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Doxycycline is a broad spectrum antibiotic that chelates metal ions and is frequently used as part of treatment of ocular surface diseases. Its therapeutic value has been attributed to an ability to inhibit matrix metalloproteinase activity and both matrix metalloproteinase and interleukin-1 synthesis. Smith and Cook studied corneal epithelial cell and keratocyte cultures and in this study they demonstrated that the minimum concentration of doxycycline required to inhibit the activities of corneal matrix metalloproteinase is similar to that required to inhibit these enzymes in other tissues. If this concentration is achievable in the tears of patients treated systemically for ocular surface disorders in addition to inhibiting matrix metalloproteinases that have been pathologically activated doxycycline may kill migratory keratocytes or fibroblasts responsible for the formation of scar …

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