It’s not enough that these weekly weight loss injections are complete and total game-changers when it comes to world of diabetes, obesity and overweight. Or, that they single-handedly improve cardiovascular biomarkers like blood pressure, C-reactive protein, cholesterol profiles, fatty liver related to overweight and symptoms of arthritis and reflux when patients lose weight. NOW, these medicines have shown that they reduce inflammation too – including inflammation related to dry eye and specifically Sjogren’s and maybe aging along with it.
This idea first caught my eye when my patients started reporting back that their rheumatoid arthritis was feeling better, that they felt less fatigued and “inflamed”, that their bloating was gone and that their eyes were feeling better. I also read a case report where a diabetic patient receiving semaglutide for glucose control who had severe plaque psoriasis unresponsible to topical and biologic therapy ultimately changed this patient’s quality of life from “extremely negative effect on patient’s life” to NO effect on patient’s lift. NO effect on patient’s life.
How? Why? We know that fat cells produce their own inflammatory cytokines so it makes sense that reducing the amount of fat would proportionately cause an improvement in systemic inflammation. But there’s more. GLP-1 receptor agonists like Wegovy, Ozempic (semaglutide) and Mounjaro (tirzepatide) appear to also function as an anti-inflammatory and immunomodulatory medication suppressing IFN-gamma, IL-17, 6 .10 and 2, TNF-beta – many of the inflammatory cytokines that have been connected to ocular surface inflammation. They also increase T regulatory cells and downregulate the inflammatory cascade through a multitude of molecular mechanism as well as promoting anti-inflammatory versions of lymphocytes and monocytes.
The possibilities don’t stop there. We see improvements in asthma, lupus, pemphigoid, and Crohn’s. The same papers are proposing an improvement in neuro-inflammation and neuroprotection that may positively impact patients with Parkinson’s, Alzheimer’s, MS, ADHD and migraine.
Although these medications are still relatively new, they have already forever changed the landscape of diabetes and obesity management. But that’s not all. Aging causes metabolic impairments like insulin resistance. We know that calorie restriction can slow the aging process and delay age related health issues. Situins are a family of signaling molecules involved in metabolic regulation and aging. Sirtuins are reduced in obese individuals and impaired by inflammation. Reduction of these factors may slow or reverse aging and metabolic decline.
Game-changer doesn’t quite sum up the impact these meds have had on the lives of patients and what I have seen in our clinics. As a dry eye referral center and aesthetics healthy aging clinic, we are always on the lookout for new medications and therapies that can help our patients.
We are currently conducting a study in patients starting these meds that also have dry eye or Sjogren’s With this novel mechanism of action, the sky may truly be limit. If you are interested in participating in the trial, call Sarah at 615.327.4015.
G Costanzo, S Curatolo et al, “Two birds one stone: semaglutide is highly effective against severe psoriasis in a type 2 diabetic patient,,” Endocrinology: Diabetes and Metabolism Case Reports, 2021;21-0007.
2. Bendotti, G, L Montefusco, M lunati, V Usuelli I Pastore, et al, “the anti-inflammatory and immunocological properties of GLP-1 Receptor Agonists, harmacol Res 2022 Aug: 182:106320.
3. Kitada, M, Y Ogura, I Monno and D Koya, “Sirtuins and Type 2 Diabetes: Role in Inflammation, Oxidative Stress, and Mitochondrial Function. Front Endocrinol 2019 Mar 27:10:187.
Eun Ju Bae, B Park, “Multiple Roles of Sirtuin 6 in Adipose Tissue Inflammation,” Diabetes Metabl J 2023 Jan 12. Online ahead of print
