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Singh S, Srivastav S, Jaffet J, Prasad D, Padala KR, Singh V, Bokara KK, Basu S. Developing a model for aqueous deficient dry eye secondary to periglandular cicatrizing conjunctivitis. Exp Eye Res 2024; 244:109949. [PMID: 38815791 DOI: 10.1016/j.exer.2024.109949] [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: 01/23/2024] [Revised: 05/02/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The current study used various techniques to develop a rabbit animal model of lacrimal gland damage caused by scarring conjunctivitis in the periglandular area. METHODS Left eyes of New Zealand white rabbits were injected with 0.1 ml of 1M NaOH subconjunctivally around superior and inferior lacrimal gland orifices (Group 1, n = 4), touched with 1M NaOH for 100 s to the superior and inferior fornices with conjunctival denuding (Group 2; n = 4), and electrocauterization to the ductal opening area (Group 3; n = 4). The ocular surface staining, Schirmer I, lacrimal gland, and conjunctival changes were observed at baseline,1, 4, 8, and 12 weeks. The degree of glandular inflammation, conjunctival fibrosis (Masson Trichrome), and goblet cell density (PAS) were also assessed. RESULTS At 12 weeks, the lacrimal glands of group 1 rabbits with periglandular injection showed severe inflammation with mean four foci/10HPF and a significant mean reduction in the Schirmer values by 7.6 mm (P = 0.007). Lacrimal glands had diffuse acinar atrophy, loss of myoepithelial cells, and ductular dilatation. The overlying conjunctiva showed fibrosis, goblet cell loss, and corneal vascularization in the inferotemporal quadrant. No lacrimal gland or ocular surface changes were observed in groups 2 and 3 at 12 weeks, except for localized subconjunctival fibrosis. CONCLUSION Periglandular injection of 0.1 ml of 1M NaOH induced extensive lacrimal gland damage with reduced secretion and scarring in the subconjunctival plane compared to direct cauterization or direct NaOH contact to the ductal orifices of the rabbit lacrimal gland.
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Affiliation(s)
- Swati Singh
- Ophthalmic Plastic Surgery Services, L V Prasad Eye Institute, Hyderabad, Telangana, India; Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India.
| | - Saumya Srivastav
- Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jilu Jaffet
- Manipal Academy of Higher Education, Manipal, Karnataka, India; Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India; Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Deeksha Prasad
- Manipal Academy of Higher Education, Manipal, Karnataka, India; Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Khyathi Ratna Padala
- CSIR-Center for Cellular and Molecular Biology, ANNEXE II, Medical Biotechnology Complex, Uppal Road, Hyderabad, Telangana, India
| | - Vivek Singh
- Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India; Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Kiran Kumar Bokara
- CSIR-Center for Cellular and Molecular Biology, ANNEXE II, Medical Biotechnology Complex, Uppal Road, Hyderabad, Telangana, India.
| | - Sayan Basu
- Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India; Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Singh S, Brabletz S, Arnold P, Schicht M, Paulsen F. Epithelial-mesenchymal transition in the lacrimal gland morphogenesis, damage and repair. Ocul Surf 2023; 29:401-405. [PMID: 37321448 DOI: 10.1016/j.jtos.2023.06.008] [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: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 06/17/2023]
Abstract
Epithelial-mesenchymal transition (EMT) constitutes an important pathway in organ fibrosis seen in the lungs, liver, eye, and salivary glands. This review summarizes the EMT observed within the lacrimal gland during its development, tissue damage and repair along with possible translational implications. Existing animal and human studies have reported the increased expression of EMT regulators i.e., transcription factors like Snail, TGF-β1 within the lacrimal glands, and a possible role of reactive oxygen species, which might be initiating the cascade of EMT. In these studies, EMT is typically detected by reduced E-cadherin expression in the epithelial cells and increased Vimentin and Snail expression within the lacrimal glands' myoepithelial or ductal epithelial cells. Other than specific markers, electron microscopic evidence of disrupted basal lamina, increased collagen deposition, reorganised cytoskeleton of myoepithelial cells also indicated EMT. Very few studies have shown myoepithelial cells to be the cells transitioning into mesenchymal cells with increased extracellular matrix deposition within the lacrimal glands. EMT in animal models seemed reversible as glands got repaired after damage with IL-1α injection or duct ligation and transiently used the EMT as a means for tissue repair. The EMT cells also expressed nestin, a marker for progenitor cells in a rabbit duct ligation model. However, lacrimal glands of ocular graft versus host disease and IgG4 dacryoadenitis demonstrate irreversible acinar atrophy along with signs of EMT-fibrosis, reduced E-cadherin, and increased Vimentin and Snail expression. Future studies exploring the molecular mechanisms of EMT and thereby developing targeted therapies capable of transforming the mesenchymal cells into epithelial cells or blocking the EMT might help in the restoration of the lacrimal gland function.
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Affiliation(s)
- Swati Singh
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany; Ophthalmic Plastic Surgery Services, LV Prasad Eye Institute, Hyderabad, Telangana, India.
| | - Simone Brabletz
- Department of Experimental Medicine I, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
| | - Philipp Arnold
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
| | - Martin Schicht
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany
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Veernala I, Jaffet J, Fried J, Mertsch S, Schrader S, Basu S, Vemuganti G, Singh V. Lacrimal gland regeneration: The unmet challenges and promise for dry eye therapy. Ocul Surf 2022; 25:129-141. [PMID: 35753665 DOI: 10.1016/j.jtos.2022.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
DED (Dry eye disease) is a common multifactorial disease of the ocular surface and the tear film. DED has gained attention globally, with millions of people affected.. Although treatment strategies for DED have shifted towards Tear Film Oriented Therapy (TFOT), all the existing strategies fall under standard palliative care when addressed as a long-term goal. Therefore, different approaches have been explored by various groups to uncover alternative treatment strategies that can contribute to a full regeneration of the damaged lacrimal gland. For this, multiple groups have investigated the role of lacrimal gland (LG) cells in DED based on their regenerating, homing, and differentiating capabilities. In this review, we discuss in detail therapeutic mechanisms and regenerative strategies that can potentially be applied for lacrimal gland regeneration as well as their therapeutic applications. This review mainly focuses on Aqueous Deficiency Dry Eye Disease (ADDE) caused by lacrimal gland dysfunction and possible future treatment strategies. The current key findings from cell and tissue-based regenerative therapy modalities that could be utilised to achieve lacrimal gland tissue regeneration are summarized. In addition, this review summarises the available literature from in vitro to in vivo animal studies, their limitations in relation to lacrimal gland regeneration and the possible clinical applications. Finally, current issues and unmet needs of cell-based therapies in providing complete lacrimal gland tissue regeneration are discussed.
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Affiliation(s)
- Induvahi Veernala
- School of Medical Sciences, University of Hyderabad, Prof C R Rao Road, Gachibowli, Hyderabad, 500046, India
| | - Jilu Jaffet
- Centre for Ocular Regeneration, Brien Holden Eye Research Centre, Champalimaud Translational Centre for Eye Research, LV Prasad Eye Institute, Kallam Anji Reddy Campus, L V Prasad Marg, Hyderabad, 500 034, India; Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Jasmin Fried
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl von Ossietzky University Oldenburg, Germany
| | - Sonja Mertsch
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl von Ossietzky University Oldenburg, Germany
| | - Stefan Schrader
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl von Ossietzky University Oldenburg, Germany
| | - Sayan Basu
- Centre for Ocular Regeneration, Brien Holden Eye Research Centre, Champalimaud Translational Centre for Eye Research, LV Prasad Eye Institute, Kallam Anji Reddy Campus, L V Prasad Marg, Hyderabad, 500 034, India
| | - Geeta Vemuganti
- School of Medical Sciences, University of Hyderabad, Prof C R Rao Road, Gachibowli, Hyderabad, 500046, India.
| | - Vivek Singh
- Centre for Ocular Regeneration, Brien Holden Eye Research Centre, Champalimaud Translational Centre for Eye Research, LV Prasad Eye Institute, Kallam Anji Reddy Campus, L V Prasad Marg, Hyderabad, 500 034, India.
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Rodboon T, Yodmuang S, Chaisuparat R, Ferreira JN. Development of high-throughput lacrimal gland organoid platforms for drug discovery in dry eye disease. SLAS DISCOVERY : ADVANCING LIFE SCIENCES R & D 2022; 27:151-158. [PMID: 35058190 DOI: 10.1016/j.slasd.2021.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Dysfunction and damage of the lacrimal gland (LG) results in ocular discomfort and dry eye disease (DED). Current therapies for DED do not fully replenish the necessary lubrication to rescue optimal vision. New drug discovery for DED has been limited perhaps because in vitro models cannot mimic the biology of the native LG. The existing platforms for LG organoid culture are scarce and still not ready for consistency and scale up production towards drug screening. The magnetic three-dimensional (3D) bioprinting (M3DB) is a novel system for 3D in vitro biofabrication of cellularized tissues using magnetic nanoparticles to bring cells together. M3DB provides a scalable platform for consistent handling of spheroid-like cell cultures facilitating consistent biofabrication of organoids. Previously, we successfully generated innervated secretory epithelial organoids from human dental pulp stem cells with M3DB and found that this platform is feasible for epithelial organoid bioprinting. Research targeting LG organogenesis, drug discovery for DED has extensively used mouse models. However, certain inter-species differences between mouse and human must be considered. Porcine LG appear to have more similarities to human LG than the mouse counterparts. We have conducted preliminary studies with the M3DB for fabricating LG organoids from primary cells isolated from murine and porcine LG, and found that this platform provides robust LG organoids for future potential high-throughput analysis and drug discovery. The LG organoid holds promise to be a functional model of tearing, a platform for drug screening, and may offer clinical applications for DED.
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Affiliation(s)
- Teerapat Rodboon
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Supansa Yodmuang
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Risa Chaisuparat
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Joao N Ferreira
- Avatar Biotechnologies for Oral Health and Healthy Longevity Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Faculty of Dentistry, National University of Singapore, Singapore.
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He X, Wang S, Sun H, He H, Shi Y, Wu Y, Wu H, Liu Z, Zhuang J, Li W. Lacrimal Gland Microenvironment Changes After Obstruction of Lacrimal Gland Ducts. Invest Ophthalmol Vis Sci 2022; 63:14. [PMID: 35289845 PMCID: PMC8934564 DOI: 10.1167/iovs.63.3.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose To investigate microenvironment changes of the lacrimal gland after obstruction of lacrimal gland ducts. Methods The ducts of rat exorbital lacrimal gland were ligated by sutures for different durations. After that, the sutures in some animals were released, and they were observed for 21 days to evaluate the recovery of the lacrimal gland. Slit lamp and tear secretion test was performed to evaluate ocular surface and lacrimal gland function. The lacrimal gland and cornea were harvested and processed for hematoxylin and eosin staining, oil red O staining, LipidTOX staining, Masson staining, quantitative real time polymerase chain reaction, and immunofluorescence staining. Results After the lacrimal gland ducts were blocked, tear secretion and the weight of the lacrimal gland were reduced. Incidence of corneal neovascularization increased after seven days. Intraglandular ducts dilated and acini destroyed. Long-term ligation induced fibrosis and lipid accumulation of the lacrimal glands. Inflammatory cell infiltrated and inflammatory factors upregulated. Proliferative and apoptotic cells increased. Structure of myoepithelial cells and basement membrane was destroyed. The p63 expression increased whereas Pax6 expression decreased. After suture release, tear secretion and structure of acini could recover in less than seven days after ligation, with a decrease in inflammatory cell infiltration and fibrosis relief. Apoptotic cells and proliferative cells increased at five days thereafter. The structure of the myoepithelial cells and basement membrane could not recover three days after ligation, and the number of mesenchymal cells increased in ligation after five to 14 days. Conclusions Blockage of the lacrimal gland ducts results in dystrophy of lacrimal gland acini cells, inflammation, and lipid accumulation of the lacrimal gland microenvironment. Long-term duct blockage will cause irreversible lacrimal gland failure.
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Affiliation(s)
- Xin He
- Department of Ophthalmology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Shaopan Wang
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.,Institute of Artificial Intelligence, Xiamen University, Xiamen, Fujian, China
| | - Huimin Sun
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Hui He
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Yalin Shi
- Department of Ophthalmology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Yiming Wu
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Han Wu
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Zuguo Liu
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| | - Jingyi Zhuang
- Department of Ophthalmology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
| | - Wei Li
- Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
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Helena Macedo M, Baião A, Pinto S, Barros AS, Almeida H, Almeida A, das Neves J, Sarmento B. Mucus-producing 3D cell culture models. Adv Drug Deliv Rev 2021; 178:113993. [PMID: 34619286 DOI: 10.1016/j.addr.2021.113993] [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: 06/09/2021] [Revised: 08/23/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
In vitro cell-based models have been used for a long time since they are normally easily obtained and have an advantageous cost-benefit. Besides, they can serve a variety of ends, from studying drug absorption and metabolism to disease modeling. However, some in vitro models are too simplistic, not accurately representing the living tissues. It has been shown, mainly in the last years, that fully mimicking a tissue composition and architecture can be paramount for cellular behavior and, consequently, for the outcomes of the studies using such models. Because of this, 3D in vitro cell models have been gaining much attention, since they are able to better replicate the in vivo environment. In this review we focus on 3D models that contain mucus-producing cells, as mucus can play a pivotal role in drug absorption. Being frequently overlooked, this viscous fluid can have an impact on drug delivery. Thus, the aim of this review is to understand to which extent can mucus affect mucosal drug delivery and to provide a state-of-the-art report on the existing 3D cell-based mucus models.
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García-Posadas L, Diebold Y. Three-Dimensional Human Cell Culture Models to Study the Pathophysiology of the Anterior Eye. Pharmaceutics 2020; 12:E1215. [PMID: 33333869 PMCID: PMC7765302 DOI: 10.3390/pharmaceutics12121215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 02/07/2023] Open
Abstract
In recent decades, the establishment of complex three-dimensional (3D) models of tissues has allowed researchers to perform high-quality studies and to not only advance knowledge of the physiology of these tissues but also mimic pathological conditions to test novel therapeutic strategies. The main advantage of 3D models is that they recapitulate the spatial architecture of tissues and thereby provide more physiologically relevant information. The eye is an extremely complex organ that comprises a large variety of highly heterogeneous tissues that are divided into two asymmetrical portions: the anterior and posterior segments. The anterior segment consists of the cornea, conjunctiva, iris, ciliary body, sclera, aqueous humor, and the lens. Different diseases in these tissues can have devastating effects. To study these pathologies and develop new treatments, the use of cell culture models is instrumental, and the better the model, the more relevant the results. Thus, the development of sophisticated 3D models of ocular tissues is a significant challenge with enormous potential. In this review, we present a comprehensive overview of the latest advances in the development of 3D in vitro models of the anterior segment of the eye, with a special focus on those that use human primary cells.
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Affiliation(s)
- Laura García-Posadas
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain;
| | - Yolanda Diebold
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain;
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Singh S, Ali MJ, Mittal V, Brabletz S, Paulsen F. Immunohistological Study of Palpebral Lobe of the Lacrimal Gland in Severe Dry Eyes Secondary to Stevens-Johnson Syndrome. Curr Eye Res 2020; 46:789-795. [PMID: 33045170 DOI: 10.1080/02713683.2020.1836227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To detect the immunohistochemical changes in the main lacrimal glands of patients suffering from chronic ocular sequelae of Stevens-Johnson syndrome (SJS). METHODS Histological sections of biopsies from the lacrimal gland of three chronic SJS patients (mean age, 33 years; 2 males) with severe dry eye disease (Schirmer = 0 mm) were assessed using double immunofluorescence techniques. Changes in the expression of secretory proteins lactoferrin (Lf), lysozyme (Ly), aquaporin 5 (AQP5), S-100, and early apoptosis marker (Annexin V) were studied. RESULTS Different morphological expressions of secretory proteins were present in the three samples. One sample had maintained the immunoreactivity for Lf, Ly, S-100, similar to healthy controls. Two samples had significantly reduced immunoreactivity for anti-Lf, anti-Ly, and S-100, the weakest being in the sample with distorted lobular architecture and mild interlobular fibrosis. AQP5 had a distinct vesicular intracytoplasmic immunoreactivity suggesting defective trafficking and integration of the protein to the apical membrane. There was no S-100 immunostaining in the acinar or ductal epithelium, whereas interstitial nerve fibers scattered in the periacinar region showed reduced immunoreactivity for S-100. There was strong Annexin V immunoreactivity in the nuclei of epithelial cells in the majority of acinar and ductal epithelia of all the samples, with distorted nuclear morphology in one sample. CONCLUSION Defective trafficking of AQP5 and variable expression of Ly, Lf, S-100 are the notable findings in the lacrimal glands of chronic SJS patients along with signs of early apoptosis. It suggests that the palpebral lobe of the lacrimal gland is involved in the pathological processes occurring in the conjunctiva of SJS patients.
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Affiliation(s)
- Swati Singh
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University of Erlangen-Nürnberg, Germany.,Cornea and Anterior segment services, Lala Jagannath Eye Institute, Ambala, India
| | - Mohammad Javed Ali
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University of Erlangen-Nürnberg, Germany.,Govindram Seksaria Institute of Dacryology, LV Prasad Eye Institute, Hyderabad, India
| | - Vikas Mittal
- Cornea and Anterior segment services, Lala Jagannath Eye Institute, Ambala, India
| | - Simone Brabletz
- Department of Experimental Medicine I, Friedrich Alexander University of Erlangen-Nürnberg, Germany
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University of Erlangen-Nürnberg, Germany
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Lacrimal Gland Involvement in Severe Dry Eyes after Stevens-Johnson Syndrome. Ophthalmology 2020; 128:621-624. [PMID: 32835747 DOI: 10.1016/j.ophtha.2020.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 12/26/2022] Open
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10
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Singh S, Basu S. The Human Lacrimal Gland: Historical Perspectives, Current Understanding, and Recent Advances. Curr Eye Res 2020; 45:1188-1198. [DOI: 10.1080/02713683.2020.1774065] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Swati Singh
- Centre for Ocular Regeneration (CORE), L V Prasad Eye Institute , Hyderabad, Telangana, India
| | - Sayan Basu
- Brien Holden Eye Research Centre (BHERC), L V Prasad Eye Institute , Hyderabad, Telangana, India
- The Cornea Institute, L V Prasad Eye Institute , Hyderabad, Telangana, India
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Optimization of a Rabbit Dry Eye Model Induced by Topical Instillation of Benzalkonium Chloride. J Ophthalmol 2020; 2020:7204951. [PMID: 32566267 PMCID: PMC7277021 DOI: 10.1155/2020/7204951] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To optimize a rabbit dry eye model induced by topical instillation of benzalkonium chloride (BAC), reduce the days of instillation of the original model by increasing the concentration of BAC from 0.1% to 0.2%. Materials and Methods An experimental, prospective, and randomized study was performed on 10 male New Zealand white rabbits, divided into two groups, considering both eyes: 5 rabbits as control (n = 10) and 5 rabbits with 0.2% BAC treatment (n = 10). Saline solution (control) and 0.2% BAC were instilled for 5 consecutive days, twice daily. Tear secretion with and without anesthesia, tear breakup time, tear osmolarity, corneal staining, conjunctival hyperemia, density of goblet cells, height of mucin cloud, and transcript levels of IL-6 were measured before and after the treatment. Results After the instillation of 0.2% BAC for 5 consecutive days, there was a significant increase in tear secretion without anesthesia (P < 0.001), corneal staining (P < 0.001), conjunctival hyperemia (P < 0.001), and levels of IL-6 mRNA (P=0.005) compared to the control group. Conversely, there was a decrease in tear secretion with anesthesia (P < 0.001), tear breakup time (P=0.007), tear osmolarity (P < 0.001), density of goblet cells (P < 0.001), and height of mucin cloud (P < 0.001). Conclusions The topical instillation of 0.2% BAC for 5 consecutive days, twice daily, was a proper procedure to induce a rabbit dry eye model, reducing the number of days of instillation compared to the original model (14 days).
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Dietrich J, Ott L, Roth M, Witt J, Geerling G, Mertsch S, Schrader S. MSC Transplantation Improves Lacrimal Gland Regeneration after Surgically Induced Dry Eye Disease in Mice. Sci Rep 2019; 9:18299. [PMID: 31797895 PMCID: PMC6892942 DOI: 10.1038/s41598-019-54840-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial disease characterized by a disrupted tear film homeostasis and inflammation leading to visual impairments and pain in patients. Aqueous-deficient dry eye (ADDE) causes the most severe progressions and depends mainly on the loss of functional lacrimal gland (LG) tissue. Despite a high prevalence, therapies remain palliative. Therefore, it is of great interest to develop new approaches to curatively treat ADDE. Mesenchymal stem/stromal cells (MSC) have been shown to induce tissue regeneration and cease inflammation. Moreover, an increasing amount of MSC was found in the regenerating LG of mice. Therefore, this study investigated the therapeutic effect of MSC transplantation on damaged LGs using duct ligation induced ADDE in mice. Due to the transplantation of sex-mismatched and eGFP-expressing MSC, MSC could be identified and detected until day 21. MSC transplantation significantly improved LG regeneration, as the amount of vital acinar structures was significantly increased above the intrinsic regeneration capacity of control. Additionally, MSC transplantation modulated the immune reaction as macrophage infiltration was delayed and TNFα expression decreased, accompanied by an increased IL-6 expression. Thus, the application of MSC appears to be a promising therapeutic approach to induce LG regeneration in patients suffering from severe DED/ADDE.
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Affiliation(s)
- Jana Dietrich
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl-von-Ossietzky University, 26121, Oldenburg, Germany.
| | - Lolita Ott
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, University Hospital Duesseldorf, 40225, Duesseldorf, Germany
| | - Mathias Roth
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, University Hospital Duesseldorf, 40225, Duesseldorf, Germany
| | - Joana Witt
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, University Hospital Duesseldorf, 40225, Duesseldorf, Germany
| | - Gerd Geerling
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, University Hospital Duesseldorf, 40225, Duesseldorf, Germany
| | - Sonja Mertsch
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl-von-Ossietzky University, 26121, Oldenburg, Germany
| | - Stefan Schrader
- Laboratory of Experimental Ophthalmology, Department of Ophthalmology, Pius-Hospital, Carl-von-Ossietzky University, 26121, Oldenburg, Germany
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Lin H, Liu Y, Yiu S. Three Dimensional Culture of Potential Epithelial Progenitor Cells in Human Lacrimal Gland. Transl Vis Sci Technol 2019; 8:32. [PMID: 31523489 PMCID: PMC6716802 DOI: 10.1167/tvst.8.4.32] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/27/2019] [Indexed: 01/02/2023] Open
Abstract
Purpose We investigate human lacrimal gland tissue to determine the presence of progenitor cells in this adult human tissue. Methods Six human lacrimal gland tissues from donors were collected and stored immediately in the culture medium at 4°C until the next procedure. One part of the lacrimal gland tissue was prepared for immunofluorescence staining and the other part was prepared for primary cell culture. Immunofluorescence analysis was conducted to evaluate cultured lacrimal epithelial phenotype and progenitor cell markers for five passages. Real-time polymerase chain reaction (PCR) was performed to assess proliferation markers in the different passages. Three-dimensional culture and PCR were conducted to determine the differentiation potential of cultured human lacrimal gland cells. Results Human lacrimal gland tissue expressed a number of epithelial progenitor cell markers. Precursor cell markers C-Kit, K15, Nestin, and P63 were observed in lacrimal gland tissues. Lacrimal gland epithelial cells were cultured successfully and passaged to P5. The cultured lacrimal gland epithelial cells were positive for pan-cytokeratin (PCK), AQP5, Rab3D, ABCB5, C-kit, K15, Ki67, and P63. Human lacrimal gland cells could form spheroids in vitro and then grow into mini-gland-like structures. PCR results showed proliferation and differentiation capability of those cultured cells. Conclusions Human lacrimal gland tissues contain precursor marker-positive cells and marker expression also was detected in ex vivo cultured cells, which showed differentiation capability. Translational Relevance Future studies of differentiation in human lacrimal gland tissue may aid in developing stem cell-based therapies for dry eye disease.
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Affiliation(s)
- Hui Lin
- Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ying Liu
- Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Samuel Yiu
- Wilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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14
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Dietrich J, Schrader S. Towards Lacrimal Gland Regeneration: Current Concepts and Experimental Approaches. Curr Eye Res 2019; 45:230-240. [PMID: 31246108 DOI: 10.1080/02713683.2019.1637438] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Dry eye disease (DED) is a complex and multifactorial disease resulting in a continual cycle of tear hyperosmolarity and inflammation. Patients suffering from DED experience severe pain and visual impairments leading to a reduced quality of life. Aqueous-deficient dry eye (ADDE), mainly caused through a loss of functional lacrimal gland tissue, results in the most severe forms of DED. Despite a high prevalence, the current treatments remain palliative and may be insufficient to alleviate the symptoms. Consequently, investigations on experimental approaches for in situ lacrimal gland regeneration are of great clinical interest. This article reviews the current knowledge about processes involved in lacrimal gland regeneration, about lacrimal gland resident stem cells, and offers deductions about possible concepts for in situ lacrimal gland regeneration. Promising starting points might be the utilization of therapeutic proteins, such as bone morphogenetic protein 7, mesenchymal stem cells (MSC) or MSC-based treatments such as conditioned medium, lyophilized cell extracts or adult acinar cells. This review further summarizes current experimental approaches for the treatment of ADDE in animal models and patients. Approaches investigating side population stem cells, epithelial progenitor cells and MSC showed that the transplantation of these cells had therapeutic effects on ADDE. However, the most promising and best-studied experimental approach is the use of MSC for induction/enhancement of in situ lacrimal gland regeneration. Their immunomodulatory effects, low immunogenicity, promotion of tissue regeneration and involvement during spontaneous lacrimal regeneration are favorable traits for clinical applications. In addition, the efficacy and safety of allogeneic MSC transplantation have already been demonstrated in a small patient cohort.
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Affiliation(s)
- Jana Dietrich
- Department of Ophthalmology, Laboratory of Experimental Ophthalmology, PIUS-HOSPITAL, Carl-von-Ossietzky University, Oldenburg, Germany
| | - Stefan Schrader
- Department of Ophthalmology, Laboratory of Experimental Ophthalmology, PIUS-HOSPITAL, Carl-von-Ossietzky University, Oldenburg, Germany
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Kawakita T. Regeneration of Lacrimal Gland Function to Maintain the Health of the Ocular Surface. Invest Ophthalmol Vis Sci 2019; 59:DES169-DES173. [PMID: 30481823 DOI: 10.1167/iovs.17-23576] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Dry eye is a multifactorial disease that is one of the most common diseases worldwide. A major cause of dry eye is the deficiency of aqueous tears, which are mainly secreted from the lacrimal gland. The lacrimal gland plays an important role in maintaining the health of the ocular surface and protecting it from environmental exposure. Dry eye can lead to ocular irritation and discomfort, as well as severe ocular surface diseases (e.g., ocular infections, corneal ulcerations, and ocular surface keratinization). These severe diseases can be induced by an atrophied or injured lacrimal gland; current therapies cannot completely restore the function of lacrimal gland. To develop more definitive therapies, it is important to understand lacrimal gland biology at the molecular level, as well as inflammatory processes affecting the function of the gland. During severe inflammation, the tissue structure of the lacrimal gland is destroyed; it is replaced by scar formation during wound healing, which leads to lacrimal gland dysfunction. Using an animal model of lacrimal gland dysfunction, many investigators have studied molecular mechanisms of inflammation in the lacrimal gland. To restore lacrimal gland function, the lacrimal acini must be restored in their niche. Notably, organ transplantation therapies have been reported to restore lacrimal gland function, directly or indirectly, in animal models. In this review, we describe the current understanding of the lacrimal gland as the therapeutic target for dry eye diseases, as well as recent advances in the field of lacrimal gland cell-based therapy to treat severe dry eye diseases.
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Affiliation(s)
- Tetsuya Kawakita
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
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