Arginine supplementation promotes extracellular matrix and metabolic changes in keratoconus

Tina B. McKay, Shrestha Priyadarsini, Tyler Rowsey, Dimitrios Karamichos

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Keratoconus (KC) is a common corneal ectatic disease that affects 1:500–1:2000 people worldwide and is associated with a progressive thinning of the corneal stroma that may lead to severe astigmatism and visual deficits. Riboflavin-mediated collagen crosslinking currently remains the only approved treatment to halt progressive corneal thinning associated with KC by improving the biomechanical properties of the stroma. Treatments designed to increase collagen deposition by resident corneal stromal keratocytes remain elusive. In this study, we evaluated the effects of arginine supplementation on steady-state levels of arginine and arginine-related metabolites (e.g., ornithine, proline, hydroxyproline, spermidine, and putrescine) and collagen protein expression by primary human corneal fibroblasts isolated from KC and non-KC (healthy) corneas and cultured in an established 3D in vitro model. We identified lower cytoplasmic arginine and spermidine levels in KC-derived constructs compared to healthy controls, which corresponded with overall higher gene expression of arginase. Arginine supplementation led to a robust increase in cytoplasmic arginine, ornithine, and spermidine levels in controls only and a significant increase in collagen type I secretion in KC-derived constructs. Further studies evaluating safety and efficacy of arginine supplementation are required to elucidate the potential therapeutic applications of modulating collagen deposition in the context of KC.

Original languageEnglish
Article number2076
Issue number8
StatePublished - Aug 2021


  • Arginine
  • Collagen
  • Cornea
  • Extracellular matrix
  • Hydroxyproline
  • Keratoconus
  • Metabolomics
  • Tissue-engineered cornea


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