Gene expression in tears of patients with dry eye disease and meibomian gland dysfunction treated with intensive pulsed light

Abstract

AbstractPurpose: To better understand the effect of IPL we have designed a study where we compared the signs and symptoms of patients with DED‐MGD and the changes in the genes found in the conjunctival cells after treatment with IPL (Thermaeye Plus) using a transcriptomic and multiplexed approach.Methods: A prospective study of 60 consecutive subjects, 30 controls and 30 patients with DED‐MGD. These were treated with 4 IPL sessions (12 flashes of 8 J/cm2) on periocular area at day 1, 14, 28, and 49 and evaluated before and 1 month after last session. Tears were collected from the conjunctival fornix at the beginning and at the end, 1 month after the last session. They were amplified with nCounter® Low RNA Input Amplification Kit and the Human Immunology V2 Panel (NanoString Technologies) with 594 transcripts genes was performed to analyse the differentially expressed genes.Results: 7 pathways' signatures upregulated in DED‐MGD were compared to controls: Type I and Type II Interferon, MHC class I and II antigen presentation, B cell Receptor signalling, Immunometabolism and T cell receptor signalling. A high correlation was observed between the clinical improvement after the IPL and the decrease in some of the upregulated genes (p < 0.01). Ten genes showed a positive significant correlation with OSDI (ADA, LTA, CD19, TLR9, IRF5, TGFB1, CD27, HLA‐DPB1, PTPN6 and MAP4K1) and IFITM1, showed inverse correlation. For osmolarity, CD19 and IRF5 were significantly and positively correlated, For TS1 parameter, we observe a positive correlation for NCR1, CEACAM8 and CCL8 genes and inverse correlation for TGFBI/SLC2A1 genes.Conclusions: High correlation between clinical data and genetic analysis was present in patients with DED‐MGD comparing pre and post‐treatment with IPL. The presence of upregulated genes related to the inflammatory process reduced after IPL treatment suggests that part of the effect of IPL is due to the improvement of inflammation.