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Teeravee Hongyok, MD; Jemin J. Chae, DVM; Young Joo Shin, MD; Daero Na, MD; Li Li, MD; Roy S. Chuck, MD, PhD

Arch Ophthalmol. 2009;127(4):525-532.

Objective  To evaluate the effect of a thiolated polymer lubricant, chitosan-N-acetylcysteine conjugate (C-NAC), in a mouse model of dry eye.

Methods  Eye drops containing 0.5% C-NAC, 0.3% C-NAC, a vehicle (control group), artificial tears, or fluorometholone were applied in a masked fashion in a mouse model of induced dry eye from 3 days to 4 weeks after botulinum toxin B injection. Corneal fluorescein staining was periodically recorded. Real-time reverse transcriptase–polymerase chain reaction and immunofluorescence staining were performed at the end of the study to evaluate inflammatory cytokine expressions.

Results  Mice treated with C-NAC, 0.5%, and fluorometholone showed a downward trend that was not statistically significant in corneal staining compared with the other groups. Chitosan-NAC formulations, fluorometholone, and artificial tears significantly decreased IL-1β (interleukin 1β), IL-10, IL-12, and tumor necrosis factor expression in ocular surface tissues.

Conclusions  The botulinum toxin B–induced dry eye mouse model is potentially useful in evaluating new dry eye treatment. Evaluation of important molecular biomarkers suggests that C-NAC may impart some protective ocular surface properties. However, clinical data did not indicate statistically significant improvement of tear production and corneal staining in any of the groups tested.

Clinical Relevance  Topically applied C-NAC might protect the ocular surface in dry eye syndrome, as evidenced by decreased inflammatory cytokine expression.

Author Affiliations: Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland (Drs Hongyok, Chae, Shin, Na, Li, and Chuck); Department of Ophthalmology, Cheju Halla General Hospital, Cheju-do, South Korea (Dr Na); and Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China (Dr Li).

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