The Gut-Eye Axis and Mandagni: An Integrated Pathophysiological and Therapeutic Framework for Dry Eye Disease Management- A Review article
DOI:
https://doi.org/10.52482/ayurline.v10i02.1006Abstract
AbstractBackground: The Gut-Eye Axis (GEA) defines a crucial bidirectional link where intestinal integrity and microbial balance significantly modulate systemic inflammatory status, impacting ocular health. Dry Eye Disease (DED) is a widespread, chronic inflammatory disorder [1] frequently managed only symptomatically by conventional methods. The identification of systemic drivers is critical for achieving therapeutic breakthroughs.
Aim: To synthesize contemporary GEA research, focusing on DED pathogenesis via cytokine and metabolite pathways, with the classical Ayurvedic concepts of Agni (digestive fire), Ama (toxins), and Pitta vitiation. This integration aims to propose a unified, evidence-based diagnostic protocol and a three-phase integrated management strategy.
Methods: A narrative review was conducted, synthesizing clinical and preclinical studies on the GEA mechanism in ocular inflammation with classical Ayurvedic texts (Charaka Samhita[4] and Astanga Hrdayam[5]). The synthesis was established through the evaluation of functional homology between modern immunological markers and traditional Ayurvedic pathological processes.
Proposed Observation/Results: Gut Dysbiosis is demonstrated to be functionally homologous to Mandagni (impaired Agni), leading to the formation of systemically active endotoxins and inflammatory signaling molecules (Ama, such as LPS and pro-inflammatory cytokines). The subsequent DED-specific ocular surface damage and inflammation are primarily mediated by Pitta vitiation
Conclusion: The integrated GEA-Agni-Ama framework provides a sophisticated, personalized model for understanding DED etiology. A phased management protocol focusing sequentially on Agni restoration, gut barrier repair, and systemic Pitta expulsion promises a more holistic and effective approach to managing chronic DED.
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