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Beirampour N, Bustos-Salgado P, Garrós N, Mohammadi-Meyabadi R, Domènech Ò, Suñer-Carbó J, Rodríguez-Lagunas MJ, Kapravelou G, Montes MJ, Calpena A, Mallandrich M. Formulation of Polymeric Nanoparticles Loading Baricitinib as a Topical Approach in Ocular Application. Pharmaceutics 2024; 16:1092. [PMID: 39204436 PMCID: PMC11360485 DOI: 10.3390/pharmaceutics16081092] [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: 06/11/2024] [Revised: 08/14/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
Topical ocular drug delivery faces several challenges due to the eye's unique anatomy and physiology. Physiological barriers, tear turnover, and blinking hinder the penetration of drugs through the ocular mucosa. In this context, nanoparticles offer several advantages over traditional eye drops. Notably, they can improve drug solubility and bioavailability, allow for controlled and sustained drug release, and can be designed to specifically target ocular tissues, thus minimizing systemic exposure. This study successfully designed and optimized PLGA and PCL nanoparticles for delivering baricitinib (BTB) to the eye using a factorial design, specifically a three-factor at five-levels central rotatable composite 23+ star design. The nanoparticles were small in size so that they would not cause discomfort when applied to the eye. They exhibited low polydispersity, had a negative surface charge, and showed high entrapment efficiency in most of the optimized formulations. The Challenge Test assessed the microbiological safety of the nanoparticle formulations. An ex vivo permeation study through porcine cornea demonstrated that the nanoparticles enhanced the permeability coefficient of the drug more than 15-fold compared to a plain solution, resulting in drug retention in the tissue and providing a depot effect. Finally, the in vitro ocular tolerance studies showed no signs of irritancy, which was further confirmed by HET-CAM testing.
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Affiliation(s)
- Negar Beirampour
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
| | - Paola Bustos-Salgado
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - Núria Garrós
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
| | - Roya Mohammadi-Meyabadi
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - Òscar Domènech
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - Joaquim Suñer-Carbó
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - María José Rodríguez-Lagunas
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 08028 Barcelona, Spain;
| | - Garyfallia Kapravelou
- Department of Physiology, Institute of Nutrition and Food Technology (INyTA), Biomedical Research Center (CIBM), Universidad de Granada, 18100 Granada, Spain;
| | - María Jesús Montes
- Department de Biologia, Sanitat i Medi Ambient, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain;
| | - Ana Calpena
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
| | - Mireia Mallandrich
- Departament de Farmàcia i Tecnologia Farmacèutica, i Fisicoquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Av. Joan XXIII 29-31, 08028 Barcelona, Spain; (N.B.); (P.B.-S.); (R.M.-M.); (J.S.-C.); (A.C.)
- Institut de Nanociència i Nanotecnologia, Universitat de Barcelona (UB), 08028 Barcelona, Spain
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Zheng Q, Liu R, Jiang B, Sun J, Wang T, Ruan Q. NF-κB c-Rel Is a Potential Therapeutic Target for Acute Corneal Transplant Rejection. Invest Ophthalmol Vis Sci 2023; 64:16. [PMID: 37962530 PMCID: PMC10653260 DOI: 10.1167/iovs.64.14.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
Purpose The purpose of this study was to determine the role of nuclear factor kappa B (NF-κB) c-Rel during acute corneal transplant rejection and whether targeting c-Rel can reduce corneal transplant rejection. Methods Allogeneic corneal transplantation was performed in wild-type and c-Rel-deficient mice. Corneal graft survival rate, opacity, neovascularization, and edema were evaluated by slit-lamp microscopy. Adeno-associated virus 6 (AAV6) expressing c-Rel-specific small hairpin RNA (AAV6-shRel) and the small-molecule compound pentoxifylline (PTXF) were used to reduce c-Rel expression. Enzyme-linked immunosorbent assay was used to determine the expression of inflammatory cytokines. c-Rel expression was determined by quantitative RT-PCR and western blot. The effect of c-Rel inhibition on corneal transplant rejection was examined using a mouse model of acute allogeneic corneal transplantation. Tear production and corneal sensitivity were measured to determine the potential toxicity of AAV6-shRel and PTXF. Results The expression of c-Rel and its inflammatory targets was increased in both mice and patients with corneal transplant rejection. Loss of c-Rel reduced corneal transplant rejection in mouse. Both AAV6-shRel and PTXF were able to downregulate the expression of c-Rel and its inflammatory targets in vitro. Treatment with AAV6-shRel or PTXF reduced corneal transplant rejection in mouse and downregulated the expression of inflammatory cytokines in peripheral blood mononuclear cells from patients with corneal transplant rejection. Treatment with AAV6-shRel or PTXF displayed no side effects on tear production or corneal sensitivity. Conclusions Increased expression of c-Rel is a risk factor for acute corneal transplant rejection, and targeting c-Rel can efficiently reduce corneal transplant rejection.
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Affiliation(s)
- Qian Zheng
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
| | - Ruiling Liu
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
| | - Bian Jiang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Jijun Sun
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
| | - Ting Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
| | - Qingguo Ruan
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
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Sakowska J, Glasner P, Dukat-Mazurek A, Rydz A, Zieliński M, Pellowska I, Biernat W, Glasner L, Michalska-Małecka K, Trzonkowski P. Local T cell infiltrates are predominantly associated with corneal allograft rejection. Transpl Immunol 2023; 79:101852. [PMID: 37196866 DOI: 10.1016/j.trim.2023.101852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Corneal transplantations (CTXs) are a vision-saving procedure. Routinely, while CTXs' survival rates remain high, the risk of graft failure increases significantly for repeated CTXs. The reason is an alloimmunization following previous CTXs and development of memory T (Tm) and B (Bm) cells. METHODS We characterized populations of cells present in explanted human corneas from patients receiving the first CTX and marked as a primary CTX (PCTX) or the second or more CTXs and marked as a repeated CTX (RCTX). Cells extracted from resected corneas and from peripheral blood mononuclear cells (PBMCs) were analyzed by the flow cytometry method using multiple surface and intracellular markers. RESULTS Overall, the number of cells was similar in PCTX and RCTX patients. Extracted infiltrates from PCTXs and RCTXs contained similar numbers of T cell subsets, namely CD4+, CD8+, CD4+ Tm, CD8+ Tm, CD4+Foxp3+ T regulatory (Tregs), CD8+ Treg cells, while very few B cells (all p = NS). However, when compared to peripheral blood, PCTX and RCTX corneas contained significantly higher percentages of effector memory CD4+ and CD8+ T cells (both p < 0,05). In comparison to PCTX, RCTX group had the highest levels of Foxp3 in T CD4+ Tregs (p = 0,04) but decreased percentage of Helios-positive CD4+ Tregs. CONCLUSION PCTXs and especially RCTXs are rejected mainly by local T cells. The accumulation of effector CD4+ and CD8+ T cells, as well as CD4+ and CD8+ Tm cells is associated with the final rejection. Furthermore, local CD4+ and CD8+ Tregs expressing Foxp3 and Helios are probably insufficient to impose the acceptance of CTX.
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Affiliation(s)
- Justyna Sakowska
- Department of Medical Immunology, Medical University of Gdańsk, Dębinki Street 7, Building 27, Gdańsk, Poland.
| | - Paulina Glasner
- Department of Ophthalmology, Medical University of Gdańsk, Smoluchowskiego Street 17, Gdańsk, Poland
| | - Anna Dukat-Mazurek
- Department of Medical Immunology, Medical University of Gdańsk, Dębinki Street 7, Building 27, Gdańsk, Poland
| | - Anna Rydz
- Department of Ophthalmology, Medical University of Gdańsk, Smoluchowskiego Street 17, Gdańsk, Poland
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdańsk, Dębinki Street 7, Building 27, Gdańsk, Poland
| | - Irena Pellowska
- Department of Clinical Pathomorphology, University Clinical Centre in Gdańsk, Smoluchowskiego Street 17, Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdańsk, Smoluchowskiego Street 17, Gdańsk, Poland
| | - Leopold Glasner
- Department of Ophthalmology, Medical University of Gdańsk, Smoluchowskiego Street 17, Gdańsk, Poland
| | | | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdańsk, Dębinki Street 7, Building 27, Gdańsk, Poland
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Wang D, Huang B, Zhu C, Wang L, Jin J, Tan J, Li Q, Xiang S, Nan K, Lin S. Efficiency Encapsulation of FK506 with New Dual Self-Assembly Multi-Hydrophobic-Core Nanoparticles for Preventing Keratoplasty Rejection. Adv Healthc Mater 2023; 12:e2203242. [PMID: 37171892 DOI: 10.1002/adhm.202203242] [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] [Received: 12/13/2022] [Revised: 04/29/2023] [Indexed: 05/14/2023]
Abstract
Nanoparticles self-assembled by amphiphilic copolymers for loading hydrophobic molecules are intensively investigated. However, their hydrophobic molecule-loading capacity is low due to the limitation of hydrophobic groups in these copolymers. In this regard, new lysine oligomer-based multi-hydrophobic side chain polymers (MHCPs) are synthesized by polymerization of γ-benzyl-l glutamate N-carboxy anhydride initiated by side-chain primary amino groups in lysine oligomer. Each hydrophobic side chain in MHCPs can be self-assembled by hydrophobic interaction to form multi-hydrophobic-core nanoparticles (MHC-NPs) with silkworm cocoon-, grape cluster-, and butterfly-like shapes (depending on hydrophobic-side-chains lengths). To increase their stability, MHC-NPs are dually self-assembled with polyethylene glycol-polyglutamic acid through charge interaction. Each hydrophobic core in MHC-NPs serves as a carrier for hydrophobic molecules, endowing their nanostructure with high loading capacity. MHC-NPs are employed to load tacrolimus (also known as FK506), and the loading amount is 18% and the loading efficiency is 80%, which are higher than those of previously reported nanomicelles self-assembled by linear amphiphilic copolymers. Topical administration of FK506-loaded nanoparticle (FK506-NP) can significantly prolong retention of FK506 on the eye surface. FK506-NP exhibits higher in vivo immunosuppressive effects than free FK506 and commercial FK506 eye drop, as well as a better protective effect against immunotoxicity in the corneal grafts after keratoplasty.
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Affiliation(s)
- Dongmei Wang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Baoshan Huang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, 325027, China
| | - Chenchen Zhu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Lei Wang
- Engineering Research Center of Clinical Functional Materials and Diagnosis and Treatment Devices of Zhejiang Province, Wenzhou Institute, UCAS, Wenzhou, Zhejiang, 325000, China
| | - Jiahui Jin
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jingyang Tan
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Qing Li
- Engineering Research Center of Clinical Functional Materials and Diagnosis and Treatment Devices of Zhejiang Province, Wenzhou Institute, UCAS, Wenzhou, Zhejiang, 325000, China
| | - Shengjin Xiang
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kaihui Nan
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, 325027, China
| | - Sen Lin
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027, China
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, 325027, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis and Treatment Devices of Zhejiang Province, Wenzhou Institute, UCAS, Wenzhou, Zhejiang, 325000, China
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5
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Musa M, Zeppieri M, Enaholo ES, Chukwuyem E, Salati C. An Overview of Corneal Transplantation in the Past Decade. Clin Pract 2023; 13:264-279. [PMID: 36826166 PMCID: PMC9955122 DOI: 10.3390/clinpract13010024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
The cornea is a transparent avascular structure located in the front of the eye that refracts light entering the eyes and also serves as a barrier between the outside world and the internal contents of the eye. Like every other body part, the cornea may suffer insult from trauma, infection, and inflammation. In the case of trauma, a prior infection that left a scar, or conditions such as keratoconus that warrant the removal of all or part of the cornea (keratoplasty), it is important to use healthy donor corneal tissues and cells that can replace the damaged cornea. The types of cornea transplant techniques employed currently include: penetrating keratoplasty, endothelial keratoplasty (EK), and artificial cornea transplant. Postoperative failure acutely or after years can result after a cornea transplant and may require a repeat transplant. This minireview briefly examines the various types of corneal transplant methodologies, indications, contraindications, presurgical protocols, sources of cornea transplant material, wound healing after surgery complications, co-morbidities, and the effect of COVID-19 in corneal transplant surgery.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
- Correspondence:
| | - Ehimare S. Enaholo
- Centre for Sight Africa, Nkpor, Onitsha 434112, Nigeria
- Africa Eye Laser Centre, Benin 300001, Nigeria
| | - Ekele Chukwuyem
- Centre for Sight Africa, Nkpor, Onitsha 434112, Nigeria
- Africa Eye Laser Centre, Benin 300001, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Immunosuppressive Therapy for High-Risk Corneal Transplant. CURRENT OPHTHALMOLOGY REPORTS 2022. [DOI: 10.1007/s40135-022-00298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hjortdal J, Griffin MD, Cadoux M, Armitage WJ, Bylesjo M, Gabhann PM, Murphy CC, Pleyer U, Tole D, Vabres B, Walkinshaw MD, Gourraud P, Karakachoff M, Brouard S, Degauque N. Peripheral blood immune cell profiling of acute corneal transplant rejection. Am J Transplant 2022; 22:2337-2347. [PMID: 35704290 PMCID: PMC9796948 DOI: 10.1111/ajt.17119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/17/2022] [Accepted: 06/09/2022] [Indexed: 01/25/2023]
Abstract
Acute rejection (AR) of corneal transplants (CT) has a profound effect on subsequent graft survival but detailed immunological studies in human CT recipients are lacking. In this multi-site, cross-sectional study, clinical details and blood samples were collected from adults with clinically diagnosed AR of full-thickness (FT)-CT (n = 35) and posterior lamellar (PL)-CT (n = 21) along with Stable CT recipients (n = 177) and adults with non-transplanted corneal disease (n = 40). For those with AR, additional samples were collected 3 months later. Immune cell analysis was performed by whole-genome microarrays (whole blood) and high-dimensional multi-color flow cytometry (peripheral blood mononuclear cells). For both, no activation signature was identified within the B cell and T cell repertoire at the time of AR diagnosis. Nonetheless, in FT- but not PL-CT recipients, AR was associated with differences in B cell maturity and regulatory CD4+ T cell frequency compared to stable allografts. These data suggest that circulating B cell and T cell subpopulations may provide insights into the regulation of anti-donor immune response in human CT recipients with differing AR risk. Our results suggest that, in contrast to solid organ transplants, genetic or cellular assays of peripheral blood are unlikely to be clinically exploitable for prediction or diagnosis of AR.
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Affiliation(s)
- Jesper Hjortdal
- Department of OphthalmologyAarhus University HospitalAarhusDenmark,Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Matthew D. Griffin
- Regenerative Medicine Institute (REMEDI) at CÚRAM SFI Centre for Research in Medical DevicesSchool of Medicine, National University of Ireland GalwayGalwayIreland
| | - Marion Cadoux
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064NantesFrance,CHU Nantes, Institut De Transplantation Urologie Néphrologie (ITUN)NantesFrance
| | - W. John Armitage
- Translational Health SciencesUniversity of BristolBristolUK,Tissue and Eye ServicesNHS Blood and TransplantBristolUK
| | - Max Bylesjo
- Fios Genomics Ltd, Nine Edinburgh BioquarterEdinburghUK
| | | | - Conor C. Murphy
- Royal Victoria Eye and Ear HospitalDublinIreland,Royal College of Surgeons in Ireland University of Medicine and Health SciencesDublinIreland
| | - Uwe Pleyer
- Department of OphthalmologyCharité University HospitalBerlinGermany
| | - Derek Tole
- University Hospitals Bristol NHS Foundations TrustBristol Eye HospitalBristolUK
| | - Bertrand Vabres
- Nantes Université, CHU Nantes, Service OphtalmologieNantesFrance
| | - Malcolm D. Walkinshaw
- Wellcome Centre for Cell Biology, School of Biological SciencesUniversity of EdinburghEdinburghUK
| | - Pierre‐Antoine Gourraud
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064NantesFrance,CHU Nantes, Institut De Transplantation Urologie Néphrologie (ITUN)NantesFrance,CHU de Nantes, INSERM, CIC 1413, Pôle Hospitalo‐Universitaire 11: Santé Publique, Clinique des donnéesNantesFrance
| | - Matilde Karakachoff
- CHU de Nantes, INSERM, CIC 1413, Pôle Hospitalo‐Universitaire 11: Santé Publique, Clinique des donnéesNantesFrance
| | - Sophie Brouard
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064NantesFrance,CHU Nantes, Institut De Transplantation Urologie Néphrologie (ITUN)NantesFrance
| | - Nicolas Degauque
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064NantesFrance,CHU Nantes, Institut De Transplantation Urologie Néphrologie (ITUN)NantesFrance
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Muacevic A, Adler JR. A Review of Corneal Blindness: Causes and Management. Cureus 2022; 14:e30097. [PMID: 36381769 PMCID: PMC9643016 DOI: 10.7759/cureus.30097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/09/2022] [Indexed: 01/25/2023] Open
Abstract
Corneal blindness refers to a group of eye disorders that change the corneal transparency, causing corneal scarring and blindness. The leading causes of corneal blindness include infectious causes, i.e., due to bacteria, viruses, fungi, and protozoa. The most common predisposing factors are trauma, contact lens usage, or the use of steroid medications. The various other diseases included are trachoma, dry eye disease, keratoconus, ophthalmia neonatorum, and non-infectious uveitis. Various clinical modalities are used for treating corneal blindness, including organ transplantation. Organ donation is cumbersome as various ethical and other factors are involved. Hence the concept of eye banking was introduced to meet the increasing demand for donors of the cornea. The eye bank's role is harvesting, processing, and keeping a record of the cornea being transplanted and donated. Furthermore, various recent advancements have been made for lamellar keratoplasty surgeries, including bioengineered corneas to fulfil the need for the unavailability of donors for the cornea. Various specific health interventions have been implemented to reduce the prevalence of corneal blindness globally. For proper management of corneal blindness, we have three components that are needed to be taken care of: prevention of corneal blindness, appropriate treatment modalities, and providing adequate rehabilitation services to the patients. This review encompasses the main reasons for corneal blindness and the management and treatment modalities available for the patients. The terms cornea, corneal blindness, treatment, management, causes, and complications were used for the review article on PubMed.
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Urbańska K, Woźniak M, Więsyk P, Konarska N, Bartos W, Biszewski M, Bielak M, Chorągiewicz T, Rejdak R. Management and Treatment Outcomes of High-Risk Corneal Transplantations. J Clin Med 2022; 11:jcm11195511. [PMID: 36233379 PMCID: PMC9572799 DOI: 10.3390/jcm11195511] [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: 08/18/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022] Open
Abstract
Corneal transplantation is the most effective treatment for corneal blindness. Standard planned keratoplasties have a high success rate. Conditions such as active inflammation at the time of surgery, the presence of ocular surface disease, previous graft disease, or neovascularization make them more susceptible to rejection. These are so-called high-risk corneal transplantations. In our study, we selected 52 patients with a higher risk of graft rejection. A total of 78 procedures were performed. The main indications for the first keratoplasty were infections (59.6%) and traumas (21.2%). Visual acuity (VA) significantly improved from 2.05 logMAR on the day of keratoplasty to 1.66 logMAR in the latest examination (p = 0.003). An analysis of the graft survival showed a 1-year survival of 54% and a 5-year survival of 19.8% of grafts. The mean observation time without complications after the first, second, and third surgery was 23, 13, and 14 months, respectively. The best results were noted among patients with infectious indications for keratoplasty (p = 0.001). Among them, those with bacterial infection had the best visual outcomes (p = 0.047).
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