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A. Iovieno, B. Stampachiacchiere, A. Micera, R. Sgrulletta, P. Lauretti, A. Lambiase, S. Bonini; Characterization of Doxycycline Effects on the Ocular Surface of Patients Affected by Chronic Blefaritis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):367.
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The aim of this study is to evaluate the effect of systemic doxycycline treatment on signs, symptoms, conjunctival cytology, and conjunctival ICAM-1 expression of patients affected by chronic blepharitis.
8 patients with chronic blepharitis (6 M/2 F; mean age 45.7 ± 17.5; ranging 25-69) were included in the study. Doxycycline was administrated orally, twice a day, for 2 weeks and once a day for additional 2 weeks. Clinical signs (conjunctival hyperemia, secretion, marginal blepharitis, meibomianitis, superficial punctuate keratopathy) and symptoms (itching, foreign body sensation, dryness, burning, tearing) were evaluated and scored (0-3) at baseline and after 4 weeks. The total sign (TSS) and the total symptom (TSyS) scores were calculated and statistically analysed according to non-parametric Mann-Whitney U-test. Conjunctival impression cytology was performed at baseline and after 4 weeks of doxycycline treatment in 3 patients (3 M; mean age 46 ± 20.6; ranging 29-69). Cell number and morphology were evaluated by PAS staining while ICAM-1 expression was detected by real-time PCR on impression cytology.
When compared to baseline, an improvement of total symptoms (TSyS baseline 4.5 ± 2.2 vs. 4 weeks 2.7 ± 1.5; p<0.05) and signs (TSS: baseline 6.6 ± 1.3 vs. 4 weeks 3.1 ± 1.9; p<0.001) was observed after 4 weeks of treatment. In particular, conjunctival hyperemia, marginal blepharitis and superficial punctuate keratopathy were significantly ameliorated (p<0.05). Qualitative (size and morphology) but not quantitative (number) changes of goblet cells was associated to clinical improvement. Real-time PCR analysis revealed a down-regulation of ICAM-1 mRNA.
The study shows that 4 weeks-treatment with doxycycline significantly improved symptoms and signs in patients with chronic blepharitis in association with a decrease of the ICAM-1 inflammatory marker. The fact that goblet cells appeared significantly changed in both size and metachromatic features might suggest a possible effect of doxycycline on goblet cells function and mucin secretion.
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