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Epithelial stem cell homeostasis in Meibomian gland development, dysfunction, and dry eye disease
Edem Tchegnon, Chung-Ping Liao, Elnaz Ghotbi, Tracey Shipman, Yong Wang, Renee M. McKay, Lu Q. Le
Edem Tchegnon, Chung-Ping Liao, Elnaz Ghotbi, Tracey Shipman, Yong Wang, Renee M. McKay, Lu Q. Le
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Research Article Ophthalmology

Epithelial stem cell homeostasis in Meibomian gland development, dysfunction, and dry eye disease

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Abstract

Dry eye disease affects over 16 million adults in the US, and the majority of cases are due to Meibomian gland dysfunction. Unfortunately, the identity of the stem cells involved in Meibomian gland development and homeostasis is not well elucidated. Here, we report that loss of Krox20, a zinc finger transcription factor involved in the development of ectoderm-derived tissues, or deletion of KROX20-expressing epithelial cells disrupted Meibomian gland formation and homeostasis, leading to dry eye disease secondary to Meibomian gland dysfunction. Ablation of Krox20-lineage cells in adult mice also resulted in dry eye disease, implicating Krox20 in homeostasis of the mature Meibomian gland. Lineage-tracing and expression analyses revealed a restricted KROX20 expression pattern in the ductal areas of the Meibomian gland, although Krox20-lineage cells generate the full, mature Meibomian gland. This suggests that KROX20 marks a stem/progenitor cell population that differentiates to generate the entire Meibomian gland. Our Krox20 mouse models provide a powerful system that delineated the identity of stem cells required for Meibomian gland development and homeostasis and can be used to investigate the factors underlying these processes. They are also robust models of Meibomian gland dysfunction–related dry eye disease, with a potential for use in preclinical therapeutic screening.

Authors

Edem Tchegnon, Chung-Ping Liao, Elnaz Ghotbi, Tracey Shipman, Yong Wang, Renee M. McKay, Lu Q. Le

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Figure 1

Deletion of KROX20 protein in epithelial lineage cells results in dry eye–mediated squamous metaplasia of the cornea.

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Deletion of KROX20 protein in epithelial lineage cells results in dry ey...
(A–D) Krox20fl/fl;K14-Cre (Krox20-cKO) mice exhibit hyperkeratinization of the cornea. (A and B) Gross images of the eye showing the corneal lesions in mutant mice (Krox20-cKO) compared with control mice (Krox20fl/fl). (C and D) H&E staining of a section of an eye showing a normal corneal surface in Krox20fl/fl controls and squamous metaplasia in the Krox20 mutant mice. (E) Krox20-cKO mice show a worsening corneal phenotype as they age (n = 6). (F–I) Coimmunostaining of K14 with (F) corneal epithelium marker K12 and (G–I) stratified epidermal markers (G) K15, (H) K1, and (I) loricrin in Krox20-cKO mice and Krox20fl/fl littermate controls. n = 26 Krox20fl/fl mice, and n = 39 Krox20-cKO mice. Among mice analyzed, 100% of Krox20-cKO mice developed corneal lesions. Representative images are shown. M, months. Scale bar: 100 μm.

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