In a new study, researchers found the presence of a specific type of antibody, called anti-citrullinated protein autoantibodies, or ACPAs, in human tear fluid.
They demonstrated that patients with dry eye disease experienced reduced signs and symptoms of the condition in response to a new eye drop treatment that targets ACPAs.
The research was conducted by a team at the University of Illinois at Chicago.
Dry eye disease is caused by abnormalities in the tear fluid and results in dry areas over the cornea, the transparent outer layer of the eye, which can lead to disabling eye pain and sensitivity to light in severe cases.
The burden of autoimmune dry eye is much greater than just having an occasional feeling of dryness.
It can severely compromise the quality of life to the point of disability and can compromise a person’s vision.
Previously, the team discovered that strands of DNA extrude from neutrophils, a type of white blood cell, to form webs on the surface of eyes affected by severe dry eye disease and cause inflammation.
In the new study, the researchers identified ACPAs as another cause of eye inflammation that also contributes to the development of these webs.
The new eye drops treat dry eye disease by knocking the immune system out of this cycle, at least partially.
The drops are formulated using pooled antibodies—which are made from immune globulins processed from the donated blood of thousands of individuals, all containing varied types of antibodies—that counteract the negative effects of ACPAs.
The phase I/II drug trial compared the antibody-based eye drops with eye drops without the antibodies.
Twenty-seven participants with severe dry eye disease participated in the trial. One group was given eye drops made from pooled antibodies and instructed to administer one drop to each eye twice daily for eight weeks.
The control group was given the same instructions with eye drops made without antibodies.
The researchers found that people using antibody-based eye drops had a big reduction in corneal damage at eight weeks compared with the control group.
There was also a big improvement among patients using the new antibody-based eye drops when compared with the eye drops without antibodies.
In the test group, the amount of pro-inflammatory biomarkers—or dry areas—also was reduced on the surface of the eye.
The lead author of the study is Dr. Sandeep Jain, UIC professor of ophthalmology and visual sciences at the College of Medicine.
The study is published in the journal The Ocular Surface.
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