Minocycline Controls Clinical Outcomes and Inflammatory Cytokines in Moderate and Severe Meibomian Gland Dysfunction

• Published in: American journal of ophthalmology 2012-12, Vol.154 (6), p.949-957.e1
• Main Authors: Lee, Hun, Min, Kyung, Kim, Eung Kweon, Kim, Tae-Im
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Clinical outcomes; Colleges & universities; Cytokines; Cytokines - metabolism; Eye Proteins - metabolism; Eyelid Diseases - drug therapy; Eyelid Diseases - metabolism; Female; Flow Cytometry; Fluorophotometry; Hospitals; Humans; Interferon; Lipids; Luminescent Measurements; Male; Medical sciences; Meibomian Glands - drug effects; Meibomian Glands - metabolism; Middle Aged; Minocycline - administration & dosage; Minocycline - therapeutic use; Miscellaneous; Ophthalmic Solutions - administration & dosage; Ophthalmology; Prospective Studies; Standard deviation; Statistical methods; Tears - metabolism; Treatment Outcome; University colleges
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2012.06.009

Purpose To assess clinical outcomes and tear cytokine levels in patients with moderate and severe meibomian gland dysfunction (MGD) after treatment with oral minocycline and artificial tears versus artificial tears only. Design Prospective, randomized clinical trial. Methods Sixty eyes of 60 patients with stage 3 or 4 meibomian gland dysfunction were enrolled. We evaluated the tear film break-up time, Schirmer test results, corneal and conjunctival fluorescein staining results, biomicroscopic examination results of lid margins and meibomian glands, and tear cytokine levels before and after 1 month and 2 months of oral minocycline and artificial tears (group 1) or artificial tears only (group 2). Tear samples were collected and analyzed using a BD Cytometric Bead Array (BD Bioscience, San Jose, California, USA) for detection of interleukin (IL)-1β, IL-6, IL-7, IL-8, IL-12p70, IL-17α, interferon-γ, tumor necrosis factor-α, and monocyte chemotactic protein-1. The Wilcoxon signed-rank test, Mann–Whitney U test, generalized linear model, and linear mixed model were performed. Results Patients in group 1 showed statistically significant improvement in all clinical signs and symptoms after 1 month and 2 months of treatment. Patients of group 1 showed more significant improvement compared with those in group 2. Patients in group 1 also showed statistically significant reductions in IL-6, IL-1β, IL-17α, tumor necrosis factor-α, and IL-12p70 after 2 months of treatment. Conclusions Oral minocycline can provide clinical benefits in treating moderate and severe meibomian gland dysfunction by reducing inflammatory cytokine levels.