rate is increased. This may help us prepare for our often stressful days ahead, but does take some toll on the tear glands and the surface of our now “saltwater -rather-than-salad-dressing-drenched” eyes. While we may not be able to easily regulate the amount of stress in our day, we can regulate the amount of caffeine and alcohol we take in. Both can adversely affect sleep, so caffeine is best consumed early in the day and alcohol in moderate amounts early in the evening. For those suffering significantly from dry eye disease, avoiding all forms of caffeine and alcohol can often be a game changing strategy.
Sleep and rest are the gifts that elevate the “PS” camp activities that restore the “salad dressing” and replenish the stores of healthy tear products that were "burned up” by the “S” camp. Melatonin is the “sleep hormone” that sets sleep in motion and can be promoted by “winding down” from online and TV/computer/gaming and phone/online activities a few hours before bedtime. I posted on issues relating to sleep here: https://www.eyethera.com/blog/do-blue-blocking-glasses-help-with-dry-eyes - and relative to the “peasant diet” as it can affect sleep, here: https://www.eyethera.com/blog/making-tears-part-2
Inside the cells lining the inner eyelids and white part of our eyes, live “protein factories.” Inside these “castle rooms",” coded messages (Messenger or “mRNA”) work with the protein architects (called ribosomes, I think of them as “bakers” and the “recipe” comes in the form of mRNA). The baker collects the necessary ingredients and then mixes them together in the “mixing bowl” called the Endoplasmic Reticulum (ER). This gets passed along by way of “chaperones” into the “oven” called the Golgi Apparatus (GA). Once “baked” into the form required by the recipe, little “sacs” can pass them through the “wall” of the cell membrane and release the final product into the water seeping through the same membranes. Again, the “salty tokens” help regulate this exchange and are driven by programmed codes that help regulate all cell life.
Salts can be similarly stored and passed through the membranes, to join the protein-laden water. At this point, we have the water, salt and protein forming the essential 3 parts of our “tear salad dressing,” but to get to the ultimate tear, we need to add oil. We also have signals in the way of nerves and hormones to regulate the volume and ultimate recipe of our tears. In future posts, I’ll attempt to explain more of this interesting and essential process. I can also share that eyes prone to repeated infections may have some difficulties in producing “Sir Lyse and Sir Lact.” Others may lack some of the antibodies and other protective mechanisms common to most people. Science continues to “drill down” on these deficiencies and continues to look for remedies.
One example of this “Better living through chemistry” act, is understanding - and modifying - our protein messengers. G-proteins are important Medieval “Pages” - messengers that couple with cells at the “in box” to affect the activities of the cell. In a remote region of the realm (the brain’s hypothalamus) these messengers can be dispatched to circulate throughout the “aqueducts” (blood vessels) and reach the targeted tissues (in our case, the tear producing “machinery”). OKYO Pharma has apparently capitalized on one of these “Pages” (for a fuller scientific account, see: https://okyopharma.com/okyo-pharma-announces-ok-101-successfully-achieved-statistical-significance-for-multiple-signs-and-symptoms-of-dry-eye-disease-including-ocular-pain-relief-in-its-first-in-human-phase-2-trial-of-ok-10/ - A quote from this article about the drug they’ve named OK-101, explains it succinctly: “OK-101 is a lipid conjugated chemerin peptide agonist of the ChemR23-protein coupled receptor which is typically found on immune cells of the eye responsible for the inflammatory response. OK-101 was developed using a membrane-anchored-peptide technology to produce a novel long-acting drug candidate for treating dry eye disease. OK-101 has been shown to produce anti-inflammatory and pain-reducing efficacy signals in mouse models of dry eye disease and corneal neuropathic pain (NCP), respectively” and Okyo Pharma “announces additional statistically significant findings in results from Phase 2 trial of OK-101 (0.05%)” - so by making a drug mimicking a G-protein “Page” we now may have a way to target the “Knights” who may have gone too “rogue” and would otherwise cause inflammation-related mayhem in corneal nerves and tear gland tissues. Understanding the cellular level of how our bodies work can allow science to help put our bodies (and eyes) back on a peaceful track and improve the quality of our lives.
To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:
(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020
(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463