Desiccating stress-induced disruption of ocular surface immune tolerance drives dry eye disease

GUZMÁN MAURICIO; KEITELMAN IRENE; SABBIONE FLORENCIA; TREVANI ANALÍA SILVINA; GIORDANO MIRTA NILDA; GALLETTI JEREMÍAS GASTÓN

CLINICAL AND EXPERIMENTAL IMMUNOLOGY

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Londres; Año: 2015

0009-9104

Dry eye is an allegedly autoimmune disorder for which the initiating mechanisms and the targeted antigens in the ocular surface are not known, yet there is extensive evidence that a localized Th1/Th17 effector T cell response is responsible for its pathogenesis. In this work, we explore the reconciling hypothesis that desiccating stress, which is usually considered an exacerbating factor, could actually be sufficient to skew the ocular surface´s mucosal response to any antigen and therefore drive the disease. Using a mouse model of dry eye, we found that desiccating stress causes an NF-κB- and time-dependent disruption of the ocular surface´s immune tolerance to exogenous ovalbumin. This pathogenic event is mediated by increased Th1 and Th17 T cells and reduced regulatory T cells in the draining lymph nodes. Conversely, topical NF-κB inhibitors reduced corneal epithelial damage and IL-1β and IL-6 levels in the ocular surface of mice under desiccating stress. The observed effect was mediated by an augmented regulatory T cell response, a finding that highlights the role of mucosal tolerance disruption in dry eye pathogenesis. Remarkably, the NF-κB pathway is also involved in mucosal tolerance disruption in other ocular surface disorders. These results altogether suggest that targeting of mucosal NF-κB activation could have therapeutic potential in dry eye.