Nasal spray induces goblet cell alterations in DED

In vivo confocal microscopy (IVCM) demonstrated that a single administration of varenicline nasal spray (OC-1, Oyster Point Pharma) significantly reduces goblet cell (GC) area and perimeter as compared to placebo in dry eye disease (DED), demonstrating goblet cell degranulation, according to a poster presentation at 2020 AAO Virtual.

Infrared meibography does not indicate a statistically significant decrease in meibomian gland area and perimeter after a single administration of varenicline nasal spray, the researchers reported. They noted that baseline meibomian gland area in the population are smaller than in other published studies using this imaging modality, and may suggest patients with more severe disease, resulting in less acute changes.

Varenicline nasal spray, a selective cholinergic agonist that has been approved in the United States for smoking cessation, results in increased tear production of the nasal lacrimal reflex. However, the effect on goblet cells remains unknown. For the study, the researchers assessed the effect of varenicline nasal spray on GC alterations and meibomian gland function in adult participants with DED by IVCM and infrared meibography. The IMPERIAL phase 2, single-center, randomized, double-masked, placebo-controlled trial included 18 patients with DED. IVCM images of the bulbar conjunctiva were taken before and 10 min after nasal spray administration and analyzed for GC alterations by Image J software. 

 Reference
Dieckmann G, et al. OC-01 (varenicline) nasal spray induces goblet cell alterations in patients with DED. Presented at: AAO 2020 Virtual [Session: PO092].