Resolution of persistent corneal erosion after administration of topical rebamipide

Abstract

Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren’s syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren’s syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various mechanisms, rebamipide improves ocular surface conditions. To our knowledge, this is the first clinical case report using rebamipide ophthalmic solution. This drug may provide a novel approach to treat drying diseases of the eye.

Rebamipide alleviates radiation‐induced colitis through improvement of goblet cell differentiation in mice

“…Application of rebamipide has been shown to increase the proliferation of goblet cells in eye disorders. 26,27 We also identified that rebamipide increases goblet cell proliferation in the normal colon through H&E and PAS staining (Fig. 3a,b).…”

Rebamipide increases barrier function and attenuates TNFα-induced barrier disruption and cytokine expression in human corneal epithelial cells

“…In addition, a clinical trial recently revealed that rebamipide ameliorated corneal and conjunctival epithelial damage as well as increasing tear film stability in individuals with dry eye 12. Rebamipide is thus now marketed in Japan as a preservative-free ophthalmic suspension for the treatment of dry eye 13. Given that inflammation has been implicated in the pathology of dry eye, the anti-inflammatory effects of rebamipide might contribute to its efficacy for the treatment of dry eye.…”

Topical rebamipide improves lid wiper epitheliopathy

“…Recently, the clinical effects of rebamipide eye drops (Mucosta® ophthalmic suspen sion UD2%; Otsuka Pharmaceutical Co, Ltd, Tokyo, Japan) for various types of dry eye were reported 1,2,23,24. Rebamipide eye drops for dry eye are also being developed for approval in the US.…”