Current Advances in Mechanisms and Treatment of Dry Eye Disease: Toward Anti-inflammatory and Immunomodulatory Therapy and Traditional Chinese Medicine

Abstract

Dry eye is currently one of the most common ocular surface disease. It can lead to ocular discomfort and even cause visual impairment, which greatly affects the work and quality of life of patients. With the increasing incidence of dry eye disease (DED) in recent years, the disease is receiving more and more attention, and has become one of the hot research fields in ophthalmology research. Recently, with the in-depth research on the etiology, pathogenesis and treatment of DED, it has been shown that defects in immune regulation is one of the main pathological mechanisms of DED. Since the non-specific and specific immune response of the ocular surface are jointly regulated, a variety of immune cells and inflammatory factors are involved in the development of DED. The conventional treatment of DED is the application of artificial tears for lubricating the ocular surface. However, for moderate-to-severe DED, treatment with anti-inflammatory drugs is necessary. In this review, the immunomodulatory mechanisms of DED and the latest research progress of its related treatments including Chinese medicine will be discussed.

Moxibustion with Walnut Shell Spectacles Could Improve the Objective Symptoms and Tear Film Stability of Patients with Dry Eye Disease: A Randomized Controlled Trial

“…Impairment of both innate and adapted immunity may lead to DED [ 48 , 49 ]. Existing studies suggest that a large number of lymphocyte infiltration can be seen in the lacrimal gland and conjunctiva of DED patients, and inflammatory cells cause proinflammatory cytokine production [ 50 ], such as interleukin 1 β (IL-1 β ), tumor necrosis factor α (TNF- α ), and interleukin 6 (IL-6) [ 51 ] TCM theory holds that moxibustion has the functions of warming and dredging channels and collaterals, regulating qi and blood [ 52 ]. Also, studies suggest that moxibustion has an anti-inflammatory and immune-regulation effect [ 53 ].…”

Potential therapeutic effects of green tea (Camellia sinensis) in eye diseases, a review

“…In Traditional Chinese Medicine (TCM), it is believed to help prevent cardiovascular diseases, cancer (such as stomach, oral, and esophageal cancers), and metabolic syndrome [ 16 , 17 ]. In Ayurvedic medicine, GT has been used for gastrointestinal diseases [ 18 ].TCM has employed GT in medicinal applications for eye diseases such as glaucoma, diabetic retinopathy, and dry eye disease [ [19] , [20] , [21] ]. Traditional Persian medicine also recognized the therapeutic benefits of GT, using it for eye swelling and infection [ 22 ].…”

Current Advances in Regenerative Strategies for Dry Eye Diseases: A Comprehensive Review

“…In lymph nodes, mature APCs stimulate effector T cells (Th1 and Th17) to migrate back to the ocular surface. This triggers an immune response causing ocular surface damage and perpetuating the cycle of DED pathogenesis by releasing inflammatory cytokines [30,31].…”