title: Role of Chronic Inflammation in Myopia Progression: Clinical Evidence and Experimental Validation.
abstract: Prevention and treatment of myopia is an important public problem worldwide. We found a higher incidence of myopia among patients with inflammatory diseases such as type 1 diabetes mellitus (7.9%), uveitis (3.7%), or systemic lupus erythematosus (3.5%) compared to those without inflammatory diseases (p<0.001) using data from children (<18years old) in the National Health Insurance Research database. We then examined the inhibition of myopia by atropine in Syrian hamsters with monocular form deprivation (MFD), an experimental myopia model. We found atropine downregulated inflammation in MFD eyes. The expression levels of c-Fos, nuclear factor κB (NFκB), interleukin (IL)-6, and tumor necrosis factor (TNF)-α were upregulated in myopic eyes and downregulated upon treatment with atropine. The relationship between the inflammatory response and myopia was investigated by treating MFD hamsters with the immunosuppressive agent cyclosporine A (CSA) or the inflammatory stimulators lipopolysaccharide (LPS) or peptidoglycan (PGN). Myopia progression was slowed by CSA application but was enhanced by LPS and PGN administration. The levels of c-Fos, NF-κB, IL-6, and TNF-α were upregulated in LPS- and PGN-treated eyes and downregulated by CSA treatment. These findings provide clinical and experimental evidence that inflammation plays a crucial role in the development of myopia.
authors.affiliation: Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chang-Ching
authors.initials: CC
authors.lastname: Wei
authors.affiliation: Department of Biotechnology, Asia University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ching-Yao
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Graduate Institute of Veterinary Pathobiology, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Ter-Hsin
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Institute of Molecular Medicine, National TsingHua University, Hsinchu, Taiwan.
authors.forename: Yu-An
authors.initials: YA
authors.lastname: Hsu
authors.affiliation: Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Hsieh
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hsuan-Ju
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; Department of Gynecology, China Medical University Hospital, Taichung, Taiwan. Electronic address: leiwan@mail.cmu.edu.tw.
authors.forename: Lei
authors.initials: L
authors.lastname: Wan
mesh_terms: D000293:Adolescent; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D018929:Cell Culture Techniques; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D006224:Cricetinae; D004195:Disease Models, Animal; D018450:Disease Progression; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D015994:Incidence; D007223:Infant; D007249:Inflammation / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D009216:Myopia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D011159:Population Surveillance; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000893:Anti-Inflammatory Agents; D001285:Atropine
keywords: Inflammation; Interleukin 6; Myopia; Nuclear factor κB; Tumor necrosis factor alpha; c-Fos