Modulation of HLA-DR in dry eye patients following 30 days of treatment with a lubricant eyedrop solution

Karen B Fernandez, Seth P Epstein, Geoffrey S Raynor, Alan T Sheyman, Morgan L Massingale, Peter G Dentone, Lukas D Landegger, Penny A Asbell, Karen B Fernandez, Seth P Epstein, Geoffrey S Raynor, Alan T Sheyman, Morgan L Massingale, Peter G Dentone, Lukas D Landegger, Penny A Asbell

Abstract

Purpose: To determine the changes in dry eye disease (DED) severity and the percentage of cells expressing HLA-DR on the ocular surface following treatment with lubricant eyedrops containing polyethylene glycol and propylene glycol (PEG/PG) and the gelling agent hydroxypropyl guar (HP-Guar).

Patients and methods: Nineteen patients with DED used PEG/PG + HP-Guar eyedrops four times per day for 30 days. Assessments included DED severity (Ocular Surface Disease Index [OSDI], corneal staining, conjunctival staining, tear film break-up time [TFBUT], and Schirmer testing) and impression cytology of the conjunctiva with masked flow cytometry at baseline and at 30 days.

Results: There was a significant decrease in corneal staining (P<0.01), OSDI (P=0.02), and TFBUT (P<0.01) following treatment with PEG/PG + HP-Guar. Results from flow cytometry revealed a significant decrease in cells expressing HLA-DR (P=0.02).

Conclusion: Treatment with PEG/PG + HP-Guar eyedrops showed improvement in dry eye severity and reduction in surface inflammation as indicated by a reduction in HLA-DR expression.

Keywords: artificial tears; dry eye disease; hydroxypropyl guar; inflammation; lubricating eyedrops; polyethylene glycol; propylene glycol.

Figures

Figure 1
Figure 1
Representative dot plot of impression cytology samples. Notes: Cell size (forward scatter pulse height [FSC-H]) versus cellular granularity (side scatter pulse height [SSC-H]) data of all events collected by cell cytology are plotted. The outlined area demonstrates a single homogenous cell subpopulation. In each sample, 1,000–10,000 cells were analyzed; samples containing less than 1,000 cells were discarded. All specimens were examined by a masked observer.
Figure 2
Figure 2
Representative dot plot of impression cytology samples collected before study treatment. Notes: Samples were analyzed after cellular debris, aggregates, and naked antibodies were excluded. Cell size (forward scatter pulse height [FSC-H]) versus cellular granularity (side scatter pulse height [SSC-H]) of samples collected before the 30-day treatment period is plotted. The outlined area demonstrates the subpopulation of cells highly expressing human leukocyte antigen D-related antigen. In each sample, 1,000–10,000 cells were analyzed. Samples containing less than 1,000 cells were discarded. A masked observer examined all specimens.
Figure 3
Figure 3
Representative dot plot of impression cytology samples collected after study treatment. Notes: Samples were analyzed after cellular debris, aggregates, and naked antibodies were excluded. Cell size (forward scatter pulse height [FSC-H]) versus cellular granularity (side scatter pulse height [SSC-H]) of patient samples collected after 30 days of treatment is plotted. The outlined area demonstrates the subpopulation of cells highly expressing human leukocyte antigen D-related antigen. In each sample, 1,000–10,000 cells were analyzed. Samples containing less than 1,000 cells were discarded. A masked observer examined all specimens.

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