Topical 0.1% prednisolone lowers nerve growth factor expression in keratoconjunctivitis sicca patients.
OBJECTIVE
To compare nerve growth factor (NGF) levels in tears and on the ocular surfaces of normal control and non-Sjögren's type keratoconjunctivitis sicca subjects, and to investigate the effect of 0.1% prednisolone eyedrops on NGF levels in keratoconjunctivitis sicca patients.


METHODS
Prospective, double-masked, randomized, comparative clinical trial.


METHODS
Forty-one keratoconjunctivitis sicca patients and 23 age- and gender-matched healthy subjects.


METHODS
Baseline tear NGF levels were measured in keratoconjunctivitis sicca patients and healthy control subjects using enzyme-linked immunosorbent assays. Keratoconjunctivitis sicca patients received 0.1% prednisolone drops in one eye and 0.1% hyaluronic acid drops in the other, 3 times a day for 28 days. Also, impression cytology (IC) and immunostaining for NGF on conjunctival epithelium were performed on both groups.


METHODS
Tear NGF/total tear protein (TP) concentration ratio, IC and NGF immunocytologic staining, subjective symptom scale, tear breakup time, and Schirmer values.


RESULTS
Keratoconjunctivitis sicca patients were found to have baseline tear NGF concentrations higher than those of age- and gender-matched healthy control subjects (65.9+/-14.5 vs. 122.1+/-45.3 pg/mug, P<0.0001). In keratoconjunctivitis sicca patients, prednisolone treatment for 28 days resulted in a decrease in tear NGF levels, symptom scores, and IC scores, whereas hyaluronic acid treatment had no such effect (68.2+/-25.0 pg/mug vs. 108.0+/-43.4 pg/mug, P<0.0001 for tear NGF/TP ratio; 2.16+/-1.01 vs. 3.39+/-1.50, P = 0.0014 for symptom scale; 1.05+/-0.67 vs. 1.61+/-0.86, P = 0.0317 for IC). Measurements taken at both 14 and 28 days indicated that neither prednisolone nor hyaluronic acid treatment affected breakup time or Schirmer values.


CONCLUSIONS
Keratoconjunctivitis sicca patients showed elevated levels of tear NGF, which were decreased by treatment with 0.1% prednisolone. These data suggest that ocular surface NGF may play an important role in ocular surface inflammation processes associated with dry eyes.
Lee
Hyung Keun
HK
Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Ryu
Ik Hee
IH
Seo
Kyoung Yul
KY
Hong
SoonWon
S
Kim
Hyung Chang
HC
Kim
Eung Kweon
EK
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000187:drug effects / Q000378:metabolism; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D004848:Epithelium / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000378:metabolism*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*
D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D020932:Nerve Growth Factor; D011239:Prednisolone