Lactoferrin concentration in tears of patients with chronic conjunctivitis and effect of Lacto eyedrops in the multicomponent treatment for this disorder


  • Galyna Drozhzhyna Filatov Institute of Eye Disease and Tissue Therapy, NAMS of Ukraine
  • L.Yu. Riazanova Filatov Institute of Eye Disease and Tissue Therapy, NAMS of Ukraine
  • Nataliya Khramenko Filatov Institute of Eye Disease and Tissue Therapy, NAMS of Ukraine
  • L.M. Velychko Filatov Institute of Eye Disease and Tissue Therapy, NAMS of Ukraine



chronic conjunctivitis, lactoferrin, tear, antimicrobial properties


Background: Lactoferrin (LF) is a non-heme iron-binding glycoprotein of the transferrin family. It is a natural component of the tear film, has bacteriostatic, bactericidal, fungicidal, antiviral, and antioxidant properties, and thus plays an important role in the protection of the ocular surface from infections. A low tear LF concentration has been found in some ocular disorders, but there have been no reports on the determination of LF concentration in tears of patients with chronic conjunctivitis (CC).

Purpose: To determine LF concentration in tears of patients with CC, and to assess the effect of LACTO eye drops in the multicomponent treatment for the disorder.

Material and Methods: Eleven patients (17 eyes) with CC were included in the study. Patient age ranged from 27 to 68 years, and the duration of CC, from 3.5 to 7 months. The ophthalmological examination included biomicroscopy of the bulbar conjunctiva and cornea, fluorescein examination, determination of corneal sensation and basal tear production (Schirmer’s II test), and microbiological examination of the conjunctiva. Corneal and conjunctival xerosis was assessed using the method of van Bijsterveld. Patients were administered a topical antiseptic four times daily, preservative-free hyaluronic acid artificial tears four times daily, and Lacto eye drops twice daily over a month. Concentration of LF in the tear samples was determined by a human LF enzyme-linked immunosorbent assay kit before treatment and at day 30 of treatment.

Results: Seven patients (11 eyes) underwent an examination after the completion of a one-month treatment with Lacto eye drops. Tear LF concentration (mean ± standard deviation (SD)) in patients with CC was 1.37 ± 0.4 mg/ml (95% confidence interval, 1.16–1.58). The examination found no microbial growth in all these 11 eyes, with 6/7 patients presenting no complaints after treatment. There was no statistically significant change in Schirmer II test values from baseline. Corneal sensation was found to be improved in 6/11 eyes. After a one-month treatment with Lacto eye drops, tear LF concentration (a) decreased from a relatively high (mean ± SD, 1.65 ± 0.45 mg/ml) value at baseline to 1.05 ± 0.33 mg/ml (р = 0.04) in four eyes (eyes nos. 1-4), (b) increased from 1.52 ± 0.21 to 2.03 ± 0.41 gm/ml in other four eyes (eyes nos. 6-8, 11), and (c)  increased from a low value (0.85 ± 0.17 mg/ml) to 1.18 ± 0.27 (р = 0.07) in eyes nos. 5, 9, and 11.

Conclusion: Lacto eye drops were found to have an immune modulating effect, with any low tear LF at baseline increased in an amount required for normalization of the conjunctival microbiota after treatment. In addition, our microbiological study after one-month administration of Lacto eye drops as a component of therapy for CC demonstrated that the medication provided a sanitizing effect, with no conjunctival microbiota growth but subjective improvement in complaints in all patients.


Schneider JE, Scheibling CM, Segall D, Sambursky R, Ohsfeldt RL, Lovejoy L. Epidemiology and economic burden of conjunctivitis: a managed care perspective. // J. Manag Care Med. 2014;17(1):78-83.

Селіванова ОВ. Клініко-експериментальне обґрунтування корекції рівня тіолових сполук в тканині кон'юнктиви та слізній рідині при медикаментозному лікуванні кон' юнктивітів. Дис. канд. мед наук, Київ 2011. 166 с

Моісеєнко РО, Михальчук ВМ, Риков СО. Офтальмологічна допомога в Україні за 2014-2017 роки. Аналітично статистичний довідник. КР-й: ПОЛІУМ». 2018. 314с.

Azari А.А, Arabi А., Conjunctivitis: a systematic review. J Ophthalmic Vis Res. 2020 July-September; 15(3): 372-395.

Benza D. Blephariris and conjunctivitis: Guidelines for diagnosis and Treatment . Barselona: Editoreal Glosa; 2006. 245 с.

Дрожжина Г.И. Конъюнктивит. Клиника, диагностика, лечение, Одесса Астропринт, 2010. 31с .

Поляк МС, Околов ИН, Пирогов ЮИ. Повреждающее действие антибиотиков. Антибиотики в офтальмологии. С.Петербург, 2015: 125-141

Брижань ГА. Профілактика ускладнень місцевої антибіотикотерапії у пацієнтів з синдромом сухого ока. Дис. канд. мед наук, Одесса 2017. 154 с.

Завгородняя НГ, БрижаньАА. Влияние профилактической антибиотикотерапии в хирургии катаракты на цитологический статус эпителия конъюнктивы. Офтальмолгия. Восточная Европа. 2016; 6(1): 14-27

Борзенкова НВ, Балабушевич НГ. Лактоферин: фізико-хімічні властивості, біологічні функції, системи доставки, лікуючі засоби та біологічно активні речовини. Біофарм. журн. 2010; 3: 3-19

Дрожжина ГИ, Великсар ТА. Невидимый защитник глаза - лактоферрин. Український журнал «Офтальмологія». 2021; 1 (12).

Janssen PT, van Bijsterveld OP. Origin and biosynthesis of human tear fluid proteins. Invest. Ophthalmol. Vis. Sci. 1983;24:623-630.

Tsai PS, Evans JE, Green KM, Sullivan RM, Schaumberg DA, Richards SM et al. Proteomic analysis of human meibomian gland secretions. Br. J. Ophthalmol. 2006; 90: 372-377.

McDermott AM. Antimicrobial compounds in tears. Exp Eye Res. 2013;117:53-61.

Flanagan JL., Willcox MD. Role of lactoferrin in the tear film. Biochimie. 2009;91:35-43.

Weinberg ED. Human lactoferrin: a novel therapeutic with broad spectrum potential. J. Pharm. Pharmacol. 2001;53:1303-1310.

Ponzini Е, Scotti L, Grandori R, Tavazzi S, Zambon A. Lactoferrin Concentration in Human Tears and Ocular Diseases: A Meta-Analysis. Invest. Ophthalmol. Vis. Sci. 2020;61(12):9.

Kijlstra A, Jeurissen SH, Koning KM. Lactoferrin levels in normal human tears. Br J Ophthalmol. 1983; 67(3): 199-202

Jensen OL, Gluud BS, Birgens HS. The concentration of lactoferrin in tears of normals and of diabetics. Acta Ophthalmol (Copenh). 1986 Feb;64(1):83-7.

Ellison 3rd RT, Giehl TJ, La Force FM. Damage of the outer membrane of enteric gram-negative bacteria by lactoferrin and transferrin. Infect. Immun. 1988;56: 2774-2781.

Oram JD, Reiter B. Inhibition of bacteria by lactoferrin and other iron-chelating agents. Biochim. Biophys. Acta. 1968;170:351-365.

Jagat R, Kanwar I, Kislay R. Multifunctional Iron Bound Lactoferrin and Nanomedicinal Approaches to Enhance Its Bioactive Functions. Molecules. 2015;20:9703-9731.

Vagge A, Senni C, Bernabei F, et al. Therapeutic effects of lactoferrin in ocular diseаses from dry eye disease to infections. Int. Journ. of Mol. Sci. 2020;21(66884):1-8.

Faulkner WJ, Varley GA. Corneal diagnostic tecnique. Cornea: Foundamentals of Cornea and External Disease. Mosby: St Louis, MO. 1997: 275-281.

Yasinska Е, Bogut А, Assessment of the role of staphylococci in the pathomechanism of conjunctivitis. Int Ophthalmol. 2021; 41(7): 2585-2600.

Jay S Pepose J, Sujata P, Sarda, Wendy Y Cheng, Nora McCormick, Hoi Ching Cheung et al. Direct and Indirect Costs of Infectious Conjunctivitis in a Commercially Insured Population in the United States Klin. Ophthalmol. 2020; 14: 377-387.

Epling J. Bacterial conjunctivitis. BMJ Clin Evid 2012;2012:0704.

Orsi N. The antimicrobial activity of lactoferrin: Current status and perspectives. BioMetals. 2004; 17: 189-196.

González-Chávez SA, Arévalo-Gallegos S, Rascón-Cruz Q. Lactoferrin: structure, function and applications. Int J Antimicrob Agents. 2009; 33(4): 301.e1-301e8

Siqueiros-Cendón T, Arévalo-Gallegos S, Iglesias-Figueroa B, García-Montoya I. A, Salazar-Martínez J, Rascón-Cruz Q. Immunomodulatory effects of lactoferrin. Acta. Pharmacol. Sin. 2014;35:557-566.

Legrand D, Elass E, Carpentier M, Mazurier J. Lactoferrin: a modulator of immune and inflammatory responses. Cell. Mol. Life Sci. 2005;62:2549-2559.

Versura P, Bavelloni A, Grillini M, Fresina M, Campos EC. Diagnostic performance of a tear protein panel in early dry eye. Mol.Vis. 2013; 19: 1247-1257.



How to Cite

Drozhzhyna G, Riazanova L, Khramenko N, Velychko L. Lactoferrin concentration in tears of patients with chronic conjunctivitis and effect of Lacto eyedrops in the multicomponent treatment for this disorder. J.ophthalmol.(Ukraine) [Internet]. 2023 Feb. 28 [cited 2023 Mar. 24];(1):39-45. Available from:



Clinical Ophthalmology