Can hyaluronan cure dry eye disease?

As you read this are your eyes burning, itchy, tired, dry or red? If so, you may be one of 21 million people in the United States living with dry eye disease (DED). If you don't have it now, you may soon-the numbers are expected to rise as the population ages, and as anyone who suffers from it can tell you, it will decrease your productivity and reduce your quality of life.

Unfortunately, treatment options for DED are limited. What is known is that the Meibomian gland undergoes age-related changes that may account for the disease. Clinical studies suggest that 85% of all dry eye cases are caused by some form of Meibomian gland dysfunction (MGD). Meibomian glands are oil glands on the edge of the eyelids; the oil they produce is an important part of the eye's tears, keeping tears from quickly drying.

Enter a discovery in the lab of Vivien Coulson-Thomas, associate professor of optometry in the University of Houston College of Optometry: an extra cellular matrix or ECM (a network of proteins and other molecules) that surrounds and supports the Meibomian gland and is rich with hyaluronan (HA), a molecule known to protect and lubricate soft tissue.

Hyaluronan is widely used for treating numerous conditions, including application around the eyes and into the eyelids in order to reduce the appearance of wrinkles.

Coulson-Thomas has been awarded a $1.6 million grant by the National Eye Institute to put those puzzle pieces together and further examine Meibomian glands' extra cellular matrix, the role of hyaluronan and whether an increased amount or HA in the gland can prevent age-related Meibomian gland dysfunction.

She believes it can, with research findings indicating that an increase in HA expression in and around the MG can maintain viable progenitor cells which, in turn, prevents age-related MGD. Progenitor cells, like stem cells, can become other types of cells.

Coulson-Thomas also aims to discover whether hyaluronan administration into the eyelids can be used to prevent dry eye disease, and that would be bombshell.

"This type of treatment requires reoccurring HA administrations, similar to BOTOX® treatment. Therefore, repeated HA applications into the eyelid has already been clinically demonstrated to be very well tolerated with negligible side effects (which are mostly associated with the administration procedure and not with HA)," said Coulson-Thomas.

"Thus, there is immense value in investigating whether this type of treatment, which is already available in the clinic for esthetic purposes, could also be used to treat a clinically relevant condition for which currently only palliative care is available."

The research team, which will also investigate how hyaluronan prevents MG atrophy, is the first to investigate the role of the extra cellular matrix in the Meibomian gland.

Reference:

Kim Y, Moon CH, Kim B-Y, Jang SY. Oral Hyaluronic Acid Supplementation for the Treatment of Dry Eye Disease: A Pilot Study. Journal of ophthalmology.