Abstract
The pathophysiology of dry eye disease (DED) remains largely unknown, accounting in part for the lack of successful treatments. We explored the pathophysiology of DED using a rabbit model of chronic DED induced with 3 weekly injections of Concanavalin A into the periorbital lacrimal glands. The transcriptome of full-thickness’s conjunctival tissue from rabbits with DED and from normal controls was determined using microarrays and, as needed, confirmatory real-time polymerase chain reactions. Results were subjected to bioinformatic analysis. DED induced large-scale changes in gene transcription involving 5,184 genes (22% of the total). Differentially expressed genes could be segregated into: functional modules and clusters; altered pathways; functionally linked genes; and groups of individual genes of known or suspected pathophysiological relevance to DED. A common feature of these subgroups is the breadth and magnitude of the changes that encompass ocular immunology and essentially all aspects of cell biology. Prominent changes concerned innate and adaptive immune responses; ocular surface inflammation; at least 25 significantly altered signaling pathways; a large number of chemokines; cell cycle; and apoptosis. Comparison of our findings to the limited extant transcriptomic data from DED patients associated with either Sjogren’s syndrome or non-Sjogren’s etiologies revealed a significant correlation between human and rabbit DED transcriptomes. Our data, establishing the large-scale transcriptomic changes of DED and their potential similarity to the human, underscore the enormous complexity of DED; establish a robust animal model of DED; will help expand our understanding of its pathophysiology; and could guide the development of successful therapeutic strategies.
Highlights
Dry eye disease (DED) is a multifactorial disease characterized by disrupted tear film homeostasis on the ocular surface and accompanied by ocular symptoms triggered by hyperosmolarity, ocular surface inflammation and neurosensory abnormalities [1,2,3]
We show that four parameters of DED, which monitor different aspect of the ocular surface, tear composition and stability, Transcriptome changes of rabbit conjunctiva in dry eye disease were all abnormal and consistent with chronic DED
Our findings provide strong evidence of large-scale changes in the expression of over a fifth of the rabbit genome in the conjunctiva associated with chronic DED
Summary
Dry eye disease (DED) is a multifactorial disease characterized by disrupted tear film homeostasis on the ocular surface and accompanied by ocular symptoms triggered by hyperosmolarity, ocular surface inflammation and neurosensory abnormalities [1,2,3]. DED affects 1 in 6 humans with an estimated prevalence of 15%, and has a staggering impact on the economy [4]. DED symptoms range widely from mild discomfort to the devastating loss of vision or neuropathic ocular pain requiring narcotics for its control [6]. Current therapies of DED, including topically administered pharmacological agents, are considered suboptimal. A thorough understanding of the pathogenesis of DED is deemed crucial if further progress in its treatment is to be made
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