TFOS European Ambassador meeting: Unmet needs and future scientific and clinical solutions for ocular surface diseases

The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019

CYP2C19 pharmacogenetics in advanced cancer: compromised function independent of genotype

CYP2C19 is a drug-metabolising enzyme involved in the metabolism of a number of chemotherapeutic agents including cyclophosphamide. Variants of the CYP2C19 gene result in a loss of function polymorphism, which affects approximately 3% of the Caucasian population. These individuals are poor metabolisers (PM) of a wide range of medications including omeprazole (OMP). In healthy subjects PM can be identified through homozygous variant genotype. However, a discordance between CYP2C19 genotype and phenotype has been reported previously in a small study of cancer patients. To investigate whether CYP2C19 activity was decreased in patients with advanced cancer, CYP2C19 genotype was determined in 33 advanced cancer patients using PCR-RFLP analysis for the two important allelic variants (*2,681G>A and *3,636G>A) and the activity of the enzyme was evaluated using the CYP2C19 probe drug OMP. The activity of the drug-metabolising enzyme CYP2C19 was severely compromised in advanced cancer patients, resulting in a PM status in 37% of the patients who had normal genotype. This is significantly (P<0.0005) higher than that would be predicted from the genotypic status of these patients. There was no evidence of a correlation between compromised CYP2C19 activity and any of the proinflammatory cytokines or acute phase response proteins studied. However, there was preliminary evidence of an association between PM status and low body mass (P=0.03). There is increasing interest in using pharmacogenetics to ‘individualise medicine', however, the results of this study indicate that in a cancer population genotyping for CYP2C19 would significantly underestimate the number of phenotypic PM of drugs, such as cyclophosphamide, which may be metabolised by this enzyme

Evaluation of cardiovascular and inflammatory factors in age-related macular degeneration [Yaa Baglí Maküla Dejeneresansínda Kardiyovasküler ve Enflamatuvar Risk Faktörlerinin Degerlendirilmesi]

Purpose: To evaluate cardiovascular and inflammatory risk factors in Age-Related Macular Degeneration (AMD). Materials and Methods: Thirty-nine patient with dry-type AMD and 37 control were included in the study. Smoking history, body mass index (BMI), serum fibrinogen CRP, IL-6, Tumour necrosis factor alpha (TNF-alpha), Apolipoprotein B, Lipoprotein A, HDL, LDL and total cholesterol values were analyzed. Cardiologic examination was performed to all participants. Results: In dry-type AMD patients, the mean BMI (33.1±5.13) were statistically significantly higher than in the control group (24.9±5.63), (p=0.045). The mean TNF-alfa levels for dry-type AMD and controls were 15.6±52.29 pg/ml and 15.5±41.37 pg/ml, respectively and statistical significant difference was observed (p=0.035). There was statistical significant difference in terms of mean IL-6 levels which were 31.9±114.6 and 1.2±1.5 pg/ml, (p<0.05), respectively. There were no significiant differences between cases and controls in terms of serum fibrinogen, HDL, LDL, total cholesterol, trigliserid, CRP, Lip (a), Apo-B, smoking. Conclusion: In the study there was no relationship between serum cardiac risk factors and AMD. In addition, there was high rate of obesity in the patient group. In the patient group, TNF alpha and IL-6 levels were higher than the control group. These results suggest that inflammatory factors may have a role in the pathogenesis of AMD

Thermal tolerance of European Sea Bass Dicentrarchus labrax Juveniles Acclimated to Three Temperature Levels

This study was carried out to determine upper (CTMax) and lower (CTMin) thermal tolerance, acclimation response ratio (ARR) and thermal tolerance polygon of the European sea bass inhabiting the Iskenderun Bay, the most southeasterly part of the Mediterranean Sea, at three acclimation temperatures (15, 20, 25 1C). Acclimation temperature significantly affected the CTMin and CTMax values of the fish. At 0.3 1C min 1 cooling or heating rate, CTMin ranged from 4.10 to 6.77 1C and CTMax ranged from 33.23 to 35.95 1C in three acclimation temperatures from 15 to 25 1C. Thermal tolerance polygon for the juveniles at the tested acclimation temperatures was calculated to be 296.14 1C2. In general, the current data show that our sea bass population possesses acclimation response ratio (ARR) values (0.25–0.27) similar to some tropical species. The cold tolerance values attained for this species ranged from 4.10 to 6.77 1C, suggesting that cold winter temperatures may not pose danger during the culture of European sea bass in deep ponds or high water exchange rate systems. Upper thermal tolerance is more of a problem in the southern part of the Mediterranean as maximum water temperature in ponds may sometimes exceed 33–34 1C, during which underground cool-water should be used to lower ambient water temperature in the mid-summer. For successful culture of sea bass in ponds, temperature should be maintained around 25 1C throughout the year and this can be managed under greenhousing systems using underground well-waters, commonly available in the region