IL-1¿ and MMP-9 tear levels of patients with active ocular rosacea before and after treatment with systemic azithromycin or doxycycline
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© 2018 S. Karger AG, Basel. All rights reserved. Aims: The purpose of this paper was to determine the lacrimal concentration of IL-1¿ and MMP-9 in patients with active ocular rosacea before and after systemic treatment with azithromycin or doxycycline. Methods: After 4 weeks of therapy with azithromycin (500 mg/day, 3 days a week PO) or doxycycline (200 mg/day PO), lacrimal samples were analyzed using an enzyme-linked immunosorbent assay multiplex. Results: There was a significant difference between baseline IL-1¿ (37.9 pg/mL) and MMP-9 (26.7 ng/mL) in rosacea eyes compared to controls (0.001 pg/mL for IL-1¿ and 0.2 ng/mL for MMP-9) (p < 0.001). IL-1¿ decreased from 47.0 pg/mL before azithromycin to 23.5 pg/mL after treatment (p = 0.024), but not after doxycycline therapy. On the contrary, baseline MMP-9 tear levels (10.28 ng/mL) decreased after treatment (8.36 pg/mL) with doxycycline (p = 0.054) but not with azithromycin. There was a strong clinical correlation of higher baseline IL-1¿ tear levels between patients who responded to doxycycline therapy and those who failed (p = 0.043). Patients unresponsive to azithromycin had significantly higher baseline MMP-9 levels than those with doxycycline (p = 0.040). Conclusions: While IL-1¿ levels decreased after azithromycin therapy, MMP-9 did so after doxycycline treatment. Baseline cytokine tear levels tend to be markedly elevated in patients with antibiotic failure, suggesting their potential role as therapeutic biomarkers for the disease.