The role of Mineralocorticoid Receptor pathway in Ocular Rosacea

Ocular rosacea (OR) is a chronic inflammatory disease of the ocular surface and the eyelids, favored by UV exposure. It can affect vision, damage the cornea and has a significant impact on quality of life. OR is linked to meibomian gland dysfunction (MGD), but is poorly understood, largely underdiagnosed and incurable. Human samples and an UVB-induced OR rat model bring evidence of the central role of mineralocorticoid receptor (MR) pathway overactivation in OR pathogenesis. In patients suffering from OR, MR was overexpressed in the meibomian glands. Signs of UVB-induced OR were exacerbated in a transgenic rat that overexpresses human MR through enhanced immune and inflammatory responses, oxidative stress and lipid dysmetabolism. Multi-omics cross-species analysis identified S100A9 as a key mediator of MR-associated pathogenicity. MR pathway antagonism appears as a potential therapeutic strategy.