Analysis of topical cyclosporine treatment of patients with dry eye syndrome: effect on conjunctival lymphocytes.
OBJECTIVE
To study the effect of topical cyclosporine on lymphocyte activation within the conjunctiva of patients with moderate to severe dry eye syndrome (Sjögren and non-Sjögren).


METHODS
Biopsy specimens were obtained at baseline and after 6 months of cyclosporine treatment from eyes of 32 patients with moderate to severe dry eye syndrome; 19 were cyclosporine treated (0.05% cyclosporine, n = 13; 0.1% cyclosporine, n = 6) and 13 were vehicle treated. Within this group there were 12 with Sjögren syndrome and 20 with non-Sjögren syndrome. Biopsy tissue was analyzed using immunohistochemical localization of binding of monoclonal antibodies to lymphocytic markers CD3, CD4, and CD8 as well as lymphocyte activation markers CD11a and HLA-DR.


RESULTS
In cyclosporine-treated eyes, biopsy results of conjunctivae showed decreases in the number of cells positive for CD3, CD4, and CD8, while in vehicle-treated eyes, results showed increases in these markers, although these differences were not statistically significant. Following treatment with 0.05% cyclosporine, there was a significant decrease in the number of cells expressing the lymphocyte activation markers CD11a (P<.05) and HLA-DR (P<.05), indicating less activation of lymphocytes as compared with vehicle treatment. Within the Sjögren patient subgroup, those treated with 0.05% cyclosporine also showed a significant decrease in the number of cells positive for CD11a (P<.001) as well as CD3 (P<.03), indicating a reduction in number of activated lymphocytes.


CONCLUSIONS
Treatment of dry eye syndrome with topical cyclosporine significantly reduced the numbers of activated lymphocytes within the conjunctiva. Arch Ophthalmol. 2000;118:1489-1496
Kunert
K S
KS
Schepens Eye Research Institute, Boston, MA 02114.
Tisdale
A S
AS
Stern
M E
ME
Smith
J A
JA
Gipson
I K
IK
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000276:immunology; D001706:Biopsy; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003228:Conjunctiva / Q000276:immunology* / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use*; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008213:Lymphocyte Activation / Q000187:drug effects*; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
D015703:Antigens, CD; D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine