Matrix metalloproteinase 9 positivity predicts long term decreased tear production

Ocul Surf. 2021 Jan:19:270-274. doi: 10.1016/j.jtos.2020.10.003. Epub 2020 Oct 21.

Abstract

Purpose: To investigate long-term correlations between Matrix Metalloproteinase-9 (MMP-9) testing and dry eye (DE) parameters. Additionally, to evaluate variability in MMP-9 results over time and with anti-inflammatory treatment.

Methods: Retrospective cohort study of DE patients with equal MMP-9 testing results (positive or negative) in both eyes and a minimum of 6 months of follow up. Our main outcome measure was to examine whether initial MMP-9 status affected change in DE parameters over time. Secondarily, we evaluated the frequency of MMP-9 status change over time and examined whether MMP-9 status change was impacted by treatment.

Results: 67 patients (76% female) fit the inclusion criteria. Mean age was 63 years with a mean follow up of 10.6 months. The majority (37/67, 55%) had concomitant systemic immune disease. MMP-9 testing was positive in both eyes in 39 individuals (58%) and negative in both eyes in 27 (42%) individuals. Of all DE parameters, initial MMP status predicted change in tear production. Individuals in the MMP-9 positive group had a greater decrease in production from baseline to final visit compared to the negative group (-2.6 vs 2.1, P = 0.013). In those initially MMP-9 positive, the frequency of becoming MMP-9 negative was higher in eyes treated with anti-inflammatory therapy compared to artificial tears (22.9% vs 3.3%, P = 0.106). However, only Lifitegrast 5% showed statistical significance compared to artificial tears (31.3% vs 3.3%, P = 0.044).

Conclusions: Eyes with detectable MMP-9 had significantly decreased tear production over time compared to those without detectable MMP-9. Anti-inflammatory treatment more frequently normalized MMP-9 compared to PFATs.

Keywords: Anti-inflammatory therapy; Diagnosis dry eye; Inflammatory dry eye; Matrix Metalloproteinase-9; Ocular surface inflammation; Tear production.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Dry Eye Syndromes* / drug therapy
  • Female
  • Humans
  • Lubricant Eye Drops
  • Male
  • Matrix Metalloproteinase 9*
  • Middle Aged
  • Retrospective Studies
  • Tears

Substances

  • Lubricant Eye Drops
  • MMP9 protein, human
  • Matrix Metalloproteinase 9