Working Groups
How to Join the TEAR-Precision COST Action
​
Researchers, clinicians, industry partners, and anyone interested in tear fluid research are warmly invited to join the TEAR-PRECISION COST Action (CA24112). Participation in a COST Action is open and free of charge for individuals affiliated with institutions from COST Member Countries or approved partner countries.
​
To become a member of TEAR-Precision and take part in one or more Working Groups (WGs):
​
-
Create an e-COST profile on the official COST platform: https://e-services.cost.eu
-
Once logged in, search for the Action CA24112 – TEAR-Precision.
-
Click “Apply to join” and select the Working Group(s) you wish to participate in.
-
In your application, please include a few sentences describing your background, expertise, motivation to join, and how your work or interests relate to tear fluid research or precision medicine. You may also indicate any relevant experience or skills that could contribute to the Action’s objectives.
-
Your application will be reviewed by the Action’s Core Group and the respective WG Leaders.
​
Members of TEAR-Precision have the opportunity to contribute to collaborative research activities, participate in Training Schools, Short-Term Scientific Missions (STSMs), conferences, and workshops, and engage with a growing international network of experts advancing the field of tear fluid biomarkers.
​
Please note, Management Committee nominations are carried out through the COST National Contact Points.
​
If you have questions or need assistance with your application, please contact us at: tear.precision@gmail.com
WG1: Harmonizing Tear Fluid Collection
Leaders
Leader: Irem Onal​
Co-Leader: Nikolay Boychev​
Relevance:
A wide variety of different tear fluid collection methods (paper Schirmer’s strips, glass capillaries, sponges, washes, etc.) are currently being used by different researchers and there is an evidence gap and lack of agreement on the best option. In order to reduce variation of tear fluid research results, it is strongly suggested to harmonize the collection method.
​
Objectives:
To reach consensus on a single tear fluid collection method for use in future tear fluid research and to provide a standard operating procedure (SOP) for tear fluid sampling.
​
Tasks:
T1.1) Collectively write an extensive scoping review (including >1400 papers!) to summarize the tear fluid collection methods that are currently being used and have been used in the past.
T1.2) Discuss advantages and disadvantages of each collection method, collect and/or generate evidence and reach consensus through a Delphi study on the most optimal method.
T1.3) Generate a SOP and instruction video on how to use that collection method as best practice for future tear fluid research.
T1.4) Organize a training school on this topic.
​
Milestones:
M1.1) Global review of tear fluid collection methods.
M1.2) Consensus for optimal tear fluid.
M1.3) Training material ready for dedicated training school.​
WG2: Harmonizing terminology and reporting of tear fluid methodologies
​Leaders
Leader: Jente Schmeetz​
Co-Leader: Clémence Bonnet​
Relevance:
Currently, there are over ten synonyms for tear fluid (such as lacrimal fluid and ocular surface fluid), which complicates the field. In addition, published tear fluid studies are not always reproducible and one reason for that is because many papers fail to report crucial information on their methodology, which is essential to repeat the study in the same way. In order to increase reproducibility of tear fluid data, it is suggested to harmonize the way of reporting tear fluid methodologies.
​
Objectives:
To reach consensus on the best terminology and reporting practices for tear fluid methodologies and to report that as recommendations.
​
Tasks:
T2.1) Identify terminology and reporting gaps by summarizing and comparing the current reporting practice in many papers (the set of papers for the scoping review (T1.1) can be used for this).
T2.2) Discuss these gaps and achieve consensus through a Delphi study on the terminology and essential factors that need to be reported.
T2.3) Generate recommendations for best practices of tear fluid terminology and methodology reporting.
T2.4) Broadly disseminate these results and ensure adherence of the guidelines by the field.
​
Milestones:
M2.1) Consensus on the best terminology and reporting practices.
M2.2) Recommendation for tear fluid terminology and methodology reporting ready for dissemination.
WG3: Harmonizing interpretation of tear fluid data
​Leaders
Leader: Bjoern Titz​
Co-Leader: Erika Ponzini​
Relevance:
Tear fluid data interpretation should be done with utmost care, as tear fluid biomarkers are highly sensitive to variations in volume. Several different ways to normalize tear fluid data are currently being used, such as tear volume, tear weight, total tear protein content, or endogenous tear proteins. The lack of consensus and evidence on normalization prevents meaningful comparison and compilation of data across studies.
​
Objectives:
To reach consensus on the best normalization method for tear fluid data and to provide a standard operating procedure (SOP).
​
Tasks:
T3.1) Write a position paper on the need to normalize tear fluid data and provide an overview of current normalization methods.
T3.2) Discuss advantages and disadvantages of each normalization approach and collect and/or generate evidence to support the most optimal method.
T3.3) Generate a SOP on how to apply that normalization method as best practice for future tear fluid research.
T3.4) Broadly disseminate these results and ensure adherence of the guidelines by the field.
​
Milestones:
M3.1) Collect and/or generate supporting evidence.
M3.2) Consensus on the best normalization method.
M3.3) Recommendation for tear fluid normalization ready for dissemination.
WG4:
Offering reference values for commonly investigated tear fluid biomarkers
​Leaders
Leader: Amalia Enriquez de Salamanca​
Co-Leader: Burak Mergen​
Relevance:
While other body fluids have established reference values for certain markers that are used as threshold values to distinguish abnormal disease situations (e.g. blood glucose levels for diabetes), tear fluid reference values have never been assembled for any tear fluid biomarker. Also, as a result of this absence, these tear fluid biomarkers are being re-investigated over and over again, using unnecessary human patient material and resources.
​
Objectives:
To offer the first proof-of-concept for tear fluid biomarker reference values and to report on that.
​
Tasks:
T4.1) Write a position paper on the importance of reference values in the field of tear fluid research.
T4.2) Agree upon a (group of) commonly investigated tear fluid biomarker(s) to create the first 10 reference values.
T4.3) Collect evidence papers (the set of papers for the scoping review (T1.1) can be used for this) and perform a systematic review with meta-analysis on the tear fluid results.
T4.4) Compile the generated reference values in a manuscript for publication.
T4.5) Organize a dedicated seminar to disseminate these results and stimulate expansion and continuation.
​
Milestones:
M4.1) Agreement on top 10 tear fluid biomarkers.
M4.2) Proof-of-concept for reference values of 10 tear biomarkers ready for dissemination.
WG5: Constructing the first central tear fluid protein database for data sharing
​Leaders
Leader: Rosa Fernandes​
Co-Leader: TBA
Relevance:
Proteomics and other –omics technologies are commonly used to investigate tear fluid proteins and other components. These results are invaluable in the discovery of disease biomarkers. To illustrate, the latest proteomics study identified over 1600 different tear proteins. However, to date, there is no central place available to store and/or share this data.
​
Objectives:
To centralize data repository of tear fluid proteins and to report on that.
​
Tasks:
T5.1) Design how the central database should look like.
T5.2) Build (and maintain) the web-based database using existing knowledge and tools.
T5.3) Generate an SOP for the use of the dataset and how to import data.
T5.4) Approach researchers with established proteomic datasets to import their data in the database.
T5.5) Organize online seminar sessions to disseminate these results.
​
Milestones:
M5.1) Launch of an online open-access tear fluid database.
M5.2) Training material for the use of this database ready for dissemination.
WG6: Harmonizing tear fluid biobanking
​Leaders
Leader: Karima Kessal​
Co-Leader: Francois Brignole-Baudouin​
Relevance:
Several research groups have started to store tear fluid samples for future research. The use of tear samples from multiple biobanks worldwide is particularly important when investigating rare diseases, diseases with varying prevalence across ethnic groups, and for large-scale epidemiological and genetic studies. To enable sharing of tear fluid samples from different biobanks, it is of utmost importance to streamline the processes of tear fluid biobanking. Additionally, a global overview of existing tear fluid biobanks is currently lacking. Establishing such an overview will facilitate collaborative and multicentric investigations on tear protein profiles across a wide range of conditions.
​
Objectives:
To harmonize tear fluid biobanking for future research and to report on that.
​
Tasks:
T6.1) Identify and invite tear biobanks in Europe and beyond.
T6.2) Develop an online global biobank database that compiles all tear biobanks.
T6.3) Publish about this novel repository of existing tear fluid biobanks and the need for starting up new tear fluid biobanks.
T6.4) Discuss and agree on the requirements (materials, resources, etc.) and processes (ethical, legal, privacy, etc.) for starting up a new tear fluid biobank (Delphi-consensus study).
T6.5) Generate a SOP and step-by-step instruction video for “Starting your own tear fluid biobank.”
T6.6) Organize visits to well-established tear biobanks.
​
Milestones:
M6.1) Launch of an online open-access global tear fluid biobank repository.
M6.2) Consensus on guidelines for starting up a new tear fluid biobank.
M6.3) Training material ready for a dedicated training school on this subject.
WG7:
Exploring fundamental knowledge gaps
​Leaders
Leader: Manuel Jimenez-Navarro​
Co-Leader: Sammar Marei​
Relevance:
Most of today’s tear fluid researchers, even the highly experienced ones, believe that tear fluid composition, production, and homeostasis are not yet fully understood and that pieces of the ‘knowledge puzzle’ are still missing. For example, it remains unclear how the blood–tear barrier functions (if it exists) and how neurological markers appear in tear fluid.
Objectives:
To identify fundamental knowledge gaps and develop a plan to address and unravel them.
​
Tasks:
T7.1) Design and distribute a survey among all tear fluid researchers to identify missing knowledge areas.
T7.2) Organize creative brainstorming sessions and invite speakers from other disciplines (e.g., researchers studying other body fluids), as well as patients and patient organizations.
T7.3) Participate in third-party conferences to learn from related research fields.
T7.4) Publish the results of the survey and the outcomes of the brainstorming sessions.
T7.5) Develop a future plan to investigate these identified gaps (e.g., form interest subgroups, apply for joint research grants, etc.).
​
Milestones:
M7.1) Identify at least three fundamental knowledge gaps.
M7.2) Define future plans and funding opportunities to address these gaps.
WG8:
Supporting tear-based point-of-care test development
​Leaders
Leader: Tatiana Suarez​
Co-Leader: Qendrese Daka​
Relevance:
A few tear-based point-of-care (POC) devices have already been developed and commercialized; however, their clinical use remains limited. A multidisciplinary approach early in the development process is required to better understand the optimal applications and mechanisms of these devices and to ensure their successful introduction and adoption in clinical practice.
​
Objectives:
To align the needs of clinicians with the development of future tear-based POC tests.
​
Tasks:
T8.1) Create a team with experts from various fields (clinicians, ophthalmologists, optometrists, nurses, biochemists, cell biologists, engineers, GPs), patient organizations, and industrial partners.
T8.2) Organize hackathon-style meetings to stimulate creativity and innovation.
T8.3) Participate in third-party conferences (e.g., Alzheimer’s, HIV, breast cancer) to gather external insights and opinions on tear fluid POC tests.
T8.4) Involve patients and patient organizations to include their perspectives and needs.
T8.5) Engage with regulatory authorities to ensure that future POC tests comply with relevant standards.
T8.6) Use artificial intelligence (AI) tools in a secure and ethical manner to supplement the needs of the stakeholders mentioned above.
T8.7) Achieve consensus on a “wish list” of desirable test features (e.g., high sensitivity, specificity, user-friendly, affordable, safe, etc.).
T8.8) Use two pre-existing examples as proof-of-principle.
​
Milestones:
M8.1) Consensus on the optimal device characteristics to ensure and accelerate clinical use.
M8.2) Proof-of-principle of two tear-based tests ready for clinical validation.