Role of Chronic Inflammation in Myopia Progression: Clinical Evidence and Experimental Validation

EBioMedicine. 2016 Aug:10:269-81. doi: 10.1016/j.ebiom.2016.07.021. Epub 2016 Jul 19.

Abstract

Prevention and treatment of myopia is an important public problem worldwide. We found a higher incidence of myopia among patients with inflammatory diseases such as type 1 diabetes mellitus (7.9%), uveitis (3.7%), or systemic lupus erythematosus (3.5%) compared to those without inflammatory diseases (p<0.001) using data from children (<18years old) in the National Health Insurance Research database. We then examined the inhibition of myopia by atropine in Syrian hamsters with monocular form deprivation (MFD), an experimental myopia model. We found atropine downregulated inflammation in MFD eyes. The expression levels of c-Fos, nuclear factor κB (NFκB), interleukin (IL)-6, and tumor necrosis factor (TNF)-α were upregulated in myopic eyes and downregulated upon treatment with atropine. The relationship between the inflammatory response and myopia was investigated by treating MFD hamsters with the immunosuppressive agent cyclosporine A (CSA) or the inflammatory stimulators lipopolysaccharide (LPS) or peptidoglycan (PGN). Myopia progression was slowed by CSA application but was enhanced by LPS and PGN administration. The levels of c-Fos, NF-κB, IL-6, and TNF-α were upregulated in LPS- and PGN-treated eyes and downregulated by CSA treatment. These findings provide clinical and experimental evidence that inflammation plays a crucial role in the development of myopia.

Keywords: Inflammation; Interleukin 6; Myopia; Nuclear factor κB; Tumor necrosis factor alpha; c-Fos.

MeSH terms

  • Adolescent
  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Atropine / therapeutic use
  • Cell Culture Techniques
  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Cricetinae
  • Disease Models, Animal
  • Disease Progression
  • Female
  • Gene Expression Profiling
  • Humans
  • Incidence
  • Infant
  • Inflammation / complications*
  • Inflammation / drug therapy
  • Inflammation / epidemiology
  • Male
  • Myopia / diagnosis
  • Myopia / epidemiology
  • Myopia / etiology*
  • Myopia / pathology*
  • Population Surveillance
  • Taiwan / epidemiology

Substances

  • Anti-Inflammatory Agents
  • Atropine