ROLE OF WAX ESTER FATTY ALCOHOLS IN CHRONIC BLEPHARITIS

Purpose. This study was performed to determine the difference in the c omposition of wax ester fatty alcohols from meibomian gland secretions from normal people and those with blepharitis, and to determine which lipids are associated significantly with specific chronic blepharitis disease groups. Methods. Fatty alcohols, isolated by thin-layer chrom atography from the wax and sterol ester fraction of human meibum, were analyzed by gas chromatography-mass spectroscopy after oxidative ozon olysis and silylation of the alcohol groups. Relative amounts of indiv idual lipids or lipid groupings in each patient group were analyzed st atistically by Dunnett's comparison, with the overall significance lev el adjusted for multiple testing (Bonferroni adjustment). Results. Sig nificant differences (P < 0.05) between the normal group and five dise ase groups were found in certain alcohol groups. These alcohols includ ed certain normal (straight chain-methyl group on chain end) and antei so (methyl group on second carbon from chain end) alcohols, as well as the ratio of iso (methyl group on first carbon from chain end) to ant eiso alcohols. The results also suggested that alpha-oxidation activit y was significantly different for certain groups. The unsaturated alco hols were primarily normal alcohols. Epoxy-fatty acids also were prese nt in the alcohol fraction. Conclusions. These data suggest that meibo mian gland lipid differences may contribute significantly to some chro nic blepharitis disease signs and also suggest that peroxisomal or end oplasmic reticulum abnormalities may contribute in part to some of the se lipid differences.