Lipids from ocular meibum and tears may serve as biomarkers for depression and post‐traumatic stress disorder

Abstract Background There is a need to develop biomarkers for diagnosis and prediction of treatment responses in depression and post‐traumatic stress disorder (PTSD). Methods Cross‐sectional study examining correlations between tear inflammatory proteins, meibum and tear sphingolipids, and symptoms of depression and PTSD‐associated anxiety. Ninety individuals filled depression (Patient Health Questionnaire 9, PHQ‐9) and PTSD‐associated anxiety (PTSD Checklist‐Military Version, PCL‐M) questionnaires. In 40 patients, a multiplex assay system was used to quantify 23 inflammatory proteins in tears. In a separate group of 50 individuals, liquid chromatography‐mass spectrometry was performed on meibum and tears to quantify 34 species of sphingolipids, encompassing ceramides, monohexosyl ceramides and sphingomyelins. Results The mean age of the population was 59.4 ± 11.0 years; 89.0% self‐identified as male, 34.4% as White, 64.4% as Black, and 16.7% as Hispanic. The mean PHQ‐9 score was 11.1 ± 7.6, and the mean PCL‐M score was 44.3 ± 19.1. Symptoms of depression and PTSD‐associated anxiety were highly correlated ( ρ =0.75, p < 0.001). Both PHQ9 and PCL‐M scores negatively correlated with multiple sphingolipid species in meibum and tears. In multivariable models, meibum Monohexosyl Ceramide 26:0 (pmol), tear Ceramide 16:0 (mol%), meibum Monohexosyl Ceramide 16:0 (mol%), and tear Ceramide 26:1 (mol%) remained associated with depression and meibum Monohexosyl Ceramide 16:0 (mol%), meibum Monohexosyl Ceramide 26:0 (pmol), tear Sphingomyelin 20:0 (mol%), and tear Sphingosine‐1‐Phosphate (mol%) remained associated with PTSD‐associated anxiety. Conclusions Certain meibum and tear sphingolipid species were related to mental health indices. These interactions present opportunities for innovative diagnostic and therapeutic approaches for mental health disorders.