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Cui S, Li L, Liu W, Zhao B, Zhong X. A real-world disproportionality analysis of cyclosporine from the FDA Adverse Event Reporting System (FAERS) database. Braz J Med Biol Res 2024; 57:e13392. [PMID: 39082578 PMCID: PMC11290814 DOI: 10.1590/1414-431x2024e13392] [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: 12/11/2023] [Accepted: 05/28/2024] [Indexed: 08/02/2024] Open
Abstract
Cyclosporine is an immunosuppressant used to prevent organ rejection in kidney, liver, and heart allogeneic transplants. This study aimed to assess the safety of cyclosporine through the analysis of adverse events (AEs) related to cyclosporine in the US Food and Drug Administration Adverse Event Reporting System (FAERS). To detect AEs associated with cyclosporine, a pharmacovigilance analysis was conducted using four algorithms on the FAERS database: reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). A statistical analysis was performed on data extracted from the FAERS database, covering 19,582 case reports spanning from 2013 to 2022. Among these cases, 3,911 AEs were identified, with 476 linked to cyclosporine as the primary suspected drug. Cyclosporin-induced AEs targeted 27 System Organ Classes (SOCs). Notably, the highest case at the SOC level included eye disorders, injury, poisoning, and procedural complications, as well as immune system disorders, all of which are listed on the cyclosporine label. Furthermore, we discovered novel potential AEs associated with hepatobiliary disorders, among others. Moreover, unexpected adverse drug reactions (ADRs), such as biliary anastomosis complication and spermatozoa progressive motility decrease, were identified. Importantly, these newly identified ADRs were not mentioned on the cyclosporine label, which were involved in injury, poisoning, and procedural complications, and investigations at the SOC level. The study used pharmacovigilance analysis of FAERS database to identify new and unexpected potential ADRs relating to cyclosporine, which can provide safety tips for the safe use of cyclosporine.
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Affiliation(s)
- Shichao Cui
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong
Provincial Reproductive Science Institute (Guangdong Provincial Fertility
Hospital), Guangzhou, China
| | - Li Li
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong
Provincial Reproductive Science Institute (Guangdong Provincial Fertility
Hospital), Guangzhou, China
| | - Wensheng Liu
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong
Provincial Reproductive Science Institute (Guangdong Provincial Fertility
Hospital), Guangzhou, China
| | - Bin Zhao
- Xiamen Health and Medical Big Data Center, Xiamen, China
- Xiamen Medicine Research Institute, Xiamen, China
- Xiamen Key Laboratory of Natural Medicine Research and
Development, Xiamen, China
| | - Xingming Zhong
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong
Provincial Reproductive Science Institute (Guangdong Provincial Fertility
Hospital), Guangzhou, China
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2
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Nunziata S, Petrini D, Dell'Anno S, Barone V, Coassin M, Di Zazzo A. Customized Scleral Lenses: An Alternative Tool for Severe Dry Eye Disease-A Case Series. J Clin Med 2024; 13:3935. [PMID: 38999500 PMCID: PMC11242800 DOI: 10.3390/jcm13133935] [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: 05/21/2024] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Purpose: Dry eye disease (DED) is a multifactorial condition significantly impacting patients' quality of life (QoL). This study aims to present a case series highlighting the effectiveness of customized scleral lenses in managing severe DED and improving patient outcomes. Methods: This case series includes three patients with severe DED refractory to conventional treatments. Customized scleral lenses were fitted for each patient, and clinical outcomes were evaluated over a period of two months. Assessments included best-corrected visual acuity (BCVA), slit-lamp examination findings, and corneal National Eye Institute (NEI) scores. Results: All three patients demonstrated significant improvements in BCVA, reductions in ocular symptoms, and enhanced ocular surface health. Patient 1, with secondary Sjögren's syndrome and suspected mucous membrane pemphigoid, showed resolution of conjunctival hyperemia and epithelial defects. Patient 2, with graft versus host disease, exhibited resolution of punctate keratitis and the absence of thread mucus. Patient 3, post-oncologic surgery, achieved complete resolution of keratoconjunctivitis sicca and the restoration of vision. Conclusions: Customized scleral lenses are a useful therapeutic option for severe DED, providing significant symptomatic relief and enhancing patients' quality of life. Their use should be considered in refractory cases to optimize ocular surface health and visual outcomes.
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Affiliation(s)
- Sebastiano Nunziata
- Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
- Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
| | - Daniele Petrini
- Science Department, University of Rome III, 00154 Rome, Italy
- Vision Optika, 00187 Rome, Italy
| | | | - Vincenzo Barone
- Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
- Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
| | - Marco Coassin
- Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
- Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
- Rare Corneal Diseases Center, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
| | - Antonio Di Zazzo
- Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
- Ophthalmology Operative Complex Unit, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
- Rare Corneal Diseases Center, Campus Bio-Medico University Hospital Foundation, 00128 Rome, Italy
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3
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Cervera-Negueruela M, Chee L, Cimolato A, Valle G, Tschopp M, Menke M, Papazoglou A, Raspopovic S. Bionic blink improves real-time eye closure in unilateral facial paralysis. J Neural Eng 2024; 21:026020. [PMID: 38507808 DOI: 10.1088/1741-2552/ad35e7] [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: 10/12/2023] [Accepted: 03/20/2024] [Indexed: 03/22/2024]
Abstract
Facial paralysis is the inability to move facial muscles thereby impairing the ability to blink and make facial expressions. Depending on the localization of the nerve malfunction it is subcategorised into central or peripheral and is usually unilateral. This leads to health deficits stemming from corneal dryness and social ostracization.Objective: Electrical stimulation shows promise as a method through which to restore the blink function and as a result improve eye health. However, it is unknown whether a real-time, myoelectrically controlled, neurostimulating device can be used as assistance to this pathological condition.Approach: We developed NEURO-BLINK, a wearable robotic system, that can detect the volitional healthy contralateral blink through electromyography and electrically stimulate the impaired subcutaneous facial nerve and orbicularis oculi muscle to compensate for lost blink function. Alongside the system, we developed a method to evaluate optimal electrode placement through the relationship between blink amplitude and injected charge.Main results: Ten patients with unilateral facial palsy were enrolled in the NEURO-BLINK study, with eight completing testing under two conditions. (1) where the stimulation was cued with an auditory signal (i.e. paced controlled) and (2) synchronized with the natural blink (i.e. myoelectrically controlled). In both scenarios, overall eye closure (distance between eyelids) and cornea coverage measured with high FPS video were found to significantly improve when measured in real-time, while no significant clinical changes were found immediately after use.Significance: This work takes steps towards the development of a portable medical device for blink restoration and facial stimulation which has the potential to improve long-term ocular health.
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Affiliation(s)
- Mar Cervera-Negueruela
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Lauren Chee
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Andrea Cimolato
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Giacomo Valle
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
| | - Markus Tschopp
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel Menke
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anthia Papazoglou
- Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland
- Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Stanisa Raspopovic
- Department of Health Sciences and Technology, Neuroengineering Laboratory, ETH Zürich, Tannenstrasse 1, 8092 Zürich, Switzerland
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Abusharha A, Pearce IE, Afsar T, Alsaqr A, Fagehi R, Razak S. Evaluation of different treatment modalities on the efficacy of hydroxypropyl Guar (HP-Guar) formulation on tear film stability (TFS) in subjects exposed to adverse environmental conditions. BMC Ophthalmol 2023; 23:226. [PMID: 37211592 DOI: 10.1186/s12886-023-02977-3] [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: 02/02/2023] [Accepted: 05/13/2023] [Indexed: 05/23/2023] Open
Abstract
The study aimed to assess the efficacy of hydroxypropyl guar (HP) formulation (Systane) to protect tear film parameters under desiccating environment using protection and relief treatment modalities. The subjects were exposed to adverse environmental conditions using a Controlled Environment Chamber (CEC) where the relative humidity (RH) was 5% and the ambient temperature was 21 °C and screened for Tear break-up time (TBUT), Tear film evaporation rate (TFER) and lipid layer thickness (LLT) using the HIRCAL grid, Servomed EP3 Evaporimeter and Keeler's TearScope-Plus respectively. Significant improvement in LLT was noticed in the protection modality. The mean tear film evaporation rate doubled after exposure to the humidity of 5% to a value of 105.37 g/m2/h (0.29 µl/min). All subjects displayed a significant reduction in non-invasive tear break-up time (NITBUT) with a mean NITBUT of 7.7 s after exposure to a desiccating environment for 15 min. A significant increase in NITBUT after the instillation of the drops was recorded in both methods. The results obtained from this study showed that a solution containing HP-Guar significantly improves tear film parameters under a desiccating environment. Apart from the tear evaporation rate, all tear parameters showed improvement after the use of HP-Guar eye drops. It is evident that tear film parameters respond differently to the management modalities and using CEC has the potential to provide researchers with a readily available method to evaluate the efficiency of tear supplementation.
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Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ian E Pearce
- Vision Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ali Alsaqr
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Raied Fagehi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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Halliday LA, Wood JPM, Chidlow G, Casson RJ, Selva D, Sun MT. Establishing human lacrimal gland cultures from biopsy-sized tissue specimens. Eye (Lond) 2023; 37:62-68. [PMID: 35001090 PMCID: PMC9829670 DOI: 10.1038/s41433-021-01872-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/11/2021] [Accepted: 11/19/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To establish cultures of human lacrimal gland from patient-derived, biopsy-sized, tissue specimens. METHODS Tissue was obtained after surgical removal from patients without dry eye disease undergoing routine procedures. Samples were subjected to mechanical and enzymatic digestion and resulting cell suspensions were plated onto collagen-coated glass coverslips and grown for up to 21 days. Cultures were analysed by immunocytochemistry and light microscopy, and resultant cellular distributions were compared to those in sections of fixed human lacrimal gland tissue. RESULTS Dissociation of biopsy-sized pieces of human lacrimal gland and seeding onto coated surfaces allowed development of a mixed population of cells in vitro. Within 7-14 days, cellular aggregation was observed and by 21 days many cells had organised themselves into distinct three-dimensional complexes. Immunohistochemistry revealed a heterogeneous population of cells, including epithelial, myoepithelial, mesenchymal and progenitor cells. Some of the epithelia labelled positively for lysozyme and lactoferrin. CONCLUSIONS Collection and dissociation of biopsy-sized pieces of human lacrimal gland leads to a cellular preparation that can proliferate in vitro and organise into three-dimensional structures. This is the first report detailing that biopsy-collected specimens of human lacrimal gland can be used to establish cell cultures.
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Affiliation(s)
- Luke A Halliday
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
| | - John P M Wood
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia.
| | - Glyn Chidlow
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
| | - Robert J Casson
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
| | - Michelle T Sun
- Discipline of Ophthalmology & Visual Sciences, Level 7 Adelaide Health and Medical Sciences Building, University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia
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Influence of Selected Ophthalmic Fluids on the Wettability and Hydration of Hydrogel and Silicone Hydrogel Contact Lenses—In Vitro Study. MATERIALS 2022; 15:ma15030930. [PMID: 35160876 PMCID: PMC8839750 DOI: 10.3390/ma15030930] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
This study attempts to evaluate the effect of incubation in selected ophthalmic fluids on contact lenses (Etafilcon A, Omafilcon A, Narafilcon A, Senofilcon A). Four research groups differing in the incubation environment were created: (1) initial state, (2) contact lens solution (CLS), (3) contact lens solution and eye drops (ED) and (4) eye drops. Dehydration by gravimetric method and the contact angle (CA) by the sessile drop method were tested. The surface free energy (SFE) was also calculated with the use of several methods: Owens–Wendt, Wu, Neumann, and Neumann–Kwok. The greatest changes in the dehydration profile were observed for contact lenses incubated in ED. The most noticeable changes in CA values were observed for contact lenses incubated in ED, in which it was not possible to settle water drop after incubation. On the basis of SFE analysis, higher values were found for hydrogel contact lenses, e.g., according to the Owens–Wendt method, they ranged from 54.45 ± 6.56 mJ/m2 to 58.09 ± 4.86 mJ/m2, while in the case of silicone-hydrogel contact lenses, they ranged from 32.86 ± 3.47 mJ/m2 to 35.33 ± 6.56 mJ/m2. Incubation in all tested environments decreased the SFE values, but the differences were in most cases statistically insignificant. Calculating the SFE may be a useful method as it can be used to estimate the possibility of bacteria adhering to contact lens surfaces.
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Abusharha A, Shbear AA, Fagehi R, Alanazi MA, Alsaqr A, El-Hiti GA, Masmali AM. Assessment of the Efficiency of HP-Guar and hyaluronic Acid Tear Supplements to Control Tear Film Evaporation Rate in Dry Eye Subjects. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The most common factor that could lead to dryness is the accelerated tear evaporation rate. Controlling the tear evaporation rate is increasingly used as a method to control dry eye complications. The present study explores the effects of different tear supplements formulations on tear film evaporation rate.
Objective:
This study aimed to evaluate the short-term effects of Systane ULTRA and Artelac Advanced eye drops on the tear film evaporation rate.
Methods:
Fifteen male dry eye subjects were enrolled in the current study. Tear film parameters were observed at several time points post installation (10, 20, 30, and 60 min). The tear film parameters observed in the current study were tear evaporation rate, noninvasive breakup time (NITBUT) and tear meniscus height (TMH). Two visits were required to conduct this study. One visit was conducted to assess the physiological tear film parameters with the use of Systane® ULTRA eye drop. The other visit was conducted to assess tear film parameters with the use of Artelac Advanced eye drop.
Results:
The mean tear evaporation rate at baseline was 52.58 ± 23.24 g/m2 h. A box plot of tear evaporation showed a reduction in tear film evaporation rate after instillation of Systane eye drop. A drop in tear film evaporation rate of 14% was observed at 20 and 60 min time point after instillation of Systane ULTRA eye drop. A significant increase in NITBUT was found after instillation of Systane ULTRA (P = 0.01) and Artelac Advanced (P = 0.02).
Conclusion:
The current study indicates a significant improvement in the tear film parameters using both HP-Guar and hyaluronic acid formulations. However, it was apparent that the use of HP-Guar was superior to hyaluronic acid in controlling the tear evaporation rate in dry eye subjects.
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8
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McMonnies CW. Transdermal anti-inflammatory therapy for aqueous deficiency. Ophthalmic Physiol Opt 2021; 41:1267-1272. [PMID: 34605579 DOI: 10.1111/opo.12891] [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: 11/24/2020] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Lacrimal gland inflammation has been identified as an important limitation on aqueous production and associated dry eye disease. Ocular surface inflammation in dry eye disease can be a downstream response to reduced quantities of warmer hyperosmotic aqueous being delivered from an inflamed lacrimal gland with high concentrations of inflammatory mediators. This review examines evidence which shows how topical applications of anti-inflammatory drugs have very limited access to the lacrimal gland and an associated limited capacity to increase aqueous flow by reducing inflammation in the main lacrimal gland. RECENT FINDINGS Using cyclosporine as an exemplar immunomodulatory drug, this review examines problems associated with the topical administration of all anti-inflammatory drugs in the treatment of dry eye disease. SUMMARY Limited access to the lacrimal gland for topical applications and their very short on-eye residence times are compared with the therapeutic potential of prolonged therapeutic episodes that could be achieved with transdermal applications of a drug to the skin at the site of the lacrimal gland. Poor access to the lacrimal gland for topically administered drugs is a major barrier to the treatment of aqueous deficiency. While topical inflammatory drug access to the ocular surface is direct, poor access to the lacrimal gland is partly due to drop placement being downstream to the flow of aqueous (Eye Vis 2020;7:1; Eye Vis 2019;6:1). This barrier is much greater according to the degree that reflex tear flow is stimulated by irritation associated with adverse drop temperature, and/or pH and/or tonicity for example.
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Affiliation(s)
- Charles W McMonnies
- Faculty of Medicine and Health, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Mofidfar M, Abdi B, Ahadian S, Mostafavi E, Desai TA, Abbasi F, Sun Y, Manche EE, Ta CN, Flowers CW. Drug delivery to the anterior segment of the eye: A review of current and future treatment strategies. Int J Pharm 2021; 607:120924. [PMID: 34324989 PMCID: PMC8579814 DOI: 10.1016/j.ijpharm.2021.120924] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/03/2023]
Abstract
Research in the development of ophthalmic drug formulations and innovative technologies over the past few decades has been directed at improving the penetration of medications delivered to the eye. Currently, approximately 90% of all ophthalmic drug formulations (e.g. liposomes, micelles) are applied as eye drops. The major challenge of topical eye drops is low bioavailability, need for frequent instillation due to the short half-life, poor drug solubility, and potential side effects. Recent research has been focused on improving topical drug delivery devices by increasing ocular residence time, overcoming physiological and anatomical barriers, and developing medical devices and drug formulations to increase the duration of action of the active drugs. Researchers have developed innovative technologies and formulations ranging from sub-micron to macroscopic size such as prodrugs, enhancers, mucus-penetrating particles (MPPs), therapeutic contact lenses, and collagen corneal shields. Another approach towards the development of effective topical drug delivery is embedding therapeutic formulations in microdevices designed for sustained release of the active drugs. The goal is to optimize the delivery of ophthalmic medications by achieving high drug concentration with prolonged duration of action that is convenient for patients to administer.
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Affiliation(s)
| | - Behnam Abdi
- Institute of Polymeric Materials (IPM), Sahand University of Technology, New Town of Sahand, Tabriz, Iran; Faculty of Polymer Engineering, Sahand University of Technology, New Town of Sahand, Tabriz, Iran
| | - Samad Ahadian
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA, USA
| | - Ebrahim Mostafavi
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; Stanford Cardiovascular Institute, Stanford University, CA, USA
| | - Tejal A Desai
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Farhang Abbasi
- Institute of Polymeric Materials (IPM), Sahand University of Technology, New Town of Sahand, Tabriz, Iran; Faculty of Polymer Engineering, Sahand University of Technology, New Town of Sahand, Tabriz, Iran
| | - Yang Sun
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Edward E Manche
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Christopher N Ta
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Charles W Flowers
- USC Roski Eye Institute, University of Southern California, Los Angeles, CA, USA.
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Yamaga M, Imada T, Tani H, Nakamura S, Yamaki A, Tsubota K. Acetylcholine and Royal Jelly Fatty Acid Combinations as Potential Dry Eye Treatment Components in Mice. Nutrients 2021; 13:2536. [PMID: 34444696 PMCID: PMC8399524 DOI: 10.3390/nu13082536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
Dry eye is a multifactorial disease characterized by ocular discomfort and visual impairment. Our previous studies have shown that royal jelly (RJ) has restored the capacity for tear secretion by modulating muscarinic calcium signaling. RJ contains acetylcholine, which is a major cholinergic neurotransmitter, and a unique set of fatty acids with C 8 to 12 chains, which are expected to be associated with health benefits. The purpose of the present study was to investigate the active components involved in tear secretion capacity, focusing on acetylcholine and fatty acids in RJ. Using the stress-induced dry-eye model mice, it was confirmed that acetylcholine with three fatty acids (10-hydroxydecanoic acid, 8-hydroxyoctanoic acid, and (R)-3,10-dihydroxydecanoic acid) was essential for tear secretion. In ex vivo Ca2+ imaging, these three fatty acids suppressed the decrease in intracellular modulation of Ca2+ in the lacrimal gland by acetylcholine when treated with acetylcholinesterase, indicating that the specific type of RJ fatty acids contributed to the stability of acetylcholine. To our knowledge, this study is the first to confirm that a specific compound combination is important for the pharmacological activities of RJ. Our results elucidate the active molecules and efficacy mechanisms of RJ.
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Affiliation(s)
- Masayuki Yamaga
- Institute for Bee Products and Health Science, Yamada Bee Company, Inc., Okayama 708-0393, Japan; (M.Y.); (H.T.); (A.Y.)
| | - Toshihiro Imada
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, Japan; (T.I.); (S.N.)
| | - Hiroko Tani
- Institute for Bee Products and Health Science, Yamada Bee Company, Inc., Okayama 708-0393, Japan; (M.Y.); (H.T.); (A.Y.)
| | - Shigeru Nakamura
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, Japan; (T.I.); (S.N.)
| | - Ayanori Yamaki
- Institute for Bee Products and Health Science, Yamada Bee Company, Inc., Okayama 708-0393, Japan; (M.Y.); (H.T.); (A.Y.)
| | - Kazuo Tsubota
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo 160-8582, Japan; (T.I.); (S.N.)
- Tsubota Laboratory, Inc., Shinjuku-ku, Tokyo 160-0016, Japan
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Jeon J, Park S. Comparison of the efficacy of eyelid warming masks and artificial tears for dry eye symptoms in contact lens wearers. Cont Lens Anterior Eye 2021; 44:30-34. [DOI: 10.1016/j.clae.2020.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/27/2020] [Accepted: 02/25/2020] [Indexed: 12/01/2022]
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12
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Abstract
Abstract
Background
Polymers are essential components of many drug delivery systems and biomedical products. Despite the utility of many currently available polymers, there exists a demand for materials with improved characteristics and functionality. Due to the extensive safety testing required for new excipient approval, the introduction and use of new polymers is considerably limited. The blending of currently approved polymers provides a valuable solution by which the limitations of individual polymers can be addressed.
Main body
Polymer blends combine two or more polymers resulting in improved, augmented, or customized properties and functionality which can result in significant advantages in drug delivery applications. This review discusses the rationale for the use of polymer blends and blend polymer-polymer interactions. It provides examples of their use in commercially marketed products and drug delivery systems. Examples of polymer blends in amorphous solid dispersions and biodegradable systems are also discussed. A classification scheme for polymer blends based on the level of material processing and interaction is presented.
Conclusion
The use of polymer blends represents a valuable and under-utilized resource in addressing a diverse range of drug delivery challenges. It is anticipated that new drug molecule development challenges such as bioavailability enhancement and the demand for enabling excipients will lead to increased applications of polymer blends in pharmaceutical products.
Graphical abstract
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13
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Starr CE, Gupta PK, Farid M, Beckman KA, Chan CC, Yeu E, Gomes JAP, Ayers BD, Berdahl JP, Holland EJ, Kim T, Mah FS. An algorithm for the preoperative diagnosis and treatment of ocular surface disorders. J Cataract Refract Surg 2020; 45:669-684. [PMID: 31030780 DOI: 10.1016/j.jcrs.2019.03.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022]
Abstract
Any ocular surface disease (OSD), but most commonly, dry-eye disease (DED), can reduce visual quality and quantity and adversely affect refractive measurements before keratorefractive and phacorefractive surgeries. In addition, ocular surgery can exacerbate or induce OSD, leading to worsened vision, increased symptoms, and overall dissatisfaction postoperatively. Although most respondents of the recent annual American Society of Cataract and Refractive Surgery (ASCRS) Clinical Survey recognized the importance of DED on surgical outcomes, many were unaware of the current guidelines and most were not using modern diagnostic tests and advanced treatments. To address these educational gaps, the ASCRS Cornea Clinical Committee developed a new consensus-based practical diagnostic OSD algorithm to aid surgeons in efficiently diagnosing and treating visually significant OSD before any form of refractive surgery is performed. By treating OSD preoperatively, postoperative visual outcomes and patient satisfaction can be significantly improved.
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Affiliation(s)
- Christopher E Starr
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA.
| | | | - Marjan Farid
- Gavin Herbert Eye Institute, University of California, Irvine, California, USA
| | - Kenneth A Beckman
- Department of Ophthalmology, The Ohio State University and Comprehensive EyeCare of Central Ohio, Westerville, Ohio, USA
| | - Clara C Chan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada
| | - Elizabeth Yeu
- Eastern Virginia Medical School, Virginia Eye Consultants, Norfolk, Virginia, USA
| | - José A P Gomes
- Paulista Medical School, Federal University of São Paulo, Brazil
| | | | | | | | - Terry Kim
- Duke University Eye Center, Durham, North Carolina, USA
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Nanoscale poly(acrylic acid)-based hydrogels prepared via a green single-step approach for application as low-viscosity biomimetic fluid tears. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110726. [PMID: 32204037 DOI: 10.1016/j.msec.2020.110726] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/16/2019] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Abstract
The present work reports a nanotechnology strategy to prepare a low-viscosity poly(acrylic acid) (PAAc)-based tear substitute with enhanced efficacy and compliance. Specifically, nanogels composed of PAAc and polyvinylpyrrolidone (PVP) were prepared by adapting an ionizing radiation method. For this purpose, different aqueous systems: PVP/PAAc nanoparticulate complexes, PVP/acrylic acid (AAc), N-vinylpyrrolidone (N-VP)/PAAc, and N-VP/AAc were exposed to gamma rays. The dynamic light scattering technique showed that stable nanogels are only produced in a relatively high yield from the PVP/AAc system. Nanogel formation was driven by the hydrogen-bonding complexation between PVP and PAAc (formed in situ) as well as the radiation-induced cross-linking. Transparency, viscosity and mucoadhesiveness of emerged nanogels were optimized by controlling the feed composition and irradiation dose. Furthermore, neutralized nanogels were topically applied in a dry eye model and compared with a PAAc-based commercial tear substitute, namely Vidisic® Gel. The results of Schirmer's test and tear break-up time demonstrated that nanogels prepared from AAc-rich feed solutions at 20 kGy enhanced markedly the dry eye conditions. The histopathological analysis also ensured the competence of PAAc-rich nanogels to completely return the corneal epithelium to its normal state.
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15
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Feizi S, Azari AA. Approaches toward enhancing survival probability following deep anterior lamellar keratoplasty. Ther Adv Ophthalmol 2020; 12:2515841420913014. [PMID: 32232195 PMCID: PMC7092383 DOI: 10.1177/2515841420913014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 02/07/2020] [Indexed: 12/16/2022] Open
Abstract
The greatest advantage of deep anterior lamellar keratoplasty over full-thickness corneal transplantation is the elimination of graft failure caused by endothelial rejection. Despite this advantage, a deep anterior lamellar keratoplasty graft can fail because of several factors, such as complications related to the donor-recipient interface, graft epithelial abnormalities, graft vascularization, stromal graft rejection, and recurrence of herpetic keratitis. Increased deep anterior lamellar keratoplasty graft survival is mainly built upon optimization of the ocular surface to provide a hospitable environment for the graft. Any predisposing factors for graft epithelial abnormalities, corneal neovascularization, and preexisting vernal keratoconjunctivitis should be identified and treated preoperatively. Prompt recognition and appropriate treatment of interface-related complications and stromal graft rejection usually result in good anatomic outcomes, with no detrimental effects on vision.
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Affiliation(s)
- Sepehr Feizi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Labbafinejad Medical Center, 9th Boostan St., Pasdaran Ave., Tehran 16666, Iran
| | - Amir A Azari
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Saffar Shahroodi A, Nejabat M, Nimrouzi M, Aghaei H, Salehi A, Rezaei Mokarram A. Effects of intranasal administration of violet oil in dry eye disease. Clin Exp Optom 2019; 102:576-582. [PMID: 31060104 DOI: 10.1111/cxo.12910] [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: 06/05/2018] [Revised: 02/03/2019] [Accepted: 03/20/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Dry eye disease is a disorder of the tear film. In this study, the effect of Viola odorata L. oily extract was examined for the treatment of patients suffering from dry eye disease. METHODS A randomised, double-blind, placebo-controlled study was designed. During the trial, Schirmer's test, tear breakup time, Oxford staining and the Ocular Surface Disease Index were assessed. Overall, 105 patients with dry eye symptoms between the ages of 18 and 60 years were allocated to the violet-almond oil, almond oil and placebo (1% w/v hydroxypropyl methylcellulose solution) groups. The treatment and placebo were administered intranasally, two drops three times a day for one month. The patients were followed up for four weeks. A total of 91 patients (32, 29 and 30 in the violet-almond oil, almond oil and placebo groups, respectively) completed the study. RESULTS At baseline, there was no difference between the three groups in terms of demographic data and the measurement parameters. After the intervention, the results revealed that the Schirmer's score without local anaesthesia and the tear breakup time results significantly improved in the violet-almond oil group. One-way ANOVA indicated a significant improvement in the Schirmer's score, tear breakup time and Ocular Surface Disease Index of the treatment group, as compared with the other groups (p < 0.05). However, the obtained results did not present any significant mean difference between and within the groups of the Oxford staining grade (p > 0.05). CONCLUSIONS This trial showed that the intranasally administered V. odorata L. oily extract enhances tear production and improves tear film stability.
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Affiliation(s)
- Aniseh Saffar Shahroodi
- Department of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Nejabat
- Poostchi Ophthalmology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Nimrouzi
- Department of Traditional Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Aghaei
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Salehi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Rezaei Mokarram
- Department of Biology, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
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17
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Dhaliwal DK, Zhou S, Samudre SS, Lo NJ, Rhee MK. Acupuncture and dry eye: current perspectives. A double-blinded randomized controlled trial and review of the literature. Clin Ophthalmol 2019; 13:731-740. [PMID: 31114151 PMCID: PMC6497118 DOI: 10.2147/opth.s175321] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/05/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: Dry eye disease (DED) is a common disorder that negatively impacts quality of life and vision. Prior studies have shown some benefit of acupuncture for dry eye, but very few have included control group to mitigate placebo effect. This study was designed with a sham acupuncture control group to evaluate true acupuncture treatment effect. Methods: This is a prospective, randomized, double-blinded, sham-acupuncture-controlled trial. Acupuncture treatment for dry eye was performed as per the Niemtzow Protocol. Twenty-four patients received true acupuncture and twenty-five received sham acupuncture. Treatment efficacy was assessed by the Ocular Surface Disease Index (OSDI) Questionnaire, ocular surface staining, tear flow, tear film break-up time (TBUT), and a general questionnaire. Atmospheric data were collected to control for the effect of atmospheric conditions on symptoms of dry eye. Results: OSDI scores in the treatment group improved compared to baseline (1 week, p<0.01, 1 month p<0.05, 3 months p<0.05, and 6 months p<0.01). OSDI scores in the control group improved, but did not reach significance (p=0.09). Secondary outcome measures showed no significant improvement in TBUT, Schiermer’s Test, ocular surface grading, or artificial tear application. However, at 3 months, a significant reduction in the frequency of eye closing was observed among participants receiving true acupuncture treatment when compared to baseline (p=0.002). Furthermore, intragroup analysis showed significant reduction in symptoms of discomfort (p=0.01), dryness (p=0.001), scratchiness (p=0.001), and redness (p=0.01) in the true acupuncture group at 3 months. Conclusion: Both true and sham acupuncture improved OSDI at 1 week after treatment, however, the improvement in OSDI was significantly greater in the true treatment groups than the sham group at 6 months after acupuncture. True acupuncture treatment improved many subjective assessments of dry eye symptoms, however, other common indicators used to objectively assess dry eye (tear flow, corneal staining, TBUT) remained unchanged. While there were trends towards improvement in the sham acupuncture group, this did not reach statistical significant during the study period. This suggests a true treatment effect of acupuncture rather than a placebo effect. Acupuncture can, therefore, be an effective adjunct to routine clinical treatment of dry eye.
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Affiliation(s)
- Deepinder K Dhaliwal
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Siwei Zhou
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sandeep S Samudre
- Department of Ophthalmology, Eastern Virginia Eye Institute, Norfolk, VA, USA
| | - Nathan J Lo
- Department of Medicine, Duke University Hospital, Durham, NC, USA
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Suárez-Barrio C, Etxebarria J, Hernáez-Moya R, Del Val-Alonso M, Rodriguez-Astigarraga M, Urkaregi A, Freire V, Morales MC, Durán JA, Vicario M, Molina I, Herrero-Vanrell R, Andollo N. Hyaluronic Acid Combined with Serum Rich in Growth Factors in Corneal Epithelial Defects. Int J Mol Sci 2019; 20:ijms20071655. [PMID: 30987108 PMCID: PMC6480555 DOI: 10.3390/ijms20071655] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 12/30/2022] Open
Abstract
The aim of this study is to assess if an adhesive biopolymer, sodium hyaluronate (NaHA), has synergistic effects with s-PRGF (a serum derived from plasma rich in growth factors and a blood derivative that has already shown efficacy in corneal epithelial wound healing), to reduce time of healing or posology. In vitro proliferation and migration studies, both in human corneal epithelial (HCE) cells and in rabbit primary corneal epithelial (RPCE) cultures, were carried out. In addition, we performed studies of corneal wound healing in vivo in rabbits treated with s-PRGF, NaHA, or the combination of both. We performed immunohistochemistry techniques (CK3, CK15, Ki67, ß4 integrin, ZO-1, α-SMA) in rabbit corneas 7 and 30 days after a surgically induced epithelial defect. In vitro results show that the combination of NaHA and s-PRGF offers the worst proliferation rates in both HCE and RPCE cells. Addition of NaHA to s-PRGF diminishes the re-epithelializing capability of s-PRGF. In vivo, all treatments, given twice a day, showed equivalent efficacy in corneal epithelial healing. We conclude that the combined use of s-PRGF and HaNA as an adhesive biopolymer does not improve the efficacy of s-PRGF alone in the wound healing of corneal epithelial defects.
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Affiliation(s)
- Carlota Suárez-Barrio
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Jaime Etxebarria
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
- Department of Ophthalmology, University Hospital of Cruces, BioCruces Health Research Institute, Begiker, 48903 Barakaldo, Spain.
| | - Raquel Hernáez-Moya
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Marina Del Val-Alonso
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Maddalen Rodriguez-Astigarraga
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Arantza Urkaregi
- Department of Applied Mathematics and Statistics and Operational Research, BioCruces Health Research Institute, 48940 Leioa, Spain.
| | - Vanesa Freire
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
- R & D Department, Instituto Clínico-Quirúrgico de Oftalmología, 48006 Bilbao, Spain.
| | - María-Celia Morales
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Juan Antonio Durán
- R & D Department, Instituto Clínico-Quirúrgico de Oftalmología, 48006 Bilbao, Spain.
- Department of Dermatology, Otorhinolaryngology and Ophthalmology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Marta Vicario
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Irene Molina
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Rocío Herrero-Vanrell
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Noelia Andollo
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
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19
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Choi JH, Li Y, Jin R, Shrestha T, Choi JS, Lee WJ, Moon MJ, Ju HT, Choi W, Yoon KC. The Efficiency of Cyclosporine A-Eluting Contact Lenses for the Treatment of Dry Eye. Curr Eye Res 2019; 44:486-496. [PMID: 30580651 DOI: 10.1080/02713683.2018.1563702] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE To investigate the efficacy and safety of a new cyclosporine A (CsA) delivery system using contact lenses (CLs) for the treatment of experimental dry eye (EDE). METHODS CsA-laden porous carriers and CsA-eluting CLs were fabricated using the supercritical fluid technique. The release of CsA from carriers and CLs was investigated using high-performance liquid chromatography. The CsA concentrations in the cornea, conjunctiva, and crystalline lens of rabbits were measured. Dry eye was induced using 0.1% benzalkonium chloride in rabbits, which were subdivided into the normal, EDE, balanced salt solution (BSS), 0.05% CsA, hydrogel CL, or CsA-CL groups. Tear volume, tear film break-up time (TBUT), and corneal staining scores were measured at 1 and 2 weeks after treatment. Periodic acid-Schiff staining for the evaluation of conjunctival goblet cell density was performed at 2 weeks. Interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and interferon-γ levels in the conjunctiva were measured using enzyme-linked immune-sorbent assay. RESULTS The porous carrier showed the release of drug. CsA-eluting CLs showed initial burst and sustained release of CsA until 48 h. The concentration of CsA elevated in the cornea, conjunctiva, and lens until 48 h after application of CsA-CLs. The CsA-CL group showed significantly higher tear volume, TBUT, and lower corneal staining scores compared to the other groups (p < 0.05). Goblet cell density was significantly higher in the CsA-CL group compared to the other groups. The CsA-CLs group showed a lower level of IL-1β than the BSS and soft CL groups (p < 0.01), and a lower level of IFN-γ than the other groups (all p < 0.01). CONCLUSIONS The newly designed CsA-eluting CLs released drug continuously and showed good penetration in the eye. In addition, the use of CsA-eluting CLs improved clinical parameters and conjunctival goblet cell density and decreased inflammatory cytokines.
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Affiliation(s)
- Jung Han Choi
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Ying Li
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Rujun Jin
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Tina Shrestha
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Ji Suk Choi
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Won Jun Lee
- b Nano Bio Research Center , Jeolanamdo , Korea
| | - Myung Jae Moon
- b Nano Bio Research Center , Jeolanamdo , Korea.,c Biochemical & Polymer Engineering Chosun University , Gwangju , Korea
| | | | - Won Choi
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
| | - Kyung Chul Yoon
- a Department of Ophthalmology , Chonnam National University Medical School and Hospital , Gwangju , Korea
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20
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Biomaterials of PVA and PVP in medical and pharmaceutical applications: Perspectives and challenges. Biotechnol Adv 2018; 37:109-131. [PMID: 30472307 DOI: 10.1016/j.biotechadv.2018.11.008] [Citation(s) in RCA: 204] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/25/2018] [Accepted: 11/20/2018] [Indexed: 01/12/2023]
Abstract
Poly(vinyl alcohol) (PVA) has attracted considerable research interest and is recognized among the largest volume of synthetic polymers that have been produced worldwide for almost one century. This is due to its exceptional properties which dictated its extensive use in a wide variety of applications, especially in medical and pharmaceutical fields. However, studies revealed that PVA-based biomaterials present some limitations that can restrict their use or performances. To overcome these limitations, various methods have been reported, among which blending with poly(vinylpyrrolidone) (PVP) showed promising results. Thus, our aim was to offer a systematic overview on the current state concerning the preparation, properties and various applications of biomaterials based on synergistic effect of mixtures between PVA and PVP. Future trends towards where the biomaterials research is headed were discussed, showing the promising opportunities that PVA and PVP can offer.
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21
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Cooper BG, Catalina Bordeianu, Nazarian A, Snyder BD, Grinstaff MW. Active agents, biomaterials, and technologies to improve biolubrication and strengthen soft tissues. Biomaterials 2018; 181:210-226. [PMID: 30092370 PMCID: PMC6766080 DOI: 10.1016/j.biomaterials.2018.07.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 12/27/2022]
Abstract
Normal functioning of articulating tissues is required for many physiological processes occurring across length scales from the molecular to whole organism. Lubricating biopolymers are present natively on tissue surfaces at various sites of biological articulation, including eyelid, mouth, and synovial joints. The range of operating conditions at these disparate interfaces yields a variety of tribological mechanisms through which compressive and shear forces are dissipated to protect tissues from material wear and fatigue. This review focuses on recent advances in active agents and biomaterials for therapeutic augmentation of friction, lubrication, and wear in disease and injured states. Various small-molecule, biological, and gene delivery therapies are described, as are tribosupplementation with naturally-occurring and synthetic biolubricants and polymer reinforcements. While reintroduction of a diseased tissue's native lubricant received significant attention in the past, recent discoveries and pre-clinical research are capitalizing on concurrent advances in the molecular sciences and bioengineering fields, with an understanding of the underlying tissue structure and physiology, to afford a desired, and potentially patient-specific, tissue mechanical response for restoration of normal function. Small and large molecule drugs targeting recently elucidated pathways as well as synthetic and hybrid natural/synthetic biomaterials for restoring a desired tissue mechanical response are being investigated for treatment of, for example, keratoconjunctivitis sicca, xeroderma, and osteoarthritis.
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Affiliation(s)
- Benjamin G Cooper
- Department of Chemistry, Boston University, Boston, MA, United States; Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
| | - Catalina Bordeianu
- Department of Chemistry, Boston University, Boston, MA, United States; Department of Biomedical Engineering, Boston University, Boston, MA, United States.
| | - Ara Nazarian
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States; Department of Biomedical Engineering, Boston University, Boston, MA, United States; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, United States.
| | - Mark W Grinstaff
- Department of Chemistry, Boston University, Boston, MA, United States; Department of Biomedical Engineering, Boston University, Boston, MA, United States; Department of Medicine, Boston University, Boston, MA, United States.
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Yenigun A, Elbay A, Dogan R, Ozturan O, Ozdemir MH. A Pilot Study Investigating the Impact of Topical Nasal Steroid Spray in Allergic Rhinitis Patients with Dry Eye. Int Arch Allergy Immunol 2018; 176:157-162. [PMID: 29734186 DOI: 10.1159/000488599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/20/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study is to demonstrate the effect of nasal steroid treatment on intraocular pressure and dry eye in allergic rhinitis patients with dry eye. MATERIALS AND METHODS Twenty-nine patients with a diagnosis of allergic rhinitis and dry eye were included. Symptoms and findings of patients before and after nasal steroid therapy were compared. RESULT Ocular Surface Disease Index scores for dry eye symptoms showed significant improvement after nasal steroid treatment (p = 0.003). In the Schirmer test, no significant change was observed in the right or left eye (p = 0.167 and p = 0.489). For the tear film break-up time, no significant change was observed in the right or left eye (p = 0.076 and (p = 0.170). No significant change was observed in the right eye or the left eye in an intraocular pressure test (p = 0.893 and p = 0.495). CONCLUSION In our study, symptoms of dry eye with allergic rhinitis were significantly improved with nasal steroid therapy, without affecting the intraocular pressure.
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Affiliation(s)
- Alper Yenigun
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ahmet Elbay
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Remzi Dogan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Orhan Ozturan
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Hakan Ozdemir
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye. Cytokine 2018; 105:37-44. [PMID: 29452970 DOI: 10.1016/j.cyto.2018.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/01/2018] [Accepted: 02/03/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Three tear supplements were compared for their effects on the signs, symptoms and inflammatory status of subjects with dry eye disease. Assessments were made before and after both 2 and 4 weeks of treatment. METHODS In this masked, randomized, 3-way crossover trial, eighteen dry eye subjects were recruited. At each visit, symptoms, tear evaporation rate, stability and osmolarity were measured and tear samples were analyzed for 7 inflammatory markers, using multiplex immunoassays. The 3 treatments included carboxymethylcellulose-glycerine-castor oil (CGC), carboxymethylcellulose (CMC) and hydroxypropyl guar (HPG). The CGC and HPG drops are emulsified lipids; CGC also contains osmoprotectants. The CMC drop is a standard aqueous polymeric supplement. RESULTS Significant improvements were seen in symptoms (OSDI) and tear stability (NITBUT) with all 3 treatments at 4 weeks. At 4 weeks post-CGC, 6 out of 7 biomarkers demonstrated a >25% reduction (in 40% of subjects). The same reduction (>25%) was seen in 10% of the subjects for CMC and in none of the subjects for HPG. No significantly different change to either evaporation rate or tear osmolarity was found following any of the three treatments. CONCLUSIONS In this study, the CGC treatment resulted in the greatest reduction in ocular biomarkers of inflammation, while all 3 treatments reduced symptoms and improved tear stability. These results indicate that subject-perceived symptomatic improvements are not necessarily associated with a reduction in objective measures of inflammation.
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Kapoor Y, Dixon P, Sekar P, Chauhan A. Incorporation of drug particles for extended release of Cyclosporine A from poly-hydroxyethyl methacrylate hydrogels. Eur J Pharm Biopharm 2017; 120:73-79. [DOI: 10.1016/j.ejpb.2017.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/06/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
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25
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An Alternative for Permanent Punctal Occlusion: Labial Mucous Membrane Graft in the Management of Severe Dry Eye. Ophthalmic Plast Reconstr Surg 2017; 33:395-396. [PMID: 28891925 DOI: 10.1097/iop.0000000000000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jiang HR, Liu SJ, Liu P, Xu SW, Yang Y, Zhang KY, Shou Y, Zhang BM. Acupuncture for dry eye syndrome: a meta-analysis of randomized controlled trials. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2017. [DOI: 10.1007/s11726-017-1011-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jóhannsdóttir S, Kristinsson JK, Fülöp Z, Ásgrímsdóttir G, Stefánsson E, Loftsson T. Formulations and toxicologic in vivo studies of aqueous cyclosporin A eye drops with cyclodextrin nanoparticles. Int J Pharm 2017; 529:486-490. [PMID: 28720540 DOI: 10.1016/j.ijpharm.2017.07.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/08/2017] [Accepted: 07/12/2017] [Indexed: 11/15/2022]
Abstract
Cyclosporin A (CyA) is an immunosuppressive drug used topically to treat ocular inflammatory disorder such as dry eye disease (DES). It is a lipophilic cyclic peptide with molecular weight of 1202.6Da. The aim of this study was to develop surfactant free aqueous 0.2% (w/v) CyA eye drops where the drug is present in an aqueous vehicle containing CyA/cyclodextrin (CyA/CD) nanoparticles and then do three-month toxicological testing in rabbits. Five formulations of different CD concentrations were studied, all of them contained 12.5% (w/v) of α-cyclodextrin (αCD) and various amounts of γ-cyclodextrin (γCD) (ranging from 0 to 12.5% w/v). αCD was used to solubilize the drug and γCD to promote formation of complex aggregates. CyA/CD complex aggregates were formed in all the formulations tested. However, the formulation containing 12.5% (w/v) αCD and 12.5% (w/v) γCD created more CyA/CD nanoparticles of suitable size and was therefore tested in vivo. The eye drops did not cause ocular irritation or toxic side effects upon topical administration to rabbits once or twice a day for three months.
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Affiliation(s)
| | | | | | | | - Einar Stefánsson
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Iceland
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Liu Q, Liu J, Ren C, Cai W, Wei Q, Song Y, Yu J. Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry. Int J Nanomedicine 2017; 12:1663-1671. [PMID: 28280333 PMCID: PMC5339014 DOI: 10.2147/ijn.s126968] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate whether acupuncture is effective at treating dry eye disease among postmenopausal women and to identify the possible mechanisms. METHODS Twenty-eight postmenopausal women with dry eye disease were randomly divided into two groups: an acupuncture plus artificial tears (AC + AT) group and an artificial tears (AT) only group. After baseline examination of clinical parameters and tear sample collection, each patient received the designated modality of topical therapy for 2 months. Post-treatment documentation of clinical parameters was recorded, and tear samples were collected. Tear samples from the AC + AT group were subjected to two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry (2D nano-LC-MS/MS). Western blot analysis was also performed on tear samples from both groups. RESULTS After treatment, the Ocular Surface Disease Index scores, symptom assessment scores, scores of sign assessment, and tear break-up time were significantly improved in both groups (P=0.000). Symptom assessment scores were significantly improved in the AC + AT group (P=0.000) compared with the AT group. 2D nano-LC-MS/MS identified 2,411 proteins, among which 142 were downregulated and 169 were upregulated. After combined AC + AT treatment, the abundance of secreted proteins was increased, whereas that of cytoplasmic proteins decreased (Pearson's χ2 test, P=0.000, P=0.000, respectively). Proteins involved in immunity and regulation were also more abundant (Pearson's χ2 test, P=0.040, P=0.016, respectively), while components and proliferation-related proteins were downregulated (Pearson's χ2 test, P=0.003, P=0.011, respectively). CONCLUSION AC + AT treatment increased protein synthesis and secretion, and improved clinical symptoms. These results indicate that acupuncture may be a complimentary therapy for treating postmenopausal dry eye disease.
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Affiliation(s)
- Qingyu Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai
| | - Junling Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai
| | - Chengda Ren
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai
| | - Wenting Cai
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai
| | - Qingquan Wei
- Department of Ophthalmology, Nanchang University, Nanchang
| | - Yi Song
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai
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Gehlsen U, Braun T, Notara M, Krösser S, Steven P. A semifluorinated alkane (F4H5) as novel carrier for cyclosporine A: a promising therapeutic and prophylactic option for topical treatment of dry eye. Graefes Arch Clin Exp Ophthalmol 2017; 255:767-775. [PMID: 28091781 PMCID: PMC5364248 DOI: 10.1007/s00417-016-3572-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/20/2016] [Accepted: 12/22/2016] [Indexed: 12/04/2022] Open
Abstract
Purpose Cyclosporine A (Cs) has been used as effective topical therapy for inflammatory dry eye disease since more than a decade. However, due to its lipophilic character, Cs is formulated as emulsions or oily solutions for topical application. This experimental study aimed to test if the use of semifluorinated alkanes (SFAs) as a preservative-free, well-tolerated non-stinging or burning vehicle maintains or even improves the benefits of Cs in the topical therapy of dry-eye disease. Methods Desiccating stress was applied to C57BL/6 mice for 14 consecutive days to induce experimental dry-eye. Cs dissolved in SFA (perfluorobutylpentane = F4H5with 0.5% Ethanol), F4H5 with 0.5% ethanol only, 0.05% Cs (Restasis®), and dexamethasone (Monodex®) were applied three times daily beginning either at day 4 or day 11 of desiccating stress for up to 3 weeks after end of dry-eye induction. Results In comparison to other groups, Cs/F4H5 demonstrated high efficacy and earlier reduction of corneal staining. In this study, Cs/F4H5 had the ability to maintain conjunctival goblet cell density once applied on day 4. Flow cytometry analysis from cervical lymphnodes demonstrated a significantly lower CD4+ and CD8+ T-cells in the Cs/F4H5 group following 3 weeks of therapy than at baseline, but no difference in regulatory T cells from regional lymphnodes were seen. Conclusions Overall, compared to a commercially available Cs formulation (Restasis®) and dexamethasone, Cs/F4H5 was shown to be equally effective but with a significantly faster therapeutic response in reducing signs of dry-eye disease in an experimental mouse model.
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Affiliation(s)
- Uta Gehlsen
- Department of Ophthalmology, Medical Faculty, University of Cologne, Kerpenerstrasse 62, 50937, Cologne, Germany.,Cluster of Excellence: Cellular Stress Response in Aging-Associated Diseases (CECAD), University Cologne, Cologne, Germany
| | - Tobias Braun
- Department of Ophthalmology, Medical Faculty, University of Cologne, Kerpenerstrasse 62, 50937, Cologne, Germany.,Cluster of Excellence: Cellular Stress Response in Aging-Associated Diseases (CECAD), University Cologne, Cologne, Germany
| | - Maria Notara
- Department of Ophthalmology, Medical Faculty, University of Cologne, Kerpenerstrasse 62, 50937, Cologne, Germany
| | | | - Philipp Steven
- Department of Ophthalmology, Medical Faculty, University of Cologne, Kerpenerstrasse 62, 50937, Cologne, Germany. .,Cluster of Excellence: Cellular Stress Response in Aging-Associated Diseases (CECAD), University Cologne, Cologne, Germany.
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Yenigun A, Dadaci Z, Sahin GO, Elbay A. Prevalence of allergic rhinitis symptoms and positive skin-prick test results in patients with dry eye. Am J Rhinol Allergy 2016; 30:e26-9. [PMID: 26980382 DOI: 10.2500/ajra.2016.30.4275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Dry eye is characterized by decreased tear production and/or increased evaporation rates of the tear film barrier. Allergic rhinitis is an inflammatory disease that develops through immunoglobulin E in the rhino-ocular mucosa due to allergens. To investigate the prevalence of allergic rhinitis symptoms and positive skin-prick test results in patients with dry eye. METHODS This is a case-control study. The study included 57 patients with dry eye and 48 healthy subjects. The prevalence of allergic symptoms and skin-prick test results were assessed and compared with the control group. RESULTS With regard to positive reactions to allergens in skin-prick tests, Dermatophagoides pteronyssinus allergy (p = 0.0003), Dermatophagoides farinae allergy (p = 0.0003), grass-mix allergy (p = 0.049), Salicaces allergy (p = 0.006), and Compositae allergy (p = 0.019) were significantly observed to be higher in the group with dry eye. Nasal obstruction (p = 0.027), discharge (p = 0.0001), sneeze (p = 0.0003), itching (p = 0.0001), and postnasal drainage (p = 0.001) symptoms were observed to be significantly higher in the group with dry eye. CONCLUSIONS Our study revealed that there was a significant association between dry eye and allergic rhinitis with positive skin-prick test results. There may be a possible link between dry eye and allergy.
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Affiliation(s)
- Alper Yenigun
- Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, Fatih, Istanbul, Turkey
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Ali M, Shah D, Pasha Z, Jassim SH, Jassim Jaboori A, Setabutr P, Aakalu VK. Evaluation of Accessory Lacrimal Gland in Muller's Muscle Conjunctival Resection Specimens for Precursor Cell Markers and Biological Markers of Dry Eye Disease. Curr Eye Res 2016; 42:491-497. [PMID: 27612554 DOI: 10.1080/02713683.2016.1214966] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The accessory lacrimal glands (ALGs) are an understudied component of the tear functional unit, even though they are important in the development of dry eye syndrome (DES). To advance our understanding of aging changes, regenerative potential, and histologic correlates to human characteristics, we investigated human ALG tissue from surgical samples to determine the presence or absence of progenitor cell markers and lacrimal epithelial markers and to correlate marker expression to relevant patient characteristics. MATERIALS AND METHODS ALG tissues obtained from Muller's muscle conjunctival resection (MMCR) specimens were created using tissue microarrays (TMAs). Immunofluorescence staining of MMCR sections was performed using primary antibodies specific to cell protein markers. Cell marker localization in TMAs was then assessed by two blinded observers using a standardized scoring system. Patient characteristics including age, race, and status of ocular surface health were then compared against expression of stem cell markers. RESULTS Human ALG expressed a number of epithelial markers, and in particular, histatin-1 was well correlated with the expression of epithelial markers and was present in most acini. In addition, we noted the presence of precursor cell markers nestin, ABCG2, and CD90 in ALG tissue. There was a decrease in precursor cell marker expression with increasing age. Finally, we noted that a negative association was present between histatin-1 expression and DES. CONCLUSIONS Thus, we report for the first time that human ALG tissues contain precursor marker-positive cells and that this marker expression may decrease with increasing age. Moreover, histatin-1 expression may be decreased in DES. Future studies will be performed to use these cell markers to isolate and culture lacrimal epithelial cells from heterogeneous tissues, determine the relevance of histatin-1 expression to DES, and isolate candidate precursor cells from ALG tissue.
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Affiliation(s)
- Marwan Ali
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Dhara Shah
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Zeeshan Pasha
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Sarmad H Jassim
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Assraa Jassim Jaboori
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Pete Setabutr
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Vinay K Aakalu
- a Department of Ophthalmology and Visual Sciences , University of Illinois at Chicago , Chicago , IL , USA
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Feng Y, Feng G, Peng S, Li H. The effects of hormone replacement therapy on dry eye syndromes evaluated by Schirmer test depend on patient age. Cont Lens Anterior Eye 2016; 39:124-7. [DOI: 10.1016/j.clae.2015.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/20/2015] [Accepted: 09/05/2015] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Over the counter (OTC) artificial tears historically have been the first line of treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet currently we know little regarding the overall efficacy of individual, commercially available artificial tears. This review provides a much needed meta-analytical look at all randomized and quasi-randomized clinical trials that have analyzed head-to-head comparisons of OTC artificial tears. OBJECTIVES To evaluate the effectiveness and toxicity of OTC artificial tear applications in the treatment of dry eye syndrome compared with another class of OTC artificial tears, no treatment, or placebo. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2015, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en) and the US Food and Drugs Administration (FDA) website (www.fda.gov). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 4 December 2015. We searched reference lists of included trials for any additional trials not identified by the electronic searches. SELECTION CRITERIA This review includes randomized controlled trials with adult participants who were diagnosed with dry eye, regardless of race and gender. We included trials in which the age of participants was not reported, and clinical trials comparing OTC artificial tears with another class of OTC artificial tears, placebo, or no treatment. This review did not consider head-to-head comparisons of artificial tears with another type of dry-eye therapy. DATA COLLECTION AND ANALYSIS We followed the standard methodological procedures expected by Cochrane. Two authors independently screened the search results, reviewed full-text copies for eligibility, examined risk of bias, and extracted data. We performed meta-analysis for trials that compared similar interventions and reported comparable outcomes with sufficient data. We summarized all other included trial results in the text. MAIN RESULTS We included 43 randomized controlled trials (3497 participants with dry eye). Due to the heterogeneity of study characteristics among the included trials with respect to types of diagnostic criteria, interventions, comparisons, and measurements taken, our ability to perform meta-analyses was limited. The review found that, in general, there was uncertainty whether different OTC artificial tears provide similar relief of signs and symptoms when compared with each other or placebo. Nevertheless, we found that 0.2% polyacrylic acid-based artificial tears were consistently more effective at treating dry eye symptoms than 1.4% polyvinyl alcohol-based artificial tears in two trials assessing this comparison (175 participants). All other included artificial tears produced contradictory between-group results or found no between-group differences. Our review also found that OTC artificial tears may be generally safe, but not without adverse events. Overall, we assessed the quality of evidence as low due to high risks of bias among included trials and poor reporting of outcome measures which were insufficient for quantitative analysis. Furthermore, we identified an additional 18 potentially eligible trials that were reported only in clinical trial registers with no associated results or publications. These trials reportedly enrolled 2079 total participants for whom no data are available. Such lack of reporting of trial results represents a high risk of publication bias. AUTHORS' CONCLUSIONS OTC artificial tears may be safe and effective means for treating dry eye syndrome; the literature indicates that the majority of OTC artificial tears may have similar efficacies. This conclusion could be greatly skewed by the inconsistencies in study designs and inconsistencies in reporting trial results. Additional research is therefore needed before we can draw robust conclusions about the effectiveness of individual OTC artificial tear formulations.
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Affiliation(s)
- Andrew D Pucker
- The Ohio State University320 West 10th AvenueColumbusOhioUSA43210
| | - Sueko M Ng
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe Street, W5010c/o Cochrane Eyes and Vision GroupBaltimoreMarylandUSA21205
| | - Jason J Nichols
- The University of Alabama at BirminghamOffice of the Vice President for Research and Economic Development, Office of Industry Engagement, Clinical Trials Office1720 2nd Avenue SouthAB 714ABirminghamAlabamaUSA35294‐0107
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Torkildsen G, Frisch S, Bai M, Gentner L, Doshi U, Zhang J. Safety and comfort evaluation of a new formulation of Visine(®) lubricant eye drops containing HydroBlend™ and GentlePur™. Clin Ophthalmol 2016; 10:331-6. [PMID: 26929596 PMCID: PMC4767116 DOI: 10.2147/opth.s84529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the clinical safety and comfort of a new benzalkonium chloride-free Visine(®) lubricant eye drop formulation (Hydroblend™ and GentlePur™) in healthy and dry eye subjects. METHODS This was a single-site, open-label clinical study comprised of 22 healthy and 22 dry eye subjects. Subjects were instructed to instill 1-2 drops of the test product four times a day for 2 weeks and were examined at visit 1 (day 0), visit 2 (day 7), and visit 3 (day 14). Assessments at each visit included postdosing product usage comfort scores, predosing fluorescein corneal staining score, predosing visual acuity, and pre- and postdosing ocular structure change using slit-lamp biomicroscopy. Adverse events were monitored throughout the course of the study. RESULTS Throughout the 14 days of the trial period, subjects from both healthy and dry eye groups rated the eye drops as "very comfortable". For dry eye group, the mean product usage comfort scores for the first 3 minutes postdosing ranged from 8.5 to 8.8 at visit 1 and 9.2 to 9.6 at visit 3 on a 0-10 point scale, with 0 being very uncomfortable and 10 being very comfortable. The mean corneal staining scores over five corneal regions changed from 0.65 at visit 1 to 0.39 at visit 3 for dry eye group. The individual region corneal staining scores were also decreased from visits 1 to 3 for dry eye group. All subjects maintained pretreatment means visual acuity at visits 2 and 3. Biomicroscopic examination indicated no structural changes at all visits. There were no significant adverse events reported during the course of the study. CONCLUSION The study confirms that GentlePur™ is an appropriate choice as a preservative for ocular application. The new formulation was safe and comfortable when used four times a day in healthy and dry eye subjects.
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Affiliation(s)
| | - Sherryl Frisch
- Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson & Johnson Consumer Companies, Inc, Morris Plains, NJ, USA
| | - Mingqi Bai
- Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson & Johnson Consumer Companies, Inc, Morris Plains, NJ, USA
| | - Louis Gentner
- Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson & Johnson Consumer Companies, Inc, Morris Plains, NJ, USA
| | - Uday Doshi
- Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson & Johnson Consumer Companies, Inc, Morris Plains, NJ, USA
| | - Jane Zhang
- Johnson & Johnson Consumer and Personal Products Worldwide, Division of Johnson & Johnson Consumer Companies, Inc, Morris Plains, NJ, USA
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Brinton M, Chung JL, Kossler A, Kook KH, Loudin J, Franke M, Palanker D. Electronic enhancement of tear secretion. J Neural Eng 2015; 13:016006. [PMID: 26655141 DOI: 10.1088/1741-2560/13/1/016006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To study electrical stimulation of the lacrimal gland and afferent nerves for enhanced tear secretion, as a potential treatment for dry eye disease. We investigate the response pathways and electrical parameters to safely maximize tear secretion. APPROACH We evaluated the tear response to electrical stimulation of the lacrimal gland and afferent nerves in isofluorane-anesthetized rabbits. In acute studies, electrical stimulation was performed using bipolar platinum foil electrodes, implanted beneath the inferior lacrimal gland, and a monopolar electrode placed near the afferent ethmoid nerve. Wireless microstimulators with bipolar electrodes were implanted beneath the lacrimal gland for chronic studies. To identify the response pathways, we applied various pharmacological inhibitors. To optimize the stimulus, we measured tear secretion rate (Schirmer test) as a function of pulse amplitude (1.5-12 mA), duration (0.1-1 ms) and repetition rate (10-100 Hz). MAIN RESULTS Stimulation of the lacrimal gland increased tear secretion by engaging efferent parasympathetic nerves. Tearing increased with stimulation amplitude, pulse duration and repetition rate, up to 70 Hz. Stimulation with 3 mA, 500 μs pulses at 70 Hz provided a 4.5 mm (125%) increase in Schirmer score. Modulating duty cycle further increased tearing up to 57%, compared to continuous stimulation in chronically implanted animals (36%). Ethmoid (afferent) nerve stimulation increased tearing similar to gland stimulation (3.6 mm) via a reflex pathway. In animals with chronically implanted stimulators, a nearly 6 mm increase (57%) was achieved with 12-fold less charge density per pulse (0.06-0.3 μC mm(-2) with 170-680 μs pulses) than the damage threshold (3.5 μC mm(-2) with 1 ms pulses). SIGNIFICANCE Electrical stimulation of the lacrimal gland or afferent nerves may be used as a treatment for dry eye disease. Clinical trials should validate this approach in patients with aqueous tear deficiency, and further optimize electrical parameters for maximum clinical efficacy.
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Affiliation(s)
- Mark Brinton
- Stanford University, Electrical Engineering, Stanford, CA, USA
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Lin H, Sun G, He H, Botsford B, Li M, Elisseeff JH, Yiu SC. Three-Dimensional Culture of Functional Adult Rabbit Lacrimal Gland Epithelial Cells on Decellularized Scaffold. Tissue Eng Part A 2015; 22:65-74. [PMID: 26414959 DOI: 10.1089/ten.tea.2015.0286] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aqueous tear-deficient dry eye disease is a multifactorial chronic disorder, in which the lacrimal gland fails to produce enough tears to maintain a healthy ocular surface. Some severe cases may develop corneal damage and significant vision loss. Treatment primarily involves palliation using ocular surface lubricants, but can only provide temporary relief. Construction of a bioengineered lacrimal gland having functional secretory epithelial cells is a potentially promising option for providing long-term relief to severe dry eye patients. Using sphere-forming culture techniques, we cultured adult rabbit lacrimal gland progenitor cells and prepared a lacrimal gland scaffold by decellularization. When progenitor cells were seeded onto the decellularized scaffold, they formed duct- and acinar-like structures in the three-dimensional culture system. Lacrimal gland epithelial cells showed good cell viability, cell differentiation, and secretory function in decellularized lacrimal gland matrix, as indicated by morphology, immunostaining, and β-hexosaminidase secretion assay. This study demonstrated the potential suitability of utilizing tissue-specific progenitor cells and a tissue-derived bioscaffold for lacrimal gland restoration.
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Affiliation(s)
- Hui Lin
- 1 Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University , Baltimore, Maryland
| | - Guoying Sun
- 1 Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University , Baltimore, Maryland
| | - Hong He
- 1 Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University , Baltimore, Maryland
| | | | - Mackenzie Li
- 3 University of British Columbia , Vancouver, British Columbia, Canada
| | - Jennifer H Elisseeff
- 1 Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University , Baltimore, Maryland.,4 Translational Tissue Engineering Center, Johns Hopkins University , Baltimore, Maryland
| | - Samuel C Yiu
- 1 Department of Ophthalmology, Wilmer Eye Institute, School of Medicine, Johns Hopkins University , Baltimore, Maryland
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Choi W, Kim JC, Kim WS, Oh HJ, Yang JM, Lee JB, Yoon KC. Clinical Effect of Antioxidant Glasses Containing Extracts of Medicinal Plants in Patients with Dry Eye Disease: A Multi-Center, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. PLoS One 2015; 10:e0139761. [PMID: 26457673 PMCID: PMC4601690 DOI: 10.1371/journal.pone.0139761] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/08/2015] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the clinical efficacy and safety of wearable antioxidant glasses containing extracts of medicinal plants in patients with mild dry eye disease (DED). Methods Fifty patients with mild DED were randomly assigned to wear either extracts of antioxidant medicinal plants containing (N = 25) or placebo glasses (N = 25). Patients wore the glasses for 15 min three times daily. The ocular surface disease index (OSDI) score, tear film break up time (BUT), and Schirmer’s test were evaluated and compared within the group and between the groups at baseline, 4 weeks, and 8 weeks after treatment. Results OSDI score and tear film BUT were significantly improved in the treatment group at 4 and 8 weeks after wearing glasses (all P < 0.001). Compared to the placebo group, the OSDI scores were significantly lower in the treatment group at 8 weeks (P = 0.007). The results of the Schirmer’s test showed significant improvement in the treatment group at 4 weeks (P = 0.035), however there were no significant differences between the other groups or within the groups. No adverse events were reported during the study. Conclusions Antioxidant glasses containing extracts of medicinal plants were effective in improving in DED both subjectively and objectively. Wearing antioxidants glasses might be a safe and adjunctive therapeutic option for DED. Trial Registration ISRCTN registry 71217488
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Affiliation(s)
- Won Choi
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Jae Chan Kim
- Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Won Soo Kim
- Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Han Jin Oh
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Jee Myung Yang
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Medical School and Hospital, Gwangju, Korea
- * E-mail: (KCY); (JBL)
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
- * E-mail: (KCY); (JBL)
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Abstract
PURPOSE This study explored a new method for removing thermosensitive acrylic punctal plugs from lacrimal puncta. METHODS A total of 14 dry eye patients (14 eyes), who required the removal of thermosensitive acrylic punctal plugs from the lacrimal puncta because of serious complications, were recruited. Among the 14 patients, lacrimal punctal granuloma formation occurred in 3 patients, tearing occurred in 6 patients, canaliculitis occurred in 3 patients, and chronic inflammation of the ocular surface occurred in 2 patients. The plugs were removed using a new method. Briefly, after local anesthesia was administered, a small lid clamp was used to flip the eyelid outward. After the application of the lid clamp, the plug could be removed without the use of any additional tools if the lacrimal punctum was large enough. If the lacrimal punctum was not large enough, microforceps were used to expand the lacrimal punctum before the application of the lid clamp. If the plug still could not be removed after the expansion of the lacrimal punctum, we moved the small lid clamp from the distal side of the lacrimal ductule to the lacrimal punctum. RESULTS Using this method, the plug was successfully removed in all of the patients. CONCLUSIONS This is a simple and effective method for removing thermosensitive acrylic punctal plugs from lacrimal puncta. CLINICAL TRIAL REGISTRATION-URL : http://www.clinicaltrials.gov. Unique identifier: ChiCTR-IPR-14005476.
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Jóhannsdóttir S, Jansook P, Stefánsson E, Loftsson T. Development of a cyclodextrin-based aqueous cyclosporin A eye drop formulations. Int J Pharm 2015. [PMID: 26220650 DOI: 10.1016/j.ijpharm.2015.07.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cyclosporin A (CyA) is a lipophilic, cyclic polypeptide drug with anti-inflammatory properties. It is used in topical treatment of dry eyes and is now commercially available in oil based surfactant containing eye drops. Surfactants can irritate the eye surface causing burning, itching and irritation of the conjunctiva, and oil-based drops can result in blurred vision. Thus, the aim of this study was to develop surfactant free aqueous 0.05% (w/v) CyA eye drops where the drug is present in an aqueous vehicle containing CyA/cyclodextrin (CyA/CD) nanoparticles. The effects of the natural α-, β- and γ-cyclodextrins (αCD, βCD and γCD), as well as of the water soluble hydroxypropyl derivatives of γCD and αCD (HPγCD, HPαCD) and randomly methylated βCD (RMβCD), were determined in pure water. αCD had the best solubilizing effect increasing the solubility of CyA above 0.05% upon addition of only 5% (w/v) αCD. γCD did not have as good solubilizing effect but was tested further due to its superior ability to form nanoparticles and its favorable toxicological profile. Seven eye drop formulations were prepared and tested. All contained 0.05% (w/v) CyA in addition to polyvinyl alcohol, benzalkonium chloride, disodium edetate and various amounts of CD (αCD, γCD and mixtures thereof). When the formulation contained only αCD most of the drug was dissolved but some small aggregates were formed with hydrodynamic diameter of about 6 and 155 nm. When the formulation contained only γCD negligible CyA/CD complexation occurred with most of the drug present as solid CyA particles. When the formulation contained a mixture of αCD and γCD, where αCD concentration was at least 3% (w/v), the entire drug content was dissolved in the media under formation of relatively large (100-2000 nm) CyA/CD nanoparticles. αCD solubilized the drug while γCD enhanced nanoparticle formation. The effect of polyvinyl alcohol, benzalkonium chloride and disodium edetate on the nanoparticle formation was also investigated and shown to have positive effect on the aggregate formation.
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Affiliation(s)
- Sunna Jóhannsdóttir
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland
| | - Phatsawee Jansook
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Einar Stefánsson
- Department of Ophthalmology, Faculty of Medicine, National University Hospital, University of Iceland, Reykjavik, Iceland
| | - Thorsteinn Loftsson
- Faculty of Pharmaceutical Sciences, University of Iceland, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
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Mantelli F, Sacchetti M, Scuderi G, Lambiase A. A closer look at nerve growth factor: from biology to clinical trials in ophthalmology. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1006196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yellepeddi VK, Sheshala R, McMillan H, Gujral C, Jones D, Raghu Raj Singh T. Punctal plug: a medical device to treat dry eye syndrome and for sustained drug delivery to the eye. Drug Discov Today 2015; 20:884-9. [PMID: 25668579 DOI: 10.1016/j.drudis.2015.01.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 01/13/2015] [Accepted: 01/30/2015] [Indexed: 11/20/2022]
Abstract
Punctal plugs (PPs) are miniature medical implants that were initially developed for the treatment of dry eyes. Since their introduction in 1975, many PPs made from different materials and designs have been developed. PPs, albeit generally successful, suffer from drawbacks such as epiphora and suppurative canaliculitis. To overcome these issues intelligent designs of PPs were proposed (e.g. SmartPLUG™ and Form Fit™). PPs are also gaining interest among pharmaceutical scientists for sustaining drug delivery to the eye. This review aims to provide an overview of PPs for dry eye treatment and drug delivery to treat a range of ocular diseases. It also discusses current challenges in using PPs for ocular diseases.
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Affiliation(s)
- Venkata K Yellepeddi
- College of Pharmacy, Roseman University of Health Sciences, South Jordan, UT, USA; Department of Pharmaceutics and Pharmaceutical Sciences, University of Utah, Salt Lake City, UT, USA
| | - Ravi Sheshala
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
| | - Hannah McMillan
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Chirag Gujral
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - David Jones
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Thakur Raghu Raj Singh
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK.
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Truong S, Cole N, Stapleton F, Golebiowski B. Sex hormones and the dry eye. Clin Exp Optom 2014; 97:324-36. [PMID: 24689906 DOI: 10.1111/cxo.12147] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 11/26/2013] [Accepted: 01/19/2014] [Indexed: 01/15/2023] Open
Abstract
The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. This review aims to present evidence for how sex hormones may affect the ocular structures involved in the production, regulation and maintenance of the normal tear film. It is hypothesised that hormone changes alter the homeostasis of the ocular surface and contribute to dry eye. Androgens impact on the structure and function of the meibomian and lacrimal glands and therefore androgen deficiency is, at least in part, associated with the aetiology of dry eye. In contrast, reports of the effects of oestrogen and progesterone on these ocular structures and on the conjunctiva are contradictory and the mechanisms of action of these female-specific sex hormones in the eye are not well understood. The uncertainty of the effects of oestrogen and progesterone on dry eye symptoms is reflected in the controversial relationship between hormone replacement therapy and the signs and symptoms of dry eye. Current understanding of sex hormone influences on the immune system suggests that oestrogen may modulate a cascade of inflammatory events, which underlie dry eye.
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Affiliation(s)
- Susan Truong
- The University of New South Wales, Kensington, New South Wales, Australia
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White CJ, Thomas CR, Byrne ME. Bringing comfort to the masses: A novel evaluation of comfort agent solution properties. Cont Lens Anterior Eye 2014; 37:81-91. [DOI: 10.1016/j.clae.2013.07.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/22/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
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Zhang W, Wang Y, Lee BTK, Liu C, Wei G, Lu W. A novel nanoscale-dispersed eye ointment for the treatment of dry eye disease. NANOTECHNOLOGY 2014; 25:125101. [PMID: 24571862 DOI: 10.1088/0957-4484/25/12/125101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A novel nanoscale-dispersed eye ointment (NDEO) for the treatment of severe evaporative dry eye has been successfully developed. The excipients used as semisolid lipids were petrolatum and lanolin, as used in conventional eye ointment, which were coupled with medium-chain triglycerides (MCT) as a liquid lipid; both phases were then dispersed in polyvinyl pyrrolidone solution to form a nanodispersion. Single-factor experiments were conducted to optimize the formulations. A transmission electron micrograph showed that the ointment matrix was entrapped in the nanoemulsion of MCT, with a mean particle size of about 100 nm. The optimized formulation of NDEO was stable when stored for six months at 4 °C, and demonstrated no cytotoxicity to human corneal epithelial cells when compared with commercial polymer-based artificial tears (Tears Natural Forte). The therapeutic effects of NDEO were evaluated on a mouse model with 'dry eye'. Both the tear break-up time and fluorescein staining demonstrated therapeutic improvement, displaying a trend of positive correlation with higher concentrations of ointment matrix in the NDEO formulations compared to a marketed product. Histological evaluation demonstrated that the NDEO restored the normal corneal and conjunctival morphology and is safe for ophthalmic application.
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Affiliation(s)
- Wenjian Zhang
- Key Laboratory of Smart Drug Delivery, Ministry of Education, Department of Pharmaceutics, School of Pharmacy, Fudan University, Shanghai 201203, People's Republic of China
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Hallak JA, Jassim S, Khanolkar V, Jain S. Symptom burden of patients with dry eye disease: a four domain analysis. PLoS One 2013; 8:e82805. [PMID: 24349365 PMCID: PMC3862676 DOI: 10.1371/journal.pone.0082805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/06/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To determine which sensory (symptom persistence and intensity) and reactive (activity and affective interference) domains of symptom analysis are essential for assessing symptom burden in dry eye disease (DED) patients. METHODS A symptom domain tool was developed to investigate all four symptom domains in DED. In a cross-sectional pilot study, we administered the symptom burden tool and the Ocular Surface Disease Index (OSDI) questionnaire to 48 DED patients. Total and domain scores from the symptom burden tool and the OSDI were normalized to achieve comparability. Spearman correlation coefficients were calculated to measure the relationship between domains and subscales. Agreement between the symptom burden tool and OSDI was assessed by Bland-Altman plot. Assigned treatments were compared by symptom burden to determine whether treatment aggressiveness is linked to symptom intensity. RESULTS There was high agreement between the symptom burden tool and the OSDI. Symptom persistence had a stronger correlation with affective interference (r = 0.62 for the symptom burden tool and r = 0.73 for the OSDI) than activity interference (r = 0.58 for the symptom burden tool and r = 0.60 for the OSDI). Symptom intensity correlated weakly with affective interference (r = 0.38) and activity interference (r = 0.37) in the symptom burden tool (OSDI does not have a subscale for intensity). In patients with equal persistence of symptoms, those having high symptom intensity were receiving more aggressive treatment (66.7%) than those with lower symptom intensity (33.3%). CONCLUSIONS Persistence of symptoms correlates better with affective interference than activity interference. Intensity of symptoms may be important for treatment decisions.
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Affiliation(s)
- Joelle A. Hallak
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, United States of America
- Department of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, Illinois, United States of America
- * E-mail:
| | - Sarmad Jassim
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, United States of America
| | - Vishakha Khanolkar
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, United States of America
| | - Sandeep Jain
- Corneal Neurobiology Laboratory, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, United States of America
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Takahashi Y, Watanabe A, Matsuda H, Nakamura Y, Nakano T, Asamoto K, Ikeda H, Kakizaki H. Anatomy of secretory glands in the eyelid and conjunctiva: a photographic review. Ophthalmic Plast Reconstr Surg 2013; 29:215-9. [PMID: 23381567 DOI: 10.1097/iop.0b013e3182833dee] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The eyelid and conjunctiva are main targets in ophthalmic plastic surgery. Although dry eyes are known to occasionally occur after ophthalmic plastic surgery, little attention has been paid to the secretory glands in the eyelid and conjunctiva. The secretary glands in the eyelid and conjunctiva contain the main lacrimal gland, accessory lacrimal glands of Wolfring and Krause, goblet cells, ciliary glands of Moll and Zeis, and the meibomian gland of the tarsal plate. Understanding the details of these glands is helpful in preventing and managing secretion reduction after oculoplastic procedures.
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Affiliation(s)
- Yasuhiro Takahashi
- Department of Ophthalmology, Aichi Medical University, Nagakute, Aichi, Japan
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Pflugfelder SC, Corrales RM, de Paiva CS. T helper cytokines in dry eye disease. Exp Eye Res 2013; 117:118-25. [PMID: 24012834 PMCID: PMC3855838 DOI: 10.1016/j.exer.2013.08.013] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 08/13/2013] [Accepted: 08/16/2013] [Indexed: 01/28/2023]
Abstract
Dry eye is an inflammatory disease that results from activation of innate inflammatory pathways in resident ocular surface cells, as well as cytokines produced by recruited T helper (Th) cells. Cytokines produced by the infiltrating Th cells alter the normal cytokine balance on the ocular surface and cause ocular surface epithelial pathology. Changes in levels of Th cytokines on the ocular surface have been measured in dry eye and the biological effects of these cytokines have been documented in experimental culture and mouse model systems. The Th2 cytokine IL-13 has a homeostatic role in promoting goblet cell differentiation. In contrast, The Th1 cytokine IFN-γ antagonizes IL-13 and promotes apoptosis and squamous metaplasia of the ocular surface epithelia. The Th17 cytokine, IL-17 promotes corneal epithelial barrier disruption. The ocular surface epithelium expresses receptors to all of these Th cytokines. Therapies that maintain normal IL-13 signaling, or suppress IFN-γ and IL-17 have potential for treating the ocular surface disease of dry eye.
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Affiliation(s)
- Stephen C Pflugfelder
- Ocular Surface Center, Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 6565 Fannin NC205, Houston, TX 77030, USA.
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Dogru M, Nakamura M, Shimazaki J, Tsubota K. Changing trends in the treatment of dry-eye disease. Expert Opin Investig Drugs 2013; 22:1581-601. [DOI: 10.1517/13543784.2013.838557] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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49
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Moosa RM, Choonara YE, du Toit LC, Kumar P, Carmichael T, Tomar LK, Tyagi C, Pillay V. A review of topically administered mini-tablets for drug delivery to the anterior segment of the eye. ACTA ACUST UNITED AC 2013; 66:490-506. [PMID: 24635554 DOI: 10.1111/jphp.12131] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 07/23/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The human eye is a unique and intricate structure which has made drug delivery to the eye a formidable undertaking. Anterior-segment eye diseases are ubiquitous, especially among elderly patients, and conventional eye drops, although a first-choice dosage form, are not always an efficient treatment option. The development of novel drug delivery systems for improved treatment is therefore imperative. KEY FINDINGS In an attempt to circumvent the obstacles presented by the structure of the eye, advanced systems such as ocular mini-tablets have been developed. In this review, a concerted effort has been made to provide a detailed overview of topically administered ocular mini-tablets and other solid devices for drug delivery to the anterior segment of the eye. These mini-tablets have been shown in vitro and in vivo to have significant advantages in comparison with liquid preparations. This is a step toward attaining better patient convenience and compliance, which are critical factors. SUMMARY Solid ophthalmic dosage forms have several advantages that can contribute to assisting with patient compliance and, ultimately, effective disease treatment. In addition to the challenges associated with topical ocular drug delivery, the shortcomings of conventional eye drops, advantages of mini-tablets, and improvements to date to these systems are discussed. The requirement for further advancements in the ocular field is also emphasized.
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Affiliation(s)
- Raeesa M Moosa
- Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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