Modulation of Inflammation-Related Genes in the Cornea of a Mouse Model of Dry Eye upon Treatment with Cyclosporine Eye Drops

Curr Eye Res. 2019 May;44(5):476-485. doi: 10.1080/02713683.2018.1563197. Epub 2019 Jan 21.


Purpose/Aim: Inflammation is recognized as playing an etiological role in dry eye disease. This study aimed to assess the efficacy of various topical cyclosporine A (CsA) formulations on cornea inflammatory markers in a mouse model of dry eye.

Material and methods: Six- to 7-week-old mice treated with scopolamine were housed in a controlled environment room to induce dry eye. Following dry eye confirmation by corneal fluorescein staining (CFS), the mice were treated three times a day with: 0.05%CsA (Restasis, Allergan), 0.1%CsA (Ikervis, Santen), 1%CsA oil solution, and 0.5% loteprednol etabonate (LE, Lotemax, Baush+Lomb), or left untreated. Aqueous tear production and CFS scores were assessed during the treatment period, and corneas were collected to measure the expression profile of a selection of inflammatory genes.

Results: After 7 days of treatment, the CFS scores were reduced by 21%, 31%, and 44% with 0.05%CsA, 0.1%CsA, and 1%CsA eye drops, respectively. By contrast, 0.5% LE did not decrease corneal fluorescein staining at day 10. A statistically significant dose-dependent CFS reduction was observed only between the 0.05% and 1%CsA formulations. The gene expression profiles indicated that 12, 18, 17 genes were downregulated by 0.05%CsA, 0.1%CsA, 1%CsA, respectively. Among them, the genes significantly downregulated were: IL1A, IL1R1, and TLR4 with 0.05%CsA; H2-Eb1, IL1A, IL1B, IL1RN, IL6, TGFB2, TGFB3, TLR2, TLR3, and TLR4 with 0.1%CsA; IL1B, IL6, TGFB3, and TLR4 with 1%CsA. TGFB1 and TGFBR1 were the only genes upregulated in all groups, but only TGFB1 upregulation reached significance. IL6RA was significantly upregulated by 0.05%CsA.

Conclusions: This study indicates that the three CsA formulations effectively modulated TLR4, TGFβ1, IL1, and IL6 pathways to reduce corneal epithelium lesions in a mouse model of severe dry eye. The study also suggests that the different anti-inflammatory eye drops modulated inflammatory genes in a slightly different manner.

Keywords: Dry eye disease; biomarkers; cornea; cyclosporine; inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Ophthalmic
  • Animals
  • Cornea / metabolism
  • Cyclosporine / therapeutic use*
  • Cytokines / genetics
  • Disease Models, Animal*
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / metabolism
  • Female
  • Fluorescein / metabolism
  • Fluorescent Dyes / metabolism
  • Gene Expression Regulation / physiology*
  • Genetic Markers / genetics*
  • Immunosuppressive Agents / therapeutic use*
  • Inflammation / genetics*
  • Mice
  • Mice, Inbred C57BL
  • Ophthalmic Solutions
  • RNA, Messenger / genetics
  • Receptors, Cytokine / genetics
  • Tears / metabolism


  • Cytokines
  • Fluorescent Dyes
  • Genetic Markers
  • Immunosuppressive Agents
  • Ophthalmic Solutions
  • RNA, Messenger
  • Receptors, Cytokine
  • Cyclosporine
  • Fluorescein