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Pagonis K, Peteinaris A, Adamou C, Tatanis V, Vagionis A, Natsos A, Obaidat M, Faitatziadis S, Liatsikos E, Kallidonis P. Minimal invasive treatment of urethral strictures: An experimental study of the effect of paclitaxel coated balloons in the wall of strictured rabbit's urethra. Arch Ital Urol Androl 2024; 96:12248. [PMID: 38389459 DOI: 10.4081/aiua.2024.12248] [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: 12/31/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE The aim of this study is the evaluation of the distribution of paclitaxel (PTX) released by a coated balloon in the layers of rabbit's urethra. METHODS 18 rabbits were included. A laser device was used for the stricture formation. After two weeks, dilation of the strictured urethra was performed by using Advance 35LP PTA balloons and Advance 18 PTX PTA balloons. The experimental models were divided into 3 groups. The group Α included two rabbits without any intervention except for the stenosis procedure. Group B compromised six rabbits that underwent dilation with Advance 35LP PTA balloons. Group C consisted of 10 rabbits to which dilation with both Advance 35LP PTA balloons and Advance 18 PTX PTA balloons was applied. Histological evaluation and Immunohistochemistry were performed on all specimens. RESULTS Inflammation, fibrosis and ruptures were detected in the specimens of the study. In specimens of Group C the decrease of inflammation and fibrosis rate was greater. Anti-PTX antibody was detected in the epithelium, lamina propria and smooth muscle layer of all specimens of urethras that have been harvested immediately and 1 day after the dilation with Advance 18 PTX PTA balloon and it was not observed in any layer of the urethral wall of the rest of the examined specimens of Group C. CONCLUSIONS PTX's enrichment was detected in the smooth muscle layer of all specimens that have been harvested immediately and 24h after the dilation with Advance 18 PTX PTA balloons. PTX may play an inhibitive role in the recurrence of the stenosis.
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Montero P, Pérez-Leal M, Pérez-Fidalgo JA, Sanz C, Estornut C, Roger I, Milara J, Cervantes A, Cortijo J. Paclitaxel Induces Epidermal Molecular Changes and Produces Subclinical Alterations in the Skin of Gynecological Cancer Patients. Cancers (Basel) 2022; 14:cancers14051146. [PMID: 35267454 PMCID: PMC8909563 DOI: 10.3390/cancers14051146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Skin toxicity is one of paclitaxel’s adverse effects. However, its real impact on the skin could be underestimated as these alterations can also appear asymptomatic. We have observed that paclitaxel modifies gene and protein expression of skin markers in a 3D epidermis model, and impairs physical, physiological, and biomechanical properties of the skin in gynecologic cancer patients. These subclinical alterations might be avoided by using prophylactic measures during treatment to prevent possible future adverse reactions. Abstract Background: Paclitaxel is a microtubule-stabilizing chemotherapeutic agent. Despite its widespread use, it damages healthy tissues such as skin. The goal of this study was to prove that the real impact of paclitaxel-induced skin toxicity could be underestimated because the adverse events might appear asymptomatic. Methods: Gynecological cancer patients were recruited. Skin parameters measurements were taken after three and six paclitaxel cycles. Measurements were conducted using specific probes which measure hydration, transepidermal water loss (TEWL), sebum, elasticity and firmness, erythema, roughness, smoothness, skin thickness, and desquamation levels. Further, a 3D epidermis model was incubated with paclitaxel to analyze gene and protein expression of aquaporin 3, collagen type 1, elastin, and fibronectin. Results: Paclitaxel induced alterations in the skin parameters with no visible clinical manifestations. Gynecological cancer patients under paclitaxel treatment had a decrease in hydration, TEWL, sebum, elasticity, and thickness of the skin, while erythema, roughness, and desquamation were increased. The molecular markers, related to hydration and the support of the skin layers, and analyzed in the 3D epidermis model, were decreased. Conclusions: Results suggest that paclitaxel modifies gene and protein expression of skin-related molecular markers, and impairs different physical, physiological, and biomechanical properties of the skin of cancer patients at a subclinical level.
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Affiliation(s)
- Paula Montero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Correspondence: ; Tel.: +34-963864631
| | - Martín Pérez-Leal
- Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain;
| | - Jose Alejandro Pérez-Fidalgo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;
- Biomedical Research Networking Centre on Cancer (CIBERONC), Health Institute Carlos III, 28029 Madrid, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Celia Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Health Sciences, Pre-Departmental Section of Medicine, Jaume I University of Castellón de la Plana, 12071 Castellón, Spain
| | - Cristina Estornut
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
| | - Inés Roger
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
| | - Javier Milara
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Pharmacy Unit, University General Hospital Consortium, 46014 Valencia, Spain
| | | | - Julio Cortijo
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Research and Teaching Unit, University General Hospital Consortium, 46014 Valencia, Spain
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de Oliveira CM, Ferreira JDLM. Overview of cicatricial modulators in glaucoma fistulizing surgery. Int Ophthalmol 2020; 40:2789-2796. [DOI: 10.1007/s10792-020-01454-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022]
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Development of a biodegradable antifibrotic local drug delivery system for glaucoma microstents. Biosci Rep 2018; 38:BSR20180628. [PMID: 30061178 PMCID: PMC6117617 DOI: 10.1042/bsr20180628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/27/2018] [Accepted: 07/26/2018] [Indexed: 12/18/2022] Open
Abstract
To prevent implant failure due to fibrosis is a major objective in glaucoma research. The present study investigated the antifibrotic effects of paclitaxel (PTX), caffeic acid phenethyl ester (CAPE), and pirfenidone (PFD) coated microstent test specimens in a rat model. Test specimens based on a biodegradable blend of poly(4-hydroxybutyrate) biopolymer and atactic poly(3-hydroxybutyrate) (at.P(3HB)) were manufactured, equipped with local drug delivery (LDD) coatings, and implanted in the subcutaneous white fat depot. Postoperatively, test specimens were explanted and analyzed for residual drug content. Fat depots including the test specimens were histologically analyzed. In vitro drug release studies revealed an initial burst for LDD devices. In vivo, slow drug release of PTX was found, whereas it already completed 1 week postoperatively for CAPE and PFD LDD devices. Histological examinations revealed a massive cell infiltration in the periphery of the test specimens. Compact fibrotic capsules around the LDD devices were detectable at 4–36 weeks and least pronounced around PFD-coated specimens. Capsules stained positive for extracellular matrix (ECM) components. The presented model offers possibilities to investigate release kinetics and the antifibrotic potential of drugs in vivo as well as the identification of more effective agents for a novel generation of drug-eluting glaucoma microstents.
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Comparison of Six Different Silicones In Vitro for Application as Glaucoma Drainage Device. MATERIALS 2018; 11:ma11030341. [PMID: 29495462 PMCID: PMC5872920 DOI: 10.3390/ma11030341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/30/2018] [Accepted: 02/24/2018] [Indexed: 12/28/2022]
Abstract
Silicones are widely used in medical applications. In ophthalmology, glaucoma drainage devices are utilized if conservative therapies are not applicable or have failed. Long-term success of these devices is limited by failure to control intraocular pressure due to fibrous encapsulation. Therefore, different medical approved silicones were tested in vitro for cell adhesion, cell proliferation and viability of human Sclera (hSF) and human Tenon fibroblasts (hTF). The silicones were analysed also depending on the sample preparation according to the manufacturer's instructions. The surface quality was characterized with environmental scanning electron microscope (ESEM) and water contact angle measurements. All silicones showed homogeneous smooth and hydrophobic surfaces. Cell adhesion was significantly reduced on all silicones compared to the negative control. Proliferation index and cell viability were not influenced much. For development of a new glaucoma drainage device, the silicones Silbione LSR 4330 and Silbione LSR 4350, in this study, with low cell counts for hTF and low proliferation indices for hSF, and silicone Silastic MDX4-4210, with low cell counts for hSF and low proliferation indices for hTF, have shown the best results in vitro. Due to the high cell adhesion shown on Silicone LSR 40, 40,026, this material is unsuitable.
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Zada M, Pattamatta U, White A. Modulation of Fibroblasts in Conjunctival Wound Healing. Ophthalmology 2017; 125:179-192. [PMID: 29079272 DOI: 10.1016/j.ophtha.2017.08.028] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/18/2017] [Accepted: 08/21/2017] [Indexed: 12/20/2022] Open
Abstract
Modulating conjunctival wound healing has the potential to improve outcomes after glaucoma filtration surgery and for several ocular disorders, including ocular cicatrial pemphigoid, vernal keratoconjunctivitis, and pterygium. Although anti-inflammatories and antimetabolites have been used with success, these nonspecific agents are not without their complications. The search for novel and more targeted means to control conjunctival fibrosis without such limitations has brought much attention to the regulation of fibroblast proliferation, differentiation, extracellular matrix production, and apoptosis. This review provides an update on where we stand with current antifibrotic agents and outlines the strategies that novel agents use, as they evolve from the bench to the bedside.
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Affiliation(s)
- Mark Zada
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia.
| | - Ushasree Pattamatta
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia
| | - Andrew White
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia; Save Sight Institute, University of Sydney, NSW, Australia
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Carvalho VFM, Migotto A, Giacone DV, de Lemos DP, Zanoni TB, Maria-Engler SS, Costa-Lotufo LV, Lopes LB. Co-encapsulation of paclitaxel and C6 ceramide in tributyrin-containing nanocarriers improve co-localization in the skin and potentiate cytotoxic effects in 2D and 3D models. Eur J Pharm Sci 2017; 109:131-143. [PMID: 28735040 DOI: 10.1016/j.ejps.2017.07.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/10/2017] [Accepted: 07/18/2017] [Indexed: 12/31/2022]
Abstract
Considering that tumor development is generally multifactorial, therapy with a combination of agents capable of potentiating cytotoxic effects is promising. In this study, we co-encapsulated C6 ceramide (0.35%) and paclitaxel (0.50%) in micro and nanoemulsions containing tributyrin (a butyric acid pro-drug included for potentiation of cytotoxicity), and compared their ability to co-localize the drugs in viable skin layers. The nanoemulsion delivered 2- and 2.4-fold more paclitaxel into viable skin layers of porcine skin in vitro at 4 and 8h post-application than the microemulsion, and 1.9-fold more C6 ceramide at 8h. The drugs were co-localized mainly in the epidermis, suggesting the nanoemulsion ability for a targeted delivery. Based on this result, the nanoemulsion was selected for evaluation of the nanocarrier-mediated cytotoxicity against cells in culture (2D model) and histological changes in a 3D melanoma model. Encapsulation of the drugs individually decreased the concentration necessary to reduce melanoma cells viability to 50% (EC50) by approximately 4- (paclitaxel) and 13-fold (ceramide), demonstrating an improved nanoemulsion-mediated drug delivery. Co-encapsulation of paclitaxel and ceramide further decreased EC50 by 2.5-4.5-fold, and calculation of the combination index indicated a synergistic effect. Nanoemulsion topical administration on 3D bioengineered melanoma models for 48h promoted marked epidermis destruction, with only few cells remaining in this layer. This result demonstrates the efficacy of the nanoemulsion, but also suggests non-selective cytotoxic effects, which highlights the importance of localizing the drugs within cutaneous layers where the lesions develop to avoid adverse effects.
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Affiliation(s)
| | - Amanda Migotto
- Institute of Biomedical Sciences, University of São Paulo, Brazil
| | | | | | - Thalita B Zanoni
- School of Pharmaceutical Sciences, University of São Paulo, Brazil
| | | | | | - Luciana B Lopes
- Institute of Biomedical Sciences, University of São Paulo, Brazil.
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Arellano-Orden E, Serrano C, Montes-Worboys A, Sánchez-López V, Laborda A, Lostalé F, Lahuerta C, Rodríguez-Panadero F, de Gregorio MÁ. Stent-induced tracheal stenosis can be predicted by IL-8 expression in rabbits. Eur J Clin Invest 2017; 47:84-92. [PMID: 27873304 DOI: 10.1111/eci.12706] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/18/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bare metal stents may cause complications like fibrous encapsulation, granulation and tracheal stenosis. We investigated the behaviour of three commercially available stents in vivo (rabbits) and in vitro (coculture of those stents with epithelial and fibroblast cell lines). Also, we investigated whether development of tracheal stenosis could be predicted by any biological marker. MATERIALS AND METHODS The tracheae of 30 rabbits were implanted with either nitinol stents, with or without paclitaxel elution, or a cobalt-based stent. An additional ten rabbits underwent mock implantation (controls). Serial peripheral venous blood samples were taken throughout the study, and several cytokines measured. Animals were euthanized on day 90, with immediate tracheal endoscopy and lavage performed, then necropsy. RESULTS Rabbits with cobalt-based stent exhibited more inflammation and the highest stenosis incidence, with reduced survival. Both in vivo and in vitro, this stent induced higher IL-8 levels than nitinol stents. Most important, the presence of stent-induced tracheal stenosis was closely associated to increase in IL-8 expression in blood just 1 day after tracheal stent implantation: a 1·19-fold increase vs. baseline had 83% sensitivity, 83% specificity, 77% positive predictive value, 88% negative predictive value and 83% accuracy to predict development of stenosis. CONCLUSIONS The cobalt-based stent had the highest incidence of tracheal inflammation and stenosis. On the other hand, the paclitaxel-eluting nitinol stent did not prevent those complications and provoked a marked reaction compared with the bare nitinol stent. Early increase in IL-8 expression in blood after stent implantation could predict development of tracheal stenosis in rabbits.
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Affiliation(s)
- Elena Arellano-Orden
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Carolina Serrano
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain
| | - Ana Montes-Worboys
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Verónica Sánchez-López
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Alicia Laborda
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain
| | - Fernando Lostalé
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain
| | - Celia Lahuerta
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain
| | - Francisco Rodríguez-Panadero
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel de Gregorio
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Interventional Radiology, Hospital Clinico Universitario, University of Zaragoza, Zaragoza, Spain.,CIBER Bioengineering, Biomaterials and Nanomedicine (BBB), Instituto de Salud Carlos III, Madrid, Spain
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Pepe D, Carvalho VF, McCall M, de Lemos DP, Lopes LB. Transportan in nanocarriers improves skin localization and antitumor activity of paclitaxel. Int J Nanomedicine 2016; 11:2009-19. [PMID: 27274232 PMCID: PMC4869655 DOI: 10.2147/ijn.s97331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In this study, the ability of nanocarriers containing protein transduction domains (PTDs) of various classes to improve cutaneous paclitaxel delivery and efficacy in skin tumor models was evaluated. Microemulsions (MEs) were prepared by mixing a surfactant blend (polyoxyethylene 10 oleoyl ether, ethanol and propylene glycol), monocaprylin, and water. The PTD transportan (ME-T), penetratin (ME-P), or TAT (ME-TAT) was added at a concentration of 1 mM to the plain ME. All MEs displayed nanometric size (32.3–40.7 nm) and slight positive zeta potential (+4.1 mV to +6.8 mV). Skin penetration of paclitaxel from the MEs was assessed for 1–12 hours using porcine skin and Franz diffusion cells. Among the PTD-containing formulations, paclitaxel skin (stratum corneum + epidermis and dermis) penetration at 12 hours was maximized with ME-T, whereas ME-TAT provided the lowest penetration (1.6-fold less). This is consistent with the stronger ability of ME-T to increase transepidermal water loss (2.4-fold compared to water) and tissue permeability. The influence of PTD addition on the ME irritation potential was assessed by measuring interleukin-1α expression and viability of bioengineered skin equivalents. A 1.5- to 1.8-fold increase in interleukin-1α expression was induced by ME-T compared to the other formulations, but this effect was less pronounced (5.8-fold) than that mediated by the moderate irritant Triton. Because ME-T maximized paclitaxel cutaneous localization while being safer than Triton, its efficacy was assessed against basal cell carcinoma cells and a bioengineered three-dimensional melanoma model. Paclitaxel-containing ME-T reduced cells and tissue viability by twofold compared to drug solutions, suggesting the potential clinical usefulness of the formulation for the treatment of cutaneous tumors.
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Affiliation(s)
- Dominique Pepe
- Department of Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY, USA
| | - Vanessa Fm Carvalho
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Melissa McCall
- Department of Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY, USA
| | - Débora P de Lemos
- Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Luciana B Lopes
- Department of Pharmaceutical Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY, USA; Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Chen N, Guo D, Guo Y, Sun Y, Bi H, Ma X. Paclitaxel inhibits cell proliferation and collagen lattice contraction via TGF-β signaling pathway in human tenon's fibroblasts in vitro. Eur J Pharmacol 2016; 777:33-40. [DOI: 10.1016/j.ejphar.2016.02.059] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 12/30/2022]
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Huang LP, Wang GQ, Jia ZS, Chen JW, Wang G, Wang XL. Paclitaxel reduces formation of hypertrophic scars in the rabbit ear model. Ther Clin Risk Manag 2015; 11:1089-95. [PMID: 26251604 PMCID: PMC4524470 DOI: 10.2147/tcrm.s82961] [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: 01/16/2023] Open
Abstract
Background and objective The onset and progression of pathological scarring involves multiple cytokines and complex mechanisms. However, hyperplasia of fibroblasts and neovascularization plays important roles, which can be inhibited by paclitaxel. The aim of this study was to investigate the efficacy of paclitaxel in the treatment of hypertrophic scars on rabbit ears. Methods Rabbit ear models of hypertrophic scars were established to observe the therapeutic effects of paclitaxel at different concentrations (12 mg/L, 24 mg/L, 48 mg/L, 96 mg/L, 18 mg/L, 54 mg/L, 162 mg/L, 486 mg/L, 30 mg/L, 150 mg/L, 750 mg/L, 3,750 mg/L). The outcome measures included hypertrophic index (HI), density of fibroblasts, density of collagenous fibers, and microvessel density. Results In comparison with the control group, the concentrations of 96 mg/L, 150 mg/L, and 162 mg/L significantly reduce the formation of hypertrophic scars in the rabbit ear models. However, local necrosis was found in the rabbit ear models treated with paclitaxel solution >400 mg/L. Conclusion Paclitaxel has strong inhibitory effects on the hyperplasia of fibroblasts, deposition of collagen, and microangiogenesis in hypertrophic scars on rabbit ears within the concentration range from 48 mg/L to 162 mg/L, without causing local necrosis.
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Affiliation(s)
- Li-Ping Huang
- Department of Physical Therapy, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Guo-Qi Wang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Zi-Shan Jia
- Department of Physical Therapy, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Jing-Wen Chen
- Department of Physical Therapy, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Gang Wang
- Department of Physical Therapy, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xing-Lin Wang
- Department of Physical Therapy, Chinese PLA General Hospital, Beijing, People's Republic of China
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Hovakimyan M, Siewert S, Schmidt W, Sternberg K, Reske T, Stachs O, Guthoff R, Wree A, Witt M, Schmitz KP, Allemann R. Development of an Experimental Drug Eluting Suprachoroidal Microstent as Glaucoma Drainage Device. Transl Vis Sci Technol 2015; 4:14. [PMID: 26175960 DOI: 10.1167/tvst.4.3.14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/28/2015] [Indexed: 12/26/2022] Open
Abstract
PURPOSE A novel glaucoma drainage device (GDD) with local drug delivery (LDD) system was created and characterized for safety and effectiveness after implantation into the suprachoroidal space (SCS) of rabbit eyes. METHODS Thin films of two different polymers, Poly(3-hydroxybutyrate) (P(3HB)) and Poly(4-hydroxybutyrate) (P(4HB)), containing the drugs mitomycin C (MitC) or paclitaxel (PTX) were attached to silicone-tubes to create LDD devices. The release kinetics of these drugs were explored in vitro using high performance liquid chromatography (HPLC). Twenty-four New Zealand white rabbits, randomly divided into eight groups, were implanted with different kinds of microstents into SCS. The intraocular pressure (IOP) was monitored noninvasively. After 6 weeks, rabbits were sacrificed and enucleated eyes were used for anterior segment optical coherence tomography (OCT), micro magnetic resonance imaging (MRI), and histology. RESULTS In vitro, faster drug release from both polymers was observed for MitC compared to PTX. Comparing polymers, the release from P(3HB) matrix was slower for both drugs. MRI and OCT showed all implants maintained a proper location. An effective IOP reduction was observed for up to 6 weeks in eyes with microstents combined with a drug-releasing LDD system. Overall, the surrounding tissue revealed mild-to-moderate inflammation. No pronounced fibrosis was observed in any of the groups. However, both drugs caused damage to the neighboring retina. CONCLUSIONS The suprachoroidal microstent reduced IOP with mild inflammation in rabbit eyes. To avoid negative effects on the retina, it is necessary to identify novel drugs with less cytotoxicity. Future studies are needed to explore the fibrotic process over the long-term. TRANSLATIONAL RELEVANCE The presented data serve as a proof of principle study for the concept of a suprachoroidal drug eluting microstent. Future device improvements will be focused on the design of LDD systems and the use of specific anti-inflammatory or antifibrotic agents with less cytotoxicity compared to MitC or PTX. Long-term animal studies using a reliable glaucoma model will be a further step towards clinical application and improvement of surgical glaucoma therapy.
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Affiliation(s)
- Marina Hovakimyan
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Stefan Siewert
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Wolfram Schmidt
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Katrin Sternberg
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Thomas Reske
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Oliver Stachs
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
| | - Rudolf Guthoff
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Andreas Wree
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Martin Witt
- Department of Anatomy, Rostock University Medical Center, Rostock, Germany
| | - Klaus-Peter Schmitz
- Institute for Biomedical Engineering Rostock University Medical Center, Rostock, Germany
| | - Reto Allemann
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
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Van de Velde S, Van Bergen T, Vandewalle E, Moons L, Stalmans I. Modulation of wound healing in glaucoma surgery. PROGRESS IN BRAIN RESEARCH 2015; 221:319-40. [PMID: 26518085 DOI: 10.1016/bs.pbr.2015.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glaucoma is a neurodegenerative disease and is the second most important cause of irreversible blindness. Filtration surgery remains the most effective therapy to reduce intraocular pressure in glaucoma patients. The main determinant of long-term surgical success is the healing response. Excessive postoperative wound healing with subsequent fibrosis may lead to obstruction of the created channel which frequently results in early surgical failure and consequent progression of visual field loss. Preoperative use of antimitotics, such as mitomycin-C and 5-fluorouracyl, effectively improves surgery outcome. However, the use of these nonspecific antiproliferative agents can be associated with severe side effects. This review provides an overview of the most important efforts that have been made to explore novel, more specific, and safer agents to prevent glaucoma filtration failure and improve surgery outcome.
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Affiliation(s)
- Sarah Van de Velde
- Department of Neurosciences, Laboratory of Ophthalmology, KU Leuven, Leuven, Belgium
| | - Tine Van Bergen
- Department of Neurosciences, Laboratory of Ophthalmology, KU Leuven, Leuven, Belgium
| | - Evelien Vandewalle
- Department of Neurosciences, Laboratory of Ophthalmology, KU Leuven, Leuven, Belgium; Department of Ophthalmology, University Hospitals Leuven (UZ Leuven), Leuven, Belgium
| | - Lieve Moons
- Research Group of Neural Circuit Development and Regeneration, Animal Physiology and Neurobiology Section, Department of Biology, KU Leuven, Leuven, Belgium
| | - Ingeborg Stalmans
- Department of Neurosciences, Laboratory of Ophthalmology, KU Leuven, Leuven, Belgium; Department of Ophthalmology, University Hospitals Leuven (UZ Leuven), Leuven, Belgium.
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Okuda T, Higashide T, Sakurai M, Fukuhira Y, Kaneko H, Shimomura M, Sugiyama K. Paclitaxel-Releasing Thin Biodegradable Film for Prevention of Bleb Avascularity Without Compromising Filtration in Rabbits. Transl Vis Sci Technol 2015; 4:10. [PMID: 26101723 DOI: 10.1167/tvst.4.3.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 04/27/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE A honeycomb-patterned film (HPF) prevents bleb scarring and mitomycin C (MMC)-related bleb avascularity in a rabbit model of filtration surgery. In this study, we examined whether a HPF-releasing paclitaxel (PTX) can prevent bleb avascularity without compromising filtration. METHODS Filtration surgery was performed in one eye of rabbits. A 14-μm thick HPF made from poly(L-lactide-co-ε-caprolactone) was placed subconjunctivally over the filtration site with the honeycomb surface turned toward the subconjunctival Tenon tissue. The rabbits were divided into four groups (n = 5 each): 1, HPF with no drug; 2, HPF + PTX 50 μg; 3, HPF + 5 μg; 4, HPF + 0.5 μg. Intraocular pressure (IOP) measurements and bleb evaluations using ultrasound biomicroscopy were performed periodically for 4 weeks followed by histological examination. A longer follow-up study (12 weeks) was performed for group 4 (experiment 2; n = 8). RESULTS Among all groups at the 4-week follow up, two blebs failed in group 1. The postoperative IOP decrease was significantly greater in PTX-treated eyes than in group 1. The bleb avascular area persisted for 4 weeks in groups 2 and 3. However, no avascular area was observed in groups 1 and 4 at 4 weeks postoperatively. Histology showed minimal fibrosis at the filtration site in all the PTX groups. In experiment 2, some blebs became flatter starting at 10 weeks after surgery. CONCLUSIONS PTX released from HPF promoted bleb survival and IOP decrease. The lowest dose of PTX (0.5 μg) was effective at preventing bleb avascularity without compromising filtration.
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Affiliation(s)
- Tetsuhiko Okuda
- Department of Ophthalmology Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tomomi Higashide
- Department of Ophthalmology Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Mayumi Sakurai
- Department of Ophthalmology Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yukako Fukuhira
- Research Laboratories III, Integrative Technology Research Institute, New Business Development Group, Teijin Limited, Tokyo, Japan
| | - Hiroaki Kaneko
- Research Laboratories III, Integrative Technology Research Institute, New Business Development Group, Teijin Limited, Tokyo, Japan
| | - Masatsugu Shimomura
- Department of Bio- and Material Photonics, Faculty of Photonics Science and Technology, Chitose Institute of Science and Technology, Chitose, Japan
| | - Kazuhisa Sugiyama
- Department of Ophthalmology Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Md Noh SM, Sheikh Abdul Kadir SH, Bannur ZM, Froemming GA, Abdul Hamid Hasani N, Mohd Nawawi H, Crowston JG, Vasudevan S. Effects of ranibizumab on the extracellular matrix production by human Tenon's fibroblast. Exp Eye Res 2014; 127:236-42. [DOI: 10.1016/j.exer.2014.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 08/05/2014] [Accepted: 08/07/2014] [Indexed: 12/16/2022]
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16
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Wallace DM, Murphy-Ullrich JE, Downs JC, O'Brien CJ. The role of matricellular proteins in glaucoma. Matrix Biol 2014; 37:174-82. [PMID: 24727033 DOI: 10.1016/j.matbio.2014.03.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 03/26/2014] [Accepted: 03/27/2014] [Indexed: 01/12/2023]
Abstract
Glaucoma is an optic neuropathy affecting approximately 60million people worldwide and is the second most common cause of irreversible blindness. Elevated intraocular pressure (IOP) is the main risk factor for developing glaucoma and is caused by impaired aqueous humor drainage through the trabecular meshwork (TM) and Schlemm's canal (SC). In primary open angle glaucoma (POAG), this elevation in IOP in turn leads to deformation at the optic nerve head (ONH) specifically at the lamina cribrosa (LC) region where there is also a deposition of extracellular matrix (ECM) molecules such as collagen and fibronectin. Matricellular proteins are non-structural secreted glycoproteins that help cells communicate with their surrounding ECM. This family of proteins includes connective tissue growth factor (CTGF), also known as CCN2, thrombospondins (TSPs), secreted protein acidic and rich in cysteine (SPARC), periostin, osteonectin, and Tenascin-C and -X and other ECM proteins. All members appear to play a role in fibrosis and increased ECM deposition. Most are widely expressed in tissues particularly in the TM and ONH and deficiency of TSP1 and SPARC have been shown to lower IOP in mouse models of glaucoma through enhanced outflow facility. The role of these proteins in glaucoma is emerging as some have an association with the pathophysiology of the TM and LC regions and might therefore be potential targets for therapeutic intervention in glaucoma.
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Affiliation(s)
- Deborah M Wallace
- UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Dept. of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.
| | | | - J Crawford Downs
- Department of Ophthalmology, Center for Ocular Biomechanics and Biotransport, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Colm J O'Brien
- UCD School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Dept. of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
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Xiong Q, Li Z, Li Z, Zhu Y, Abdulhalim S, Wang P, Cai X. Anti-VEGF agents with or without antimetabolites in trabeculectomy for glaucoma: a meta-analysis. PLoS One 2014; 9:e88403. [PMID: 24523890 PMCID: PMC3921170 DOI: 10.1371/journal.pone.0088403] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 01/05/2014] [Indexed: 12/11/2022] Open
Abstract
PURPOSE We aimed to evaluate the intraoperative application of antimetabolites compared with anti-vascular endothelial growth factor (VEGF) agents with or without antimetabolites in trabeculectomy (Trab) for glaucoma. METHODS Relevant studies were selected through extensive search using PubMed, EMBASE, the Cochrane Library, and Web of Science databases in August 2013. The primary efficacy estimate was measured using weighted mean difference of the percentage of intraocular pressure reduction (IOPR%) from baseline to end-point, and the secondary efficacy estimates were odds ratio (OR) and 95% confidence interval (CI) for complete success rate and qualified success rate. ORs were also used to measure the tolerability estimate for adverse events. Meta-analyses of fixed or random effects models were conducted using RevMan software 5.2 to pool the results of the studies included. Heterogeneity was assessed using Chi(2) test and the I(2) measure. RESULTS Nine studies enrolling a total of 349 patients were included. The weighted mean difference of IOPR% from baseline was 7.23 (95% CI: 2.57-11.89) for antimetabolites vs. anti-VEGF agents and 3.96 (95% CI: -4.18-12.10) for antimetabolites vs. anti-VEGF agents plus antimetabolites. The pooled ORs comparing antimetabolites with anti-VEGF agents were 2.37 (95% CI: 0.78, 7.21) for the complete success rate and 1.93 (95% CI: 0.52, 7.16) for qualified success rate. The pooled ORs comparing antimetabolites with anti-VEGF agents plus antimetabolites were 1.43 (95% CI: 0.48, 4.29) for the complete success rate and 2.11 (95% CI: 0.12, 37.72) for qualified success rate. The rates of adverse events did not significantly differ between antimetabolites and anti-VEGF agents, with pooled ORs of 0.86 (0.28-2.69) for bleb leakage, 3.01 (0.45-20.10) for choroidal effusion, 0.96 (0.23-3.98) for flat anterior chamber, and 0.90 (0.12-6.60) for hypotony. Further, the rates of adverse events were similar between antimetabolites and anti-VEGF agents plus antimetabolites, with pooled ORs of 0.40 (0.08-2.00) and 8.00 (0.93-68.59) for bleb leakage and hypotony, respectively. CONCLUSIONS In comparison with anti-VEGF agents, antimetabolites were more effective in lowering IOP in Trab, while the intraoperative application of these two types of agents did not indicate statistically significant differences in the complete success rate, qualified success rate, or incidence of adverse events.
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Affiliation(s)
- Qi Xiong
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
| | - Zhiliang Li
- Department of Orthpedics, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zhaohui Li
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
| | - Yi Zhu
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
| | - Sancar Abdulhalim
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
| | - Ping Wang
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
| | - Xiaojun Cai
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, P.R. China
- * E-mail:
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18
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Abstract
Epibulbar glaucoma drainage devices have been only slightly modified since their introduction more than 40 years ago. Having been used primarily in only difficult cases with a poor prognosis (and therefore with poor clinical results) the recently published trabeculectomy versus tube study (TVT) led to a change in our understanding of these devices. In this study epibulbar glaucoma drainage devices (here the Baerveldt device) were employed for early implantation (in some cases as primary glaucoma surgery intervention). Being sceptically monitored the results over the first 5 year clearly showed an almost equal or even better outcome in comparison to trabeculectomy. Despite these good results a critical evaluation seems mandatory mainly because of the unsolved problems concerning late complications. Late tube erosion with subsequent blebitis and enophthalmitis as well as late base plate encapsulation need to be mentioned here. The latter leads to thick fibrous tissue around the base plate resulting in an increase of intraocular pressure (IOP). Late corneal decompensation is also a late complication the pathomechanism of which is only poorly understood. Solving and treating such late complications are often troublesome and time consuming. Future experiments should lead to development of new drainage implant designs and the bulk material should be enhanced and optimized to increase clinical surgical results.
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Affiliation(s)
- H Thieme
- Universitätsmedizin, Augenklinik und Augenpoliklinik, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
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Thieme H. Current status of epibulbar anti-glaucoma drainage devices in glaucoma surgery. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:659-64. [PMID: 23094002 DOI: 10.3238/arztebl.2012.0659] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 03/26/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND The term "glaucoma" covers a heterogeneous group of progressive optic neuropathies that are accompanied by characteristic visual-field defects. Primary open-angle glaucoma, the most common type, progresses insidiously and causes blindness if untreated. All current forms of treatment aim at lowering the intraocular pressure (IOP) in patients whose IOP is elevated. The implantation of anti-glaucoma drainage systems is one of the available options for surgical treatment. METHODS This review is based on pertinent literature retrieved by a selective search, including glaucoma treatment guidelines from Germany and abroad. RESULTS A paradigm shift is currently underway regarding the indications for the implantation of anti-glaucoma drainage systems. Trabeculectomy (a "fistulating" operation in which the aqueous humor is led out of the eye under the conjunctiva) is still considered the surgical gold standard, but drainage systems have been implanted with increasing frequency in recent years. Studies have shown that these systems are more likely to be beneficial the earlier they are implanted in the course of the patient's disease. Five-year follow-up data from the randomized, multicenter Tube Versus Trabeculectomy (TVT) study have now revealed that anti-glaucoma drainage systems are equivalent to trabeculectomy with respect to long-term IOP reduction, complication rates, and absolute and relative clinical success rates. CONCLUSION Glaucoma is a major clinical and socio-economic problem whose surgical treatment increasingly involves the implantation of anti-glaucoma drainage systems.
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Affiliation(s)
- Hagen Thieme
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Germany.
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De Falco E, Scafetta G, Napoletano C, Puca R, Vingolo EM, Ragona G, Iorio O, Frati G. A standardized laboratory and surgical method for in vitro culture isolation and expansion of primary human Tenon's fibroblasts. Cell Tissue Bank 2012; 14:277-87. [PMID: 22820760 DOI: 10.1007/s10561-012-9325-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 07/03/2012] [Indexed: 11/25/2022]
Abstract
Good manufacturing practices guidelines require safer and standardized cell substrates especially for those cell therapy products to treat ocular diseases where fibroblasts are used as feeder layers. However, if these are unavailable for stem cells culturing, murine fibroblasts are regularly used, raising critical issues as accidentally transplanting xenogenous graft and adversely affecting stem cell clinical trials. Moreover, human fibroblasts play a significant role in testing novel ophthalmologic drugs. Accordingly, we developed a standardized laboratory and surgical approach to isolate normal and undamaged Tenon's fibroblasts to implement the setting up of banks for both stem cells-based ocular cell therapy and in vitro drug testing. A 2-3 cm(2) undamaged Tenon's biopsy was surgically obtained from 28 patients without mutually correlated ocular diseases. Nineteen dermal biopsies were used as control. Fibroblasts were isolated with or without collagenase, cultured in autologous, fetal bovine or AB serum, tested for viability by trypan blue, vimentin expression and standardized until passage 6. Successful Tenon's fibroblasts isolation was age dependent (P = 0.001) but not sex, pathology or surgery related. A significant rate of successful cultures were obtained when biopsies were not digested by collagenase (P = 0.013). Moreover, cultures in autologous or fetal bovine serum had comparable proliferative properties (P = 0.77; P = 0.82). Through our surgical and laboratory standardized procedure, we elucidated for the first time key points of this human primary culture system, the role of the autologous serum, comparing Tenon's and dermal fibroblasts. Our protocol may be clinically useful to reduce the risk above mentioned and may be potentially more effective for ophthalmological clinical purposes.
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Affiliation(s)
- Elena De Falco
- Department of Science and Medical-Surgical Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome Sapienza, C.so della Repubblica 79, 04100, Latina, Italy.
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21
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Stahnke T, Löbler M, Kastner C, Stachs O, Wree A, Sternberg K, Schmitz KP, Guthoff R. Different fibroblast subpopulations of the eye: a therapeutic target to prevent postoperative fibrosis in glaucoma therapy. Exp Eye Res 2012; 100:88-97. [PMID: 22579993 DOI: 10.1016/j.exer.2012.04.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 04/20/2012] [Accepted: 04/23/2012] [Indexed: 12/17/2022]
Abstract
The aim of this study is the characterization of fibroblasts mainly responsible for fibrosis processes associated with trabeculectomy or microstent implantation for glaucoma therapy. Therefore we isolated human primary fibroblasts from choroidea, sclera, Tenon capsule, and orbital fat tissues. These fibroblast subpopulations were analysed in vitro for expression of the extracellular matrix components which are responsible for postoperative scarring in glaucoma therapy. For scarring the proteins of the collagen family are predominant and so we focused on the expression of collagen I, collagen III and collagen VI in every fibroblast subpopulation. Also, the extracellular matrix protein fibronectin which crosslinks collagen fibres or other extracellular matrix components and cell surfaces, was analyzed. Collagen I, III and VI were prominent in every fibroblast subpopulation. The highest amounts of collagen III were found in hCF and hOF, whereas the signal in hSF and hTF was negligible. Additionally, there is a link between scarring processes and proliferating potential of fibroblasts, in case of microstent implantation triggered through the infiltration of inflammatory cells. Thus we analyzed fibroblast subpopulations for the presence of TGF-β1 which is one of the most important cytokines involved in proliferation processes. TGF-β1 was prominent in all fibroblast subpopulations with lowest expression in hCF cultures. To prevent postoperative fibroblast proliferation we analyzed in vitro the proliferation-inhibitors paclitaxel and mitomycin C which are potential candidates in drug eluting drainage systems on ocular fibroblast subpopulations. These inhibitors arrest fibroblast proliferation and viability, being, however, not very specific and have a cytotoxic potential also on healthy tissues surrounding the microstent outflow area. Significant differences in protein synthesis of fibroblasts subpopulations which could be specific targets for inhibition may help to find out fibroblast specific inhibitors to prevent postoperative scarring and could prevent patients from secondary surgery after microstent implantation.
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Affiliation(s)
- Thomas Stahnke
- Department of Ophthalmology, University of Rostock, Doberaner Straße 140, D-18057 Rostock, Germany.
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Löbler M, Sternberg K, Stachs O, Allemann R, Grabow N, Roock A, Kreiner CF, Streufert D, Neffe AT, Hanh BD, Lendlein A, Schmitz KP, Guthoff R. Polymers and drugs suitable for the development of a drug delivery drainage system in glaucoma surgery. J Biomed Mater Res B Appl Biomater 2011; 97:388-95. [DOI: 10.1002/jbm.b.31826] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 12/07/2010] [Accepted: 12/29/2010] [Indexed: 12/16/2022]
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Current World Literature. Curr Opin Ophthalmol 2011; 22:141-6. [DOI: 10.1097/icu.0b013e32834483fc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wen H, Hao J, Li SK. Influence of permeant lipophilicity on permeation across human sclera. Pharm Res 2010; 27:2446-56. [PMID: 20734114 DOI: 10.1007/s11095-010-0237-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 08/02/2010] [Indexed: 12/28/2022]
Abstract
PURPOSE The objectives of this study were to determine the effects of permeant lipophilicity on permeant uptake into and transport across human sclera for transscleral delivery. METHODS Model permeants with a wide range of lipophilicities were selected and studied with human sclera. Uptake experiments were carried out to measure permeant partitioning into the sclera. Transport experiments were performed in side-by-side diffusion cells, and the permeability coefficients and transport lag times of the permeants across the sclera were evaluated. RESULTS Permeants with higher lipophilicity showed higher partition coefficients to human sclera, and the apparent transport lag time also increased significantly as the permeant lipophilicity increased. No correlation between the permeability coefficients and lipophilicity of the model permeants was observed in this study with human sclera. A hypothesis on the different findings between the present and previous studies was proposed. CONCLUSIONS Permeants with higher lipophilicity exhibited stronger binding to human sclera and would therefore lead to larger permeant partitioning to the sclera and longer transport lag time. The steady-state permeability coefficients of the permeants were not significantly affected by permeant lipophilicity.
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Affiliation(s)
- He Wen
- Division of Pharmaceutical Sciences James L. Winkle College of Pharmacy, University of Cincinnati, 3225 Eden Avenue 136 HPB, Cincinnati, Ohio 45267, USA
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