Tweet
I have noted with great interest over the years, that many DES patients report their symptoms improve with nervous system stimulation, e.g. through - caffeine, NAC, stress, eating, exercise etc.
Recent research has implicated a neuropeptide (CGRP a potent cranial vasodilator) as playing a role in this phenomenon.
Research also suggests a hormonal link, with progesterone possibly enhancing CGRP effects and estrogen inhibiting it.
CGRP agonists = caffeine, NAC, omega 3s, forskolin, capsaicin, calcium, nicotine, nitroglycerin, steroids, amphetamines. Pregnancy also increases CGRP levels.
CGRP antagonists = triptans ( used to treat migraine headaches), botox , retinoic acid (accutane) decreases calitonic and GGRP mRNA levels.
1) Decreased tear levels of NPY and CGRP in dry eye disease
Article: Alterations of tear neuromediators in dry eye disease
http://www.ncbi.nlm.nih.gov/pubmed/21825181
2) parasympathetic neurotransmitters and their agonists influence the function of human meibomian gland epithelial cells.
David A. Sullivan Inv. Opthalmology vision science Oct. 2011
3) CGRP may play a role in wound-healing after Lasik
Article: Increased release of (CGRP) in tears after excimer laser keratectomy
http://www.ncbi.nlm.nih.gov/pubmed/7641848
4) Topical NAC may improve DES symptoms
Article: Efficacy of topical N-acetylcysteine in the treatment of meibomian gland dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/20653477
Article: Comparison of the efficacy of topical N-acetyl-cysteine and a topical steroid-antibiotic combination therapy in the treatment of meibomian gland dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/21751879.
Article: Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome. http://www.ncbi.nlm.nih.gov/pubmed?term=Article%3A
Article: Topical N-acetylcysteine reduces interleukin-1-alpha in tear fluid after laser subepithelial keratectomy. http://www.ncbi.nlm.nih.gov/pubmed?term=Topical%20N-
5) Oral NAC may help Sjogren’s syndrome symptoms
Article: A double-blind, cross-over, study of oral N-acetylcysteine in Sjögren's syndrome. http://www.ncbi.nlm.nih.gov/pubmed/3296153
Recent research has implicated a neuropeptide (CGRP a potent cranial vasodilator) as playing a role in this phenomenon.
Research also suggests a hormonal link, with progesterone possibly enhancing CGRP effects and estrogen inhibiting it.
CGRP agonists = caffeine, NAC, omega 3s, forskolin, capsaicin, calcium, nicotine, nitroglycerin, steroids, amphetamines. Pregnancy also increases CGRP levels.
CGRP antagonists = triptans ( used to treat migraine headaches), botox , retinoic acid (accutane) decreases calitonic and GGRP mRNA levels.
1) Decreased tear levels of NPY and CGRP in dry eye disease
Article: Alterations of tear neuromediators in dry eye disease
http://www.ncbi.nlm.nih.gov/pubmed/21825181
2) parasympathetic neurotransmitters and their agonists influence the function of human meibomian gland epithelial cells.
David A. Sullivan Inv. Opthalmology vision science Oct. 2011
3) CGRP may play a role in wound-healing after Lasik
Article: Increased release of (CGRP) in tears after excimer laser keratectomy
http://www.ncbi.nlm.nih.gov/pubmed/7641848
4) Topical NAC may improve DES symptoms
Article: Efficacy of topical N-acetylcysteine in the treatment of meibomian gland dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/20653477
Article: Comparison of the efficacy of topical N-acetyl-cysteine and a topical steroid-antibiotic combination therapy in the treatment of meibomian gland dysfunction. http://www.ncbi.nlm.nih.gov/pubmed/21751879.
Article: Comparison of local acetylcysteine and artificial tears in the management of dry eye syndrome. http://www.ncbi.nlm.nih.gov/pubmed?term=Article%3A
Article: Topical N-acetylcysteine reduces interleukin-1-alpha in tear fluid after laser subepithelial keratectomy. http://www.ncbi.nlm.nih.gov/pubmed?term=Topical%20N-
5) Oral NAC may help Sjogren’s syndrome symptoms
Article: A double-blind, cross-over, study of oral N-acetylcysteine in Sjögren's syndrome. http://www.ncbi.nlm.nih.gov/pubmed/3296153