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Tersi N, Kassumeh S, Ohlmann A, Strehle L, Priglinger SG, Hartmann D, Wolf A, Wertheimer CM. Pharmacological Therapy of Proliferative Vitreoretinopathy: Systematic In Vitro Comparison of 36 Pharmacological Agents. J Ocul Pharmacol Ther 2023; 39:148-158. [PMID: 36867160 DOI: 10.1089/jop.2022.0078] [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: 03/04/2023] Open
Abstract
Purpose: Proliferative vitreoretinopathy (PVR) is currently treated surgically. Reliable pharmaceutical options would be desirable, and numerous drugs have been proposed. This in vitro study is intended to systematically compare and determine the most promising candidates for the treatment of PVR. Methods: A structured literature review was conducted in the "PubMed" database to identify previously published agents proposed for medical treatment of PVR -36 substances that met the inclusion criteria. Toxicity and antiproliferative effects were evaluated on primary human retinal pigment epithelial (hRPE) using colorimetric viability assays. The seven substances with the widest therapeutic range between toxicity and no longer detectable antiproliferative effect were then validated with a bromodeoxyuridine assay and a scratch wound healing assay using primary cells derived from surgically excised human PVR membranes (hPVR). Results: Among 36 substances, 12 showed no effect on hRPE at all. Seventeen substances had a significant (P < 0.05) toxic effect of which nine did not have an antiproliferative effect. Fifteen substances significantly reduced hRPE proliferation (P < 0.05). The seven most promising drugs with the highest difference between toxicity and antiproliferative effects on hRPE were dasatinib, methotrexate, resveratrol, retinoic acid, simvastatin, tacrolimus, and tranilast. Whereof resveratrol, simvastatin, and tranilast additionally showed antiproliferative and dasatinib, resveratrol, and tranilast antimigratory effects on hPVR (P < 0.05). Conclusion: This study presents a systematic comparison of drugs that have been proposed for PVR treatment in a human disease model. Dasatinib, resveratrol, simvastatin, and tranilast seem to be promising and are well-characterized in human use.
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Affiliation(s)
- Natalie Tersi
- Department of Ophthalmology and University Hospital, LMU Munich, Munich, Germany
| | - Stefan Kassumeh
- Department of Ophthalmology and University Hospital, LMU Munich, Munich, Germany
| | - Andreas Ohlmann
- Department of Ophthalmology and University Hospital, LMU Munich, Munich, Germany
| | - Laura Strehle
- Department of Ophthalmology, University Hospital, Ulm University, Ulm, Germany
| | | | - Daniela Hartmann
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - Armin Wolf
- Department of Ophthalmology and University Hospital, LMU Munich, Munich, Germany
- Department of Ophthalmology, University Hospital, Ulm University, Ulm, Germany
| | - Christian M Wertheimer
- Department of Ophthalmology and University Hospital, LMU Munich, Munich, Germany
- Department of Ophthalmology, University Hospital, Ulm University, Ulm, Germany
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Inhibition of proliferative vitreoretinopathy by a newly developed methotrexate loaded drug carrier in vitro. Biomed Pharmacother 2023; 158:114088. [PMID: 36502758 DOI: 10.1016/j.biopha.2022.114088] [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: 10/12/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Repeated intravitreal injections of methotrexate for proliferative vitreoretinopathy, a rare ocular condition that can cause vision loss, have shown beneficial effects in recent clinical studies. The purpose of this study was to develop a slow-release, long-term drug carrier composed of the polymer polylactide-co-glycolide and methotrexate that can be injected intravitreally. METHODS The required composition of the drug carrier was modeled using pharmacokinetic parameters based on current literature. Release kinetics were determined using an ocular pharmacokinetic model. Epiretinal PVR-membranes were harvested during pars plana vitrectomy and subsequently transferred to cell culture. The effect of the drug carrier on cell migration was investigated using time-lapse microscopy and a scratch-induced migration assay. The colorimetric WST-1-assay and a live-dead-assay were performed to determine viability, and the BrdU-assay was applied for proliferation. RESULTS The release profile showed an initial and a final burst of methotrexate with an intervening steady state that lasted 9-11 weeks. It showed inhibitory effects on pathobiological processes in human PVR-cells in vitro. Cell velocity in the time-lapse assay, migration in the scratch assay (p = 0.001), and proliferation in the BrdU assay (p = 0.027) were reduced after addition of the drug carrier. These effects occurred without causing a reduction in viability in the WST-1 assay (p > 0.99) and the live-dead assay. CONCLUSION The methotrexate-loaded drug carrier can maintain a stable concentration for 9-11 weeks and influence the pathobiological process of PVR cells in vitro. Therefore, it represents a potential therapeutic orphan drug for PVR.
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Fung AT, Galvin J, Tran T. Epiretinal membrane: A review. Clin Exp Ophthalmol 2021; 49:289-308. [PMID: 33656784 DOI: 10.1111/ceo.13914] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 02/07/2023]
Abstract
The prevalence of epiretinal membrane (ERM) is 7% to 11.8%, with increasing age being the most important risk factor. Although most ERM is idiopathic, common secondary causes include cataract surgery, retinal vascular disease, uveitis and retinal tears. The myofibroblastic pre-retinal cells are thought to transdifferentiate from glial and retinal pigment epithelial cells that reach the retinal surface via defects in the internal limiting membrane (ILM) or from the vitreous cavity. Grading schemes have evolved from clinical signs to ocular coherence tomography (OCT) based classification with associated features such as the cotton ball sign. Features predictive of better prognosis include absence of ectopic inner foveal layers, cystoid macular oedema, acquired vitelliform lesions and ellipsoid and cone outer segment termination defects. OCT-angiography shows reduced size of the foveal avascular zone. Vitrectomy with membrane peeling remains the mainstay of treatment for symptomatic ERMs. Additional ILM peeling reduces recurrence but is associated with anatomical changes including inner retinal dimpling.
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Affiliation(s)
- Adrian T Fung
- Westmead Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia.,Save Sight Institute, Central Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, New South Wales, Australia
| | - Justin Galvin
- St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Tuan Tran
- Save Sight Institute, Central Clinical School, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, New South Wales, Australia
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Namba R, Kaneko H, Suzumura A, Shimizu H, Kataoka K, Takayama K, Yamada K, Funahashi Y, Ito S, Nonobe N, Terasaki H. In Vitro Epiretinal Membrane Model and Antibody Permeability: Relationship With Anti-VEGF Resistance in Diabetic Macular Edema. ACTA ACUST UNITED AC 2019; 60:2942-2949. [DOI: 10.1167/iovs.19-26788] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Rina Namba
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroki Kaneko
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayana Suzumura
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideyuki Shimizu
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keiko Kataoka
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Takayama
- Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan
| | - Kazuhisa Yamada
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seina Ito
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norie Nonobe
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Blanc J, Seydou A, Ben Ghezala I, Deschasse C, Meillon C, Bron AM, Binquet C, Creuzot-Garcher C. Vitreomacular Interface Abnormalities and Glaucoma in an Elderly Population (The MONTRACHET Study). ACTA ACUST UNITED AC 2019; 60:1996-2002. [DOI: 10.1167/iovs.18-26510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Julie Blanc
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Alassane Seydou
- Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Center Investigation, Clinical Epidemiology/Clinical Trials Unit, Universal Hospital, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | | | | | - Cyril Meillon
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Alain M. Bron
- University Hospital, Department of Ophthalmology, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | - Christine Binquet
- Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical Center Investigation, Clinical Epidemiology/Clinical Trials Unit, Universal Hospital, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
| | - Catherine Creuzot-Garcher
- University Hospital, Department of Ophthalmology, Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, Centre National pour la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), University Bourgogne Franche-Comté, Dijon, France
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Vogt D, Vielmuth F, Wertheimer C, Hagenau F, Guenther SR, Wolf A, Spindler V, Priglinger SG, Schumann RG. Premacular membranes in tissue culture. Graefes Arch Clin Exp Ophthalmol 2018; 256:1589-1597. [PMID: 29931427 DOI: 10.1007/s00417-018-4033-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/04/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To investigate integrity and characteristics of human premacular membranes (PMM) with and without standard tissue culturing using mechanical traction. METHODS Premacular membranes were harvested from 32 eyes of 32 patients with idiopathic macular pucker during standard vitrectomy. By flat-mount preparation with phase contrast and interference microscopy, specimens were prepared for time-lapse microscopy, immunocytochemistry, and transmission electron microscopy. Sixteen of 32 specimens were held in tissue culture with tangential traction by using entomological pins. Of these, specimens of 7 eyes were analyzed with and without tissue culturing for comparison. Primary antibodies were used for myofibroblasts, hyalocytes, macro-/microglial cells, and retinal pigment epithelial and immune cells. RESULTS Hyalocytes, macroglia, and microglia composed the main cell composition of surgically removed PMM. Correlation of time-lapse microscopy with immunofluorescence microscopy identified fast and unidirectional moving small round cells as microglia. Slowly moving elongated large cells were characterized as alpha-smooth muscle actin (α-SMA)-positive myofibroblasts. Following tissue culturing with tangential stretch, enhanced positive immunolabelling for α-SMA and integrins-αv was seen. All other labelling results were demonstrated to be similar with pre-culture conditions. Ultrastructural analysis revealed fibroblasts, myofibroblasts, and proliferation of glial cells following tissue culture. CONCLUSION This study demonstrates abundance of fibroblasts, myofibroblasts, and glial cells in PMM from idiopathic macular pucker following tissue culture with tangential stretch application. We found enhanced contractive properties of the cultured PPM that appear to indicate transdifferentiation of the cell composition. This in vitro model may improve understanding of pathogenesis in traction maculopathies and help to establish further anti-fibrosis treatment strategies.
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Affiliation(s)
- Denise Vogt
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany.
| | - Franziska Vielmuth
- Institute of Anatomy and Cell Biology, Department I, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christian Wertheimer
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Felix Hagenau
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Stefanie R Guenther
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Armin Wolf
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Volker Spindler
- Institute of Anatomy and Cell Biology, Department I, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Siegfried G Priglinger
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Ricarda G Schumann
- Department of Ophthalmology, Vitreoretinal Pathology Unit, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
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