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Jiao X, Dong X, Shan H, Qin Z. Assessing the Efficacy of PLGA-Loaded Antimicrobial Peptide OH-CATH30 Microspheres for the Treatment of Bacterial Keratitis: A Promising Approach. Biomolecules 2023; 13:1244. [PMID: 37627308 PMCID: PMC10452858 DOI: 10.3390/biom13081244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Bacterial keratitis in animals presents challenges due to ocular structural barriers, hindering effective drug delivery. In this study, we used biocompatible and biodegradable poly(lactic-co-glycolic acid) (PLGA) to encapsulate the naturally occurring antimicrobial peptide OH-CATH30, an alternative to conventional antibiotics, for the treatment of bacterial keratitis in animals. Microspheres (MS) were prepared using a modified water-in-oil-in-water (W/O/W) double-emulsion method with optimized osmotic pressure. We conducted comprehensive evaluations, including in vitro characterization, encapsulation efficiency determination, in vitro release kinetics, and in vivo/vitro assessments of irritation and bacterial inhibition. The optimized method yielded microspheres with impressive encapsulation efficiency of 75.2 ± 3.62% and a loading capacity of 18.25 ± 5.73%, exhibiting a well-defined particle size distribution (200-1000 nm) and a ζ-potential of -17.3 ± 1.91 mV. The microspheres demonstrated initial burst release followed by sustained and controlled release in vitro. Both in vitro and in vivo tolerance tests confirmed the biocompatibility of the drug-loaded microspheres, as they did not elicit significant irritation in ocular tissues. Remarkable antibacterial effects were observed in both in vitro and in vivo experiments. Our developed PLGA microspheres show promise as an alternative therapeutic option for topical administration in managing keratitis, offering exceptional drug delivery capabilities, improved bioavailability, and potent antibacterial efficacy.
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Affiliation(s)
| | | | | | - Zhihua Qin
- College of Veterinary Medicine, Qingdao Agricultural University, Qingdao 266109, China; (X.J.); (X.D.); (H.S.)
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Yao G, Mo X, Liu S, Wang Q, Xie M, Lou W, Chen S, Pan T, Chen K, Yao D, Lin Y. Snowflake-inspired and blink-driven flexible piezoelectric contact lenses for effective corneal injury repair. Nat Commun 2023; 14:3604. [PMID: 37330515 PMCID: PMC10276863 DOI: 10.1038/s41467-023-39315-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 06/06/2023] [Indexed: 06/19/2023] Open
Abstract
The cornea is a tissue susceptible to various injuries and traumas with a complicated cascade repair process, in which conserving its integrity and clarity is critical to restoring visual function. Enhancing the endogenous electric field is recognized as an effective method of accelerating corneal injury repair. However, current equipment limitations and implementation complexities hinder its widespread adoption. Here, we propose a snowflake-inspired, blink-driven flexible piezoelectric contact lens that can convert mechanical blink motions into a unidirectional pulsed electric field for direct application to moderate corneal injury repair. The device is validated on mouse and rabbit models with different relative corneal alkali burn ratios to modulate the microenvironment, alleviate stromal fibrosis, promote orderly epithelial arrangement and differentiation, and restore corneal clarity. Within an 8-day intervention, the corneal clarity of mice and rabbits improves by more than 50%, and the repair rate of mouse and rabbit corneas increases by over 52%. Mechanistically, the device intervention is advantageous in blocking growth factors' signaling pathways specifically involved in stromal fibrosis whilst preserving and harnessing the signaling pathways required for indispensable epithelial metabolism. This work put forward an efficient and orderly corneal therapeutic technology utilizing artificial endogenous-strengthened signals generated by spontaneous body activities.
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Affiliation(s)
- Guang Yao
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
- State Key Laboratory of Electronic Thin films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
- Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China, Shenzhen, 518110, China.
| | - Xiaoyi Mo
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Shanshan Liu
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Sciences Institute, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Qian Wang
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Maowen Xie
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Wenhao Lou
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Shiyan Chen
- Department of Ophthalmology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Taisong Pan
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Ke Chen
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Sciences Institute, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
- Department of Ophthalmology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
| | - Dezhong Yao
- MOE Key Laboratory for Neuroinformation, The Clinical Hospital of Chengdu Brain Sciences Institute, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China
| | - Yuan Lin
- School of Materials and Energy, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
- State Key Laboratory of Electronic Thin films and Integrated Devices, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
- Medico-Engineering Cooperation on Applied Medicine Research Center, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan, China.
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3
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Eriksson E, Griffith GL, Nuutila K. Topical Drug Delivery in the Treatment of Skin Wounds and Ocular Trauma Using the Platform Wound Device. Pharmaceutics 2023; 15:pharmaceutics15041060. [PMID: 37111546 PMCID: PMC10145636 DOI: 10.3390/pharmaceutics15041060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/18/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023] Open
Abstract
Topical treatment of injuries such as skin wounds and ocular trauma is the favored route of administration. Local drug delivery systems can be applied directly to the injured area, and their properties for releasing therapeutics can be tailored. Topical treatment also reduces the risk of adverse systemic effects while providing very high therapeutic concentrations at the target site. This review article highlights the Platform Wound Device (PWD) (Applied Tissue Technologies LLC, Hingham, MA, USA) for topical drug delivery in the treatment of skin wounds and eye injuries. The PWD is a unique, single-component, impermeable, polyurethane dressing that can be applied immediately after injury to provide a protective dressing and a tool for precise topical delivery of drugs such as analgesics and antibiotics. The use of the PWD as a topical drug delivery platform has been extensively validated in the treatment of skin and eye injuries. The purpose of this article is to summarize the findings from these preclinical and clinical studies.
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Nutraceuticals: A Promising Therapeutic Approach in Ophthalmology. Nutrients 2022; 14:nu14235014. [PMID: 36501043 PMCID: PMC9740859 DOI: 10.3390/nu14235014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
Oxidative stress represents one of the main factors driving the pathophysiology of multiple ophthalmic conditions including presbyopia, cataracts, dry eye disease (DED), glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy (DR). Currently, different studies have demonstrated the role of orally administered nutraceuticals in these diseases. For instance, they have demonstrated to improve lens accommodation in presbyopia, reduce protein aggregation in cataracts, ameliorate tear film stability, break up time, and tear production in dry eye, and participate in the avoidance of retinal neuronal damage and a decrease in intraocular pressure in glaucoma, contribute to the delayed progression of AMD, or in the prevention or treatment of neuronal death in diabetic retinopathy. In this review, we summarized the nutraceuticals which have presented a positive impact in ocular disorders, emphasizing the clinical assays. The characteristics of the different types of nutraceuticals are specified along with the nutraceutical concentration used to achieve a therapeutic outcome in ocular diseases.
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Kasus-Jacobi A, Washburn JL, Land CA, Pereira HA. Neutrophil Granule Proteins Inhibit Amyloid Beta Aggregation and Neurotoxicity. Curr Alzheimer Res 2021; 18:414-427. [PMID: 34429047 DOI: 10.2174/1567205018666210823095044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/01/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND A role for neutrophils in the pathogenesis of Alzheimer's disease (AD) is emerging. We previously showed that the neutrophil granule proteins cationic antimicrobial protein of 37 kDa (CAP37), cathepsin G (CG), and neutrophil elastase (NE) directly bind the amyloid-beta peptide Aβ1-42, a central player in AD pathogenesis. CAP37, CG, and NE are serine proteases that can cleave Aβ1-42 at different sites and with different catalytic activities. OBJECTIVE In this study, we compared the effects of these three proteins on Aβ1-42 fibrillation and neurotoxicity. METHODS Using mass spectrometry and in vitro aggregation assay, we found that NE and CG efficiently cleave Aβ1-42. This cleavage correlates well with the inhibition of Aβ1-42 aggregation into fibrils. In contrast, CAP37 did not efficiently cleave Aβ1-42, but was still able to inhibit its fibrillation, most likely through a quenching effect. Inhibition of Aβ1-42 aggregation by NE and CG neutralized its toxicity measured in cultured neurons. In contrast, inhibition of Aβ1-42 aggregation by CAP37 did not inhibit its neurotoxicity. RESULTS We found that a peptide derived from CAP37 could mimic the quenching and inhibition of Aβ1-42 aggregation effects of the full-length protein. Additionally, this peptide was able to inhibit the neurotoxicity of the most toxic Aβ1-42 aggregate, an effect that was not found with the full-length CAP37. CONCLUSION These results shed light on the mechanisms of action of neutrophil granule proteins with regard to inhibition of Aβ1-42 aggregation and neurotoxicity and open up a possible strategy for the discovery of new disease-modifying drugs for AD.
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Affiliation(s)
- Anne Kasus-Jacobi
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jennifer L Washburn
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Craig A Land
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Heloise Anne Pereira
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Menon SN, Flegg JA. Mathematical Modeling Can Advance Wound Healing Research. Adv Wound Care (New Rochelle) 2021; 10:328-344. [PMID: 32634070 PMCID: PMC8082733 DOI: 10.1089/wound.2019.1132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 06/26/2020] [Indexed: 12/27/2022] Open
Abstract
Significance: For over 30 years, there has been sustained interest in the development of mathematical models for investigating the complex mechanisms underlying each stage of the wound healing process. Despite the immense associated challenges, such models have helped usher in a paradigm shift in wound healing research. Recent Advances: In this article, we review contributions in the field that span epidermal, dermal, and corneal wound healing, and treatments of nonhealing wounds. The recent influence of mathematical models on biological experiments is detailed, with a focus on wound healing assays and fibroblast-populated collagen lattices. Critical Issues: We provide an overview of the field of mathematical modeling of wound healing, highlighting key advances made in recent decades, and discuss how such models have contributed to the development of improved treatment strategies and/or an enhanced understanding of the tightly regulated steps that comprise the healing process. Future Directions: We detail some of the open problems in the field that could be addressed through a combination of theoretical and/or experimental approaches. To move the field forward, we need to have a common language between scientists to facilitate cross-collaboration, which we hope this review can support by highlighting progress to date.
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Affiliation(s)
| | - Jennifer A. Flegg
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Australia
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Griffith GL, Holt AW, Eriksson E, Johnson AJ, McDaniel JS. Human platelet lysate delivered via an ocular wound chamber for the treatment of corneal epithelial injuries. Exp Eye Res 2021; 206:108493. [PMID: 33596441 DOI: 10.1016/j.exer.2021.108493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/13/2021] [Accepted: 02/07/2021] [Indexed: 12/16/2022]
Abstract
Current strategies to address corneal surface defects are insufficient to successfully resolve damage caused by injury and/or disease. To address this issue, we have developed an ocular wound chamber (OWC) that creates a fluid-filled environment by encompassing damaged ocular and periocular tissues allowing for the continuous delivery of therapeutics. This study tested human platelet lysate (hPL) as a treatment for corneal epithelial defects when used with the OWC. Corneal epithelial injuries were created in anesthetized guinea pigs by debridement of the central cornea. An OWC was placed over the injured eye and animals randomly grouped followed by injection of either 20% hPL, 100% hPL, or vehicle (balanced salt solution, BSS) into the chamber. Eyes were assessed at 0, 24, 48, and 72 h using intraocular pressure (IOP), optical coherence tomography (OCT), and fluorescein imaging. Whole globes were histologically processed, and hematoxylin and eosin (H&E) stained. No differences in IOP were recorded as a result of corneal wounding, chamber placement, and/or therapeutic application. OCT images demonstrated increased corneal swelling at 48 h and 72 h in the vehicle group compared to 20% hPL. Fluorescein staining showed increased corneal re-epithelialization in the 20% and 100% hPL groups at 48 h compared to vehicle only. H&E staining revealed increased stromal cellular infiltrate in the BSS group. This study demonstrates the delivery of hPL via the OWC improves corneal re-epithelialization and supports the expanded usage of the chamber in combination with hPL to manage a variety of corneal surface injuries, diseases and/or periocular conditions.
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Affiliation(s)
- Gina L Griffith
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | - Andrew W Holt
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | | | - Anthony J Johnson
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | - Jennifer S McDaniel
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA.
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Antimicrobial peptides - Advances in development of therapeutic applications. Life Sci 2020; 260:118407. [PMID: 32931796 PMCID: PMC7486823 DOI: 10.1016/j.lfs.2020.118407] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023]
Abstract
The severe infection is becoming a significant health problem which threaten the lives of patients and the safety and economy of society. In the way of finding new strategy, antimicrobial peptides (AMPs) - an important part of host defense family, emerged with tremendous potential. Up to date, huge numbers of AMPs has been investigated from both natural and synthetic sources showing not only the ability to kill microbial pathogens but also propose other benefits such as wound healing, anti-tumor, immune modulation. In this review, we describe the involvements of AMPs in biological systems and discuss the opportunity in developing AMPs for clinical applications. In the detail, their properties in antibacterial activity is followed by their application in some infection diseases and cancer. The key discussions are the approaches to improve biological activities of AMPs either by modifying chemical structure or incorporating into delivery systems. The new applications and perspectives for the future of AMPs would open the new era of their development.
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Evaluation of a Cationic Antimicrobial Peptide as the New Antibiotic Candidate to Treat Staphylococcus aureus Keratitis. Int J Pept Res Ther 2020. [DOI: 10.1007/s10989-020-10126-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Kasus-Jacobi A, Land CA, Stock AJ, Washburn JL, Pereira HA. Antimicrobial Peptides Derived from the Immune Defense Protein CAP37 Inhibit TLR4 Activation by S100A9. Invest Ophthalmol Vis Sci 2020; 61:16. [PMID: 32298435 PMCID: PMC7401491 DOI: 10.1167/iovs.61.4.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Corneal abrasion is a common eye injury, and its resolution can be seriously complicated by bacterial infection. We showed that topical application of the cationic antimicrobial protein of 37 kDa (CAP37) promotes corneal re-epithelialization in mice, and peptides derived from CAP37 can recapitulate the antibacterial and wound-healing effects of the full-length protein. The current study was designed to identify the molecular mechanisms mediating the wound-healing effect of CAP37 and derived bioactive peptides. Methods We used a TriCEPS-based, ligand-receptor glycocapture method to identify the binding partners of CAP37 on live human corneal epithelial cells using the hTCEpi cell line. We used an ELISA method to confirm binding with identified partners and test the binding with CAP37-derived peptides. We used a reporter cell line to measure activation of the identified membrane receptor by CAP37 and derived peptides. Results We pulled down S100 calcium-binding protein A9 (S100A9) as a binding partner of CAP37 and found that CAP37 and four derived peptides encompassing two regions of CAP37 bind S100A9 with high affinities. We found that CAP37 and the S100A9-binding peptides could also directly interact with the Toll-like receptor 4 (TLR4), a known receptor for S100A9. CAP37 and one peptide partially activated TLR4. The other three peptides did not activate TLR4. Finally, we found that CAP37 and all four peptides could inhibit the activation of TLR4 by S100A9. Conclusions This study identifies a mechanism of action for CAP37 and derived antimicrobial peptides that may restrain inflammatory responses to corneal injury and favor corneal re-epithelialization.
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Mayandi V, Sridhar S, Fazil MHUT, Goh ETL, Htoon HM, Orive G, Choong YK, Saravanan R, Beuerman RW, Barkham TMS, Yang L, Baskaran M, Jhanji V, Loh XJ, Verma NK, Lakshminarayanan R. Protective Action of Linear Polyethylenimine against Staphylococcus aureus Colonization and Exaggerated Inflammation in Vitro and in Vivo. ACS Infect Dis 2019; 5:1411-1422. [PMID: 31099239 DOI: 10.1021/acsinfecdis.9b00102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Increased evolution of multidrug resistant pathogens necessitates the development of multifunctional antimicrobials. There is a perceived need for developing new antimicrobials that can interfere with acute inflammation after bacterial infections. Here, we investigated the therapeutic potential of linear polyethylenimine (LPEI) in vitro and in vivo. The minimum inhibitory concentration of LPEI ranged from 8 to 32 μg/mL and elicited rapid bactericidal activity against clinical isolates of meticillin-resistant Staphylococcus aureus (MRSA). The polymer was biocompatible for human cultured ocular and dermal cells. Prophylactic addition of LPEI inhibited the bacterial colonization of human primary dermal fibroblasts (hDFs). In a scratch wound cell migration assay, LPEI attenuated the migration inhibitory effects of bacterial secretions. The polymer neutralized the cytokine release by hDFs exposed to bacterial secretions, possibly by blocking their accessibility to host cell receptors. Topical instillation of LPEI (1 mg/mL) was noncytotoxic and did not affect the re-epithelialization of injured porcine cornea. In a prophylactic in vivo model of S. aureus keratitis, LPEI was superior to gatifloxacin in terms of reducing stimulation of cytokines, corneal edema, and overall severity of the infection. These observations demonstrate therapeutic potential of LPEI for antimicrobial prophylaxis.
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Affiliation(s)
- Venkatesh Mayandi
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Sreepathy Sridhar
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
| | - Mobashar Hussain Urf Turabe Fazil
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 59 Nanyang Drive, Experimental Medicine Building, Singapore 636921, Singapore
| | - Eunice Tze Leng Goh
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
| | - Hla Myint Htoon
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
| | - Gorka Orive
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006 Vitoria-Gasteiz, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine, CIBER-BBN, Vitoria-Gasteiz, Spain
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Yeu Khai Choong
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 59 Nanyang Drive, Experimental Medicine Building, Singapore 636921, Singapore
| | - Rathi Saravanan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 59 Nanyang Drive, Experimental Medicine Building, Singapore 636921, Singapore
| | - Roger W. Beuerman
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
| | | | - Liang Yang
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, Singapore 637551, Singapore
- Singapore Centre for Environmental Life Sciences, Nanyang Technological University Singapore, Singapore 637551, Singapore
| | - Mani Baskaran
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- Singapore National Eye Centre, Singapore 168751, Singapore
| | - Vishal Jhanji
- UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, United States
| | - Xian Jun Loh
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, 138634, Singapore
| | - Navin Kumar Verma
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 59 Nanyang Drive, Experimental Medicine Building, Singapore 636921, Singapore
- Skin Research Institute of Singapore, 8A Biomedical Grove, Immunos, Singapore 138648, Singapore
| | - Rajamani Lakshminarayanan
- Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, Singapore 169856, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
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Vaidyanathan U, Hopping GC, Liu HY, Somani AN, Ronquillo YC, Hoopes PC, Moshirfar M. Persistent Corneal Epithelial Defects: A Review Article. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:163-176. [PMID: 31598519 PMCID: PMC6778469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Persistent corneal epithelial defects (PEDs or PCEDs) result from the failure of rapid re-epithelialization and closure within 10-14 days after a corneal injury, even with standard supportive treatment. Disruptions in the protective epithelial and stromal layers of the cornea can render the eye susceptible to infection, stromal ulceration, perforation, scarring, and significant vision loss. Although several therapies exist and an increasing number of novel approaches are emerging, treatment of PEDs can still be quite challenging. It is important to treat the underlying causative condition, which may include an infection, limbal stem cell deficiency, or diabetes, in order to facilitate wound healing. Standard treatments, such as bandage contact lenses (BCLs) and artificial tears (ATs), aim to provide barrier protection to the epithelial layer. Recently-developed medical treatments can target the re-epithelialization process by facilitating access to growth factors and anti-inflammatory agents, and novel surgical techniques can provide re-innervation to the cornea. PEDs should be treated within 7-10 days to avoid secondary complications. These interventions, along with a step-wise approach to management, can be useful in patients with PEDs that are refractory to standard medical treatment. In this review, we discuss the epidemiology, etiology, diagnosis, current and novel management, and prognosis of persistent epithelial defects.
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Affiliation(s)
- Uma Vaidyanathan
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Grant C. Hopping
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Harry Y. Liu
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Anisha N. Somani
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | | | - Phillip C. Hoopes
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
| | - Majid Moshirfar
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA, John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah Salt Lake City, UT, USA, Utah Lions Eye Bank, Murray, UT, USA
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13
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McDaniel JS, Holt AW, Por ED, Eriksson E, Johnson AJ, Griffith GL. The utilization of an ocular wound chamber on corneal epithelial wounds. Clin Ophthalmol 2018; 12:903-911. [PMID: 29785086 PMCID: PMC5957065 DOI: 10.2147/opth.s156184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Currently available ocular moisture chambers are not adequate to manage the treatment of periocular burns, corneal injuries, and infection. The purpose of these studies was to demonstrate that a flexible, semi-transparent ocular wound chamber device adapted from technology currently used on dermal wounds is safe for use on corneal epithelial injuries. Materials and methods A depilatory cream (Nair™, 30 seconds) was utilized to remove the excess hair surrounding the left eyes of anesthetized Institute Armand Frappier (IAF) hairless, female guinea pigs (Crl:HA-Hrhr). A 4 mm corneal epithelium defect was created using a corneal rust ring remover (Algerbrush®II). Epithelial defects were either left untreated or the eyes were fitted with an ocular wound chamber and 0.5 mL of hydroxypropyl methylcellulose (HPMC) gel (GenTeal®) or HPMC liquid (GenTeal®) was injected into each chamber (N=5 per group). At 0, 24, 48, and 72 hours fluorescein and optical coherence tomography imaging was collected and the intraocular pressure (IOP) was measured. H&E staining was performed on corneal and eyelid skin samples and evaluated by a veterinary pathologist. Results Corneal epithelial wounds demonstrated 100% closure rates when left untreated or treated with an ocular wound chamber containing HPMC gel at 72 hours while wounds treated with an ocular wound chamber containing HPMC liquid were 98% healed. No significant differences were found in corneal thickness and wound healing, IOP, or eyelid skin pathology in any treatment group when compared to controls. Conclusions This study indicates that adapted wound chamber technology can be safely used on sterile, corneal epithelial wounds without adverse effects on periocular or ocular tissue when filled with a liquid or gel.
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Affiliation(s)
- Jennifer S McDaniel
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | - Andrew W Holt
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | - Elaine D Por
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | | | - Anthony J Johnson
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
| | - Gina L Griffith
- Department of Sensory Trauma, United States Army Institute of Surgical Research, San Antonio, TX, USA
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Kasus-Jacobi A, Griffith GL, Lerner M, Pereira HA. Effect of Cationic Antimicrobial Protein CAP37 on Cytokine Profile during Corneal Wound Healing. JOURNAL OF OCULAR DISEASES AND THERAPEUTICS 2017; 5:19-27. [PMID: 30542656 PMCID: PMC6287921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The cationic antimicrobial protein of 37 kDa (CAP37) mediates proliferation, migration, and adhesion of human corneal epithelial cells and promotes corneal re-epithelialization in mouse. The purpose of this study was to investigate the cytokine profile following abrasion of the corneal epithelium, and to identify the cytokines modulated by topical treatment with CAP37 to determine the mechanism by which CAP37 contributes to the recruitment of inflammatory cells and healing of the cornea. The corneal epithelium in mouse eyes was removed and wounds were treated with a saline vehicle or human recombinant CAP37. Wounds were visualized with fluoresce in staining at 0, 16, 24 and 48 h. Mouse corneas were excised at 0, 6, 16, 24 and 48 h post corneal abrasion. The excised corneas were analyzed by immunohistochemistry for re-epithelialization and infiltration of inflammatory cells while the expression profiles of thirty-two cytokines were investigated by multiplex analysis. Results corroborating previous studies showed accelerated wound closure in corneas treated with CAP37 compared to those treated with the saline vehicle. Immunohistochemistry revealed less neutrophil infiltration in CAP37-treated corneas when compared to controls at 24 h. By 48 h post-wounding, histological analysis revealed more staining for neutrophils than the staining observed in the controls. Modulation of cytokine expression occurred for the majority of the cytokines tested at the time of corneal abrasion, during re-epithelialization, and/or by CAP37 treatment. Cytokines monocyte chemoattractant protein-1 (MCP-1) and regulated on activation, normal T cell expressed and secreted (RANTES) were induced during re-epithelialization, at the early 16 h time point. Interleukin 6 (IL-6), leukemia inhibitory factor (LIF), granulocyte colony-stimulating factor (G-CSF), IL-12p70, macrophage inflammatory protein 1 beta (MIP-1β), and interferon gamma-induced protein 10 (IP-10) were induced at 24 h and unchanged during CAP37 treatment. By contrast, IL-15, monokine induced by gamma interferon (MIG), keratinocyte-derived cytokine (KC), tumor necrosis factor alpha (TNF-α), MIP-1α, IL-1β, and macrophage colony-stimulating factor (M-CSF) were modulated by CAP37 treatment. In general, CAP37 appeared to decrease pro-inflammatory cytokines at 24 h and increase them at 48 h when compared to the control group. These data demonstrate that CAP37 modulates the production of cytokines in the cornea and suggest that limiting the number of neutrophils recruited during the early inflammatory phase may support corneal re-epithelialization.
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Affiliation(s)
- Anne Kasus-Jacobi
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Address correspondence to this author at the University of Oklahoma Health Sciences Center 1110 N. Stonewall Ave., Oklahoma City, OK 73117; Tel: 405-271-1484; Fax: 405-271-7505;
| | - Gina L. Griffith
- U.S. Army Institute of Surgical Research, Sensory Trauma, Fort Sam Houston, Texas 78234-7767, USA
| | - Megan Lerner
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104
| | - H. Anne Pereira
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104,Department of Cell Biology University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104
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