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Gonzalez-Molina J, Moyano-Galceran L, Single A, Gultekin O, Alsalhi S, Lehti K. Chemotherapy as a regulator of extracellular matrix-cell communication: Implications in therapy resistance. Semin Cancer Biol 2022; 86:224-236. [PMID: 35331851 DOI: 10.1016/j.semcancer.2022.03.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/08/2023]
Abstract
The development of most solid cancers, including pancreatic, breast, lung, liver, and ovarian cancer, involves a desmoplastic reaction: a process of major remodeling of the extracellular matrix (ECM) affecting the ECM composition, mechanics, and microarchitecture. These properties of the ECM influence key cancer cell functions, including treatment resistance. Furthermore, emerging data show that various chemotherapeutic treatments lead to alterations in ECM features and ECM-cell communication. Here, we summarize the current knowledge around the effects of chemotherapy on both the ECM remodeling and ECM-cell signaling and discuss the implications of these alterations on distinct mechanisms of chemoresistance. Additionally, we provide an overview of current therapeutic strategies and ongoing clinical trials utilizing anti-cancer drugs to target the ECM-cell communication and explore the future challenges of these strategies.
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Affiliation(s)
- Jordi Gonzalez-Molina
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
| | - Lidia Moyano-Galceran
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Andrew Single
- Department of Biomedical Laboratory Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Okan Gultekin
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Shno Alsalhi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Kaisa Lehti
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Department of Biomedical Laboratory Science, Norwegian University of Science and Technology, Trondheim, Norway.
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Aribas YK, Tefon Aribas AB, Ercin U, Sarıkaya B, Bilgihan A, Bilgihan K. Iontophoresis Corneal Cross-linking With Oxygen Supplementation in Ovine Eyes. J Refract Surg 2022; 38:674-681. [DOI: 10.3928/1081597x-20220906-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Belviranli S, Oltulu R. Efficacy of pulsed-light accelerated crosslinking in the treatment of progressive keratoconus: Two-year results. Eur J Ophthalmol 2019; 30:1256-1260. [PMID: 31505958 DOI: 10.1177/1120672119872375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study was to evaluate the 2-year results of epithelium-off pulsed-light accelerated corneal collagen crosslinking treatment in progressive keratoconus using 30 mW/cm2 ultraviolet A light for 6 min with a total dose of 5.4 J/cm2. METHODS A total of 30 eyes of 22 patients with documented progressive keratoconus and treated with epithelium-off pulsed-light accelerated corneal collagen crosslinking using the KXL® crosslinking device (Avedro Inc, Waltham, MA, USA) were included in this retrospective study. Corneal tomographic measurements and best spectacle-corrected visual acuity were compared using analysis of variance with repeated measurements between the baseline visit (before the corneal collagen crosslinking treatment), and the sixth month, first, and second year visits. RESULTS Flat keratometry (K1), steep keratometry (K2), and mean keratometry (Km) decreased significantly at sixth month, first, and second years (p < 0.001, p = 0.001, and p < 0.001, respectively). Maximum keratometry (Kmax) decreased from 55.40 ± 4.90 D at baseline to 54.82 ± 4.68 D, 54.80 ± 5.12 D, and 54.65 ± 5.36 D at sixth month, first year, and second year, respectively (p = 0.007). The best spectacle-corrected visual acuity improved from 0.34 ± 0.24 logMAR at baseline to 0.25 ± 0.16 logMAR, 0.22 ± 0.15 logMAR, and 0.17 ± 0.13 logMAR at sixth month, first year, and second year, respectively (p < 0.001). At the second year visit, best spectacle-corrected visual acuity remained stable (no lines lost) with respect to the baseline in 8 eyes and increased 1 or more lines in 22 eyes. CONCLUSION Pulsed-light accelerated corneal collagen crosslinking using 30 mW/cm2 ultraviolet A light for 6 min with a total dose of 5.4 J/cm2 is an effective treatment modality in cases with progressive keratoconus-it stops progression at 2 years also regresses some of the cases.
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Affiliation(s)
- Selman Belviranli
- Department of Ophthalmology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Refik Oltulu
- Department of Ophthalmology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Ziaei M, Vellara H, Gokul A, Patel D, McGhee CNJ. Prospective 2-year study of accelerated pulsed transepithelial corneal crosslinking outcomes for Keratoconus. Eye (Lond) 2019; 33:1897-1903. [PMID: 31273313 DOI: 10.1038/s41433-019-0502-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/27/2019] [Accepted: 04/24/2019] [Indexed: 01/17/2023] Open
Abstract
AIMS To report 2-year outcomes of transepithelial, accelerated, pulsed, corneal crosslinking (t-ACXL) for patients with progressive keratoconus. METHODS Prospective, interventional case series at a university hospital tertiary referral centre. Forty eyes with progressive keratoconus undergoing t-ACXL were included. Treatment was performed with pulsed illumination (1 s on/1 s off) using 45 mW/cm2 for 5 min and 20 s, for a surface dose of 7.2 J cm2. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal tomography, anterior segment optical coherence tomography (OCT) and confocal microscopy were evaluated preoperatively and at 12 and 24 months postoperatively. RESULTS The mean patient age was 23.32 ± 5.18 years (SD) (range 14-42 years). The mean CDVA significantly improved from 0.38 ± 0.32 logMAR at baseline to 0.30 ± 0.21 logMAR at 24 months (P < 0.01). There was no significant difference in UDVA, MRSE, asymmetry indices, tomographic parameters and endothelial density. The improvement in visual acuity was inversely correlated with preoperative CDVA and preoperative KMax. No complications were encountered. CONCLUSIONS In this prospective study, t-ACXL appeared safe and effective in halting progression of keratoconus within a follow-up period of 24 months.
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Affiliation(s)
- Mohammed Ziaei
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Hans Vellara
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Dipika Patel
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Charles N J McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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Abstract
PURPOSE There has been a recent explosion in the variety of techniques used to accomplish corneal cross-linking (CXL) for the treatment of ectatic corneal diseases. To understand the success or failure of various techniques, we review the physicochemical basis of corneal CXL and re-evaluate the current principles and long-standing conventional wisdom in the light of recent, compelling, and sometimes contradictory research. METHODS Two clinicians and a medicinal chemist developed a list of current key topics, controversies, and questions in the field of corneal CXL based on information from current literature, medical conferences, and discussions with international practitioners of CXL. RESULTS Standard corneal CXL with removal of the corneal epithelium is a safe and efficacious procedure for the treatment of corneal ectasias. However, the necessity of epithelium removal is painful for patients, involves risk and requires significant recovery time. Attempts to move to transepithelial corneal CXL have been hindered by the lack of a coherent understanding of the physicochemistry of corneal CXL. Misconceptions about the applicability of the Bunsen-Roscoe law of reciprocity and the Lambert-Beer law in CXL hamper the ability to predict the effect of ultraviolet A energy during CXL. Improved understanding of CXL may also expand the treatment group for corneal ectasia to those with thinner corneas. Finally, it is essential to understand the role of oxygen in successful CXL. CONCLUSIONS Improved understanding of the complex interactions of riboflavin, ultraviolet A energy and oxygen in corneal CXL may provide a successful route to transepithelial corneal CXL.
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Bao F, Zheng Y, Liu C, Zheng X, Zhao Y, Wang Y, Li L, Wang Q, Chen S, Elsheikh A. Changes in Corneal Biomechanical Properties With Different Corneal Cross-linking Irradiances. J Refract Surg 2018; 34:51-58. [PMID: 29315442 DOI: 10.3928/1081597x-20171025-01] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 10/19/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether different corneal cross-linking (CXL) irradiances, all with the same delivered total energy, achieve similar increases in corneal material stiffness. METHODS One hundred twenty-six healthy white Japanese rabbits were randomly divided into seven groups (n = 18 each). After removing the epithelium of the left corneas, six groups were exposed to riboflavin (0.22% concentration by volume) and ultraviolet-A (370 nm) at different CXL irradiations, all with the same total dose (5.4 J/cm2), ranging from 3 mW/cm2 for 30 minutes to 90 mW/cm2 for 1 minute. The left corneas of the seventh group were exposed to riboflavin without irradiation. Twelve corneas of each group were prepared for inflation testing, where they were subjected to internal hydrostatic pressure simulating intraocular pressure, whereas the other six specimens were processed for electron microscopy measurements of fibril diameter and interfibrillar spacing. The inverse modeling process was used to estimate the tangent modulus of the tissue, which is considered an accurate measure of the material stiffness. RESULTS The stiffening effect of CXL decreased when using high irradiation/short duration settings. Compared with the group with no irradiation (NUVA group), the tangent modulus increases reduced from 212.5% in the 3mW/30min group to 196.8% in the 90mW/1min group. These increases were significant (P < .05) in the 3mW/30min and 9mW/10min groups, but became insignificant in other CXL groups. The interfibrillar spacing in the anterior 50 μm of the corneal stroma also reduced with high irradiation/short duration settings, changing from 20.05 ± 1.89 nm in the NUVA group down to 13.06 ± 2.07 and 14.37 ± 1.90 nm in the 3mW/30min and 9mW/10min groups, respectively. These changes were significant (P < .05) between non-adjacent groups, but became non-significant otherwise. The corresponding changes in fibril diameter were small and nonsignificant in all cases (P > .05). CONCLUSIONS Because the effect of CXL in stiffening the tissue and reducing the interfibrillar spacing consistently decreased with reducing the irradiance duration, the Bunsen-Roscoe law may not be readily applicable in the CXL of corneal tissue. [J Refract Surg. 2018;34(1):51-58.].
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Accelerated versus conventional corneal crosslinking for refractive instability: an update. Curr Opin Ophthalmol 2017; 28:343-347. [PMID: 28594649 DOI: 10.1097/icu.0000000000000375] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Corneal crosslinking (CXL) is a relatively new treatment modality offering refractive stability in patients with ectatic disorders. The procedure as initially described (Dresden protocol) is time consuming; accelerated protocols have been lately developed. The purpose of this review is to present the recent findings regarding the comparison of accelerated CXL with the conventional Dresden protocol. RECENT FINDINGS A variety of accelerated protocols are described in the literature. Safety and efficacy of the procedures with regard to stability seem to be equivalent in initial studies but indirect measures of efficacy, such as demarcation line depth and laboratory measurements, do not always confirm equivalence of accelerated protocols in comparison to conventional one. Modified accelerated protocols must be developed in order to overcome this. SUMMARY Accelerated CXL protocols seem to be a valid alternative to the conventional protocol; however, more comparative long term studies are needed to confirm the validity and to elucidate which accelerated protocol is ideal in each case.
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Zhou HY, Cao Y, Wu J, Zhang WS. Role of corneal collagen fibrils in corneal disorders and related pathological conditions. Int J Ophthalmol 2017; 10:803-811. [PMID: 28546941 DOI: 10.18240/ijo.2017.05.24] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/23/2017] [Indexed: 01/24/2023] Open
Abstract
The cornea is a soft tissue located at the front of the eye with the principal function of transmitting and refracting light rays to precisely sense visual information. Corneal shape, refraction, and stromal stiffness are to a large part determined by corneal fibrils, the arrangements of which define the corneal cells and their functional behaviour. However, the modality and alignment of native corneal collagen lamellae are altered in various corneal pathological states such as infection, injury, keratoconus, corneal scar formation, and keratoprosthesis. Furthermore, corneal recuperation after corneal pathological change is dependent on the balance of corneal collagen degradation and contraction. A thorough understanding of the characteristics of corneal collagen is thus necessary to develop viable therapies using the outcome of strategies using engineered corneas. In this review, we discuss the composition and distribution of corneal collagens as well as their degradation and contraction, and address the current status of corneal tissue engineering and the progress of corneal cross-linking.
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Affiliation(s)
- Hong-Yan Zhou
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Yan Cao
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Jie Wu
- Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Wen-Song Zhang
- Department of Ophthalmology, the Second Hospital of Jilin University, Changchun 130000, Jilin Province, China
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Géhl Z, Bakondi E, Resch MD, Hegedűs C, Kovács K, Lakatos P, Szabó A, Nagy Z, Virág L. Diabetes-induced oxidative stress in the vitreous humor. Redox Biol 2016; 9:100-103. [PMID: 27454767 PMCID: PMC4961280 DOI: 10.1016/j.redox.2016.07.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 07/05/2016] [Accepted: 07/06/2016] [Indexed: 11/16/2022] Open
Abstract
Purpose Diabetes is accompanied by fundamental rearrangements in redox homeostasis. Hyperglycemia triggers the production of reactive oxygen and nitrogen species which contributes to tissue damage in various target organs. Proliferative diabetic retinopathy (PDR) is a common manifestation of diabetic complications but information on the possible role of reactive intermediates in this condition with special regard to the involvement of the vitreous in PDR-associated redox alterations is scarce. The aim of the study was to determine key parameters of redox homeostasis [advanced glycation endproducts (AGE); protein carbonyl and glutathione (GSH)] content in the vitreous in PDR patients. Methods The study population involved 10 diabetic patients undergoing surgery for complications of proliferative diabetic retinopathy and 8 control (non-diabetic) patients who were undergoing surgery for epiretinal membranes. Vitreal fluids were assayed for the above biochemical parameters. Results We found elevated levels of AGE in the vitreous of PDR patients (812.10 vs 491.69 ng AGE/mg protein). Extent of protein carbonylation was also higher in the samples of diabetic patients (2.08 vs 0.67 A/100 μg protein). The GSH content also increased in the vitreous of PDR patients as compared to the control group (4.54 vs 2.35 μmol/μg protein), respectively. Conclusion The study demonstrates that diabetes-associated redox alterations also reach the vitreous with the most prominent changes being increased protein carbonylation and increased antioxidant levels. Vitreal AGE levels are elevated in PDR patients. Extent of protein carbonylation is higher in the vitreal samples of PDR patients. The glutathione content is increased in the vitreous of PDR patients.
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Affiliation(s)
- Zsuzsanna Géhl
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Edina Bakondi
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklós D Resch
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Csaba Hegedűs
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Katalin Kovács
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; MTA-DE Cell Biology and Signaling Research Group of the Hungarian Academy of Sciences, Debrecen, Hungary
| | - Petra Lakatos
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Antal Szabó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltán Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - László Virág
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; MTA-DE Cell Biology and Signaling Research Group of the Hungarian Academy of Sciences, Debrecen, Hungary.
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Yuksel N, Ozel-Turkcu U, Yalinbas D, Novruzlu S, Bilgihan A, Bilgihan K. Comparison of Aqueous Humor Nitric Oxide Levels After Different Corneal Collagen Cross-Linking Methods. Curr Eye Res 2016; 41:1539-1542. [PMID: 27216990 DOI: 10.3109/02713683.2016.1139726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Nitric oxide production can cause either apoptotic or necrotic cell death through oxidative stress. We aimed to investigate the nitrite oxide metabolites (NOx) and nitrite levels in the aqueous humor of rabbit eyes after different methods of corneal collagen cross-linking (CXL). MATERIALS AND METHODS Twenty-four eyes of 12 adult New Zealand rabbits were used. They were assigned into four groups, each including six eyes. Group 1 (control) consisted of eyes with no treatment. Group 2 received UV-A power setting at 3 mW/cm2 for 30 minutes of continuous exposure and named as standard CXL group. Group 3 received UV-A power setting at 30 mW/cm2 for 3 minutes of continuous exposure and named as accelerated CXL (A-CXL) group. Group 4 received UV-A power setting at 30 mW/cm2 for 6 minutes of pulsed exposure (1 sec on, 1 sec off) and named as pulse-light accelerated CXL (PLA-CXL). Aqueous humors were aspirated from anterior chamber with a 27G needle after 1 hour UV-A exposure. NOx and nitrite levels were measured Results: The nitrite levels in aqueous humor were significantly increased in Group 2 and Group 3 when compared with Group 1 (p = 0.000, p = 0.036, respectively). When treatment modalities were compared with each other, high nitrite level in Group 2 was statistically significant when compared with Group 4 (p = 0.019). NOx levels were higher in Group 2 when compared with Group 1 (p = 0.006). CONCLUSIONS Numerous studies investigated the physiological and pathophysiological roles of NO. NO is considered one of the most important molecule for ocular health. According to NOx level in aqueous humor, it seems that PLA-CXL is the safest method due to the similar results with control group.
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Affiliation(s)
- Nilay Yuksel
- a Department of Ophthalmology , Ataturk Training and Research Hospital , Ankara , Turkey
| | - Ummuhani Ozel-Turkcu
- b Department of Medical Biochemistry, Faculty of Medicine , Mugla Sitki Kocman University , Mugla , Turkey
| | - Duygu Yalinbas
- c Department of Ophthalmology, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - Sahin Novruzlu
- d Department of Ophthalmology , National Centre of Ophthalmology named after academician Zarifa Aliyeva , Baku , Azerbaijan
| | - Ayse Bilgihan
- e Department of Medical Biochemistry, Faculty of Medicine , Gazi University , Ankara , Turkey
| | - Kamil Bilgihan
- c Department of Ophthalmology, Faculty of Medicine , Gazi University , Ankara , Turkey
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