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Published on: October 13, 2017
Matrix metalloproteinase 9 positivity predicts long term decreased tear production
Matias Soifer1, Hazem M Mousa1, Sandra S Stinnett2
1Foster Center for Ocular Immunology, Duke Eye Institute, USA; Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705, USA.
Purpose:
To investigate long-term correlations between Matrix Metalloproteinase-9 (MMP-9) testing and dry eye (DE) parameters. Additionally, to evaluate variability in MMP-9 results over time and with anti-inflammatory treatment.
Methods:
Retrospective cohort study of DE patients with equal MMP-9 testing results (positive or negative) in both eyes and a minimum of 6 months of follow up. Our main outcome measure was to examine whether initial MMP-9 status affected change in DE parameters over time. Secondarily, we evaluated the frequency of MMP-9 status change over time and examined whether MMP-9 status change was impacted by treatment.
Results:
67 patients (76% female) fit the inclusion criteria. Mean age was 63 years with a mean follow up of 10.6 months. The majority (37/67, 55%) had concomitant systemic immune disease. MMP-9 testing was positive in both eyes in 39 individuals (58%) and negative in both eyes in 27 (42%) individuals. Of all DE parameters, initial MMP status predicted change in tear production. Individuals in the MMP-9 positive group had a greater decrease in production from baseline to final visit compared to the negative group (-2.6 vs 2.1, P = 0.013). In those initially MMP-9 positive, the frequency of becoming MMP-9 negative was higher in eyes treated with anti-inflammatory therapy compared to artificial tears (22.9% vs 3.3%, P = 0.106). However, only Lifitegrast 5% showed statistical significance compared to artificial tears (31.3% vs 3.3%, P = 0.044).
Conclusions:
Eyes with detectable MMP-9 had significantly decreased tear production over time compared to those without detectable MMP-9. Anti-inflammatory treatment more frequently normalized MMP-9 compared to PFATs.
Insights
Matrix Metalloproteinase-9 (MMP-9) positive dry eye patients experienced decreased tear production over time. Anti-inflammatory treatments, particularly Lifitegrast, were more effective at normalizing MMP-9 levels compared to artificial tears.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Dry eye disease (DE) is a multifactorial condition affecting millions worldwide.
- Matrix Metalloproteinase-9 (MMP-9) is an inflammatory marker implicated in DE pathogenesis.
Purpose of the Study:
- To determine the long-term relationship between MMP-9 levels and dry eye parameters.
- To assess the impact of anti-inflammatory treatments on MMP-9 variability in DE patients.
Main Methods:
- A retrospective cohort study analyzed 67 DE patients with consistent MMP-9 test results.
- The study evaluated changes in DE parameters over a mean follow-up of 10.6 months.
- MMP-9 status changes and treatment effects were secondary outcomes.
Main Results:
- Initial MMP-9 positivity predicted a significant decrease in tear production over time.
- Patients with positive MMP-9 showed a greater decline in tear production compared to negative.
- Anti-inflammatory therapy, especially Lifitegrast 5%, increased the likelihood of MMP-9 normalization.
Conclusions:
- Detectable MMP-9 is associated with reduced tear production in dry eye patients.
- Anti-inflammatory treatments are more effective than artificial tears in normalizing MMP-9 levels.
