氧化壓力是導致人體老化的一個重要原因，同時也涉及了許多眼睛疾病的病理過程。而為了保護並維持眼睛組織的透明與完整性不受到氧化壓力的傷害，許多抗氧化酵素、蛋白質、小分子化合物們共同建構出了眼房水中獨特的抗氧化防禦系統。眼房水的組成主要來自於血漿，並經由睫狀體的製造與分泌進入眼後房，而在其由眼後房流向眼前房的過程中，眼房水不僅僅提供了養分給沒有血管供應的眼睛組織，同時也提供了重要的抗氧化物質給這些眼睛組織。由於房水循環一直被認為是眼睛內部很重要的抗氧化物質來源。因此，本篇論文的目的就是要探究分析眼房水之抗氧化系統及其與眼睛健康之關係。
我們開發了一個總體抗氧化能力 (total antioxidant capacity, TAC) 分析套組，能夠藉由銅離子Cu2+的還原反應，去檢驗房水中的TAC。而為了進一步探究眼房水之抗氧化能力組成，我們檢測了眼房水之抗壞血酸 (ascorbic acid, AA) 濃度，也同時分析了眼房水之抗氧化蛋白質體學，希望藉由結合小分子檢驗與蛋白質體學的研究，對房水中之抗氧化能力進行較為全面的分析。此外，我們也探究了眼房水之TAC與AA濃度對眼睛健康的影響。我們執行了一個包含129位病人的病例對照研究，去評估眼房水之TAC、AA濃度、與角膜內皮細胞密度之間的關係。在這個研究中，參與者會根據他們原始的角膜內皮細胞密度，被分入角膜內皮細胞密度不足 (角膜內皮細胞密度 < 2100 cells/mm2 )的組別或是健康的對照組。而進一步我們也執行了另一個病例系列研究，去探討眼房水之TAC與白內障嚴重度之關係。
我們的結果顯示AA貢獻了超過70%的眼房水TAC，並且兩者之間是有顯著相關性的 (rho > 0.8, P < 0.001)。此外，我們發現TAC跟AA濃度都是對抗角膜內皮細胞密度不足顯著的保護因子，其中針對角膜內皮細胞密度不足，TAC校正後的勝算比為0.02 (P = 0.017)，而AA校正後的勝算比為0.023 (P = 0.033)。而在眼房水之TAC與白內障嚴重度相關性的研究當中，眼房水之TAC展現了與超音波白內障乳化手術耗能之間獨立的關聯性。因此，在結論上，我們發現眼房水之TAC及AA濃度與角膜內皮細胞密度及白內障之嚴重度之間都有顯著的相關性，這樣的結果也許可以推斷房水之TAC及AA濃度皆與眼睛健康密切相關。

Oxidative stress is one of the leading causes of age-related health problems and implicated in the pathological process of various ocular diseases. To protect the transparent ocular tissues from oxidative stress, several antioxidative enzymes, proteins, and small molecules build up the unique antioxidant defense system in the aqueous humor (AqH). AqH is formed from the plasma components and secreated into the posterior chamber by the ciliary body. As the AqH travels from posterior chamber to anterior chamber, it not only supplies nutrition, but also provides antioxidants for the avascular ocular tissues. Because the AqH circulation is considered an important source for the antioxidants in the eye, the purpose of this study is to investigate the antioxidant system in AqH and analyze its correlation with eye health.
We have developed a total antioxidant capacity (TAC) assay to detect the TAC in AqH based on the redox reaction of Cu2+. To further delve into the composition of AqH TAC, we measured the concentration of ascorbic acid (AA), and analyzed the antioxidant proteomics in AqH in order to give a holistic view of the AqH antioxidant capacity. In addition, we have investigated the influence of AqH TAC and AA on eye health. We conducted a case control study with 129 patients to evaluate the correlation among AqH TAC, AA concentrations, and corneal endothelial cell density (ECD). In the study, participants were classified into insufficient endothelial cell density (IECD, ECD < 2100 cells/mm2) group or control group according to their baseline ECD values. Moreover, we have conducted a case series study to investigate the correlation between AqH TAC and cataract severity.
Our findings showed that AA contributes over 70% of the AqH TAC, and there’s a high correlation between AqH TAC and AA concentration (rho > 0.8, P < 0.001). In addition, we found both TAC and AA are significant protective factors against the IECD. The adjusted odds ratio of TAC and AA are 0.02 (P = 0.017) and 0.023 (P = 0.033) respectively for IECD.As to the correlation between AqH TAC and cataract severity, the AqH TAC demonstrated an independent association with the cumulative dissipated energy during the cataract surgery (P < 0.001). In conclusion, the AqH TAC and AA both showed significant correlations with the ECD and the severity of cataract. These results might indicate that both TAC and AA in the AqH have a notable correlation with the eyes’ health.

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