Synergistic Effect of Artificial Tears Containing Epigallocatechin Gallate and Hyaluronic Acid for the Treatment of Rabbits with Dry Eye Syndrome

PLoS One. 2016 Jun 23;11(6):e0157982. doi: 10.1371/journal.pone.0157982. eCollection 2016.

Abstract

Dry eye syndrome (DES) is a common eye disease. Artificial tears (AT) are used to treat DES, but they are not effective. In this study, we assessed the anti-inflammatory effect of AT containing epigallocatechin gallate (EGCG) and hyaluronic acid (HA) on DES. Human corneal epithelial cells (HCECs) were used in the WST-8 assay to determine the safe dose of EGCG. Lipopolysaccharide-stimulated HCECs showing inflammation were treated with EGCG/HA. The expression of IL-1ß, IL-6, IL-8, and TNF-α was assessed by real-time PCR and AT physical properties such as the viscosity, osmolarity, and pH were examined. AT containing EGCG and HA were topically administered in a rabbit DES model established by treatment with 0.1% benzalkonium chloride (BAC). Tear secretion was assessed and fluorescein, H&E, and TUNEL staining were performed. Inflammatory cytokine levels in the corneas were also examined. The non-toxic optimal concentration of EGCG used for the treatment of HCECs in vitro was 10 μg/mL. The expression of several inflammatory genes, including IL-1ß, IL-6, IL-8, and TNF-α, was significantly inhibited in inflamed HCECs treated with 10 μg/mL EGCG and 0.1% (w/v) HA (E10/HA) compared to that in inflamed HCECs treated with either EGCG or HA alone. AT containing E10/HA mimic human tears, with similar osmolarity and viscosity and a neutral pH. Fluorescence examination of the ocular surface of mouse eyes showed that HA increased drug retention on the ocular surface. Topical treatment of DES rabbits with AT plus E10/HA increased tear secretion, reduced corneal epithelial damage, and maintained the epithelial layers and stromal structure. Moreover, the corneas of the E10/HA-treated rabbits showed fewer apoptotic cells, lower inflammation, and decreased IL-6, IL-8, and TNF-α levels. In conclusion, we showed that AT plus E10/HA had anti-inflammatory and mucoadhesive properties when used as topical eye drops and were effective for treating DES in rabbits.

MeSH terms

  • Animals
  • Catechin / analogs & derivatives*
  • Catechin / chemistry
  • Catechin / pharmacology
  • Cytokines / genetics
  • Cytokines / metabolism
  • Disease Models, Animal
  • Drug Synergism
  • Dry Eye Syndromes / drug therapy
  • Dry Eye Syndromes / genetics*
  • Dry Eye Syndromes / metabolism*
  • Dry Eye Syndromes / pathology
  • Epithelial Cells / drug effects
  • Epithelial Cells / metabolism
  • Epithelium, Corneal / cytology
  • Epithelium, Corneal / drug effects
  • Epithelium, Corneal / metabolism
  • Epithelium, Corneal / pathology
  • Gene Expression Profiling
  • Humans
  • Hyaluronic Acid / chemistry
  • Hyaluronic Acid / pharmacology*
  • Inflammation Mediators
  • Lubricant Eye Drops / chemistry*
  • Lubricant Eye Drops / pharmacology*
  • Male
  • Rabbits

Substances

  • Cytokines
  • Inflammation Mediators
  • Lubricant Eye Drops
  • Catechin
  • Hyaluronic Acid
  • epigallocatechin gallate

Grants and funding

This work was supported by grants from Ministry of Science and Technology (MOST), Taiwan under grant number at MOST 102-2221-E-038 -007; and an integrated research grant in health and medical sciences from National Health Research Institute (NHRI), Taiwan at grant number of NHRI-EX103-10334EI awarded to CL Tseng. An Innovation grant of Southern Taiwan Science Park at grant number of CZ-01-01-01-105 was awarded to HW Fang.