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Koh DS, Stratiievska A, Jana S, Otto SC, Swanson TM, Nhim A, Carlson S, Raza M, Naves LA, Senning EN, Mehl RA, Gordon SE. Genetic code expansion, click chemistry, and light-activated PI3K reveal details of membrane protein trafficking downstream of receptor tyrosine kinases. eLife 2024; 12:RP91012. [PMID: 39162616 PMCID: PMC11335347 DOI: 10.7554/elife.91012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024] Open
Abstract
Ligands such as insulin, epidermal growth factor, platelet-derived growth factor, and nerve growth factor (NGF) initiate signals at the cell membrane by binding to receptor tyrosine kinases (RTKs). Along with G-protein-coupled receptors, RTKs are the main platforms for transducing extracellular signals into intracellular signals. Studying RTK signaling has been a challenge, however, due to the multiple signaling pathways to which RTKs typically are coupled, including MAP/ERK, PLCγ, and Class 1A phosphoinositide 3-kinases (PI3K). The multi-pronged RTK signaling has been a barrier to isolating the effects of any one downstream pathway. Here, we used optogenetic activation of PI3K to decouple its activation from other RTK signaling pathways. In this context, we used genetic code expansion to introduce a click chemistry noncanonical amino acid into the extracellular side of membrane proteins. Applying a cell-impermeant click chemistry fluorophore allowed us to visualize delivery of membrane proteins to the plasma membrane in real time. Using these approaches, we demonstrate that activation of PI3K, without activating other pathways downstream of RTK signaling, is sufficient to traffic the TRPV1 ion channels and insulin receptors to the plasma membrane.
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Affiliation(s)
- Duk-Su Koh
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | | | - Subhashis Jana
- Department of Biochemistry and Biophysics, Oregon State UniversityCorvallisUnited States
| | - Shauna C Otto
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Teresa M Swanson
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Anthony Nhim
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Sara Carlson
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Marium Raza
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Ligia Araujo Naves
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
| | - Eric N Senning
- Department of Neuroscience, University of Texas at AustinAustinUnited States
| | - Ryan A Mehl
- Department of Biochemistry and Biophysics, Oregon State UniversityCorvallisUnited States
| | - Sharona E Gordon
- University of Washington, Department of Physiology & BiophysicsSeattleUnited States
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Castillo-Macías A, Arreola-Martínez JE, Loya-García D, Valdez-García JE. Prevalence and clinical characteristics of neurotrophic keratopathy in hispanic population in northeastern Mexico. Int Ophthalmol 2023:10.1007/s10792-023-02726-x. [PMID: 37140835 PMCID: PMC10400685 DOI: 10.1007/s10792-023-02726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 04/14/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE To evaluate the prevalence and clinical characteristics of neurotrophic keratopathy (NK) in northeastern Mexico. METHODS Retrospective cross-sectional study in which NK patients admitted to our ophthalmology clinic between 2015 and 2021 were consecutively enrolled. Data regarding demographics, clinical characteristics, and comorbidities were collected at the time diagnosis of NK was made. RESULTS In the period from 2015 to 2021, a total of 74,056 patients were treated and of these 42 had a diagnosis of neurotrophic keratitis. The prevalence found was 5.67 [CI95 3.95-7.38] in 10,000 cases. The mean age observed was 59 ± 17.21 years occurring more frequently in males in 59% and with corneal epithelial defects in 66.7%. The most frequent antecedents were the use of topical medications in 90%, the presence of diabetes mellitus 2 in 40.5% and systemic arterial hypertension in 26.2%. A higher proportion of male patients with corneal alterations and a higher proportion of female patients with corneal ulcerations and/or perforation were observed. CONCLUSION Neurotrophic keratitis is an underdiagnosed disease with a broad clinical spectrum. The antecedents that were contracted corroborate what was reported in the literature as risk factors. The prevalence of the disease in this geographical area was not reported, so it is expected to increase over time when searching for it intentionally.
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Affiliation(s)
- Alberto Castillo-Macías
- Instituto de Ciencias Visuales y Oftalmología, Hospital Zambrano Hellion, TecSalud, Av. Batallón de San Patriciio #112, Real de San Agustín, San Pedro Garza García, Nuevo León, México
| | - Jesús Enrique Arreola-Martínez
- Instituto de Ciencias Visuales y Oftalmología, Hospital Zambrano Hellion, TecSalud, Av. Batallón de San Patriciio #112, Real de San Agustín, San Pedro Garza García, Nuevo León, México
| | - Denise Loya-García
- Instituto de Ciencias Visuales y Oftalmología, Hospital Zambrano Hellion, TecSalud, Av. Batallón de San Patriciio #112, Real de San Agustín, San Pedro Garza García, Nuevo León, México
| | - Jorge Eugenio Valdez-García
- Instituto de Ciencias Visuales y Oftalmología, Hospital Zambrano Hellion, TecSalud, Av. Batallón de San Patriciio #112, Real de San Agustín, San Pedro Garza García, Nuevo León, México.
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Bianchi F, Cocilovo FM, Ruggiero A, Tamburrini G. Optic Pathway Gliomas: The Trends of Basic Research to Reduce the Impact of the Disease on Visual Function. Adv Tech Stand Neurosurg 2023; 48:123-137. [PMID: 37770684 DOI: 10.1007/978-3-031-36785-4_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Pediatric optic pathway gliomas (OPG) are low-grade brain tumors characterized by slow progression and invalidating visual loss. Common therapeutic strategies include surgery, radiotherapy, chemotherapy, and combinations of these modalities, but despite the different treatment strategies, no actual treatment exists to prevent or revert visual impairment. Nowadays, several reports of the literature show promising results regarding NGF eye drop instillation and improvement of visual outcome. Such results seem to be related with the NGF-linked prevention in caspase activation, which reduces retinal ganglion cell loss.Reducing retinal ganglion cell loss results clinically in visual field improvement as well as visual electric potential and optical coherence tomography gain. Nonetheless, visual acuity fails to show significant changes.Visual impairment represents nowadays one of the major issues in dealing with OPGs. Secondary to the interesting results offered by NGF eye drop administration, further studies are warranted to better comprehend potential treatment strategies.
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Affiliation(s)
| | | | - Antonio Ruggiero
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Milan, Italy
| | - Gianpiero Tamburrini
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Milan, Italy
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Gautier B, Meneux L, Feret N, Audrain C, Hudecek L, Kuony A, Bourdon A, Le Guiner C, Blouin V, Delettre C, Michon F. AAV2/9-mediated gene transfer into murine lacrimal gland leads to a long-term targeted tear film modification. Mol Ther Methods Clin Dev 2022; 27:1-16. [PMID: 36156877 PMCID: PMC9463184 DOI: 10.1016/j.omtm.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/27/2022]
Abstract
Corneal blindness is the fourth leading cause of blindness worldwide. Since corneal epithelium is constantly renewed, non-integrative gene transfer cannot be used to treat corneal diseases. In many of these diseases, the tear film is defective. Tears are a complex biological fluid secreted by the lacrimal apparatus. Their composition is modulated according to the context. After a corneal wound, the lacrimal gland secretes reflex tears, which contain growth factors supporting the wound healing process. In various pathological contexts, the tear composition can support neither corneal homeostasis nor wound healing. Here, we propose to use the lacrimal gland as bioreactor to produce and secrete specific factors supporting corneal physiology. In this study, we use an AAV2/9-mediated gene transfer to supplement the tear film. First, we demonstrate that a single injection of AAV2/9 is sufficient to transduce all epithelial cell types of the lacrimal gland efficiently and widely. Second, we detect no adverse effect after AAV2/9-mediated nerve growth factor expression in the lacrimal gland. Only a transitory increase in tear flow is measured. Remarkably, AAV2/9 induces an important and long-lasting secretion of this growth factor in the tear film. Altogether, our findings provide a new clinically applicable approach to tackle corneal blindness.
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Affiliation(s)
- Benoit Gautier
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
- Corresponding author Benoit Gautier, Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France.
| | - Léna Meneux
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
| | - Nadège Feret
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
| | - Christine Audrain
- TarGeT, Nantes University, INSERM UMR 1089, CHU Nantes, Nantes, France
| | - Laetitia Hudecek
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
- MRI, Biocampus, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Alison Kuony
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
- Cell Adhesion and Mechanics Lab, Université de Paris, CNRS, Institut Jacques Monod, Paris, France
| | - Audrey Bourdon
- INSERM UMR 1089, Université de Nantes, CHU de Nantes, Nantes, France
| | | | - Véronique Blouin
- INSERM UMR 1089, Université de Nantes, CHU de Nantes, Nantes, France
| | - Cécile Delettre
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
| | - Frédéric Michon
- Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
- Corresponding author Frédéric Michon, Institute for Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France.
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Luzu J, Antoine L, Annabelle RLG, Ghislaine R, Hong L, Bénédicte D, Benjamin B, Damien S, Christophe B. In vivo confocal microscopic study of corneal innervation in Sjögren's Syndrome with or without small fiber neuropathy. Ocul Surf 2022; 25:155-162. [PMID: 35872076 DOI: 10.1016/j.jtos.2022.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To study changes in the subbasal nerve plexus by In vivo confocal microscopy (IVCM) in Sjögren's Syndrome (SS) with or without associated Small Fiber Neuropathy (SFN), in order to prevent diagnostic delay. METHODS Seventy-one patients with SS, including 19 with associated SFN, 20 healthy volunteers and 20 patients with Meibomian gland dysfunction (MGD) were included in this retrospective case-control study. IVCM was used to investigate subbasal nerve plexus density and morphology. RESULTS Corneal sensitivity as evaluated with the Cochet-Bonnet aesthesiometer was significantly reduced in the SS group versus the control group (P = 0.026) and the MGD group (P = 0.037). The number of inflammatory cells was significantly increased in the SS group to 86.2 ± 82.1 cells/mm2 compared to the control group (P < 0.001). The density of the subbasal nerve plexus was significantly reduced to 16.7 ± 6.5 mm/mm2 in the SS group compared to the control group (P < 0.005) and the MGD group (P = 0.042). The tortuosity of the nerves in the SS group was significantly increased compared to the control group (P < 0.001) and the MGD group (P = 0.025). The average number of subbasal nerve plexus neuromas was significantly increased in the SS group compared to the control group (P = 0.001), with a significant increase in the average number of neuromas in SS patients with associated SFN compared to SS patients without SFN (P = 0.008). CONCLUSION IVCM can be useful to detect corneal nerve changes in SS patients and may allow earlier diagnosis of the disease and to consider new therapeutic approaches.
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Affiliation(s)
- Jade Luzu
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France.
| | - Labbé Antoine
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France
| | - Réaux-Le Goazigo Annabelle
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France
| | - Rabut Ghislaine
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France
| | - Liang Hong
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France
| | - Dupas Bénédicte
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France
| | - Blautain Benjamin
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France
| | - Sène Damien
- Departement of Internal Medecine, Lariboisière Hospital, 2 rue Ambroise Paré, F-75010, Paris, France
| | - Baudouin Christophe
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28 rue de Charenton, F-75012, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, IHU FOReSIGHT, 17 rue Moreau, F-75012, Paris, France
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In Vivo Confocal Microscopy Automated Morphometric Analysis of Corneal Subbasal Nerve Plexus in Patients With Dry Eye Treated With Different Sources of Homologous Serum Eye Drops. Cornea 2019; 38:1412-1417. [DOI: 10.1097/ico.0000000000002005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sacchetti M, Lambiase A, Schmidl D, Schmetterer L, Ferrari M, Mantelli F, Allegretti M, Garhoefer G. Effect of recombinant human nerve growth factor eye drops in patients with dry eye: a phase IIa, open label, multiple-dose study. Br J Ophthalmol 2019; 104:127-135. [PMID: 30944103 PMCID: PMC6922013 DOI: 10.1136/bjophthalmol-2018-312470] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 02/19/2019] [Accepted: 03/09/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Dry eye disease (DED) affects more than 14% of the elderly population causing decrease of quality of life, high costs and vision impairment. Current treatments for DED aim at lubricating and controlling inflammation of the ocular surface. Development of novel therapies targeting different pathogenic mechanisms is sought-after. The aim of this study is to evaluate safety and efficacy of recombinant human nerve growth factor (rhNGF) eye drops in patients with DED. METHODS Forty consecutive patients with moderate to severe DED were included in a phase IIa, prospective, open label, multiple-dose, clinical trial to receive rhNGF eye drops at 20 µg/mL (Group 1: G1) or at 4 µg/mL (Group 2: G2) concentrations, two times a day in both eyes for 28 days (NCT02101281). The primary outcomes measures were treatment-emerged adverse events (AE), Symptoms Assessment in Dry Eye (SANDE) scale, ocular surface staining and Schirmer test. RESULTS Of 40 included patients, 39 completed the trial. Both tested rhNGF eye drop concentrations were safe and well tolerated. Twenty-nine patients experienced at least one AE (14 in G1 and 15 in G2), of which 11 had at least 1 related AE (8 in G1 and 3 in G2). Both frequency and severity of DED symptoms and ocular surface damage showed significant improvement in both groups, while tear function improved only in G1. CONCLUSIONS The data of this study indicate that rhNGF eye drops in both doses is safe and effective in improving symptoms and signs of DED. Randomised clinical trials are ongoing to confirm the therapeutic benefit of rhNGF in DED. TRIAL REGISTRATION NUMBER NCT02101281.
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Affiliation(s)
- Marta Sacchetti
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Gerhard Garhoefer
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Pérez-Bartolomé F, Mingo Botín D, de Dompablo E, de Arriba P, Arnalich Montiel F, Muñoz Negrete FJ. Post-herpes neurotrophic keratopathy: Aetiopathogenesis, clinical signs and current therapies. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2019; 94:171-183. [PMID: 30718014 DOI: 10.1016/j.oftal.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/03/2019] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
Neurotrophic keratopathy (NK) is a degenerative corneal disease caused by damage of trigeminal innervation. This leads to epithelial defects, ulceration and, eventually, perforation. Both herpes simplex and varicella zoster keratitis are reported to be the main causes of NK. Furthermore, prognosis in this type of NK is poor. Classic clinical findings in post-herpes NK are spontaneous epithelial breakdown, round and central epithelial defects with smooth edges, stromal melting and thinning, scarring, and neovascularisation. Although several medical and surgical treatments have been reported, no therapies are currently available to definitely restore corneal sensitivity. Therefore, NK remains a challenging disease to treat. In this review a summary is presented of the pathogenesis, manifestations, and current management of post-herpes NK. The role of antiviral treatment and varicella-zoster vaccination is also discussed. A description is also presented on both medical and surgical novel therapies, such as regenerative drugs and corneal neurotization.
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Affiliation(s)
- F Pérez-Bartolomé
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, España.
| | - D Mingo Botín
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, España
| | - E de Dompablo
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, España
| | - P de Arriba
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, España
| | | | - F J Muñoz Negrete
- Departamento de Oftalmología, Hospital Ramón y Cajal, Madrid, España
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Versura P, Giannaccare G, Pellegrini M, Sebastiani S, Campos EC. Neurotrophic keratitis: current challenges and future prospects. Eye Brain 2018; 10:37-45. [PMID: 29988739 PMCID: PMC6029608 DOI: 10.2147/eb.s117261] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Neurotrophic keratitis (NK) is a degenerative corneal disease caused by damage of trigeminal corneal innervation, which leads to spontaneous epithelial breakdown and corneal ulceration. The impairment of corneal sensory innervation causes the reduction of both protective reflexes and trophic neuromodulators that are essential for the vitality, metabolism, and wound healing of ocular surface tissues. A wide range of ocular and systemic conditions, including herpetic keratitis, ocular chemical burns, corneal surgery, diabetes, multiple sclerosis, and neurosurgical procedures, can cause NK by damaging trigeminal innervation. Diagnosis of NK requires careful investigation of any ocular and systemic condition associated with the disease, complete ocular surface examination, and quantitative measurement of corneal sensitivity. The clinical stages of NK range from corneal epithelial alterations (stage 1) to persistent epithelial defect (stage 2) and ulcer (stage 3), which may progress to corneal perforation. Management of NK is based on clinical severity, and the aim of the therapy is to halt the progression of corneal damage and promote epithelial healing. Although several medical and surgical treatments have been proposed, no therapies are currently available to restore corneal sensitivity, and thus, NK remains difficult and challenging to treat. The purpose of this review is to summarize available evidence on the pathogenesis, diagnosis, and treatment of NK. Novel medical and surgical therapies including the topical administration of nerve growth factor and corneal neurotization are also described.
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Affiliation(s)
- Piera Versura
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Sant'Orsola-Malpighi Teaching Hospital, Bologna, Italy,
| | - Giuseppe Giannaccare
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Sant'Orsola-Malpighi Teaching Hospital, Bologna, Italy,
| | - Marco Pellegrini
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Sant'Orsola-Malpighi Teaching Hospital, Bologna, Italy,
| | - Stefano Sebastiani
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Sant'Orsola-Malpighi Teaching Hospital, Bologna, Italy,
| | - Emilio C Campos
- Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Sant'Orsola-Malpighi Teaching Hospital, Bologna, Italy,
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Rocco ML, Soligo M, Manni L, Aloe L. Nerve Growth Factor: Early Studies and Recent Clinical Trials. Curr Neuropharmacol 2018; 16:1455-1465. [PMID: 29651949 PMCID: PMC6295934 DOI: 10.2174/1570159x16666180412092859] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/23/2018] [Accepted: 04/04/2018] [Indexed: 12/02/2022] Open
Abstract
Since its discovery, nerve growth factor (NGF) has long occupied a critical role in developmental and adult neurobiology for its many important regulatory functions on the survival, growth and differentiation of nerve cells in the peripheral and central nervous system. NGF is the first discovered member of a family of neurotrophic factors, collectively indicated as neurotrophins, (which include brain-derived neurotrophic factor, neurotrophin-3 and neurotrophin 4/5). NGF was discovered for its action on the survival and differentiation of selected populations of peripheral neurons. Since then, an enormous number of basic and human studies were undertaken to explore the role of purified NGF to prevent the death of NGF-receptive cells. These studies revealed that NGF possesses important therapeutic properties, after topical administration, on human cutaneous pressure ulcer, corneal ulcers, glaucoma, retinal maculopathy, Retinitis Pigmentosa and in pediatric optic gliomas and brain traumas. The aim of this review is to present our previous, recent and ongoing clinical studies on the therapeutic properties of NGF.
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Affiliation(s)
| | | | | | - Luigi Aloe
- Address correspondence to this author at the Fondazione IRET ONLUS, Via Tolara di Sopra 41/E, 40064 Ozzano Emilia (BO), Italy; Tel: +39-051-798776; Fax: +39-051-799673; E-mail:
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Dieckmann G, Goyal S, Hamrah P. Neuropathic Corneal Pain: Approaches for Management. Ophthalmology 2017; 124:S34-S47. [PMID: 29055360 DOI: 10.1016/j.ophtha.2017.08.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 01/16/2023] Open
Abstract
Neuropathic pain is caused by a primary lesion or dysfunction of the nervous system and can occur in the cornea. However, neuropathic corneal pain (NCP) is currently an ill-defined disease. Patients with NCP are extremely challenging to manage, and evidence-based clinical recommendations for the management of patients with NCP are scarce. The objectives of this review are to provide guidelines for diagnosis and treatment of patients with NCP and to summarize current evidence-based literature in this area. We performed a systematic literature search of all relevant publications between 1966 and 2017. Treatment recommendations are, in part, based on methodologically sound randomized controlled trials (RCTs), demonstrating superiority to placebo or relevant control treatments, and on the consistency of evidence, degree of efficacy, and safety. In addition, the recommendations include our own extensive experience in the management of these patients over the past decade. A comprehensive algorithm, based on clinical evaluation and complementary tests, is presented for diagnosis and subcategorization of patients with NCP. Recommended first-line topical treatments include neuroregenerative and anti-inflammatory agents, and first-line systemic pharmacotherapy includes tricyclic antidepressants and an anticonvulsant. Second-line oral treatments recommended include an opioid-antagonist and opiate analgesics. Complementary and alternative treatments, such as cardiovascular exercise, acupuncture, omega-3 fatty acid supplementation, and gluten-free diet, may have additional benefits, as do potential noninvasive and invasive procedures in recalcitrant cases. Medication selection should be tailored on an individual basis, considering side effects, comorbidities, and levels of peripheral and centralized pain. Nevertheless, there is an urgent need for long-term studies and RCTs assessing the efficacy of treatments for NCP.
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Affiliation(s)
- Gabriela Dieckmann
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts; Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Sunali Goyal
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Pedram Hamrah
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts; Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
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Blood derived eye drops for the treatment of cornea and ocular surface diseases. Transfus Apher Sci 2017; 56:595-604. [DOI: 10.1016/j.transci.2017.07.023] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/26/2017] [Accepted: 07/30/2017] [Indexed: 12/30/2022]
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Mastropasqua L, Massaro-Giordano G, Nubile M, Sacchetti M. Understanding the Pathogenesis of Neurotrophic Keratitis: The Role of Corneal Nerves. J Cell Physiol 2016; 232:717-724. [PMID: 27683068 DOI: 10.1002/jcp.25623] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 09/27/2016] [Indexed: 11/06/2022]
Abstract
Neurotrophic keratitis (NK) is a rare degenerative disease of the cornea caused by trigeminal nerve damage, which leads to loss of corneal sensitivity, corneal epithelium breakdown, and poor healing. Though extremely uncommon, NK is increasingly recognized for its characteristics as a distinct and well-defined clinical entity rather than a rare complication of various diseases that can disrupt trigeminal innervation. Indeed, the defining feature of NK is loss of corneal sensitivity, and its clinical findings do not correlate with the wide range of systemic or ocular conditions that underlie trigeminal nerve damage. Despite increasing awareness of NK as a distinct condition, its management continues to be challenged by the lack of treatments that target nerve regeneration. This review focuses on the role of corneal nerves in maintaining ocular surface homeostasis, the consequences (such as alterations in neuromediators and corneal cell morphology/function) of impaired innervation, and advances in NK diagnosis and management. Novel therapeutic strategies should aim to improve corneal innervation in order support corneal renewal and healing. J. Cell. Physiol. 232: 717-724, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Leonardo Mastropasqua
- Department of Medicine and Ageing Sciences, Ophthalmology Clinic, University Gabriele d'Annunzio of Chieti-Pescara, via dei Vestini Chieti, Italy
| | - Giacomina Massaro-Giordano
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mario Nubile
- Department of Medicine and Ageing Sciences, Ophthalmology Clinic, University Gabriele d'Annunzio of Chieti-Pescara, via dei Vestini Chieti, Italy
| | - Marta Sacchetti
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Ambroziak AM, Szaflik J, Szaflik JP, Ambroziak M, Witkiewicz J, Skopiński P. Immunomodulation on the ocular surface: a review. Cent Eur J Immunol 2016; 41:195-208. [PMID: 27536206 PMCID: PMC4967654 DOI: 10.5114/ceji.2016.60995] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 02/29/2016] [Indexed: 12/20/2022] Open
Abstract
The increasing understanding of immune mechanisms changed our perception of the ocular surface, which is now considered a compartment of the common mucosal immune system. It offered the possibility to alter the physiological immune response on the ocular surface and effectively combat inflammation, which impairs stability of the tear film and causes tear hyperosmolarity, causing symptoms of dry eye disease. The paper provides an overview of ocular surface anatomy and physiology, explains the underlying mechanisms of dry eye disease and discusses novel and promising treatment modalities, such as cyclosporine A, biological therapies using autologous serum and various growth factors as well as experimental treatment methods which are currently being investigated.
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Affiliation(s)
- Anna M. Ambroziak
- SPKSO Ophthalmic University Hospital, Warsaw, Poland
- Information Optics Department, Faculty of Physics, University of Warsaw, Poland
| | - Jerzy Szaflik
- SPKSO Ophthalmic University Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Poland
| | - Jacek P. Szaflik
- SPKSO Ophthalmic University Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Poland
| | | | | | - Piotr Skopiński
- SPKSO Ophthalmic University Hospital, Warsaw, Poland
- Department of Histology and Embryology Centre of Biostructure, Medical University of Warsaw, Poland
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Chao W, Belmonte C, Benitez del Castillo JM, Bron AJ, Dua HS, Nichols KK, Novack GD, Schrader S, Willcox MD, Wolffsohn JS, Sullivan DA. Report of the Inaugural Meeting of the TFOS i2 = initiating innovation Series: Targeting the Unmet Need for Dry Eye Treatment. Ocul Surf 2016; 14:264-316. [DOI: 10.1016/j.jtos.2015.11.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/09/2015] [Accepted: 11/11/2015] [Indexed: 01/09/2023]
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Safety and pharmacokinetics of escalating doses of human recombinant nerve growth factor eye drops in a double-masked, randomized clinical trial. BioDrugs 2015; 28:275-83. [PMID: 24327173 PMCID: PMC4030100 DOI: 10.1007/s40259-013-0079-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Nerve growth factor (NGF) is a neurotrophin with therapeutic possibilities that extend from the nervous system to the eye. We tested the safety, maximal tolerated dose, pharmacokinetics, and antigenicity of a novel human recombinant NGF (rhNGF) eye-drop formulation in a phase I study. METHODS This prospective, randomized, double-masked, vehicle-controlled trial, sponsored by Dompé SpA (registered as NCT01744704 at ClinicalTrials.gov), enrolled 74 healthy volunteers (24 females, 50 males, age 40.2 ± 11.8 years). Subjects were randomized in three cohorts to receive (1) a single eye-drop containing 0.0175, 0.175, or 0.7 μg rhNGF; (2) a single ascending dose of rhNGF eye drops three times a day for 1 day (total daily dose 2.1, 6.3, or 18.9 μg), or vehicle; or (3) a multiple ascending dose of rhNGF eye drops three times a day for 5 days (total dose 10.5, 31.5, or 94.5 μg), or vehicle. Outcome measures included blood chemistry, urinalyses, vital signs, electrocardiograms (ECGs), serum NGF antibodies, ocular and systemic adverse events (AEs), visual acuity, tear function, intraocular pressure, fundus oculi, and ocular symptoms. RESULTS Administration of rhNGF eye drops did not result in a significant increase of circulating NGF levels and no antidrug antibodies were detected in serum. No serious AEs were recorded, and a few mild, transient ocular AEs related to rhNGF administration were reported only at the highest concentration. CONCLUSIONS rhNGF eye drops were well tolerated, with no detectable clinical evidence of systemic AEs. These results pave the way for the development of clinical trials on rhNGF in ophthalmology.
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Bodaghi B. Diclofenac sodium 0.1% ophthalmic solution: update on pharmacodynamics, clinical interest and safety profile. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.3.2.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Stapleton F, Marfurt C, Golebiowski B, Rosenblatt M, Bereiter D, Begley C, Dartt D, Gallar J, Belmonte C, Hamrah P, Willcox M. The TFOS International Workshop on Contact Lens Discomfort: report of the subcommittee on neurobiology. Invest Ophthalmol Vis Sci 2013; 54:TFOS71-97. [PMID: 24058137 PMCID: PMC5963174 DOI: 10.1167/iovs.13-13226] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 09/10/2013] [Indexed: 12/26/2022] Open
Abstract
This report characterizes the neurobiology of the ocular surface and highlights relevant mechanisms that may underpin contact lens-related discomfort. While there is limited evidence for the mechanisms involved in contact lens-related discomfort, neurobiological mechanisms in dry eye disease, the inflammatory pathway, the effect of hyperosmolarity on ocular surface nociceptors, and subsequent sensory processing of ocular pain and discomfort have been at least partly elucidated and are presented herein to provide insight in this new arena. The stimulus to the ocular surface from a contact lens is likely to be complex and multifactorial, including components of osmolarity, solution effects, desiccation, thermal effects, inflammation, friction, and mechanical stimulation. Sensory input will arise from stimulation of the lid margin, palpebral and bulbar conjunctiva, and the cornea.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Carl Marfurt
- Indiana University School of Medicine–Northwest, Gary, Indiana
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Mark Rosenblatt
- Weill Cornell Medical College, Cornell University, Ithaca, New York
| | - David Bereiter
- University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Carolyn Begley
- Indiana University School of Optometry, Bloomington, Indiana
| | - Darlene Dartt
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Juana Gallar
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernandez–Consejo Superior de Investigaciones Cientificas, Alicante, Spain
| | - Carlos Belmonte
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernandez–Consejo Superior de Investigaciones Cientificas, Alicante, Spain
| | - Pedram Hamrah
- Massachusetts Eye and Ear Infirmary, Stoneham, Massachusetts
| | - Mark Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Griffith M, Polisetti N, Kuffova L, Gallar J, Forrester J, Vemuganti GK, Fuchsluger TA. Regenerative approaches as alternatives to donor allografting for restoration of corneal function. Ocul Surf 2012; 10:170-83. [PMID: 22814644 DOI: 10.1016/j.jtos.2012.04.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 04/22/2012] [Accepted: 04/01/2012] [Indexed: 12/13/2022]
Abstract
A range of alternatives to human donor tissue for corneal transplantation are being developed to address the shortfall of good quality tissues as well as the clinical conditions for which allografting is contraindicated. Classical keratoprostheses, commonly referred to as artificial corneas, are being used clinically to replace minimal corneal function. However, they are used only as last resorts, as they are associated with significant complications, such as extrusion/rejection, glaucoma, and retinal detachment. The past few years have seen significant developments in technologies designed to replace part or the full thickness of damaged or diseased corneas with materials that encourage regeneration to different extents. This review describes selected examples of these corneal substitutes, which range from cell-based regenerative strategies to keratoprostheses with regenerative capabilities via tissue-engineered scaffolds pre-seeded with stem cells. It is unlikely that one corneal substitute will be best for all indications, but taken together, the various approaches may soon be able to supplement the supply of human donor corneas for transplantation or allow restoration of diseased or damaged corneas that cannot be treated by currently available techniques.
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Affiliation(s)
- May Griffith
- Integrative Regenerative Medicine Centre, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
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Elevated Nerve Growth Factor in Dry Eye Associated With Established Contact Lens Wear. Eye Contact Lens 2009; 35:232-7. [DOI: 10.1097/icl.0b013e3181b3e87f] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sivilia S, Giuliani A, Fernández M, Turba ME, Forni M, Massella A, De Sordi N, Giardino L, Calzà L. Intravitreal NGF administration counteracts retina degeneration after permanent carotid artery occlusion in rat. BMC Neurosci 2009; 10:52. [PMID: 19473529 PMCID: PMC2699342 DOI: 10.1186/1471-2202-10-52] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 05/27/2009] [Indexed: 01/19/2023] Open
Abstract
Background The neurotrophin nerve growth factor (NGF) is produced by different cell types in the anterior and posterior eye, exerting a neuroprotective role in the adult life. The visual system is highly sensitive to NGF and the retina and optic nerve provides suitable subjects for the study of central nervous system degeneration. The model of bilateral carotid occlusion (two-vessel occlusion, 2VO) is a well-established model for chronic brain hypoperfusion leading to brain capillary pathology, to retina and optic nerve degeneration. In order to study if a single intravitreal injection of NGF protects the retina and the optic nerve from degeneration during systemic circulatory diseases, we investigated morphological and molecular changes occurring in the retina and optic nerve of adult rats at different time-points (8, 30 and 75 days) after bilateral carotid occlusion. Results We demonstrated that a single intravitreal injection of NGF (5 μg/3 μl performed 24 hours after 2VO ligation) has a long-lasting protective effect on retina and optic nerve degeneration. NGF counteracts retinal ganglion cells degeneration by early affecting Bax/Bcl-2 balance- and c-jun- expression (at 8 days after 2VO). A single intravitreal NGF injection regulates the demyelination/remyelination balance after ischemic injury in the optic nerve toward remyelination (at 75 days after 2VO), as indicated by the MBP expression regulation, thus preventing optic nerve atrophy and ganglion cells degeneration. At 8 days, NGF does not modify 2VO-induced alteration in VEFG and related receptors mRNA expression. Conclusion The protective effect of exogenous NGF during this systemic circulatory disease seems to occur also by strengthening the effect of endogenous NGF, the synthesis of which is increased by vascular defect and also by the mechanical lesion associated with NGF or even vehicle intraocular delivery.
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Pepose JS, Johnson EM. Is there a role for neurotrophin treatment of the ocular surface following laser in situ keratomileusis (LASIK)? Am J Ophthalmol 2005; 139:1090-4. [PMID: 15953442 DOI: 10.1016/j.ajo.2005.03.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Revised: 03/23/2005] [Accepted: 03/23/2005] [Indexed: 10/25/2022]
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Micera A, Lambiase A, Aloe L, Bonini S, Levi-Schaffer F, Bonini S. Nerve growth factor involvement in the visual system: implications in allergic and neurodegenerative diseases. Cytokine Growth Factor Rev 2004; 15:411-7. [PMID: 15561599 DOI: 10.1016/j.cytogfr.2004.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this review is to outline the main role of nerve growth factor (NGF) in the visual system and particularly in the ocular surface in physiological and pathological conditions. The present review of experimental and clinical studies will highlight old and recent strategies for treating ocular surface and tear disorders with NGF.
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Affiliation(s)
- Alessandra Micera
- CIR Laboratorio di Oftalmologia, Campus Bio-Medico and Fondazione GB Bietti, Rome, Italy
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Abstract
Dry eye syndrome (DES) refers to a spectrum of ocular surface diseases with diverse and frequently multiple aetiologies. The common feature of the various manifestations of DES is an abnormal tear film. Tear film abnormalities associated with DES are tear deficiency, owing to insufficient supply or excessive loss, and anomalous tear composition. These categorizations are artificial, as in reality both often coexist. DES disrupts the homeostasis of the tear film with its adjacent structures, and adversely affects its ability to perform essential functions such as supporting the ocular surface epithelium and preventing microbial invasion. In addition, whatever the initial trigger, moderate and severe DES is characterized by ocular surface inflammation, which in turn becomes the cause and consequence of cell damage, creating a self-perpetuating cycle of deterioration. Progress has been made in our understanding of the aetiology and pathogenesis of DES, and these advances have encouraged a proliferation of therapeutic options. This article aims to amalgamate prevailing ideas of DES development, and to assist in that, relevant aspects of the structure, function, and production of the tear film are reviewed. Additionally, a synopsis of therapeutic strategies for DES is presented, detailing treatments currently available, and those in development.
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Affiliation(s)
- Michael E Johnson
- School of Optometry and Vision Sciences, Cardiff University, King Edward VII Avenue, Cardiff CF10 3NB, UK.
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Creuzot-Garcher C, Lafontaine PO, Brignole F, Pisella PJ, d'Athis P, Bron A, Lapierre V, Baudouin C. Traitement des syndromes secs graves par sérum autologue. J Fr Ophtalmol 2004; 27:346-51. [PMID: 15173640 DOI: 10.1016/s0181-5512(04)96139-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dry eye syndrome with tear deficiency can be improved with artificial tears, which can be associated with topical anti-inflammatory agents. Autologous serum can provide the ocular surface with beneficial growth factors and vitamins. PATIENTS AND METHODS Twenty-one patients suffering from severe dry eye due to Sjögren's syndrome were treated with 20% autologous serum for 2 Months. The Schirmer I test, break-up time, and fluorescein and lissamine green stainings were performed before and after treatment. Subjective complaints such as burning, foreign body sensation, dryness and photophobia were assessed by a questionnaire as well as a face score reflecting the current condition of patients' eyes. RESULTS Lissamine green and fluorescein scores improved significantly as well as subjective symptoms of burning, foreign body sensation and dryness (p<0.05). The face score was significantly improved. Bacterial culture of serum delivered to the patients all remained negative. DISCUSSION Autologous serum provides growth factors and vitamins that are useful for an altered ocular surface due to Sjögren's disease. However, some problems still remain: risk of contamination, arbitrary dilution of autologous serum, and a current lack of regulations for use of autologous serum. A close collaboration between ophthalmologists and the Etablissement Français du Sang (French Blood Bank) is mandatory because autologous serum should be considered as a useful tool to treat severe ocular surface disorders. CONCLUSION The use of autologous serum improved symptoms and objective signs caused by severe Sjögren's syndrome. Currently, a lack of clear regulations prevents its widespread use in severe ocular surface disorders.
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Affiliation(s)
- C Creuzot-Garcher
- Service d'Ophtalmologie, CHU, 3, rue du Faubourg Raines, 21000 Dijon.
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