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The era of anti-vascular endothelial growth factor (VEGF) drugs in ophthalmology, VEGF and anti-VEGF therapy. Cent Eur J Immunol 2016; 41:311-316. [PMID: 27833450 PMCID: PMC5099389 DOI: 10.5114/ceji.2016.63132] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 01/22/2016] [Indexed: 01/14/2023] Open
Abstract
Angiogenesis is a clue process for tissue development and function, both in normal and pathological conditions. This process is regulated by multiple molecular systems. One of the most potent is vascular endothelial growth factor (VEGF) and its receptor (VEGFR) system. Members of this family are involved in new vessel formation in embryogenesis and maturation, as well as in reparative or pathological reactions in later stages. They play a substantial role in regeneration, inflammation, wound healing, as well as in cancer pathology. Nowadays it is possible to modulate VEGF-VEGFR interactions in many pathological conditions using anti-VEGF therapy. This therapy has already achieved a grounded position in the management of rheumatological disorders, tumour progression, and metastasis. Such drugs as bevacizumab, ranibizumab, aflibercept, and pegaptanib have also proven to be very effective in the treatment of several ocular diseases, such as age-related macular degeneration (AMD), macular oedema, or proliferative retinopathies and iris neovascularisation. The indications for the application of this therapy in ophthalmology are becoming wider and wider. It may also be used for corneal pathologies and in anti-glaucoma procedures.
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202
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Factors regulating capillary remodeling in a reversible model of inflammatory corneal angiogenesis. Sci Rep 2016; 6:32137. [PMID: 27561355 PMCID: PMC4999823 DOI: 10.1038/srep32137] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 08/03/2016] [Indexed: 02/06/2023] Open
Abstract
Newly formed microcapillary networks arising in adult organisms by angiogenic and inflammatory stimuli contribute to pathologies such as corneal and retinal blindness, tumor growth, and metastasis. Therapeutic inhibition of pathologic angiogenesis has focused on targeting the VEGF pathway, while comparatively little attention has been given to remodeling of the new microcapillaries into a stabilized, functional, and persistent vascular network. Here, we used a novel reversible model of inflammatory angiogenesis in the rat cornea to investigate endogenous factors rapidly invoked to remodel, normalize and regress microcapillaries as part of the natural response to regain corneal avascularity. Rapid reversal of an inflammatory angiogenic stimulus suppressed granulocytic activity, enhanced recruitment of remodelling macrophages, induced capillary intussusception, and enriched pathways and processes involving immune cells, chemokines, morphogenesis, axonal guidance, and cell motility, adhesion, and cytoskeletal functions. Whole transcriptome gene expression analysis revealed suppression of numerous inflammatory and angiogenic factors and enhancement of endogenous inhibitors. Many of the identified genes function independently of VEGF and represent potentially new targets for molecular control of the critical process of microvascular remodeling and regression in the cornea.
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203
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Thakur Singh RR, Tekko I, McAvoy K, McMillan H, Jones D, Donnelly RF. Minimally invasive microneedles for ocular drug delivery. Expert Opin Drug Deliv 2016; 14:525-537. [DOI: 10.1080/17425247.2016.1218460] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Raghu Raj Thakur Singh
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
| | - Ismaiel Tekko
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
| | - Kathryn McAvoy
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
| | - Hannah McMillan
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
| | - David Jones
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
| | - Ryan F. Donnelly
- School of Pharmacy, Queen’s University Belfast, Medical Biology Centre, Belfast, Northern Ireland, UK
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204
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Han H, Son S, Son S, Kim N, Yhee JY, Lee JH, Choi JS, Joo CK, Lee H, Lee D, Kim WJ, Kim SH, Kwon IC, Kim H, Kim K. Reducible Polyethylenimine Nanoparticles for Efficient siRNA Delivery in Corneal Neovascularization Therapy. Macromol Biosci 2016; 16:1583-1597. [DOI: 10.1002/mabi.201600051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 07/14/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Hyounkoo Han
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
- Department of Chemical and Biomolecular Engineering; Sogang University; Shinsu-dong Mapo-gu Seoul 121-742 South Korea
| | - Sohee Son
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Sejin Son
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Namho Kim
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Ji Young Yhee
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Jae Hyeop Lee
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
- Department of Chemical and Biomolecular Engineering; Sogang University; Shinsu-dong Mapo-gu Seoul 121-742 South Korea
| | - Jun-Sub Choi
- Department of Ophthalmology and Visual Science; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; 505, Banpo-dong Seocho-gu Seoul 137-040 South Korea
| | - Choun-Ki Joo
- Department of Ophthalmology and Visual Science; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; 505, Banpo-dong Seocho-gu Seoul 137-040 South Korea
| | - Hohyeon Lee
- Department of Chemical and Biomolecular Engineering; Sogang University; Shinsu-dong Mapo-gu Seoul 121-742 South Korea
| | - Duhwan Lee
- Center for Self-Assembly and Complexity; Institute for Basic Science (IBS); Pohang 790-784 South Korea
- Department of Chemistry Polymer Research Institute; Pohang University of Science and Technology (POSTECH); Pohang 790-784 South Korea
| | - Won Jong Kim
- Center for Self-Assembly and Complexity; Institute for Basic Science (IBS); Pohang 790-784 South Korea
- Department of Chemistry Polymer Research Institute; Pohang University of Science and Technology (POSTECH); Pohang 790-784 South Korea
| | - Sun Hwa Kim
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Ick Chan Kwon
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
| | - Hyuncheol Kim
- Department of Chemical and Biomolecular Engineering; Sogang University; Shinsu-dong Mapo-gu Seoul 121-742 South Korea
| | - Kwangmeyung Kim
- Center for Theragnosis; Biomedical Research Institute Korea Institute of Science and Technology (KIST); Hwarangno 14-gil 6 Seongbuk-gu Seoul 136-791 South Korea
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205
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Method for Angiographically Guided Fine-Needle Diathermy in the Treatment of Corneal Neovascularization. Cornea 2016; 35:1029-32. [DOI: 10.1097/ico.0000000000000865] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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206
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Modulated cellular delivery of anti-VEGF siRNA (bevasiranib) by incorporating supramolecular assemblies of hydrophobically modified polyamidoamine dendrimer in stealth liposomes. Int J Pharm 2016; 510:30-41. [PMID: 27291973 DOI: 10.1016/j.ijpharm.2016.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 12/16/2022]
Abstract
A novel lipopolymer based system was designed and characterized for cellular delivery of anti-VEGF siRNA in SKBR-3 breast tumor cell line. Polyamidoamine (PAMAM) dendrimers of low generations (G1, G2 and G3) were incorporated into polyethylene glycol (PEG)-stabilized liposomes by following the consecutive steps: (a) synthesis of the cholesterol conjugates (40% molar ratio of cholesterol to primary amines of PAMAM), (b) incorporation of the conjugates in liposome by lipid mixing and (c) microencapsulation of the siRNA using the ethanol drop method. The cholesterol conjugates of PAMAM dendrimers (G1-Chol40%, G2-Chol40% and G3-Chol40%) formed self assembly with low CMC values (<11μg/ml). Not only did G2-Chol40% show the highest lipid mixing among the cholesterol conjugates, but also, had the lowest leakage of encapsulated carboxyfluorescein tracer. Various N(amine))/L(lipid)/P(phosphate) mole ratios were investigated for siRNA condensation by ethidium bromide dye exclusion assay. The optimum N/L/P ratio of 20:33:10 was chosen for microencapsulation of anti-VEGF siRNA by ethanol drop method, showing particle size of 130nm, zeta-potential of +4mV, siRNA loading efficiency and capacity of 96% and 13wt%, and high stability against heparin sulfate (extracellular matrix). TEM shows uniform and discrete oligo- or multi-lamellar vesicular structures. The liposome incorporating G2-Chol40% was successfully internalized into SKBR-3 cells mainly through clathrin-mediated endocytosis, which was able to escape from endosomes and showed a significantly higher sequence-specific inhibition of VEGF expression and cell growth than the respective G2-Chol40%/siRNA dendriplexes. Importantly, the cytotoxicity decreased with incorporation of G2-Chol40% in the liposomes.
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207
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Chang JH, Putra I, Huang YH, Chang M, Han K, Zhong W, Gao X, Wang S, Dugas-Ford J, Nguyen T, Hong YK, Azar DT. Limited versus total epithelial debridement ocular surface injury: Live fluorescence imaging of hemangiogenesis and lymphangiogenesis in Prox1-GFP/Flk1::Myr-mCherry mice. Biochim Biophys Acta Gen Subj 2016; 1860:2148-56. [PMID: 27233452 DOI: 10.1016/j.bbagen.2016.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/04/2016] [Accepted: 05/20/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Immunohistochemical staining experiments have shown that both hemangiogenesis and lymphangiogenesis occur following severe corneal and conjunctival injury and that the neovascularization of the cornea often has severe visual consequences. To better understand how hemangiogenesis and lymphangiogenesis are induced by different degrees of ocular injury, we investigated patterns of injury-induced corneal neovascularization in live Prox1-GFP/Flk1::myr-mCherry mice, in which blood and lymphatic vessels can be imaged simultaneously in vivo. METHODS The eyes of Prox1-GFP/Flk1::myr-mCherry mice were injured according to four models based on epithelial debridement of the: A) central cornea (a 1.5-mm-diameter circle of tissue over the corneal apex), B) total cornea, C) bulbar conjunctiva, and D) cornea+bulbar conjunctiva. Corneal blood and lymphatic vessels were imaged on days 0, 3, 7, and 10 post-injury, and the percentages of the cornea containing blood and lymphatic vessels were calculated. RESULTS Neither central corneal nor bulbar conjunctival debridement resulted in significant vessel growth in the mouse cornea, whereas total corneal and corneal+bulbar conjunctival debridement did. On day 10 in the central cornea, total cornea, bulbar conjunctiva, and corneal+bulbar conjunctival epithelial debridement models, the percentage of the corneal surface that was occupied by blood vessels (hemangiogenesis) was 1.9±0.8%, 7.14±2.4%, 2.29±1%, and 15.05±2.14%, respectively, and the percentage of the corneal surface that was occupied by lymphatic vessels (lymphangiogenesis) was 2.45±1.51%, 4.85±0.95%, 2.95±1.27%, and 4.15±3.85%, respectively. CONCLUSIONS Substantial corneal debridement was required to induce corneal neovascularization in the mouse cornea, and the corneal epithelium may therefore be partially responsible for maintaining corneal avascularity. GENERAL SIGNIFICANCE Our study demonstrates that GFP/Flk1::myr-mCherry mice are a useful model for studying coordinated hemangiogenic and lymphangiogenic responses.
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Affiliation(s)
- Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
| | - Ilham Putra
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Yu-Hui Huang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Kyuyeon Han
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Wei Zhong
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Xinbo Gao
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Shuangyong Wang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer Dugas-Ford
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Tara Nguyen
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Young-Kwon Hong
- Department of Surgery, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dimitri T Azar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
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208
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Sella R, Gal-Or O, Livny E, Dachbash M, Nisgav Y, Weinberger D, Livnat T, Bahar I. Efficacy of topical aflibercept versus topical bevacizumab for the prevention of corneal neovascularization in a rat model. Exp Eye Res 2016; 146:224-232. [DOI: 10.1016/j.exer.2016.03.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 03/05/2016] [Accepted: 03/22/2016] [Indexed: 12/27/2022]
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209
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Yu T, Rajendran V, Griffith M, Forrester JV, Kuffová L. High-risk corneal allografts: A therapeutic challenge. World J Transplant 2016; 6:10-27. [PMID: 27011902 PMCID: PMC4801785 DOI: 10.5500/wjt.v6.i1.10] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/03/2015] [Accepted: 12/04/2015] [Indexed: 02/05/2023] Open
Abstract
Corneal transplantation is the most common surgical procedure amongst solid organ transplants with a high survival rate of 86% at 1-year post-grafting. This high success rate has been attributed to the immune privilege of the eye. However, mechanisms originally thought to promote immune privilege, such as the lack of antigen presenting cells and vessels in the cornea, are challenged by recent studies. Nevertheless, the immunological and physiological features of the cornea promoting a relatively weak alloimmune response is likely responsible for the high survival rate in “low-risk” settings. Furthermore, although corneal graft survival in “low-risk” recipients is favourable, the prognosis in “high-risk” recipients for corneal graft is poor. In “high-risk” grafts, the process of indirect allorecognition is accelerated by the enhanced innate and adaptive immune responses due to pre-existing inflammation and neovascularization of the host bed. This leads to the irreversible rejection of the allograft and ultimately graft failure. Many therapeutic measures are being tested in pre-clinical and clinical studies to counter the immunological challenge of “high-risk” recipients. Despite the prevailing dogma, recent data suggest that tissue matching together with use of systemic immunosuppression may increase the likelihood of graft acceptance in “high-risk” recipients. However, immunosuppressive drugs are accompanied with intolerance/side effects and toxicity, and therefore, novel cell-based therapies are in development which target host immune cells and restore immune homeostasis without significant side effect of treatment. In addition, developments in regenerative medicine may be able to solve both important short comings of allotransplantation: (1) graft rejection and ultimate graft failure; and (2) the lack of suitable donor corneas. The advances in technology and research indicate that wider therapeutic choices for patients may be available to address the worldwide problem of corneal blindness in both “low-risk” and “high-risk” hosts.
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210
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Inhibition of Pathologic Corneal Neovascularization by Topical Application of a Novel Peptide In Vivo. Cornea 2016; 34:1295-302. [PMID: 26266428 DOI: 10.1097/ico.0000000000000548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the antiangiogenic effect of topical application of H-KI20, a novel 20-amino acid peptide from the hepatocyte growth factor, on 2 animal models of corneal neovascularization (NV), and its possible toxic effects on the cornea and conjunctiva. METHODS The antiangiogenic effect of topical H-KI20 in vivo was studied on corneal NV induced by a mouse corneal micropocket assay and rat intrastromal suture model. In each model, H-KI20, scrambled control peptide H-KI20S, bevacizumab, and phosphate buffer solution (PBS) were applied topically 4 times a day. Corneal NV was examined, photographed, and analyzed. Histological analysis of the corneas was performed. Tear film breakup time and gross and histological examinations were used to study the possible toxicity of topical H-KI20. RESULTS Topical application of H-KI20 significantly inhibited corneal NV induced by vascular endothelial growth factor (VEGF), and intrastromal suture (P < 0.01 vs. the PBS group), and the area of corneal NV was suppressed by 80.3% and 83.6%, respectively (PBS group as 100%). No significant difference was found between 1.0 mg/mL H-KI20 and 10 mg/mL bevacizumab (P > 0.05). Both hematoxylin and eosin and CD34 staining revealed fewer new blood vessels in the H-KI20 and bevacizumab groups. Tear film breakup time and histological examinations showed that H-KI20 had no obvious toxic effects on the cornea and conjunctiva in vivo. CONCLUSIONS The novel peptide H-KI20 is an effective and safe inhibitor of corneal NV. It may provide a promising alternative for ocular topical antiangiogenic therapy.
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211
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Topical Use of Angiopoietin-like Protein 2 RNAi-loaded Lipid Nanoparticles Suppresses Corneal Neovascularization. MOLECULAR THERAPY-NUCLEIC ACIDS 2016; 5:e292. [PMID: 27111418 PMCID: PMC5014459 DOI: 10.1038/mtna.2016.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/20/2015] [Indexed: 12/31/2022]
Abstract
Corneal neovascularization (CNV) is a sight-threatening condition that is encountered in various inflammatory settings including chemical injury. We recently confirmed that angiopoietin-like protein 2 (ANGPTL2) is a potent angiogenic and proinflammatory factor in the cornea, and we have produced a single-stranded proline-modified short hairpin anti-ANGPTL2 RNA interference molecule that is carried in a lipid nanoparticle (ANGPTL2 Li-pshRNA) for topical application. In this study, we have further examined the topical delivery and anti-ANGPTL2 activity of this molecule and have found that fluorescence-labeled ANGPTL2 Li-pshRNA eye drops can penetrate all layers of the cornea and that ANGPTL2 mRNA expression was dramatically inhibited in both epithelium and stroma at 12 and 24 hours after administration. We also examined the inhibitory effect of ANGPTL2 Li-pshRNA on CNV in a mouse chemical injury model and found that the area of angiogenesis was significantly decreased in corneas treated with ANGPTL2 Li-pshRNA eye drops compared to controls. Together, these findings indicate that this modified RNA interference agent is clinically viable in a topical formulation for use against CNV.
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212
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Bone marrow-derived cells in ocular neovascularization: contribution and mechanisms. Angiogenesis 2016; 19:107-18. [PMID: 26880135 PMCID: PMC4819501 DOI: 10.1007/s10456-016-9497-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 02/02/2016] [Indexed: 01/16/2023]
Abstract
Ocular neovascularization often leads to severe vision loss. The role of bone marrow-derived cells (BMCs) in the development of ocular neovascularization, and its significance, is increasingly being recognized. In this review, we discuss their contribution and the potential mechanisms that mediate the effect of BMCs on the progression of ocular neovascularization. The sequence of events by which BMCs participate in ocular neovascularization can be roughly divided into four phases, i.e., mobilization, migration, adhesion and differentiation. This process is delicately regulated and liable to be affected by multiple factors. Cytokines such as vascular endothelial growth factor, granulocyte colony-stimulating factor and erythropoietin are involved in the mobilization of BMCs. Studies have also demonstrated a key role of cytokines such as stromal cell-derived factor-1, tumor necrosis factor-α, as well as vascular endothelial growth factor, in regulating the migration of BMCs. The adhesion of BMCs is mainly regulated by vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and vascular endothelial cadherin. However, the mechanisms regulating the differentiation of BMCs are largely unknown at present. In addition, BMCs secrete cytokines that interact with the microenvironment of ocular neovascularization; their contribution to ocular neovascularization, especially choroidal neovascularization, can be aggravated by several risk factors. An extensive regulatory network is thought to modulate the role of BMCs in the development of ocular neovascularization. A comprehensive understanding of the involved mechanisms will help in the development of novel therapeutic strategies related to BMCs. In this review, we have limited the discussion to the recent progress in this field, especially the research conducted at our laboratory.
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213
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NADPH oxidase 2 plays a role in experimental corneal neovascularization. Clin Sci (Lond) 2016; 130:683-96. [PMID: 26814205 DOI: 10.1042/cs20150103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 01/26/2016] [Indexed: 12/14/2022]
Abstract
Corneal neovascularization, the growth of new blood vessels in the cornea, is a leading cause of vision impairment after corneal injury. Neovascularization typically occurs in response to corneal injury such as that caused by infection, physical trauma, chemical burns or in the setting of corneal transplant rejection. The NADPH oxidase enzyme complex is involved in cell signalling for wound-healing angiogenesis, but its role in corneal neovascularization has not been studied. We have now analysed the role of the Nox2 isoform of NADPH oxidase in corneal neovascularization in mice following chemical injury. C57BL/6 mice aged 8-14 weeks were cauterized with an applicator coated with 75% silver nitrate and 25% potassium nitrate for 8 s. Neovascularization extending radially from limbal vessels was observed in corneal whole-mounts from cauterized wild type mice and CD31+ vessels were identified in cauterized corneal sections at day 7. In contrast, in Nox2 knockout (Nox2 KO) mice vascular endothelial growth factor-A (Vegf-A), Flt1 mRNA expression, and the extent of corneal neovascularization were all markedly reduced compared with their wild type controls. The accumulation of Iba-1+ microglia and macrophages in the cornea was significantly less in Nox2 KO than in wild type mice. In conclusion, we have demonstrated that Nox2 is implicated in the inflammatory and neovascular response to corneal chemical injury in mice and clearly VEGF is a mediator of this effect. This work raises the possibility that therapies targeting Nox2 may have potential for suppressing corneal neovascularization and inflammation in humans.
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214
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Benini R, Roth R, Khoja Z, Avoli M, Wintermark P. Does angiogenesis play a role in the establishment of mesial temporal lobe epilepsy? Int J Dev Neurosci 2016; 49:31-6. [PMID: 26773167 DOI: 10.1016/j.ijdevneu.2016.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/23/2015] [Accepted: 01/05/2016] [Indexed: 01/03/2023] Open
Abstract
Mesial temporal lobe epilepsy (MTLE) is a focal epileptic disorder that is frequently associated with hippocampal sclerosis. This study investigated whether blocking angiogenesis prevents the development of seizures and hippocampal atrophy in the pilocarpine rat model of MTLE. To block angiogenesis, a subset of animals were given sunitinib orally. Continuous video recordings were performed to identify seizures. Brains were then extracted and sectioned, and hippocampal surfaces and angiogenesis were assessed. After a latent period of 6.6 ± 2.6 days, the sham-treated pilocarpine rats presented convulsive seizures, while the pilocarpine rats treated with sunitinib did not develop seizures. Sham-treated pilocarpine rats but not sunitinib-treated pilocarpine rats had significantly smaller hippocampi. Endothelial cell counts in sham-treated pilocarpine rats were significantly greater than in controls and sunitinib-treated pilocarpine rats. Blocking angiogenesis immediately following the initial insult in this animal model prevented thus angiogenesis and hippocampal atrophy and averted the development of clinical seizures.
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Affiliation(s)
- Ruba Benini
- Division of Pediatric Neurology, Department of Pediatrics, Montreal Children's Hospital, Canada
| | - Raquel Roth
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, Canada
| | - Zehra Khoja
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, Canada
| | - Massimo Avoli
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Pia Wintermark
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, Canada.
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215
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Corneal Fine Needle Diathermy With Adjuvant Bevacizumab to Treat Corneal Neovascularization in Children. Cornea 2016; 34:773-7. [PMID: 25811720 DOI: 10.1097/ico.0000000000000419] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the outcomes of corneal fine needle diathermy (FND) with adjuvant intrastromal and subconjunctival bevacizumab injection for corneal neovascularization (CN) in children. METHODS Medical records of all children who had undergone FND with adjuvant bevacizumab injection were reviewed retrospectively. Treatment efficacy was evaluated by changes in visual acuity, regression of CN, and clearing of lipid deposits with the aid of slit-lamp color images that were taken before surgical intervention and at last follow-up visit. Postoperative complications were recorded and served to assess the safety of the procedure. RESULTS Nine eyes of 9 patients were included in the study. The mean age of the patients was 8.4 ± 4.2 years (4-15 years) and the mean follow-up time was 18.7 ± 12.2 months (5-35 months). Three eyes had a history of herpes simplex keratitis (HSK), 3 eyes had complete corneal anesthesia, 2 eyes had CN following suture tract infection after corneal transplant for HSK scar and limbal dermoid excision, and 1 eye had blepharokeratoconjunctivitis. After treatment, 8 eyes had complete CN resolution, and 1 eye with corneal anesthesia following brain tumor resection had partial regression in vessel distribution and size. Lipid deposition clearance lagged behind CN resolution. Mean duration of CN before treatment was 15.3 ± 14.0 months (1-37 months). Mean corrected distance visual acuity before and after surgery was 0.66 ± 0.31 and 0.50 ± 0.37 logMAR, respectively (P = 0.02). CONCLUSIONS Corneal FND with adjuvant bevacizumab injection is effective at treating sectorial corneal vessels in children.
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Yang JF, Walia A, Huang YH, Han KY, Rosenblatt MI, Azar DT, Chang JH. Understanding lymphangiogenesis in knockout models, the cornea, and ocular diseases for the development of therapeutic interventions. Surv Ophthalmol 2015; 61:272-96. [PMID: 26706194 DOI: 10.1016/j.survophthal.2015.12.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 12/08/2015] [Accepted: 12/09/2015] [Indexed: 01/05/2023]
Abstract
A major focus of cancer research for several decades has been understand the ability of tumors to induce new blood vessel formation, a process known as angiogenesis. Unfortunately, only limited success has been achieved in the clinical application of angiogenesis inhibitors. We now know that lymphangiogenesis, the growth of lymphatic vessels, likely also plays a major role in tumor progression. Thus, therapeutic strategies targeting lymphangiogenesis or both lymphangiogenesis and angiogenesis may represent promising approaches for treating cancer and other diseases. Importantly, research progress toward understanding lymphangiogenesis is significantly behind that related to angiogenesis. A PubMed search of "angiogenesis" returns nearly 80,000 articles, whereas a search of "lymphangiogenesis" returns 2,635 articles. This stark contrast can be explained by the lack of molecular markers for identifying the invisible lymphatic vasculature that persisted until less than 2 decades ago, combined with the intensity of research interest in angiogenesis during the past half century. Still, significant strides have been made in developing strategies to modulate lymphangiogenesis, largely using ocular disease models. Here we review the current knowledge of lymphangiogenesis in the context of knockout models, ocular diseases, the biology of activators and inhibitors, and the potential for therapeutic interventions targeting this process.
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Affiliation(s)
- Jessica F Yang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Amit Walia
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yu-hui Huang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kyu-yeon Han
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Dimitri T Azar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA.
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Lin Y, Ma Q, Lin S, Zhou H, Wen Q, Gao S, Cheng G. Inhibitory effects of 90Sr/ 90Y β-irradiation on alkali burn-induced corneal neovascularization in rats. Exp Ther Med 2015; 11:409-414. [PMID: 26893623 PMCID: PMC4734155 DOI: 10.3892/etm.2015.2907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/22/2015] [Indexed: 01/29/2023] Open
Abstract
The aim of the present study was to investigate the inhibitory effects of 90Sr-90Y β-irradiation in a rat model of alkali burn-induced corneal neovascularization (CNV). Alkali burn-induced CNV was induced in the right eyes of 30 female Wistar rats, which were randomly divided into the following three groups (n=10/group): i) The alkali burn control group, which received a balanced salt solution treatment; ii) group 1, which received treatment with angiogenesis inhibitors; and iii) group 2, which received 90Sr-90Y β-irradiation treatment. A further 10 female Wistar rats comprised a blank control group and received only balanced salt solution. Digital photographs of the corneas were acquired and the area of NV was calculated. In addition, the expression levels of matrix metalloproteinase (MMP)-9, vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR)-1 and VEGFR-2 in alkali-burned rat corneas were determined using western blot analysis. The results suggested that the number of new vessels and the area of CNV were significantly decreased in groups 1 and 2, as compared with the alkali burn group at each time point (P<0.05). In addition, the number of inflammatory cells and the degree of edema were decreased in groups 1 and 2, as compared with the alkali burn group, with group 2 exhibiting the most marked reduction. Western blot analysis demonstrated that the expression levels of MMP-9, VEGF, VEGFR-1 and VEGFR-2 were significantly decreased in groups 1 and 2, as compared with the alkali burn control group, with group 2 exhibiting the most significant reduction (P<0.05). The results of the present study suggested that 90Sr-90Y β-irradiation and angiogenesis inhibitor treatments were able to inhibit alkali burn-induced CNV, although 90Sr-90Y β-irradiation may be more effective.
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Affiliation(s)
- Yuanqiang Lin
- Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Qingjie Ma
- Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Shan Lin
- Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Hongyan Zhou
- Department of Ophthalmology, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Qiang Wen
- Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Shi Gao
- Department of Nuclear Medicine, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Guanghui Cheng
- Department of Radiotherapy, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
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Chang JH, Huang YH, Cunningham CM, Han KY, Chang M, Seiki M, Zhou Z, Azar DT. Matrix metalloproteinase 14 modulates signal transduction and angiogenesis in the cornea. Surv Ophthalmol 2015; 61:478-97. [PMID: 26647161 DOI: 10.1016/j.survophthal.2015.11.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 11/12/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022]
Abstract
The cornea is transparent and avascular, and retention of these characteristics is critical to maintaining vision clarity. Under normal conditions, wound healing in response to corneal injury occurs without the formation of new blood vessels; however, neovascularization may be induced during corneal wound healing when the balance between proangiogenic and antiangiogenic mediators is disrupted to favor angiogenesis. Matrix metalloproteinases (MMPs), which are key factors in extracellular matrix remodeling and angiogenesis, contribute to the maintenance of this balance, and in pathologic instances, can contribute to its disruption. Here, we elaborate on the facilitative role of MMPs, specifically MMP-14, in corneal neovascularization. MMP-14 is a transmembrane MMP that is critically involved in extracellular matrix proteolysis, exosome transport, and cellular migration and invasion, processes that are critical for angiogenesis. To aid in developing efficacious therapies that promote healing without neovascularization, it is important to understand and further investigate the complex pathways related to MMP-14 signaling, which can also involve vascular endothelial growth factor, basic fibroblast growth factor, Wnt/β-catenin, transforming growth factor, platelet-derived growth factor, hepatocyte growth factor or chemokines, epidermal growth factor, prostaglandin E2, thrombin, integrins, Notch, Toll-like receptors, PI3k/Akt, Src, RhoA/RhoA kinase, and extracellular signal-related kinase. The involvement and potential contribution of these signaling molecules or proteins in neovascularization are the focus of the present review.
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Affiliation(s)
- Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yu-Hui Huang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Christy M Cunningham
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kyu-Yeon Han
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Motoharu Seiki
- Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Zhongjun Zhou
- Department of Biochemistry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Dimitri T Azar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA.
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Walia A, Yang JF, Huang YH, Rosenblatt MI, Chang JH, Azar DT. Endostatin's emerging roles in angiogenesis, lymphangiogenesis, disease, and clinical applications. BIOCHIMICA ET BIOPHYSICA ACTA 2015; 1850:2422-38. [PMID: 26367079 PMCID: PMC4624607 DOI: 10.1016/j.bbagen.2015.09.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/02/2015] [Accepted: 09/10/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Angiogenesis is the process of neovascularization from pre-existing vasculature and is involved in various physiological and pathological processes. Inhibitors of angiogenesis, administered either as individual drugs or in combination with other chemotherapy, have been shown to benefit patients with various cancers. Endostatin, a 20-kDa C-terminal fragment of type XVIII collagen, is one of the most potent inhibitors of angiogenesis. SCOPE OF REVIEW We discuss the biology behind endostatin in the context of its endogenous production, the various receptors to which it binds, and the mechanisms by which it acts. We focus on its inhibitory role in angiogenesis, lymphangiogenesis, and cancer metastasis. We also present emerging clinical applications for endostatin and its potential as a therapeutic agent in the form a short peptide. MAJOR CONCLUSIONS The delicate balance between pro- and anti-angiogenic factors can be modulated to result in physiological wound healing or pathological tumor metastasis. Research in the last decade has emphasized an emerging clinical potential for endostatin as a biomarker and as a therapeutic short peptide. Moreover, elevated or depressed endostatin levels in diseased states may help explain the pathophysiological mechanisms of the particular disease. GENERAL SIGNIFICANCE Endostatin was once sought after as the 'be all and end all' for cancer treatment; however, research throughout the last decade has made it apparent that endostatin's effects are complex and involve multiple mechanisms. A better understanding of newly discovered mechanisms and clinical applications still has the potential to lead to future advances in the use of endostatin in the clinic.
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Affiliation(s)
- Amit Walia
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Jessica F Yang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Yu-Hui Huang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
| | - Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA.
| | - Dimitri T Azar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
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Human Serum Eye Drops in Eye Alterations: An Insight and a Critical Analysis. J Ophthalmol 2015; 2015:396410. [PMID: 26504592 PMCID: PMC4609447 DOI: 10.1155/2015/396410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 07/07/2015] [Indexed: 12/13/2022] Open
Abstract
Human serum contains a physiological plethora of bioactive elements naturally released by activated platelets which might have a significant effect on the regeneration of corneal layers by stimulating the cell growth. This mechanism supported the use of human serum eye drops in some ocular diseases associated with dystrophic changes and alterations of the tear film, such as persistent corneal epithelial defects and dry eye syndrome. We focused our effort on potential benefits and limitations of the use of human serum eye drops when conventional therapies failed. We reviewed the recent literature by reporting published studies from 2010 to 2014. Despite the limited evaluated study populations, most of the clinical studies have confirmed that serum eye drop therapy is effective in corneal healing by reducing ocular symptom, particularly during the short-term follow-up. In addition, three recent published studies have shown the efficacy of the serum eye drop therapy in comparison to traditional ones in intractable patients. Besides, reported ongoing clinical studies confirmed the open debate regarding the use of biologic tools for cornea regeneration. Results from these studies might open novel challenges and perspectives in the therapy of such refractory patients.
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Cornel S, Adriana ID, Mihaela TC, Speranta S, Algerino DS, Mehdi B, Jalaladin HR. Anti-vascular endothelial growth factor indications in ocular disease. Rom J Ophthalmol 2015; 59:235-242. [PMID: 29450313 PMCID: PMC5712945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 06/08/2023] Open
Abstract
The purpose of this systemic review was to investigate the indications of anti-vascular endothelial growth factor (anti-VEGF) in the treatment of ocular diseases. For this, a comprehensive literature research was performed exploring the current use of anti-VEGF in a variety of retinal or anterior segment diseases and highlighting the visual outcome for these patients. The anti-VEGF therapy is now commonly used for a wide range of pathologies like age-related macular degeneration, retinal vein occlusion or diabetic retinopathy. Pathological processes such as abnormal neovascularization, ocular angiogenesis and macular edema which can greatly reduce visual acuity are now targeted by anti-VEGF treatment, having a major impact on vision.
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Affiliation(s)
- Stefan Cornel
- Central Military Emergency University Hospital „Dr.Carol Davila”, Ophthalmology Department
| | | | | | | | - De Simone Algerino
- Central Military Emergency University Hospital „Dr.Carol Davila”, Ophthalmology Department
| | - Batras Mehdi
- Central Military Emergency University Hospital „Dr.Carol Davila”, Ophthalmology Department
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Abstract
PURPOSE To compare the antiangiogenic effects of tacrolimus and bevacizumab on corneal neovascularization (CNV) in rabbits. METHODS Neovascularization was induced in 32 eyes of 16 rabbits by placing a suture in the corneal stroma. Seven days after suture placement, all rabbits were divided into 4 groups and were treated subconjunctivally with bevacizumab (AVA_sub) 0.05 mL (5 mg/0.05 mL), tacrolimus (TAC_sub) 0.05 mL (0.25 mg/0.05 mL), balanced salt solution (0.05 mL was subconjunctivally injected in 1 eye of each rabbit and applied by eye drops in the other eyes, control group), and tacrolimus eye drops (TAC_drop) (5 mg/5 mL applied 4 times daily). Digital photographs were obtained and surface area of CNV was measured 7 days after subconjunctival injections. Corneal specimens were analyzed histopathologically and were used to measure the concentration of vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interleukin-1 beta (IL-1β), and monocyte chemoattractant protein 1 mRNA by reverse transcription polymerase chain reaction. RESULTS In digital photographs, the neovascularized area was decreased in all treatment groups (AVA_sub, 0.58; TAC_sub, 0.60; TAC_drop, 0.68) compared with the control group (balanced salt solution, 0.81). Histological examination showed markedly regressed new vessels in treatment groups, and immunohistochemical staining revealed weakly stained anti-VEGF and anti-F4/80 antibodies in treatment groups. In semiquantitative reverse transcription polymerase chain reaction, concentration of VEGF (AVA_sub, 0.24; TAC_drop, 0.18), TNF-α (AVA_sub, 0.19; TAC_sub, 0.24; TAC_drop 0.15), and IL-1β (AVA_sub, 0.19; TAC_sub, 0.33; TAC_drop, 0.18) mRNA were significantly lower in treatment groups than in the control group (VEGF, 0.47; TNF-α, 0.44; IL-1β, 0.87) (P < 0.05). CONCLUSIONS Topical and subconjunctival tacrolimus application may be useful in reducing CNV and have comparable effects to subconjunctival bevacizumab injection.
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Hydrogels in ophthalmic applications. Eur J Pharm Biopharm 2015; 95:227-38. [DOI: 10.1016/j.ejpb.2015.05.016] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 05/05/2015] [Accepted: 05/21/2015] [Indexed: 12/20/2022]
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Inhibition of Rho-Associated Kinase Prevents Pathological Wound Healing and Neovascularization After Corneal Trauma. Cornea 2015; 34:1120-9. [DOI: 10.1097/ico.0000000000000493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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225
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Faraj LA, Said DG, Al-Aqaba M, Otri AM, Dua HS. Clinical evaluation and characterisation of corneal vascularisation. Br J Ophthalmol 2015; 100:315-22. [DOI: 10.1136/bjophthalmol-2015-306686] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 06/21/2015] [Indexed: 11/03/2022]
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226
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Kaya MK, Demir T, Bulut H, Akpolat N, Turgut B. Effects of lapatinib and trastuzumab on vascular endothelial growth factor in experimental corneal neovascularization. Clin Exp Ophthalmol 2015; 43:449-57. [PMID: 25640924 DOI: 10.1111/ceo.12500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 11/20/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND The aim of this study was to compare the effects of lapatinib and trastuzumab on vascular endothelial growth factor on experimental corneal neovascularization. METHODS A total of 35 Wistar albino rats were randomly divided into five groups, each containing seven animals. Corneas of rats in the control group were not cauterized and did not receive any treatment. A silver nitrate pencil was applied on the right corneas of rats in the non-control groups to induce corneal neovascularization. Rats in the sham, lapatinib, trastuzumab and lapatinib + trastuzumab groups were administered systemic saline, 50 mg/kg lapatinib once a day orally by gavage, 4 mg/kg trastuzumab once a day intraperitoneally, or 50 mg/kg lapatinib once a day orally by gavage together with 4 mg/kg trastuzumab once a day intraperitoneally, respectively, for 7 days. Rats were sacrificed on the eighth day, and corneas were excised using a 4-mm punch trephine. Vascular endothelial growth factor immunostaining in the corneal epithelial and stromal layers was evaluated. Staining intensities were determined semi-quantitatively, and corneal vascular endothelial growth factor levels were measured by enzyme-linked immunosorbent assay. RESULTS The mean immunostaining intensities of epithelial and stromal vascular endothelial growth factor in the control group were significantly lesser than those in the sham group (P < 0.05). The mean immunostaining intensities of epithelial and stromal vascular endothelial growth factor and vascular endothelial growth factor enzyme-linked immunosorbent assay levels of corneas in all treatment groups (lapatinib, trastuzumab and lapatinib + trastuzumab groups) were lesser than those in the sham group (P < 0.05); however, it was similar to those in the control group (P > 0.05). CONCLUSIONS It is suggested that systemically administered lapatinib is more effective than systemically administered trastuzumab in preventing corneal neovascularization.
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Affiliation(s)
- Mehmet K Kaya
- Ophthalmology Clinic, Avrupa Göz Hastanesi, Elazig, Turkey
| | - Tamer Demir
- Department of Ophthalmology, School of Medicine, Fırat University, Elazig, Turkey
| | - Hakan Bulut
- School of Veterinary Science, Fırat University, Elazig, Turkey
| | - Nusret Akpolat
- Department of Pathology, School of Medicine, İnönü University, Malatya, Turkey
| | - Burak Turgut
- Department of Ophthalmology, School of Medicine, Fırat University, Elazig, Turkey
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227
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Angiogenesis in glaucoma filtration surgery and neovascular glaucoma: A review. Surv Ophthalmol 2015; 60:524-35. [PMID: 25980779 DOI: 10.1016/j.survophthal.2015.04.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 04/10/2015] [Accepted: 04/13/2015] [Indexed: 12/25/2022]
Abstract
Angiogenesis may pose a clinical challenge in glaucoma, for example, during the wound healing phase after glaucoma filtration surgery and in the severe secondary glaucoma called neovascular glaucoma (NVG). Upregulation of vascular endothelial growth factor (VEGF), a key mediator of angiogenesis, occurs in eyes that have undergone glaucoma filtration surgery, as well as those with NVG. This has led investigation of the ability of anti-vascular endothelial growth factor therapy to improve outcomes, and we examine the findings with respect to the safety and efficacy of anti-vascular endothelial growth factor agents, mainly bevacizumab and ranibizumab, in eyes that have undergone glaucoma filtration surgery or have NVG. Combining conventional therapies-such as antimetabolites after filtration surgery and panretinal photocoagulation in NVG-and anti-vascular endothelial growth factor drugs may produce a synergetic effect, although further studies are required to evaluate the long-term efficacy of combination treatments.
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Abbaszadeh M, Aidenloo NS, Nematollahi MK, Motarjemizadeh Q. Investigating the Association between Angiogenic Cytokines and Corneal Neovascularization in Sulfur Mustard Intoxicated Subjects 26 Years after Exposure. Toxicol Int 2015; 21:300-6. [PMID: 25948970 PMCID: PMC4413414 DOI: 10.4103/0971-6580.155375] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the associations between the concentrations of three major angiogenic cytokines-vascular endothelial growth factor-A165 (VEGF-A165), basic fibroblast growth factor (bFGF), and platelet-derived growth factor-BB (PDGF-BB)-in the tear of sulfur mustard (SM)-exposed subjects and corneal neovascularization (CNV) 26 years after exposure. MATERIALS AND METHODS The concentrations of VEGF-A, bFGF, and PDGF-BB were measured by enzyme-linked immunosorbent assay (ELISA) in reflex tears of (i) SM-injured patients with CNV (positive case group including 18 individuals) and (ii) SM-injured patients without CNV (negative case group including 22 individuals). Then results were compared to corresponding values obtained from tears of 40 healthy control subjects. RESULTS The mean concentrations of all investigated growth factors, VEGF-A165, bFGF, and PDGF-BB, were significantly higher in positive cases than controls (P ≤ 0.001, P = 0.028, and P = 0.041, respectively). Whereas, VEGF-A165 was the only growth factor which displayed significantly elevated concentrations in negative case group compared to the healthy individuals (P = 0.030). Additionally, the mean level of VEGF-A165 was also higher in positive patient group than negative patients (P = 0.022). Subjects with increased concentrations of tear VEGF-A165 were more than 10 times more likely to suffer from CNV than normal individuals (odds ratio (OR) = 10.43, confidence interval (CI): 2.14-38.46, P = 0.001), while elevated levels of bFGF and PDGF-BB increased the risk of CNV by about twofold. CONCLUSION Although all investigated cytokines had increased in tears of positive patients, VEGF-A was the only one which showed a significant correlation with the severity of CNV, and thus played a crucial role in corneal angiogenesis.
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Huang J, Li YJ, Liu JY, Zhang YY, Li XM, Wang LN, Yao J, Jiang Q, Yan B. Identification of Corneal Neovascularization–Related Long Noncoding RNAs Through Microarray Analysis. Cornea 2015; 34:580-7. [DOI: 10.1097/ico.0000000000000389] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Çakmak H, Ergin K, Bozkurt G, Kocatürk T, Evliçoğlu GE. The effects of topical everolimus and sunitinib on corneal neovascularization. Cutan Ocul Toxicol 2015; 35:97-103. [PMID: 25864572 DOI: 10.3109/15569527.2015.1034360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate the effects of topical everolimus and sunitinib on corneal neovascularization (CNV). METHODS CNV was induced by application of silver nitrate to the cornea for all groups. Rats were divided into four groups of 10 rats each, and two corneas were obtained from each rat. Group I received 1 mg/ml everolimus, Group II received 0.5 mg/ml sunitinib, Group IV received no treatment (control group) and Group IV received 1% Dimethylsulfoxide (DMSO). All treatments were administrated twice daily for 2 weeks. The right corneas were used for extracellular signal-regulated kinase 1/2 (ERK 1/2) protein analysis by western blot analysis and the left corneas were used for ERK 1/2 and vascular endothelial growth factor-receptor (VEGFR-2) gene expression analysis by quantitative real-time PCR. RESULTS VEGFR-2 mRNA expression levels (ΔCt, median, min-max) were reduced in the everolimus 1.0 (0.25-1.81) and sunitinib 1.06 (0.24-2.68) treated groups compared with the control 4.74 (1.02-14.74) and DMSO groups 7.41 (0.72-13.10). The expression of ERK 1/2 protein and mRNA levels were reduced in everolimus group compared with the control group (p < 0.05). These differences were not seen between the sunitinib and control groups. CONCLUSION Topical administration of both everolimus and sunitinib reduced VEGFR-2 levels and inhibited CNV. In additon, everolimus reduced ERK 1/2 levels and seems to be more effective than sunitinib on CNV.
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Affiliation(s)
| | - Kemal Ergin
- b Department of Histology and Embryology , and
| | - Gökay Bozkurt
- c Department of Genetics, Adnan Menderes University Medical Faculty , Aytepe , Aydin , Turkey
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Seong H, Ryu J, Jeong JY, Chung IY, Han YS, Hwang SH, Park JM, Kang SS, Seo SW. Resveratrol suppresses vascular endothelial growth factor secretion via inhibition of CXC-chemokine receptor 4 expression in ARPE-19 cells. Mol Med Rep 2015; 12:1479-84. [PMID: 25815440 DOI: 10.3892/mmr.2015.3518] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 03/05/2015] [Indexed: 11/06/2022] Open
Abstract
The present study characterizes the effects of resveratrol (Res) on vascular endothelial growth factor (VEGF) secretion in retinal pigment epithelial (RPE) cells. ARPE-19 cells were treated with CoCl2, a hypoxia mimetic agent. CoCl2 treatment increased protein levels of hypoxia inducible factor-1α (HIF-1α) and CXC-chemokine receptor 4 (CXCR4), and secretion of VEGF. To confirm the effects of Res on VEGF secretion, the human umbilical vein endothelial cell tube formation assay was performed with conditioned medium from Res-treated ARPE-19 cells. The well-known antioxidant Res effectively blocked these effects and reduced phosphorylation of nuclear factor (NF)-κB, an upstream activator of CXCR4. Furthermore, Res also suppressed VEGF secretion induced by SDF-1, a ligand of CXCR4. Conditioned medium from Res-treated ARPE-19 cells clearly suppressed tube formation compared with hypoxia-treated conditioned medium. The results demonstrated that Res inhibited the hypoxia mimetic CoCl2-induced expression of VEGF in ARPE-19 cells. Res suppressed CXCR4 expression through decreased phosphorylation of NF-κB, resulting in downregulation of VEGF secretion.
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Affiliation(s)
- Hyemin Seong
- Department of Anatomy and Convergence Medical Science, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Jinhyun Ryu
- Department of Anatomy and Convergence Medical Science, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Joo Yeon Jeong
- Department of Anatomy and Convergence Medical Science, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - In Young Chung
- Department of Ophthalmology, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Yong-Seop Han
- Department of Ophthalmology, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Soo Hyun Hwang
- Department of Neurosurgery, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Jong Moon Park
- Department of Ophthalmology, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Sang Soo Kang
- Department of Anatomy and Convergence Medical Science, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
| | - Seong Wook Seo
- Department of Ophthalmology, Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Gyeongnam 660‑751, Republic of Korea
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Huang T, Wang H, Chen NG, Frentzen A, Minev B, Szalay AA. Expression of anti-VEGF antibody together with anti-EGFR or anti-FAP enhances tumor regression as a result of vaccinia virotherapy. MOLECULAR THERAPY-ONCOLYTICS 2015; 2:15003. [PMID: 27119102 PMCID: PMC4782963 DOI: 10.1038/mto.2015.3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/20/2014] [Indexed: 01/09/2023]
Abstract
The tumor microenvironment plays an important role in tumor growth and progression. Here we demonstrate that vaccinia virus-mediated, constitutively expressed intratumoral antibodies against vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), and fibroblast activation protein (FAP) significantly improved tumor regression and oncolytic virotherapy through suppression of angiogenesis, cell proliferation, and stromagenesis in virus-colonized tumors. In contrast to the tumor growth inhibition by the three tumor growth-inhibiting antibodies individually, when two of the three antibodies were expressed simultaneously by single vaccinia virus strains tumor regression was further enhanced. These findings strongly indicate that interference with the two tumor growth-stimulating mechanisms did in fact result in enhanced therapeutic efficacy in tumor xenograft models and may lead to an effective therapy in patients with cancer.
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Affiliation(s)
- Ting Huang
- Department of Biochemistry, Rudolph Virchow Center for Experimental Biomedicine, Institute for Molecular Infection Biology, University of Würzburg , Würzburg, Germany
| | - Huiqiang Wang
- Genelux Corporation, San Diego Science Center , San Diego, California, USA
| | - Nanhai G Chen
- Genelux Corporation, San Diego Science Center, San Diego, California, USA; Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, USA
| | - Alexa Frentzen
- Genelux Corporation, San Diego Science Center , San Diego, California, USA
| | - Boris Minev
- Genelux Corporation, San Diego Science Center, San Diego, California, USA; Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, USA; Division of Neurosurgery, University of California, San Diego, California, USA
| | - Aladar A Szalay
- Department of Biochemistry, Rudolph Virchow Center for Experimental Biomedicine, Institute for Molecular Infection Biology, University of Würzburg, Würzburg, Germany; Genelux Corporation, San Diego Science Center, San Diego, California, USA; Department of Radiation Medicine and Applied Sciences, Rebecca & John Moores Comprehensive Cancer Center, University of California, San Diego, California, USA
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Evaluation of a newly developed HPMC ophthalmic insert with sustainehttp://10.10.23.106:8080/TDXPSLIVEGANG/gateway/elsevierjournal/index.jsp#d release properties as a carrier for thermolabile therapeutics. Int J Pharm 2015; 481:37-46. [DOI: 10.1016/j.ijpharm.2015.01.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/16/2015] [Accepted: 01/21/2015] [Indexed: 11/21/2022]
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Prakash S, Agrawal S, Kumar S, Prasad N. Impact of vascular endothelial growth factor single nucleotide polymorphism association on acute renal allograft rejection. Nephron Clin Pract 2015; 129:91-6. [PMID: 25659610 DOI: 10.1159/000368700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 09/26/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF) is a cytokine which plays an important role in the division, proliferation and migration of endothelial cells. In the kidney, VEGF expression is found in glomerular podocytes and in tubular epithelial cells, which may result in acute inflammatory reactions. METHODS The role of VEGF gene polymorphisms (-2578 C/A, -2549 18 bp Ins/Del, -1154 G/A and +936 C/T) was investigated in 272 patients who underwent renal transplantation. ARMS-PCR and PCR-RFLP were used. Patients were categorized into acute allograft rejection (n = 76) and nonrejection (n = 196). RESULTS The VEGF -1154 GG genotype and the +936 T allele were found to be susceptible to acute rejection (AR). T-A-A-I, T-A-A-D, T-G-C-I and C-A-A-I haplotypes revealed a predisposition among AR cases. In silico analysis revealed +936 T as a significant allele involved in the transcription regulation. CONCLUSION These results highlight the role of VEGF polymorphisms in acute allograft rejection.
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Affiliation(s)
- Swayam Prakash
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Abstract
PURPOSE The aim of this study was to investigate transmission of topical silicate nanoparticles (SiNPs) through the corneal stroma, anterior chamber, and vitreous fluids by scanning electron microscopy (SEM), transmission electron microscopy (TEM), and inductively coupled plasma atomic emission spectrometry (ICP-AES), respectively. METHODS SiNPs with a mean diameter of 40.6 ± 5.6 nm determined by dynamic light scattering were used in this study. The permeability of SiNPs was examined across isolated corneal buttons over a 30-minute period. To visualize the transport and diffusion of nanoparticles through the corneal tissue, SiNPs were applied over the corneal surface and evaluated at 5 and 30 minutes after SiNPs loading for SEM and 15 minutes for TEM. Sections of 10-μm thickness were cut and visualized using SEM. TEM study was performed on 70- to 90-nm-thick sections. ICP-AES was used to determine the concentration of SiNPs. RESULTS The determined range of synthesized SiNPs by dynamic light scattering was 40 nm (41.9 ± 5.6 nm). Transmission of SiNPs through the corneal stroma was shown successfully with electron microscopic (SEM and TEM) images. The ICP-AES results revealed SiNPs in the anterior chamber and vitreous fluid. CONCLUSIONS Topical administration of SiNPs, as a noninvasive, and available modality with acceptable penetration through the corneal stroma and deep into the intraocular fluids including the anterior chamber and vitreous cavity, may be considered as a suitable alternative to invasive intravitreal injection of other expensive antineovascularization agents.
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Voiculescu OB, Voinea LM, Alexandrescu C. Corneal neovascularization and biological therapy. J Med Life 2015; 8:444-8. [PMID: 26664467 PMCID: PMC4656949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Corneal avascularity is necessary for the preservation of optimal vision. The cornea maintains a dynamic balance between pro- and antiangiogenic factors that allows it to remain avascular under normal homeostatic conditions. Corneal neovascularization (NV) is a condition that can develop in response to inflammation, hypoxia, trauma, or limbal stem cell deficiency and it is a significant cause of blindness. New therapeutic options for diseases of the cornea and ocular surface are now being explored in experimental animals and clinical trials. Antibody based biologics are being tested for their ability to reduce blood and lymphatic vessel ingrowth into the cornea, and to reduce inflammation. Numerous studies have shown that biologics with specificity for VEGF A such as bevacizumab and ranibizumab (a recombinant antibody and an antibody fragment, respectively) or anti-tumor necrosis factor-α microantibody, are effective in the treatment of corneal neovascularization.
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Affiliation(s)
- OB Voiculescu
- Department of Cellular and Molecular Medicine,
”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - LM Voinea
- Department of Ophthalmology, University Emergency Hospital Bucharest, Romania
| | - C Alexandrescu
- Department of Ophthalmology, University Emergency Hospital Bucharest, Romania
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237
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Guzman-Aranguez A, Loma P, Pintor J. Small-interfering RNAs (siRNAs) as a promising tool for ocular therapy. Br J Pharmacol 2014; 170:730-47. [PMID: 23937539 DOI: 10.1111/bph.12330] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/23/2013] [Accepted: 08/04/2013] [Indexed: 12/26/2022] Open
Abstract
RNA interference (RNAi) can be used to inhibit the expression of specific genes in vitro and in vivo, thereby providing an extremely useful tool for investigating gene function. Progress in the understanding of RNAi-based mechanisms has opened up new perspectives in therapeutics for the treatment of several diseases including ocular disorders. The eye is currently considered a good target for RNAi therapy mainly because it is a confined compartment and, therefore, enables local delivery of small-interfering RNAs (siRNAs) by topical instillation or direct injection. However, delivery strategies that protect the siRNAs from degradation and are suitable for long-term treatment would be help to improve the efficacy of RNAi-based therapies for ocular pathologies. siRNAs targeting critical molecules involved in the pathogenesis of glaucoma, retinitis pigmentosa and neovascular eye diseases (age-related macular degeneration, diabetic retinopathy and corneal neovascularization) have been tested in experimental animal models, and clinical trials have been conducted with some of them. This review provides an update on the progress of RNAi in ocular therapeutics, discussing the advantages and drawbacks of RNAi-based therapeutics compared to previous treatments.
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Affiliation(s)
- A Guzman-Aranguez
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Inhibition of pathological corneal neovascularization by a small peptide derived from human apolipoprotein (a) Kringle V. Cornea 2014; 33:405-13. [PMID: 24452210 DOI: 10.1097/ico.0000000000000032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the antiangiogenic activity of AU6, a novel 6-amino acid peptide derived from Kringle V of human apolipoprotein (a). METHODS RF/6A rhesus macaque choroid endothelial cells were used for in vitro studies. MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium, inner salt] assays and modified Boyden chamber and Matrigel assays were used to evaluate the inhibitory effect of AU6 on vascular endothelial growth factor (VEGF)-stimulated endothelial cell functions, including cell proliferation, migration, and tube formation. The chick chorioallantoic membrane model, micropocket corneal neovascularization (CNV) model, and alkali burn CNV model were evaluated in vivo. Bevacizumab (Avastin), the VEGF-neutralizing antibody, and a scrambled peptide (AU6s) were used as positive and negative controls, respectively. RESULTS AU6 inhibited VEGF-induced RF/6A cell migration, proliferation, and tube formation. It also reduced pathological neovascularization in the chorioallantoic membrane model and in the 2 CNV models, that is, the mouse corneal micropocket model and the rat cornea alkali burn model. CONCLUSIONS AU6 effectively inhibited pathogenic CNV. This novel peptide shows potential as a new treatment for ocular neovascularization.
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Wen L, Zhu M, Madigan MC, You J, King NJC, Billson FA, McClellan K, Sutton G, Petsoglou C. Immunomodulatory effects of bone marrow-derived mesenchymal stem cells on pro-inflammatory cytokine-stimulated human corneal epithelial cells. PLoS One 2014; 9:e101841. [PMID: 25003339 PMCID: PMC4086952 DOI: 10.1371/journal.pone.0101841] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/12/2014] [Indexed: 01/31/2023] Open
Abstract
Purpose To investigate the modulatory effect of rat bone marrow mesenchymal stem cells (MSC) on human corneal epithelial cells (HCE-T) stimulated with pro-inflammatory cytokines interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) in an in vitro co-cultured model. Methods HCE-T alone and co-cultured with MSC were stimulated with IFN-γ/TNF for 24 and 48 hours or left untreated. The expression of intracellular adhesion molecule (ICAM)-1, human leukocyte antigen ABC, DR and G (HLA-ABC, HLA-DR, HLA-G) were investigated by flow cytometry. Subcellular localization of nuclear factor-kappa B (NF-κB) and expression of indoleamine 2,3-dioxygenase (IDO) were assessed by immunofluorescence staining and western blot. The concentration of transforming growth factor beta 1 (TGF-β1) in the conditioned media from different cultures was evaluated by enzyme-linked immunosorbent assay. NF-κB and TGF-β1 signaling pathway blocking experiments were performed to analyze associations between the expression of cell surface molecules and the NF-κB transcription pathway, and the expression of IDO and TGF-β1 signaling pathway. Results IFN-γ/TNF treatment significantly up-regulated expression of ICAM-1, HLA-ABC, and induced de novo expression of HLA-DR and IDO on HCE-T cultured alone, while HLA-G expression remained unaffected. Up-regulation was significantly inhibited by co-culture with MSC. Increased TGF-β1 secretion was detected in 48 h IFN-γ/TNF-stimulated MSC monocultures and HCE-T/MSC co-cultures. MSC attenuated the activation of cytokine-induced NF-κB and IDO induction. Blockade of NF-κB transcription pathway by BMS-345541 significantly reduced the up-regulation of ICAM-1, HLA-ABC, HLA-DR and IDO expression, while blockade of TGF-β1 signaling pathways reversed the modulatory effect of MSC on IDO expression. Conclusions MSC reduced the expression of adhesion and immunoregulatory molecules on pro-inflammatory cytokine-stimulated HCE-T via the NF-κB transcription pathway. MSC attenuated expression of IDO through both NF-κB transcription and TGF-β1 signaling pathways. Co-culture of HCEC with MSC therefore provides a useful in vitro model to study the anti-inflammatory properties of MSC on corneal epithelium.
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Affiliation(s)
- Li Wen
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
| | - Meidong Zhu
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Lions New South Wales Eye Bank, NSW Organ and Tissue Donation Service, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
- * E-mail:
| | - Michele C. Madigan
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- School of Optometry & Vision Science, University of New South Wales, Kensington, New South Wales, Australia
| | - Jingjing You
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas J. C. King
- Discipline of Pathology, School of Medical Sciences and Bosch Institute, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Francis A. Billson
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
- Sight for Life Foundation, Sydney, New South Wales, Australia
| | - Kathryn McClellan
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Lions New South Wales Eye Bank, NSW Organ and Tissue Donation Service, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Gerard Sutton
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Lions New South Wales Eye Bank, NSW Organ and Tissue Donation Service, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
- Vision Eye Institute, Chatswood, New South Wales, Australia
- Auckland University, Auckland, New Zealand
| | - Con Petsoglou
- Save Sight Institute & Discipline of Clinical Ophthalmology, University of Sydney, Sydney, New South Wales, Australia
- Lions New South Wales Eye Bank, NSW Organ and Tissue Donation Service, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
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Early effects of dexamethasone and anti-VEGF therapy in an inflammatory corneal neovascularization model. Exp Eye Res 2014; 125:118-27. [PMID: 24933712 DOI: 10.1016/j.exer.2014.06.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/03/2014] [Accepted: 06/05/2014] [Indexed: 01/15/2023]
Abstract
Inflammatory angiogenesis is the pathogenic mechanism of various sight-threatening eye diseases, among them corneal neovascularization. Current treatment options include steroids which have undesirable side effects, or anti-VEGF which has only limited efficacy. In an inflammatory environment, however, angiogenesis can be stimulated by numerous factors not directly targeted by anti-VEGF therapy. The aim of this study was to induce corneal inflammation leading to angiogenesis, and investigate the early, differential effects of steroid and anti-VEGF therapy at the cellular, tissue, and gene expression levels. Fifty-two Wistar rats received a single intrastromal corneal suture to induce a controlled inflammatory angiogenic response. Rats were subsequently treated with dexamethasone, rat specific anti-VEGF, or goat IgG (control), topically 4 times daily for 7 days. In vivo confocal microscopy of the cornea was performed longitudinally from 5 h up to 7 d to investigate morphology at the cellular and tissue-level. In vivo photographic vessel analysis and immunohistochemistry were also performed. RT-PCR for VEGF-A, FGF-2, IL-6, TNF-α, CXCL2, CCL2, CCL3 and DLL4 was performed at 24 h, and for VEGF-A, IL-6, TNF-α, FGF-2, CXCL2, CCL2, and CCL3 at 7 days. Early infiltration of CD11b + myeloid cells into the cornea at 5 h post-suture was delayed by both treatments relative to controls; however neither treatment was able to suppress accumulation of myeloid cells at day 2 or 7. Limbal vessel dilation was inhibited at 5 h by both treatments, but only dexamethasone showed sustained effect until day 2. Early macrophage recruitment was also suppressed by dexamethasone (but not by anti-VEGF) until day 2. Dexamethasone furthermore suppressed corneal neovascularization at day 7 by over 90%, whereas suppression by anti-VEGF was 14%. Despite differential suppression of vessel dilation, macrophage recruitment, and vascular invasion, anti-VEGF and dexamethasone both down-regulated VEGF-A and IL-6 expression at 24 h with sustained effect to 7 d. They also both down regulated FGF-2 and TNF-α at 24 h and CCL2 at 7 d. In conclusion, anti-angiogenic treatments influence early, pre-angiogenic tissue activity such as limbal vessel dilation, inflammatory cell infiltration of the stroma, and macrophage recruitment. Importantly, the differential effects of steroids and anti-VEGF treatment in suppressing neovascular growth could not be attributed to differential inhibition of several major angiogenic and inflammatory factors in the early pre-sprouting phase, including IL-6, VEGF-A, FGF-2, TNF-α, CCL2, CCL3, CXCL2, or DLL4.
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Park PJ, Chang M, Garg N, Zhu J, Chang JH, Shukla D. Corneal lymphangiogenesis in herpetic stromal keratitis. Surv Ophthalmol 2014; 60:60-71. [PMID: 25444520 DOI: 10.1016/j.survophthal.2014.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 05/23/2014] [Accepted: 06/04/2014] [Indexed: 12/26/2022]
Abstract
Corneal lymphangiogenesis is the extension of lymphatic vessels into the normally alymphatic cornea, a process that compromises the cornea's immune-privileged state and facilitates herpetic stromal keratitis (HSK). HSK results most commonly from infection by herpes simplex virus-1 (HSV-1) and is characterized by immune- and inflammation-mediated damage to the deep layers of the cornea. Current research demonstrates the potential of anti-lymphangiogenic therapy to decrease and prevent herpes-induced lymphangiogenesis.
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Affiliation(s)
- Paul J Park
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael Chang
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nitin Garg
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jimmy Zhu
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Department of Physiology and Biophysics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Department of Physiology and Biophysics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Deepak Shukla
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Department Microbiology and Immunology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
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Sari ES, Yazici A, Aksit H, Yay A, Sahin G, Yildiz O, Ermis SS, Seyrek K, Yalcin B. Inhibitory effect of sub-conjunctival tocilizumab on alkali burn induced corneal neovascularization in rats. Curr Eye Res 2014; 40:48-55. [PMID: 24910898 DOI: 10.3109/02713683.2014.914541] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND To evaluate the effects of sub-conjunctivally applied interleukin-6 receptor (IL-6R) antibody (tocilizumab) on alkali burn induced corneal neovascularization (CNV) in rats. METHODS Alkali burn induced corneal neovascularization was created in 24 right eyes of 24 rats. The rats were then randomized into 2 groups. Group 1 received sub-conjunctival injection of 4 mg/0.2 ml tocilizumab and Group 2 received sub-conjunctival injection of 0.2 ml normal saline at the 5th day of alkali burn. The corneal surface area invaded with neovascular vessels were calculated on photographs. The rats were sacrificed and the corneas were excised at the15th day. The corneal specimens were stained with hemotoxylin-eosin to evaluate tissue morphology and with Willebrand factor (vWF) to evaluate microvascular structures immunohistochemically. Vascular endothelial growth factor (VEGF) expression was analyzed by ELISA. RESULTS The percent area of CNV was 26.9% in Group 1 and 56.5% in Group 2 (p < 0.001). The histological evaluation showed that the corneal structures were not visibly altered by sub-conjuntival tocilizumab injection. Group 1 showed significantly lower corneal inflammation score than Group 2 (p < 0.001). The number of vessels stained with vWF were significantly higher in Group 2 than Group 1 (15.23 and 5.46, respectively; p < 0.001). ELISA analyses showed that corneal VEGF levels were significantly lower in Group 1 compared to Group 2 (p = 0.013) CONCLUSION: The present data demonstrated first time the beneficial effects of sub-conjunctival tocilizumab on decreasing CNV in alkali burn model of the rat cornea. Further studies are warranted to confirm these findings for the clinical application.
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Affiliation(s)
- Esin Sogutlu Sari
- Department of Ophthalmology, Faculty of Medicine, Balıkesir University , Balıkesir , Turkey
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Liu W, Schultz KM, Zhang K, Sasman A, Gao F, Kume T, Zhang HF. In vivo corneal neovascularization imaging by optical-resolution photoacoustic microscopy. PHOTOACOUSTICS 2014; 2:81-86. [PMID: 25013754 PMCID: PMC4083229 DOI: 10.1016/j.pacs.2014.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Corneal neovascularization leads to blurred vision, thus in vivo visualization is essential for pathological studies in animal models. Photoacoustic (PA) imaging can delineate microvasculature and hemodynamics noninvasively, which is suitable for investigating corneal neovascularization. In this study, we demonstrate in vivo imaging of corneal neovascularization in the mouse eye by optical-resolution photoacoustic microscopy (OR-PAM), where corneal neovascularization is induced by deliberate alkali burn injuries in C57BL6/J inbred mice corneas on the left eye. We used OR-PAM to image five mice with corneal alkali burn injuries; the uninjured eyes (right eye) in these mice are then used as the controls. Corneal images acquired by OR-PAM with and without alkali burn injury are compared, clear signs of corneal neovascularization are present in the OR-PAM images of injured eyes; the OR-PAM results are also confirmed by postmortem fluorescence-labeled confocal microscopy.
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Affiliation(s)
- Wenzhong Liu
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Kathryn M. Schultz
- Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Kevin Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Amy Sasman
- Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Fengli Gao
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun 130012, China
| | - Tsutomu Kume
- Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Corresponding author at: Feinberg Cardiovascular Research Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. Tel.: +13126954965.
| | - Hao F. Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Ophthalmology, Northwestern University, Chicago, IL 60611, USA
- Corresponding author at: Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA. Tel.: +18474912946.
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Next target of tranilast: Inhibition of corneal neovascularization. Med Hypotheses 2014; 82:700-2. [DOI: 10.1016/j.mehy.2014.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 03/05/2014] [Indexed: 11/18/2022]
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Sharaf MG, Cetinel S, Heckler L, Damji K, Unsworth L, Montemagno C. Nanotechnology-Based Approaches for Ophthalmology Applications: Therapeutic and Diagnostic Strategies. Asia Pac J Ophthalmol (Phila) 2014; 3:172-80. [PMID: 26107588 DOI: 10.1097/apo.0000000000000059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this article was to review recent advances in applications of nanotechnology in ophthalmology. DESIGN Literature review. METHODS Research articles about nanotechnology-based treatments for particular eye diseases and diagnostic technologies were searched through Web of Science, and the most recent advances were reported. RESULTS Nanotechnology enabled to improve drug and gene delivery systems, medicine solubility and short half-life in biological systems, controlled release, targeted delivery, bioavailability, diffusion limitations, and biocompatibility so far. These promising achievements are the assurance of next-generation treatment technologies. As well as treatment, nanofabrications systems such as microelectromechanical manufacturing systems removed the limitations of nanodevice generations and led the development of diagnostic tools such as intraocular pressure monitors and biosensors. CONCLUSIONS The pursuit of personalized medicine approaches for combating ocular diseases may be possible only through the development of nanotechnology platforms that include molecular-level engineering. Nanoparticle engineering is a common thread; herein, we attempt to show unmodified nanoparticles as well as interesting and representative biomimetic strategies can be used for specific diseases. Finally, through combining microelectromechanical and nanoelectromechanical manufacturing system strategies, interesting manufacturing and sensor development can be accomplished for early detection and, in some cases, treatment of ocular diseases.
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Affiliation(s)
- Mehdi Ghaffari Sharaf
- From the *Chemical & Materials Engineering, †Ingenuity Lab, and ‡Ophthalmology and Visual Sciences, University of Alberta; and §National Institute of Nanotechnology, National Research Council, Edmonton, Alberta, Canada
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Lockington D, Fan Gaskin JC, McGhee CNJ, Patel DV. A prospective study of acute corneal hydrops by in vivo confocal microscopy in a New Zealand population with keratoconus. Br J Ophthalmol 2014; 98:1296-302. [DOI: 10.1136/bjophthalmol-2013-304145] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Onder HI, Erdurmus M, Bucak YY, Simavli H, Oktay M, Kukner AS. Inhibitory effects of regorafenib, a multiple tyrosine kinase inhibitor, on corneal neovascularization. Int J Ophthalmol 2014; 7:220-5. [PMID: 24790861 DOI: 10.3980/j.issn.2222-3959.2014.02.06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 03/09/2014] [Indexed: 01/06/2023] Open
Abstract
AIM To evaluate the inhibitory effects of regorafenib (BAY 73-4506), a multikinase inhibitor, on corneal neovascularization (NV). METHODS Thirty adult male Sprague-Dawley rats weighing 250-300 g, were used. Corneal NV was induced by NaOH in the left eyes of each rat. Following the establishment of alkali burn, the animals were randomized into five groups according to topical treatment. Group 1 (n = 6) received 0.9% NaCl, Group 2 (n = 6) received dimethyl sulfoxide, Group 3 (n = 6) received regorafenib 1 mg/mL, Group 4 (n =6) received bevacizumab 5 mg/mL and Group 5 (n = 6) received 0.1% dexamethasone phosphate. On the 7d, the corneal surface covered with neovascular vessels was measured on photographs as the percentage of the cornea's total area using computer-imaging analysis. The corneas obtained from rats were semiquantitatively evaluated for caspase-3 and vascular endothelial growth factor by immunostaining. RESULTS A statistically significant difference in the percent area of corneal NV was found among the groups (P <0.001). Although the Group 5 had the smallest percent area of corneal NV, there was no difference among Groups 3, 4 and 5 (P >0.005). There was a statistically significant difference among the groups in apoptotic cell density (P = 0.002). The staining intensity of vascular endothelial growth factor in the epithelial and endothelial layers of cornea was significantly different among the groups (P <0.05). The staining intensity of epithelial and endothelial vascular endothelial growth factor was significantly weaker in Groups 3, 4 and 5 than in Groups 1 and 2. CONCLUSION Topical administration of regorafenib 1 mg/mL is partly effective for preventing alkali-induced corneal NV in rats.
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Affiliation(s)
- Halil Ibrahim Onder
- Department of Ophthalmology, Duzce University Medical Faculty, Duzce 81160, Turkey
| | - Mesut Erdurmus
- Department of Ophthalmology, Abant Izzet Baysal University Medical School, Bolu 14280, Turkey
| | - Yasin Yücel Bucak
- Ophthalmology Clinic, Izzet Baysal State Hospital, Bolu 14000, Turkey
| | - Hüseyin Simavli
- Ophthalmology Clinic, Izzet Baysal State Hospital, Bolu 14000, Turkey
| | - Murat Oktay
- Department of Pathology, Duzce University Medical Faculty, Duzce 81160, Turkey
| | - Ahmet Sahap Kukner
- Department of Ophthalmology, Abant Izzet Baysal University Medical School, Bolu 14280, Turkey
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Fasciani R, Mosca L, Giannico MI, Ambrogio SA, Balestrazzi E. Subconjunctival and/or intrastromal bevacizumab injections as preconditioning therapy to promote corneal graft survival. Int Ophthalmol 2014; 35:221-7. [PMID: 24715230 DOI: 10.1007/s10792-014-9938-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 03/22/2014] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to investigate whether subconjunctival and/or intrastromal Bevacizumab injections could help to prevent graft failure in high-risk keratoplasties. Twenty seven eyes of 27 patients, affected by high immune rejection risk and corneal neovascularization, were involved in this prospective interventional case-control series (case group: 14 eyes and control group: 13 eyes). Case group was submitted to a cycle of three subconjunctival and/or intrastromal injections of 5 mg/0.2 ml Bevacizumab. After a mean period of 6.36 months ± 3.38 SD from the last injection, all patients underwent keratoplasty. An adjunctive injection was performed intraoperatively at the end of the surgical procedure. Control group did not receive any Bevacizumab injection, but directly underwent keratoplasty. Each patient was submitted to a complete eye examination and corneal confocal microscopy. The absence of immune rejection signs in the graft, at clinical and confocal microscopy examination, was considered as main outcome measure. All cases showed less ocular inflammation and activity of vessels. No side effects were detected after the injection procedure. No corneal graft rejection was seen during the follow-up (mean 26.1 months ± 5.7 SD) in the case group. Six eyes of the control group showed graft rejection 3.8 months ± 1.4 SD after keratoplasty. As a conclusion, Bevacizumab injection may represent a preconditioning treatment to improve prognosis in high-risk corneal transplantation. The procedure seems to be safe and it may help to reduce the inflammatory stimulus that plays a key role in corneal graft rejection.
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Affiliation(s)
- Romina Fasciani
- Ophthalmology Department, A. Gemelli Policlinic, Catholic University of "Sacro Cuore", Largo A. Gemelli 8, 00168, Rome, Italy,
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Deng Y, Wang CC, Choy KW, Du Q, Chen J, Wang Q, Li L, Chung TKH, Tang T. Therapeutic potentials of gene silencing by RNA interference: Principles, challenges, and new strategies. Gene 2014; 538:217-27. [DOI: 10.1016/j.gene.2013.12.019] [Citation(s) in RCA: 175] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 11/27/2013] [Accepted: 12/11/2013] [Indexed: 12/27/2022]
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Treatment of Corneal Neovascularization Using Anti-VEGF Bevacizumab. J Ophthalmol 2014; 2014:178132. [PMID: 24778865 PMCID: PMC3981012 DOI: 10.1155/2014/178132] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 02/18/2014] [Accepted: 02/19/2014] [Indexed: 12/27/2022] Open
Abstract
Purpose. To evaluate antiangiogenic effect of local use of bevacizumab (anti-VEGF antibody) in patients with corneal neovascularization. Methods. Patients were divided into two groups. All patients suffered from some form of corneal neovascularization (NV). Patients in group A received 0.2–0.5 mL of bevacizumab solution subconjunctivally (concentration 25 mg/mL) in a single dose. Group A included 28 eyes from 27. Patients in group B applied bevacizumab eye drops twice daily (concentration 2.5 mg/mL) for two weeks. Group B included 38 eyes from 35 patients. We evaluated the number of corneal segments affected by NV, CDVA, and the incidence of complications and subjective complaints related to the treatment. The minimum follow-up period was six months. Results. By the 6-month follow-up, in group A the percentage reduction of the affected peripheral segments was 21.6% and of the central segments was 9.6%; in group B the percentage reduction of the central segments was 22.7% and of the central segments was 38.04%. In both groups we noticed a statistically significant reduction in the extent of NV. Conclusion. The use of bevacizumab seems to be an effective and safe method in the treatment of corneal neovascularization, either in the subconjunctival or topical application form.
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