Is Doxycycline 20mg better for inflammation than 50mg

My mentor and advisor at Harvard Medical School, Dr. Judah Folkman, used to say that eye surgeons should only use 20mg Doxycycline and not higher doses for dry eye issues (he & we did not really know about Meibomian Gland Disease back then) and inflammation.

Many eyeMDs prescribe 50mg per day, but this is not considered low dose.
Likely 20mg Doxycyline exerts better anti-inflammatory activities than 50mg as well.
See below.

Mediators of Inflammation
Volume 2015, Article ID 329418, 10 pages
Research Article

Anti-Inflammatory Properties of Low and High Doxycycline Doses: An In Vitro Study

Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
Received 13 January 2015; Accepted 25 March 2015
Academic Editor: Tânia Silvia Fröde
Copyright © 2015 Roberta Di Caprio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Doxycycline is used to treat infective diseases because of its broadspectrum efficacy. High dose administration (100 or 200 mg/day) is often responsible for development of bacterial resistances and endogenous flora alterations, whereas low doses (20–40 mg/day) do not alter bacteria susceptibility to antibiotics and exert anti-inflammatory activities. In this study, we wanted to assess the efficacy of both low and high doxycycline doses in modulating IL-8, TNF-α, and IL-6 gene expression in HaCaT cells stimulated with LPS. Three experimental settings were used, differing in the timing of doxycycline treatment in respect to the insult induced by LPS: pretreatment, concomitant, and posttreatment. Low doses were more effective than high doses in modulating gene expression of LPS-induced proinflammatory cytokines (IL-8, TNF-α, and IL-6), when added before (pretreatment) or after (posttreatment) LPS stimulation. This effect was not appreciated when LPS and doxycycline were simultaneously added to cell cultures: in this case high doses were more effective. In conclusion, our in vitro study suggests that low doxycycline doses could be safely used in chronic or acute skin diseases in which the inflammatory process, either constantly in progress or periodically recurring, has to be prevented or controlled.
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