Glaucoma patients have an increased level of trimethylamine, a toxic product of gut bacteria, in the aqueous humor: a pi
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ORIGINAL PAPER
Glaucoma patients have an increased level of trimethylamine, a toxic product of gut bacteria, in the aqueous humor: a pilot study Janusz Skrzypecki . J. Izdebska . A. Kamin´ska . J. Badowska . J. Przybek-Skrzypecka . J. Bombuy . E. Samborowska . J. P. Szaflik
Received: 27 April 2020 / Accepted: 29 August 2020 Ó The Author(s) 2020
Abstract Purpose Animal studies suggest that gut bacteria metabolites are involved in regulation of intraocular pressure or development of glaucoma. However, clinical data are lacking. Here, we wanted to compare level of trimethylamine (TMA), an uremic toxin produced by gut bacteria, along with betaine and trimethylamine N-oxide (TMAO), a substrate and a product of its metabolism, in the aqueous humor and in plasma of patients with glaucoma and their controls. Methods Twenty patients were selected for cataract phacoemulsification, and 20 patients selected for phacotrabeculectomy were enrolled in the study. Patients were matched with controls on systemic diseases and estimated glomerular filtration rate.
J. Skrzypecki (&) Laboratory of Centre for Preclinical Research, Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland e-mail: [email protected] J. Skrzypecki J. Izdebska A. Kamin´ska J. Badowska J. Przybek-Skrzypecka J. Bombuy J. P. Szaflik Department of Ophthalmology, SPKSO Ophthalmic Hospital, Medical University of Warsaw, Warsaw, Poland E. Samborowska Mass Spectrometry Laboratory, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
Blood samples were collected in the preoperative suite, whereas aqueous humor samples were collected as the first step of both procedures. Subsequently, level of betaine, TMA and TMAO was analyzed by means of chromatography. Results In the aqueous humor, level of TMA, but not betaine or TMAO, was significantly higher in the phacotrabeculectomy group than in the phacoemulsification group. Plasma level of betaine, TMA and TMAO was similar between groups. In both groups, level of betaine and TMA, but not TMAO, was significantly higher in plasma than in the aqueous humor. Conclusion TMA, but not TMAO or betaine level, is increased in the aqueous humor of patients with glaucoma. TMA might play a role in pathogenesis of glaucoma; however, prospective studies are needed to confirm our findings. Keywords Betaine
TMA TMAO Intraocular pressure
Introduction The most recent studies prove that bacterial metabolites are involved in pathophysiology of many diseases [1]. Their role in multiple sclerosis, hypertension, heart failure or cancer has been highlighted [2]. Furthermore, recent evidence implies that gut
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bacterial metabolites, including short-chain fatty acids (SCFA), hydrogen sulfide and trimethylamine N-oxide (TMAO), play an important role in regulation of intraocular pressure (IOP) [3–5]. In vitro experiments suggest that TMAO, a product of betaine, c
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