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Analysis of Topical Cyclosporine Treatment of Patients With Dry Eye Syndrome
Effect on Conjunctival Lymphocytes
Kathleen S. Kunert, MD;
Ann S. Tisdale, MS;
Michael E. Stern, PhD;
J. A. Smith;
Ilene K. Gipson, PhD
Arch Ophthalmol. 2000;118:1489-1496.
Objective To study the effect of topical cyclosporine on lymphocyte activation within the conjunctiva of patients with moderate to severe dry eye syndrome (Sjögren and non-Sjögren).
Methods Biopsy specimens were obtained at baseline and after 6 months of cyclosporine treatment from eyes of 32 patients with moderate to severe dry eye syndrome; 19 were cyclosporine treated (0.05% cyclosporine, n = 13; 0.1% cyclosporine, n = 6) and 13 were vehicle treated. Within this group there were 12 with Sjögren syndrome and 20 with non–Sjögren syndrome. Biopsy tissue was analyzed using immunohistochemical localization of binding of monoclonal antibodies to lymphocytic markers CD3, CD4, and CD8 as well as lymphocyte activation markers CD11a and HLA-DR.
Results In cyclosporine-treated eyes, biopsy results of conjunctivae showed decreases in the number of cells positive for CD3, CD4, and CD8, while in vehicle-treated eyes, results showed increases in these markers, although these differences were not statistically significant. Following treatment with 0.05% cyclosporine, there was a significant decrease in the number of cells expressing the lymphocyte activation markers CD11a (P<.05) and HLA-DR (P<.05), indicating less activation of lymphocytes as compared with vehicle treatment. Within the Sjögren patient subgroup, those treated with 0.05% cyclosporine also showed a significant decrease in the number of cells positive for CD11a (P<.001) as well as CD3 (P<.03), indicating a reduction in number of activated lymphocytes.
Conclusion Treatment of dry eye syndrome with topical cyclosporine significantly reduced the numbers of activated lymphocytes within the conjunctiva.
From the Schepens Eye Research Institute and Department of Ophthalmology, Harvard Medical School, Boston, Mass (Drs Kunert and Gipson, Ms Tisdale); Allergan, Inc, Irvine, Calif (Dr Stern); and the National Eye Institute, Bethesda, Md (Ms Smith). Dr Stern is an employee of Allergan Inc.
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