Comparison of matrix metallopeptidase-9 expression following cyclosporine and diquafosol treatment in dry eye

Ann Med. 2023 Dec;55(1):2228192. doi: 10.1080/07853890.2023.2228192.

Abstract

Purpose: We sought to evaluate the expression of matrix metalloproteinase-9 (MMP-9) in dry eyes treated with 0.05% cyclosporin A and 3.0% diquafosol tetrasodium.

Methods: One-hundred ninety-five eyes of 195 patients with dry eye were divided into three groups as follows: group 1, cyclosporin group (n = 69); group 2, diquafosol group (n = 59); and group 3, artificial tears eyes (n = 67). All eyes were treated and followed up for three months. Schirmer I Test, corneal staining, tear-film break-up time (TBUT), and tear-film MMP-9 content were measured at three months and compared between groups. The expression of MMP-9 was confirmed using a point-of-care test device (InflammaDry®; RPS Diagnostics, Sarasota, FL, USA) and graded as zero to four points.

Results: At the third month, MMP-9 expression was lower in group 1 as compared with in groups 2 and 3 (p = 0.020 and 0.006, respectively). The mean MMP-9 grade according to point-of-care testing was also lower in group 1 than in groups 2 or 3 (p = 0.002 and 0.038, respectively). MMP-9 showed a correlation with corneal staining in both groups 1 and 2 (all p < 0.001) and with Schirmer I Test and TBUT in group 1 (p = 0.018 and 0.015, respectively).

Conclusions: MMP-9 expression and grade were lower after treatment with cyclosporin than after treatment with diquafosol in the dry eye disease. Anti-inflammatory treatment can decrease ocular MMP-9 levels in dry eye disease.

Keywords: 0.05% cyclosporin A; 3.0% diquafosol tetrasodium; Dry eye disease; MMP-9.

Plain language summary

MMP-9 expression and grade were lower after treatment with cyclosporin than after treatment with diquafosol in the dry eye disease. Anti-inflammatory treatment can decrease ocular MMP-9 levels in dry eye disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cyclosporine* / therapeutic use
  • Dry Eye Syndromes* / drug therapy
  • Humans
  • Matrix Metalloproteinase 9
  • Uracil Nucleotides / therapeutic use

Substances

  • Cyclosporine
  • diquafosol
  • Matrix Metalloproteinase 9
  • Uracil Nucleotides

Grants and funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education [2018R1D1A1A02085334, 2022R1F1A1069218]. All authors have no financial disclosures and attest that they meet the current ICMJE criteria for authorship.