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New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease

Ocular discomfort and eye pain are frequently reported by patients with dry eye disease (DED), and their management remains a real therapeutic challenge for the Ophthalmologist. In DED patients, injury at the level of each structure of the ocular surface can determine variable symptoms, ranging from...

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Autores principales: Giannaccare, Giuseppe, Ghelardini, Carla, Mancini, Alessandra, Scorcia, Vincenzo, Di Cesare Mannelli, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745516/
https://www.ncbi.nlm.nih.gov/pubmed/35011849
http://dx.doi.org/10.3390/jcm11010108
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author Giannaccare, Giuseppe
Ghelardini, Carla
Mancini, Alessandra
Scorcia, Vincenzo
Di Cesare Mannelli, Lorenzo
author_facet Giannaccare, Giuseppe
Ghelardini, Carla
Mancini, Alessandra
Scorcia, Vincenzo
Di Cesare Mannelli, Lorenzo
author_sort Giannaccare, Giuseppe
collection PubMed
description Ocular discomfort and eye pain are frequently reported by patients with dry eye disease (DED), and their management remains a real therapeutic challenge for the Ophthalmologist. In DED patients, injury at the level of each structure of the ocular surface can determine variable symptoms, ranging from mild ocular discomfort up to an intolerable pain evoked by innocuous stimuli. In refractory cases, the persistence of this harmful signal is able to evoke a mechanism of maladaptive plasticity of the nervous system that leads to increased pain responsiveness. Peripheral and, subsequently, central sensitization cause nociceptor hyperexcitability and persistent pain perception that can culminate in the paradoxical situation of perceiving eye pain even in the absence of ocular surface abnormalities. Effective therapeutic strategies of these cases are challenging, and new options are desirable. Recently, a theoretical novel therapeutic approach concerns enkephalins thanks to the evidence that eye pain sensations are modulated by endogenous opioid peptides (enkephalins, endorphins and dynorphins). In this regard, new topical agents open up a new theoretical scenario in the treatment of ocular discomfort and eye pain in the setting of DED, such as, for example, a multimolecular complex based on proteins and glycosaminoglycans also containing opiorphin that may assist the physiological pain-relieving mechanism of the eye.
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spelling pubmed-87455162022-01-11 New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease Giannaccare, Giuseppe Ghelardini, Carla Mancini, Alessandra Scorcia, Vincenzo Di Cesare Mannelli, Lorenzo J Clin Med Review Ocular discomfort and eye pain are frequently reported by patients with dry eye disease (DED), and their management remains a real therapeutic challenge for the Ophthalmologist. In DED patients, injury at the level of each structure of the ocular surface can determine variable symptoms, ranging from mild ocular discomfort up to an intolerable pain evoked by innocuous stimuli. In refractory cases, the persistence of this harmful signal is able to evoke a mechanism of maladaptive plasticity of the nervous system that leads to increased pain responsiveness. Peripheral and, subsequently, central sensitization cause nociceptor hyperexcitability and persistent pain perception that can culminate in the paradoxical situation of perceiving eye pain even in the absence of ocular surface abnormalities. Effective therapeutic strategies of these cases are challenging, and new options are desirable. Recently, a theoretical novel therapeutic approach concerns enkephalins thanks to the evidence that eye pain sensations are modulated by endogenous opioid peptides (enkephalins, endorphins and dynorphins). In this regard, new topical agents open up a new theoretical scenario in the treatment of ocular discomfort and eye pain in the setting of DED, such as, for example, a multimolecular complex based on proteins and glycosaminoglycans also containing opiorphin that may assist the physiological pain-relieving mechanism of the eye. MDPI 2021-12-25 /pmc/articles/PMC8745516/ /pubmed/35011849 http://dx.doi.org/10.3390/jcm11010108 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Giannaccare, Giuseppe
Ghelardini, Carla
Mancini, Alessandra
Scorcia, Vincenzo
Di Cesare Mannelli, Lorenzo
New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title_full New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title_fullStr New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title_full_unstemmed New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title_short New Perspectives in the Pathophysiology and Treatment of Pain in Patients with Dry Eye Disease
title_sort new perspectives in the pathophysiology and treatment of pain in patients with dry eye disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745516/
https://www.ncbi.nlm.nih.gov/pubmed/35011849
http://dx.doi.org/10.3390/jcm11010108
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