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Lactobacillus sakei is an investigational biologic therapy being developed by Shiraz University of Medical Sciences for the treatment of dry eye syndrome. The therapy utilizes the probiotic bacterial strain *Latilactobacillus sakei* (formerly *Lactobacillus sakei*) and is being evaluated in two distinct formulations: an ophthalmic eye drop containing a bacterial lysate (a postbiotic) and an oral capsule containing live probiotic bacteria. [2, 4] A Phase 2 clinical trial (NCT04938908) found that the ophthalmic formulation, branded Protears, significantly improved signs and symptoms of dry eye disease, whereas the oral probiotic formulation did not show a significant effect. [2, 3] The mechanism of action is believed to involve the modulation of the ocular surface microbiome and the downregulation of inflammatory responses by reducing levels of inflammatory cytokines such as IL-6, TNF-α, and IFN-γ. [2, 4] The eye drop formulation is approved as a medical device in the European Union. [2, 3]
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