ESCRS - FPS11.11 - Gene Expression Analysis In Tears Of Patients With Dry Eye Disease And Meibomian Gland Dysfunction (Ded-Mgd) After Treatmen With Intensive Pulsed Light (Ipl)

Gene Expression Analysis In Tears Of Patients With Dry Eye Disease And Meibomian Gland Dysfunction (Ded-Mgd) After Treatmen With Intensive Pulsed Light (Ipl)

Published 2022 - 40th Congress of the ESCRS

Reference: FPS11.11 | Type: Free paper | DOI: 10.82333/x9tk-8j39

Authors: José Salgado Borges 1 , Carlos Vérges* 2 , Ana Gimenez 3 , Franch March de Ribot 4

1Ophthalmology,Clinica Oftalmológica Salgado Borges,Porto,Portugal, 2Ophthalmology,Area Oftalmologica Avanzada. Hospital Quiron Dexeus. Universitat Autónoma de Barcelona,Barcelona,Spain, 3Oncology,(2) Pangaea Oncology Laboratory. Hospital Quiron Dexeus. Universitat Autónoma de Barcelona,Brcelona,Spain, 4Ophthalmology,Girona Hospital, Girona University,Girona,Spain

Purpose

Some clinical studies in patients with dry eye (DED) and meibomian gland dysfunction (MGD) show the benefits of treatment with Intensive Pulsed Light (IPL), especially the symptoms of the disease, but there is still a lack of studies that corroborate this clinical improvement and to better understand how IPL works. The purpose of this study is to prove if the treatment of dry eye with IPL shows an improvement in the genetic expression in the tear analysis of these patients.

Setting

: Department of Ophthalmology and Pangaea Oncology Laboratory. Hospital Quiron Dexeus. Universitat Autónoma de Barcelona. Barcelona, Spain.

Methods

Prospective study of 60 consecutive subjects (60 eyes), 30 correspond to control group, G1 and 30 correspond to mild-moderate DED-MGD patient’s, G2. G2 patients were treated with 4 IPL sessions (Thermaeye Plus), 12 flashes, (8 J/cm2) on the periocular area at day 1, 14, 28, and 49. All were evaluated before IPL sessions and 1 month after the last session. Tears were collected from the conjunctival fornix at the beginning and at the end, after 80 ds, 1 m from the last session in G2. Tears samples were amplified with nCounter® Low RNA Input Amplification Kit  and  the Human Immunology V2 Panel (NanoString Technologies) with 594 transcripts of which 15 are housekeeping genes was performed to analyze the differentially expressed genes (DEGs).

Results

We observed 7 pathways’ signatures upregulated in DED-MGD compared to controls: Type I and Type II Interferon, MHC class I and II antigen presentation, B cell Receptor signaling, Immunometabolism and T cell receptor signaling. A high correlation was observed between the clinical improvement after the IPL and the decrease in some of the upregulated genes (P<0.001). Ten genes show 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

Our results show clinical improvement after IPL treatment, similar to previous studies but the most relevant was the high correlation between the clinical data and the genetic analysis. We detect 45 genes upregulated in patients with DED-MGD versus controls and the Machine learning analysis resulted in a 4-gene signature including IFITM1, HLA-A, CTSS and CCL4. These genes were downregulated after treatment with IPL in the majority of patients. Moreover the presence of upregulated genes that belong to 7 pathways related to  the inflammatory process reduced after treatment with the IPL, sugests that part of the effect of IPL is due to the improvement of inflammation runnig in parallel with the symptoms suffered by patients with DED-MGD.