Inhibition of ceramide de novo synthesis ameliorates meibomian gland dysfunction induced by SCD1 deficiency

High expression of stearoyl-CoA desaturase-1 (SCD1) in meibomian glands produces monounsaturated fatty acids that allow the biosynthesis of glycerolipids and other wax-esters but only the low production of sphingolipids. Here, we found that SCD1 deficiency in mice induces the spill of free fatty acids into a parallel pathway for ceramide biosynthesis, resulting in severe meibomian gland dysfunction associated with meibum accumulation in duct lumen and orifices and subsequent atrophy and loss of acinar cells. Genetic and pharmacological inhibition of SCD1 in mice resulted in meibomian gland pathological phenotypes, including local lipid microenvironment alterations, reduced normal cellular differentiation, increased keratinization, inflammatory cell infiltration, cell apoptosis, and mitochondrial dysfunction. However, inhibition of serine palmitoyltransferase, the initial enzyme in ceramide biosynthesis, improved meibomian gland metabolism and morphology in SCD1-deficient mice, resulting in normal cell differentiation and reduced inflammation infiltration, cell apoptosis, and keratinization. These results indicate that elevated levels of endogenous ceramides are a sign of MGD and suggest that inhibition of ceramide de novo biosynthesis could be a new clinical approach to treating MGD.