Treatment of Ocular Rosacea With Once-Daily Low-Dose Doxycycline

Sobolewska, Bianka; Doycheva, Deshka; Deuter, Christoph; Pfeffer, Ines; Schaller, Martin; Zierhut, Manfred

doi:10.1097/ico.0000000000000051

Cited by 66 publications

(39 citation statements)

References 23 publications

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“…Furthermore, combined therapy with tetracyclines and steroids has shown promising therapeutic effects in asthmatic patients. In addition, doxycycline has been used in ocular diseases, such as meibomian gland disease and rosacea, 6,17 and recurrent corneal erosions. 18,19 In a randomized, proof-of-concept clinical trial of participants with diabetic retinopathy who received oral doxycycline monohydrate, 50 mg, daily for 24 months was associated with improved frequency doubling the perimetry foveal sensitivity compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

“…Doxycycline has been reported to be useful for treating a number of inflammatory and/or immune diseases, including rheumatoid arthritis, rosacea, periodontitis, experimental autoimmune neuritis, and myocardial infarction. [5][6][7][8][9] Therefore, doxycycline may represent a therapeutic option for the treatment of uveitis. However, the function of doxycycline in uveitis has not yet been explored.…”

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confidence: 99%

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Doxycycline Attenuates Endotoxin-Induced Uveitis by Prostaglandin E2-EP4 Signaling

Huang

Chen

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Citation: Huang J, Su W, Chen X, et al. Doxycycline attenuates endotoxin-induced uveitis by prostaglandin E2-EP4 signaling. Invest Ophthalmol Vis Sci. 2015;56:6686-6693. DOI:10.1167/ iovs.15-17045 PURPOSE. We explored the anti-inflammatory effects of doxycycline in experimental uveitis and the underlying mechanisms.METHODS. Rats with endotoxin-induced uveitis (EIU) received doxycycline (1.5 mg/kg) or the control vehicle via intraperitoneal injection. Clinical scores were graded under a slit lamp. Rat peritoneal macrophages were used in vitro to further explore the anti-inflammatory mechanisms of doxycycline. The levels of nitric oxide (NO), TNF-a, IL-1b, prostaglandin E2 (PGE2), cyclooxygenase (COX)-2, I kappa B-a (IjB-a), inducible nitric oxide synthase (iNOS), Akt, caspase-3, and nuclear factor-kappa B (NF-jB) were analyzed.RESULTS. Treatment with doxycycline dramatically reduced the clinical scores of EIU (P < 0.001), with significant decreases in inflammatory cell infiltration, protein concentrations, and the production of NO, TNF-a, and IL-1b in the aqueous humor (AqH). In vitro, doxycycline significantly inhibited the production of NO, IL-1b, and TNF-a in peritoneal macrophages by modulating the PI3K/Akt/IjB-a/NF-jB pathway. Importantly, we found that doxycycline significantly enhanced COX2 expression and PGE2 production both in vivo and in vitro. More importantly, blockade of the EP4 receptor of PGE2 significantly reversed the doxycycline-mediated inhibition of macrophages and the PI3K/Akt pathway in vitro. Furthermore, simultaneous injection of an EP4 antagonist and doxycycline significantly blocked the doxycycline-mediated attenuation of EIU.CONCLUSIONS. Doxycycline can ameliorate EIU, and PGE2-EP4 signaling is essential for the antiinflammatory effects of doxycycline in vitro and in vivo.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Doxycycline Attenuates Endotoxin-Induced Uveitis by Prostaglandin E2-EP4 Signaling

Huang

Chen

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…En los casos graves con lisis corneal y riesgo de perforación ocular, puede ser necesario el tratamiento con fármacos inmunosupresores o inmunomoduladores sistémicos 10 .…”

Section: Formas Gravesunclassified

La rosácea ocular en la frontera de la dermatología y la oftalmología

Jacob¹,

Bueis²,

Casas³

2016

Más Dermatol

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La rosácea es una enfermedad cutánea caracterizada por un eritema facial que se localiza en la nariz, las mejillas, la frente y el mentón, y que, con el tiempo, se hace persistente, acompañado de pápulas y pústulas 1 . En algunas ocasiones, se produce hiperplasia de tejidos blandos. Es una enfermedad muy común. Es más frecuente en personas de piel clara, durante la juventud y la madurez. Se observa un predominio del sexo femenino, aunque el desarrollo de hiperplasia de tejidos blandos de la nariz o rinofima es más común en hombres. ETIOpATOGENIALa etiología se desconoce, pero se han identificado varios factores que contribuyen a su desarrollo como: predisposición genética, trastornos psicológicos, parasitación por el ácaro Demodex folliculorum y alteraciones digestivas inespecíficas o relacionadas con Helicobacter pylori. Ninguno de ellos se ha confirmado de forma definitiva. Los pacientes presentan labilidad vasomotora o hiperreactividad vascular facial con tendencia a la vasodilatación ante varios estímulos como el calor, el frío, las radiaciones solares, las bebidas alcohólicas, las comidas calientes o las emociones. Son frecuentes los episodios de rubor. INTRODUCCIÓN: IMpORTANCIA DE LA COLAbORACIÓN MULTIDIsCIpLINARIALa rosácea es una enfermedad multidisciplinaria, que obliga, en muchas ocasiones, a la colaboración entre dos especialidades que tienen muchas afinidades entre sí, como son la dermatología y la oftalmología.

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“…The treatment of ocular rosacea is based on systemic anti-inflammatory drug therapy, topical therapy with artificial tears, and eyelid hygiene. Once-daily low dose (40 mg) doxycycline is a safe and effective treatment [63]. Cyclosporine A is a calcineurin inhibitor that possesses anti-inflammatory properties.…”

Section: Treatment Of Rosaceamentioning

confidence: 99%

Recent advances in the understanding and management of rosacea

Wollina¹

2014

F1000Prime Rep

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Rosacea is a chronic relapsing inflammatory facial dermatosis. There are several known triggers but the pathogenesis remains unknown. Recent achievements in understanding this disease point to the importance of skin-environmental interactions. This includes physical and chemical factors, but also microbial factors. The impairment of the skin barrier function and the activation of the innate immune defences are major and connected pathways contributing to an ongoing inflammatory response in the affected skin. This becomes modulated by endogenous factors like neurovascular, drugs, and psychological factors. These factors offer new therapeutic targets for rosacea treatment. There is a broader range of anti-inflammatory compounds available with a favourable safety record. Only recently have persistent erythema and flushing been addressed by new drug formulations.

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Treatment of Ocular Rosacea With Once-Daily Low-Dose Doxycycline

Abstract: An antiinflammatory dose of slow-release doxycycline 40 mg given daily may be an effective and safe therapy of ocular rosacea.

Cited by 66 publications

References 23 publications

Doxycycline Attenuates Endotoxin-Induced Uveitis by Prostaglandin E2-EP4 Signaling

Doxycycline Attenuates Endotoxin-Induced Uveitis by Prostaglandin E2-EP4 Signaling

La rosácea ocular en la frontera de la dermatología y la oftalmología

Recent advances in the understanding and management of rosacea

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