Benzalkonium chloride (BAC) has been a culprit in the ongoing battle of treating patients ocular surface disease (OSD). When patients must be treated for glaucoma and other conditions in which the topical regimen has this preservative included in the formulation, many suffer deleterious effects from the drug.
Those with dry eye disease (DED) have a compounded effect that adds insult to injury. An interesting pre-publication in Investigative Ophthalmology & Visual Science (IOVS) by Zhang et al titled “Therapeutic Effects of Topical Doxycycline in a Benzalkonium Chloride-Induced Mouse Dry Eye Model” presents an interesting study of a possible treatment option in the future for our patients. We have seen positive effects of oral doxycycline in patients having meibomian gland dysfunction (MGD) and this study is a novel approach which includes evaluation of tear break-up time (BUT), fluorescein staining, inflammatory index, and tear volume were performed on Day 0, 1, 4, 7, and 10. Eye drops containing 0.025%, 0.1% doxycycline or solvent were administered to a BAC-induced dry eye model four times daily. Here are a few of the results: improvements in decreasing fluorescein staining scores, increasing Ki-67 positive cells, and decreasing TUNEL and keratin-10 positive cells than other groups. The mucin-filled goblet cells in conjunctivas were increased, and the expression of CD11b and levels of matrix metalloproteinase-9, interleukin (IL)-1β, IL-6, tumor necrosis factor-α, macrophage inflammatory protein-2, and cytokine-induced neutrophil chemoattractant in corneas were decreased in both doxycycline-treated groups. Wow, could this be the next blockbuster drug that might be able to obtain FDA approval or should it be something to consider simply having formulated at a compounding pharmacy?
Read more here.
Authors: Zhang Z1, Yang WZ, Zhu ZZ, Hu QQ, Chen YF, He H, Chen Y, Liu ZG.