Androgen and meibomian gland dysfunction: from basic molecular biology to clinical applications

Meibomian gland, the largest sebaceous gland of the body, is responsible for the biosynthesis of lipid layer of the tear film to prevent excessive evaporation. The loss of normal functions of meibomian gland, known as meibomian gland dysfunction (MGD), is a chronic disease and is the leading cause of dry eye symptoms in the clinics. Studies have found sex hormones, especially androgen, play vital roles in the regulation of the functions of meibomian gland. Recently, androgen has also been preliminarily applied in clinics for the treatment of MGD and showed promising results, especially in people with endogenous androgen deficiency. This review summarized the mechanisms of the function of androgen on meibomian gland based on molecular, animal, and clinical studies, and proposed evidence-based views about its potential applications for the treatment of MGD.