Molecule In Our Tears May Provide Noninvasive Test For Neuropathy

There’s a lot more to our tears than saltwater. For instance, our tears contain a nerve cell signaling molecule called substance P.

Recently, researchers found that elevated levels of substance P in our tears may be a useful indicator for diabetes-related nerve damage, or neuropathy.

Substance P, among other duties, plays a role in the nutrition, and maintenance of the eye’s cornea. The transparent cornea contains a wealth of fine nerve fibers that protect and heal the eye’s surface.

Using a method called confocal microscopy, the structure of corneal nerves can be viewed and measured, and earlier studies suggest their density is predictive for peripheral neuropathy. Though damage to peripheral nerves is visible on biopsy samples, this requires an invasive procedure.

The researchers wanted to determine whether substance P levels in tear film reflects the health of corneal nerves in diabetic patients, which in turn may reflect the health of their peripheral nerves. First, they measured substance P levels in the tear film of nine adults with diabetes, and 17 adults without diabetes, and found those with diabetes had significantly lower substance P levels in their tears.


Next, using confocal microscopy, the investigators noticed diabetes patients had substantially less corneal nerve fiber density than the non-diabetes subjects, and that substance P levels corresponded “moderately” with the fiber density measurements.

“The positive correlation between substance P and corneal nerve density indicates that substance P may be a potential biomarker for corneal nerve health,” wrote researcher Dr. Maria Markoulli and colleagues at the University of New South Wales, Sydney, Australia.

If further research confirms a link between substance P, corneal fiber density, and peripheral nerve damage, measuring this substance in tear film could become a noninvasive test for peripheral neuropathy risk in diabetes patients. Other studies suggest substance P derivatives may facilitate healing of diabetes-related corneal defects.

Source: Wolters Kluwer
Photo credit: Raoul Snyman



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