Irritable eye syndrome: neuroimmune mechanisms and benefits of selected nutrients

Ocul Surf. 2014 Apr;12(2):134-45. doi: 10.1016/j.jtos.2013.09.002. Epub 2013 Dec 30.


Previous studies showed comorbidity of some ocular, enteral, and affective symptoms comprising irritable eye syndrome. Aims of the present study were to learn more about the pathogenic mechanisms of this syndrome and to evaluate benefits of food supplements on these disorders. In in vitro assay, Lactobacillus acidophilus lysate inhibited interleukin (IL)-1β and tumor necrosis factor (TNF)-α generation of lipopolysaccharide (LPS)-stimulated macrophages in dose- and size-dependent manner. For a prospective, open-label phase I/II controlled clinical trial, 40 subjects affected by ocular dysesthesia and hyperesthesia and comorbid enteral and anxiety-depression symptoms were randomly assigned either into the treated group, which received a composition containing probiotic lysate, vitamins A, B, and D and omega 3 fatty acids, or into the control group, which received vitamins and omega 3 fatty acids. For reference, 20 age- and sex-matched healthy subjects were also selected. White blood count (WBC) and lymphocyte and monocyte counts, as well as IL-6 and TNF-α levels, were significantly above the reference levels in both treated and control groups. After 8 weeks, WBC and lymphocyte and monocyte counts, and cytokine levels significantly decreased, and ocular, enteral, and anxiety-depression symptoms significantly improved in the treated group as compared to the control group. This proof-of-concept study suggested that subclinical inflammation may be a common mechanism connecting ocular, enteral, and anxiety/depression symptoms, and supplements affecting dysbiosis may be a new approach to treating this syndrome.

Keywords: TNF-α; anxiety; cod liver oil; constipation; depression; diarrhea; incontinence; interleukin (IL)-6; monocyte count; ocular dysesthesia; ocular hyperesthesia; probiotic lysate; vitamin B; white blood cell count.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Cod Liver Oil / administration & dosage
  • Constipation / complications
  • Depression / complications
  • Diarrhea / complications
  • Fatty Acids, Omega-3 / administration & dosage*
  • Female
  • Humans
  • Interleukin-1beta / immunology
  • Interleukin-6 / immunology
  • Keratitis / complications
  • Keratitis / immunology*
  • Keratitis / therapy*
  • Lactobacillus acidophilus
  • Macrophages / immunology
  • Male
  • Mice, Inbred Strains
  • Middle Aged
  • Neuroimmunomodulation / immunology
  • Paresthesia / immunology
  • Paresthesia / therapy
  • Probiotics / therapeutic use*
  • Prospective Studies
  • Tumor Necrosis Factor-alpha / immunology
  • Vitamins / administration & dosage*


  • Fatty Acids, Omega-3
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Vitamins
  • Cod Liver Oil