Formaldehyde Gas Exposure Increases Inflammation in an In Vitro Model of Dry Eye

Dry eye (DE) is a multifactorial ocular surface disease whose incidence continues to rise. Various environmental stresses such as low air humidity and pollution are known to be involved in epithelial alterations inducing ocular discomfort. However, no experimental study assessing the combined effects of dry air and polluted atmospheres has been conducted so far. Formaldehyde (FA) is a ubiquitous pollutant present in the living spaces where humans spend most of their time. Using an in vitro DE model, we evaluated the cytotoxic and inflammatory responses of a conjunctival cell line exposed at the air-liquid interface (ALI) conditions to various controlled atmospheres combining low humidity (LH), airflow (AF), and formaldehyde gas (FG). Conjunctiva-derived cells grown onto transwell inserts were directly exposed to LH conditions without AF, with AF or with FG flow at 100 or 1200 µg/m3 for 15-30 min. Cell viability assays revealed an increase in cell death after a 15-min exposure to FG at 100 or 1200 µg/m3, whatever the recovery period. After a 1-h recovery period, an increase in IL-6 and CXCL8/IL-8 gene expression was observed with the 15-min exposure at 100 µg/m3 FG and with 30 min of exposure at 1200 µg/m3 FG. After 24 h of recovery, we also noted increased secretion of the proinflammatory cytokine MIF with 100 µg/m3 FG exposure and CXCL8/IL-8 at 1200 µg/m3, for both exposure periods. Together, these findings suggest that the exposure to FG at environmental levels aggravates cell death and inflammation observed in dry air conditions. This in vitro model of DE seems to be a relevant tool to study and explain the inflammatory responses observed in dry eye patients when exposed to combined environmental disturbances such as LH, airflow, and the presence of airborne pollutants.