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    Systemic therapy eases dry eye symptoms

    Agent controls inflammatory responses, helps with natural production of enzymes

    Lexington, SC-BioTears Oral Gel Caps (Bio-syntrx) is a systemic treatment for dry eye, specifically designed to address the root inflammatory causes and resulting symptoms of dry eye syndrome. It is the newest product from the researchers who developed HydroEye.

    Dr. Thornton
    "Dry eye syndrome is a multifactorial disease. The disease process is partially degenerative and partially a result of immune deficiency," said Spencer Thornton, MD, clinical professor of ophthalmology, University of Tennessee Health Science Center, Memphis, TN. "Dry eye syndrome results in degenerative changes in the surface of the eye, and inflammatory changes in the corneal surface and in the conjunctiva. Thus, it is a very disabling illness."

    Based on recent advances in the area of lipid metabolism, the product has been formulated to control the systemic inflammatory processes associated with dry eye. Its formulation is complex and addresses several of the processes that underlie dry eye.

    Many products have been developed to address the symptoms of dry eye. BioTears Oral Gel Caps systemically address the underlying causes of dry eye, he said.

    He is quick to respond when asked about why systemic treatment, as opposed to topical therapy, is beneficial. "Our product works to enhance and restore function to the glands involved in all three layers of the tear film," he said.

    Further, instead of relying on pharmacologic agents to alleviate the symptoms of dry eye, Bio-Tears Oral Gel Caps work on influencing physiologic responses with naturally occurring substances, working with the body to reverse the processes that lead to dry eye.

    "Everything we have in the formula is a natural substance. These are not pharmacologic, synthetic agents. As a subspecialty, this is the next field in ophthalmology to gain momentum: the natural response to dietary stimulants," he said. "These stimulants are natural products that jump-start the body's production of those things that have degenerated or that have been damaged by inflammation."

    BioTears Oral Gel Caps are not recommended in patients currently receiving anticoagulant therapy, he said.

    BioTears Oral Gel Caps systemically address the underlying causes of dry eye.
    BioTears Oral Gel Caps contain a blend of omega-3 and omega-6 essential fatty acids, plus all the nutrient co-factors necessary to enhance the metabolic conversion associated with the tear-specific series-one anti-inflammatory prostaglandin PGE1. Specifically, BioTears Oral Gel Caps contain specific omega-6 essential fatty acids with sufficient amounts of gamma-linolenic acid (GLA) to stimulate the natural production of series-one prostaglandins (PGE1) specific to tears. PGE1 reduces ocular inflammation.

    Pharmaceutical-grade cod liver oil is the source of omega-3 essential fatty acids and serves as a metabolic gateway boost to the downstream conversion of omega-3 fatty acids into the anti-inflammatory PGE3.

    The source of the omega-6 essential fatty acids is black currant seed oil, which was specifically chosen, noted Dr. Thornton, because it is more chemically stable than other sources, including flax seed oil. Omega-6 fatty acids convert to PGE1 via linolenic acid (LA) to GLA, and eventually to PGE1. The nutrient co-factors vitamin A, vitamin C, vitamin B6, and magnesium were included to ensure this conversion. In addition, these nutrient co-factors also work to modulate goblet cell production and neurotransmitter blink response.

    "The enzymes necessary for these conversions are disrupted by alcohol, aging, smoking, elevated cholesterol levels, and other environmental factors," he said. "With-out the additional nutrient co-factors, we wouldn't have the results that we get."

    Vitamin E, specifically gamma tocopherol, stabilizes the essential fatty acids and thus prevents oxidation. It also works to inhibit COX-2 enzyme activity that promotes inflammatory response. Curcumin, a natural COX-2 inhibitor, blocks omega-6 and omega-3 fatty acids from metabolizing to the pro-inflammatory PGE2 and IL-1. Curcumin is similar to the nonsteroidal anti-inflammatory drugs (NSAIDs) Motrin and Advil, but it does not inhibit the production of COX-1 enzyme, which protects the lining of the stomach. Therefore, severe gastric bleeding is not a risk.

    Vitamin C, as ascorbic acid and fat-soluble absorbyl palmitate, modulates PGE1 synthesis due to the extended half-life of the fat-soluble vitamin C over water-soluble ascorbic acid. This combination also enhances the production of IgE concentrates in tears, the first line of basophil and mast cell defense against invading pathogens and allergens that frequently cause dry eye symptoms.

    APO-lactoferrin inhibits the growth of both viral and bacterial pathogens in the three-layer tear film. Lactoferrin increases the level of iron-binding proteins, which help inhibit viral and bacterial infections. It also works to balance other tear lipocalins (a family of proteins that transport small hydrophobic molecules), which modulate the surface tension of the tear film. Lactoferrin is naturally produced in the tear film by neutrophils. These neutrophils are the eye's first line of defense against infection.

    "Lactoferrin is a normal, broad-spectrum antibiotic found in tears. That rationale is the same as that for 'priming the pump.' You put into the pump what you want to get out of the pump. We have primed the pump, so to speak, for lactoferrin in tears," Dr. Thornton said.

    "In post-LASIK patients, BioTears Oral Gel Caps inhibit dry eye by supporting post-surgical wound healing response, enhancing lacrimal and meibomian gland output, and enhancing the postoperative acetylcholine neurotransmitter blink response," he concluded.

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