Abstract
Dry eye disease (DED) is caused by a reduction in the volume or quality of tears. The prevalence of DED is estimated to be 100 million in the developed world. As aging is a risk factor for DED, the prevalence of DED is expected to grow at a rapid pace in aging populations, thus creating an increased need for new therapies. This review summarizes DED medications currently in clinical use. Most current medications for DED focus on stimulating tear secretion, mucin secretion, or suppressing inflammation, rather than simply replenishing the ocular surface with moisture to improve symptoms. We recently reported that the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide) induces tear secretion and suppresses corneal injury caused by a reduction in tears. Moreover, it has been reported that a PACAP in water and a 0.9% saline solution at +4 °C showed high stability and achieved 80–90% effectiveness after 2 weeks of treatment. These results reveal PACAP as a candidate DED medication. Further research on the clinical applications of PACAP in DED is necessary.
Highlights
Dry eye disease is an umbrella term covering several symptoms associated with compromised ocular lubrication, or in other words a reduced quantity of tears on the ocular surface
We recently reported that pituitary adenylate cyclase-activating polypeptide, or PACAP, plays important roles in protecting against Dry eye disease (DED)-like symptoms in mice [63]
We recently reported that PACAP stimulates tear secretion and plays important roles in protecting against DED symptoms in mice [63]
Summary
Dry eye disease is an umbrella term covering several symptoms associated with compromised ocular lubrication, or in other words a reduced quantity of tears on the ocular surface. Aqueous tear-deficient type DED is characterized by a decreased secretion of tears from the lacrimal glands, whereas evaporative type DED results from increased evaporation of tear fluid from the eye surface These conditions are not mutually exclusive; they often overlap. About two-thirds of contact lens prescriptions are for women, and women are more likely than men to undergo refractive surgery such as LASIK (laser in situ keratomileusis) [13] These factors are associated with DED, in addition to which the number of patients diagnosed with the condition has increased in recent years, which could be due to the wearing of contact lenses or the popularity of video display devices [14,15]. The reduced tear secretion that is characteristic of aqueous-deficient type DED results in tear film hyperosmolarity associated with an inflammatory cascade that produces various proinflammatory cytokines, such as interleukin-1α (IL-1α), IL-1β, tumor necrosis factor- α (TNF-α), and matrix metalloproteinase 9 [19]
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