Downregulation of IL-8, ECP, and total IgE in the tears of patients with atopic keratoconjunctivitis treated with rebamipide eyedrops.

Mayumi Ueta,Shigeru Kinoshita,Chie Sotozono,Jun Shoji

doi:10.1186/2045-7022-4-40

Abstract

Rebamipide eyedrops are approved in Japan for the treatment of dry eye disease. Some patients with allergic conjunctival diseases also manifest dry eye. Earlier we reported that rebamipide suppressed polyI:C-induced inflammatory cytokines in human conjunctival epithelial cells. In the current study we examined the effect of rebamipide eyedrops on the level of interleukin-8 (IL-8), eosinophil cationic protein (ECP), and total IgE on the ocular surface.We prescribed rebamipide eyedrops to patients with atopic keratoconjunctivitis (AKC) who presented with dry eye (6 eyes in 4 AKC patients) and measured the IL-8, ECP, and total IgE levels in their tears before- and 2, and 4–6 weeks after the start of rebamipide treatment. To measure the IL-8 and total IgE levels in their tears we used BD™ CBA Flex sets; ECP measurements were with ELISA. The level of IL-8, ECP, and total IgE in the tears of AKC patients was reduced significantly 4–6 weeks after the start of rebamipide treatment. We also recorded subjective symptoms associated with AKC, e.g. itching, foreign body sensation, and eye mucus discharge, by using a patient questionnaire. Their subjective symptoms associated with AKC were also significantly ameliorated at 2 and 4–6 weeks.Our observations suggest that the anti-inflammatory effects of rebamipide eyedrops help to combat human ocular surface inflammation and that they may be a new effective therapy in patients with AKC.Electronic supplementary materialThe online version of this article (doi:10.1186/2045-7022-4-40) contains supplementary material, which is available to authorized users.

Highlights

Rebamipide was developed as a gastroprotective drug; it increases gastric mucus production [1,2] and suppresses gastric mucosal inflammation [3,4]
We found that rebamipide suppressed polyI:C-induced inflammatory cytokines in human conjunctival epithelial cells [11] and suggested that the combination of rebamipide eyedrops and conventional anti-allergic treatments might be effective in patients with vernal/atopic keratoconjunctivitis (VKC, AKC) refractory to conventional treatment with anti-allergic- and/or immunosuppressive/steroid eyedrops [12]
Our findings suggest that rebamipide eyedrops contribute to the reduction of the level of cytokines IL-8, and eosinophil cationic protein (ECP) level in the tears of AKC patients

Summary

Introduction

Rebamipide was developed as a gastroprotective drug; it increases gastric mucus production [1,2] and suppresses gastric mucosal inflammation [3,4]. Urashima et al reported that rebamipide up-regulated the secretion and production of mucin of the ocular surface [5]. Rebamipide eyedrops are approved in Japan for the treatment of dry eye disease. We found that rebamipide suppressed polyI:C-induced inflammatory cytokines in human conjunctival epithelial cells [11] and suggested that the combination of rebamipide eyedrops and conventional anti-allergic treatments might be effective in patients with vernal/atopic keratoconjunctivitis (VKC, AKC) refractory to conventional treatment with anti-allergic- and/or immunosuppressive/steroid eyedrops [12]

Methods

Results

Conclusion