1
|
Hosny OH, Abd-Elkareem M, Ali MM, Ahmed AF. Advanced platelet-rich fibrin promotes healing of induced corneal ulcer in donkeys (Equus asinus). Sci Rep 2023; 13:21824. [PMID: 38071242 PMCID: PMC10710484 DOI: 10.1038/s41598-023-48933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Ulcerative keratitis is a common disease in horses which may cause blindness. To prevent secondary bacterial and fungal infections and promote quick re-growth of the epithelial layer, different treatment approaches have been employed. This study aimed to examine the effects of advanced platelet-rich fibrin (A-PRF) gel on the healing process of experimentally induced corneal ulcers in donkeys. Nine healthy adult donkeys were used for the study. The donkeys were divided into two groups: the control group, where no medication was applied to the corneal ulcer, and the A-PRF gel group, where A-PRF gel was applied once a day on specific days after ulcer induction. The healing process was evaluated through various examinations and analyses. The results demonstrated that the A-PRF gel group showed significant improvement in the corneal ulcer area, with epithelial and stromal regeneration. At day 35, about 60% of the A-PRF group showed negative fluorescein uptake. Additionally, fewer complications were observed during the healing process compared to the control group. In conclusion, A-PRF gel is an important and safe therapeutic option for controlling ocular surface infection and promoting corneal healing. We recommend using A-PRF gel as an alternative approach, avoiding eyelid suturing, and minimizing corneal irritation.
Collapse
Affiliation(s)
- Omar H Hosny
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt.
| | - Mahmoud Abd-Elkareem
- Department of Cell and Tissues, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Magda M Ali
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Ahmed F Ahmed
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| |
Collapse
|
2
|
Niruthisard D, Bonnet C, Tanasugarn L, Le B, Deng SX. Autologous Serum Eye Drops in the Management of Limbal Stem Cell Deficiency Associated With Glaucoma Surgery. Eye Contact Lens 2023; 49:19-24. [PMID: 36322388 PMCID: PMC9789170 DOI: 10.1097/icl.0000000000000951] [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] [Accepted: 09/11/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate safety and efficacy of autologous serum eye drops (AS) in the treatment of limbal stem cell deficiency (LSCD) associated with glaucoma surgery. METHODS Retrospective case series of eyes with glaucoma surgery-induced LSCD treated with AS. Diagnosis of LSCD was confirmed by anterior segment optical coherence tomography, in vivo confocal microscopy, and/or impression cytology. Limbal stem cell deficiency severity was staged using a clinical scoring system (2-10 points). Outcome measures were changes (≥2 points) of the LSCD score and best-corrected visual acuity (BCVA) from the baseline to the last follow-up. RESULTS Thirteen eyes of 12 consecutive patients treated with 50% AS for at least 3 months were included. The mean age was 78.9±7.5 years and the mean duration of AS use was 20.9±16.8 months. Indications of AS included LSCD progression in eight eyes (61.5%) and visual axis threatening in five eyes (38.5%). The mean LSCD score at baseline (6.7±1.6) was similar to that at last follow-up (6.5±2.2, P =0.625). Two eyes (15.4%) showed improvement, nine eyes (69.2%) were stable, and two eyes (15.4%) worsened. The mean baseline BCVA (0.89±0.64 logMAR) was similar to the mean final BCVA (1.05±0.63 logMAR, P =0.173). There were no serious adverse complications related to AS. CONCLUSION AS appears to be well tolerated and may stabilize the progression of LSCD with limited effects. A larger study is necessary to confirm the findings.
Collapse
Affiliation(s)
- Duangratn Niruthisard
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Ophthalmology, Banphaeo General Hospital, Samut Sakhon, Thailand
| | - Clémence Bonnet
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Cornea Department, Cochin Hospital, AP-HP, F-75014, Paris University, Paris, France
| | - Lokachet Tanasugarn
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Bryan Le
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Drexel University College of Medicine
| | - Sophie X. Deng
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Molecular Biology Institute, University of California, Los Angeles, USA
| |
Collapse
|
3
|
Peyrecave-Capo X, Saulnier N, Maddens S, Gremillet B, Desjardins I. Equine Umbilical Cord Serum Composition and Its Healing Effects in Equine Corneal Ulceration. Front Vet Sci 2022; 9:843744. [PMID: 35372560 PMCID: PMC8970184 DOI: 10.3389/fvets.2022.843744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Human autologous serum (AS) and umbilical cord serum (UCS) both contain growth and neurotrophic factors that promote corneal healing. Aim Our objectives were to compare equine AS and UCS cytokine and growth factor profiles and to assess the safety and clinical feasibility of the therapeutic use of UCS eye drops in cases of spontaneous complex ulcers. Study Design Prospective clinical trial. Methods Vitamin A insulin growth factor, platelet-derived growth factor-BB, transforming growth factor (TGF)-β1 (enzyme-linked immunosorbent assay), interleukin (IL)-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were determined in 10 AS collected from different horses and 10 UCS sampled at delivery. Six client-owned horses presenting with complex non-healing corneal defects of >5 mm2 were included in a clinical trial and treated with conventional therapy and conditioned UCS drops for 8–15 days. Ulcer surface and time to complete epithelialization were recorded. Results Median concentrations of vitamin A, insulin growth factor, and platelet-derived growth factor-BB were not significantly different in AS compared with UCS (respectively, 14.5 vs. 12.05 μg/ml; 107.8 vs. 107.3 pg/ml; and 369.1 vs. 924.2 pg/ml). TGF-β1 median concentration in UCS was significantly higher than in AS (3,245 vs. 2571pg/ml) (p = 0.04). IL-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were variable in AS and undetectable in UCS. The corneal median ulcerative area was 37.2 mm2 (6.28–57.14 mm2) and had a duration of 4–186 days (median 19 days). All lesions healed within 13–42 days (median 17 days). No adverse effects nor recurrences within 1 month were noticed. Limitations The sample size was small. Spontaneous corneal epithelial defects presented with variable clinical characteristics. There were no age-matched control horses to assess corneal healing time and rate. Conclusion and Clinical Significance Equine UCS may be beneficial, as it contains no pro-inflammatory cytokines and a greater concentration of TGF-β1 compared with AS. Topical UCS appears safe and may potentially be used as adjunctive therapy for equine complex non-healing ulcers.
Collapse
Affiliation(s)
- Xavier Peyrecave-Capo
- Equine Department, Faculty of Veterinary Medicine, VetAgro-Sup, University of Lyon, Marcy l'Etoile, France
| | | | | | - Bérengère Gremillet
- Department of Clinical Sciences, Veterinary Medicine, University of Liège, Sart-Tilman, Liège, Belgium
| | - Isabelle Desjardins
- Equine Department, Faculty of Veterinary Medicine, VetAgro-Sup, University of Lyon, Marcy l'Etoile, France
- *Correspondence: Isabelle Desjardins
| |
Collapse
|
4
|
Jeng BH, Hamrah P, Kirshner ZZ, Mendez BC, Wessel HC, Brown LR, Steed DL. Exploratory Phase II Multicenter, Open-Label, Clinical Trial of ST266, a Novel Secretome for Treatment of Persistent Corneal Epithelial Defects. Transl Vis Sci Technol 2022; 11:8. [PMID: 34994777 PMCID: PMC8742509 DOI: 10.1167/tvst.11.1.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective An exploratory phase II, multicenter, open-label, clinical trial (NCT03687632) was conducted to evaluate the safety and effectiveness in treating persistent corneal epithelial defects (PEDs) with ST266, a proprietary novel multi-cytokine platform biologic solution secreted by cultured Amnion-derived Multipotent Progenitor (AMP) cells. Methods Subjects with a PED were treated with ST266 eye drops 4 times daily for 28 days, then followed for 1 week. Safety was assessed by monitoring of adverse events (AEs) and serious adverse events (SAEs). Efficacy was assessed by measuring the area of the PED by slit lamp biomicroscopy. Tolerability of ST266, percentage of eyes with complete healing, reduction in area of the epithelial defect, and maintenance of a reduction in the area of the epithelial defect 7 days after treatment were recorded. Results Thirteen patients were enrolled into the trial at one of eight sites. The first patient withdrew after 5 days. The remaining 12 patients with PEDs with median duration of 39 days (range = 12 to 393 days) completed treatment. Ten of the 12 eyes had been refractory to treatment with various conventional therapies prior to enrollment. After 28 days of treatment, there was a significant decrease in mean PED area compared with baseline (66.4% ± 35.3%, P = 0.001). At follow-up, 1 week after completion of treatment, on day 35, the PED area was further reduced by 78.8% ± 37.5% (P = 0.01) compared with baseline. During 28 days of treatment, 5 eyes (41.7%) had complete wound closure. There were no AEs of concern thought to be related to the drug, and no SAEs were noted. Conclusions In this trial, we found ST266 eye drops might promote corneal epithelization, thereby reducing the PED area, including in refractory cases in a wide range of etiologies. ST266 was well-tolerated by most patients.
Collapse
Affiliation(s)
- Bennie H Jeng
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Pedram Hamrah
- Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Ziv Z Kirshner
- Noveome Biotherapeutics, Inc., Pittsburgh, Pennsylvania, USA
| | | | - Howard C Wessel
- Noveome Biotherapeutics, Inc., Pittsburgh, Pennsylvania, USA
| | - Larry R Brown
- Noveome Biotherapeutics, Inc., Pittsburgh, Pennsylvania, USA
| | - David L Steed
- Noveome Biotherapeutics, Inc., Pittsburgh, Pennsylvania, USA
| |
Collapse
|
5
|
Abstract
PURPOSE To describe the efficacy of autologous serum (AS) eye drops to reverse severe contact lens (CL)-induced limbal stem cell (LSC) deficiency (LSCD). METHODS This is a prospective, uncontrolled, interventional case series that enrolled 20 eyes of 14 consecutive patients diagnosed with severe CL-induced LSCD at presentation, based on clinical examination, at a tertiary referral center for the period December 2016 to December 2018. All eyes underwent AS treatment for at least 2 weeks with a follow-up for at least 2 months. Demographic data and treatment outcomes were collected and analyzed. RESULTS The mean patient age at presentation was 30.5 years (range, 19-49 years). The mean duration of soft contact lens wear was 15.6 years (SD, 7.58 years; range, 5-31 years). All study eyes had pain and blurred vision at presentation. All eyes had recurrent or persistent corneal epithelial defect, stromal scarring and opacity, and superficial vascularization and peripheral pannus at presentation. Aggressive treatment with AS succeeded in all eyes. Signs and symptoms of LSCD stabilized in all eyes within 2 weeks and resolved in 6 eyes (30.0%) in 2 weeks, 9 eyes (45.0%) in 4 weeks, and 5 eyes (25.0%) in 8 weeks. The mean follow-up time was 9.45 ± 1.79 weeks (range, 8-24 weeks). CONCLUSIONS Early identification and aggressive treatment of the ocular surface disease with AS can medically reverse severe CL-induced LSCD and prevent the need for surgical intervention.
Collapse
|
6
|
Yeh SI, Yu SH, Chu HS, Huang CT, Tsao YP, Cheng CM, Chen WL. Pigment Epithelium-Derived Factor Peptide Promotes Corneal Nerve Regeneration: An In Vivo and In Vitro Study. Invest Ophthalmol Vis Sci 2021; 62:23. [PMID: 33481984 PMCID: PMC7838554 DOI: 10.1167/iovs.62.1.23] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate the potential of a pigment epithelium-derived factor (PEDF) peptide 44-mer to promote nerve regeneration in a rabbit corneal nerve injury model to demonstrate its neurotrophic ability in cultivated mouse trigeminal neuron cells. Methods Subconjunctival or intrastromal injection of 44-mer on the cornea was performed in a rabbit model of corneal nerve injury created by corneal epithelial debridement. Immunocytochemical analysis (44-mer, anti-tubulin III, SMI312, CD11b, and α-SMA) and in vivo confocal microscopy were performed. Corneal sensation was estimated using a Cochet-Bonnet corneal esthesiometer. Primary cultivated mouse trigeminal neurons were used to examine the in vitro neurotrophic ability of 44-mer. The cellular morphology and the immunocytochemical staining with anti-tubulin III and SMI312 in different concentrations of 44-mer were compared, and a quantitative assessment of neurite outgrowth was performed. Results Immunohistochemical staining showed the retention of 44-mer in the corneal stroma for at least 7 days after a single dose of corneal intrastromal injection and promoted corneal nerve regeneration revealed by in vivo confocal microscopy. Corneal esthesiometer demonstrated gradual recovery of the corneal sensation in 44-mer-treated eyes with a lower corneal touch threshold than wounded vehicles and closer to baseline at 3 weeks after corneal injury (P < 0.001). In vitro studies showed a dose-dependent neurotrophic effect of 44-mer in cultivated trigeminal neuron cells. Conclusions The 44-mer showed in vivo and in vitro corneal neurotrophic abilities. Our results suggest that intrastromal injection of 44-mer into the corneal stroma may have a potential role in treating diseases related to corneal nerve damage.
Collapse
Affiliation(s)
- Shu-I Yeh
- Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Sung-Hsun Yu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
| | - Hsiao-Sang Chu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
| | - Chin-Te Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yeou-Ping Tsao
- Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University, Taipei, Taiwan
- Department of Ophthalmology, College of Medicine, National Taiwan University; Taipei, Taiwan
| |
Collapse
|
7
|
Huang CT, Chu HS, Hung KC, Chen LW, Chen MY, Hu FR, Chen WL. The effect of human platelet lysate on corneal nerve regeneration. Br J Ophthalmol 2019; 105:884-890. [PMID: 31748333 DOI: 10.1136/bjophthalmol-2019-314408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/09/2019] [Accepted: 11/07/2019] [Indexed: 11/03/2022]
Abstract
AIM This study aimed to test whether human platelet lysate (HPL) has neurotrophic ability for corneal nerve regeneration. METHODS We measured the neurotrophic factors in human peripheral serum (HPS) and two commercially available HPLs, UltraGRO and PLTMax. In vitro, we compared the growth rates, neuronal differentiation and immunostaining of neuron markers in mouse neuroblastoma cell line (Neuro-2a) and primary culture of mouse trigeminal ganglion cells that were cultivated in different concentrations of fetal bovine serum, HPS and HPL. In vivo, we created corneal wounds on Sprague Dawley rats with a rotating burr and evaluated the effects of topical HPL on wound healing and corneal nerve regeneration by in vivo confocal microscopy and corneal aesthesiometry. RESULTS HPLs had significantly higher concentrations of various neurotrophic factors compared with HPS (p<0.05). In Neuro-2a cells, 3% HPL was better at promoting neuronal growth and differentiation compared with HPS at the same concentration. HPL was also found to have superior neurotrophic effects compared with HPS in primary cultures of mouse trigeminal ganglion cells. In vivo, HPL-treated eyes had better corneal epithelial wound healing rate, nerve regeneration length and corneal touch threshold compared with eyes treated with artificial tears (p<0.05). CONCLUSION HPL has significantly higher concentrations of neurotrophic factors compared with HPS. It showed not only in vitro but also in vivo corneal neurotrophic abilities. Our results suggest that HPL may have a potential role in the treatment of diseases related to corneal nerve damage or degeneration.
Collapse
Affiliation(s)
- Chin-Te Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Ophthalmology, Chung Shan Medical University Hospital, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsiao-Sang Chu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Advanced Ocular Surface and Corneal Nerve Regeneration Center, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuo-Chi Hung
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Ophthalmology, Sinying Hospital, Tainan, Taiwan
| | - Lily Wei Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Yun Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan .,Advanced Ocular Surface and Corneal Nerve Regeneration Center, National Taiwan University Hospital, Taipei, Taiwan.,Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
8
|
Buzzi M, Versura P, Grigolo B, Cavallo C, Terzi A, Pellegrini M, Giannaccare G, Randi V, Campos EC. Comparison of growth factor and interleukin content of adult peripheral blood and cord blood serum eye drops for cornea and ocular surface diseases. Transfus Apher Sci 2018; 57:549-555. [PMID: 29929885 DOI: 10.1016/j.transci.2018.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/31/2018] [Accepted: 06/05/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Various blood-derived products have been proposed for the topical treatment of ocular surface diseases. The aim of the study was to compare the different content of Growth Factors (GFs) and Interleukins (ILs) in peripheral blood (PB-S) and Cord Blood (CB-S) sera. MATERIALS AND METHODS Sera were obtained from 105 healthy adult donors (PB-S) and 107 umbilical/placental veins at the time of delivery (CB-S). The levels of epithelial-GF (EGF), fibroblast-GF (FGF), platelet-derived-GF (PDGF), insulin-GF (IGF), transforming-GF alpha (TGF-α,) and beta 1-2-3 (TGF-β1-β2-β3), vascular endothelial-GF (VEGF), nerve-GF (NGF), Interleukin (IL)-1β,IL-4,IL-6,IL-10, and IL-13 were assessed by Bio-Plex Protein Array System (Bio-Rad Laboratories, CA, USA). The Mann-Whitney test for unpaired data was applied to compare GFs and ILs levels in the two sources. The associations among each GF/IL level and the obstetric data for CB-S and hematological characteristics for PB-S were also investigated. RESULTS The levels of EGF, TGF-α, TGF-β2, FGF, PDGF, VEGF, NGF, IL-1B, IL-4, IL-6, IL-10, and IL-13 were significantly higher in CB-S compared to PB-S. Conversely, the levels of IGF-1, IGF-2, and TGF-β1 were significantly higher in PB-S. The female sex and the weight of the child showed a significant association in predicting EGF and PDGF levels. CONCLUSION A significantly different content in those GFs and ILs was demonstrated in the two blood sources. Since each GF/IL selectively regulates different cellular processes involved in corneal healing, the use of PB-S or CB-S should be chosen on the basis of the cellular mechanism to be promoted in each clinical case.
Collapse
Affiliation(s)
- M Buzzi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - P Versura
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy.
| | - B Grigolo
- RAMSES Laboratory, Department of Research & Innovation, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - C Cavallo
- RAMSES Laboratory, Department of Research & Innovation, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Terzi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - M Pellegrini
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - G Giannaccare
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - V Randi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - E C Campos
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| |
Collapse
|
9
|
The corneal epitheliotrophic abilities of lyophilized powder form human platelet lysates. PLoS One 2018; 13:e0194345. [PMID: 29547658 PMCID: PMC5856377 DOI: 10.1371/journal.pone.0194345] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 03/01/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To evaluate whether lyophilized human platelet lysate (HPL) powder can preserve the growth factor concentrations and epitheliotrophic properties of liquid HPL, and potentially be used as a clinically-friendly treatment option. Methods Two commercialized liquid HPLs, UltraGRO TM (Helios, Atlanta, GA) and PLTMax (Mill Creek, Rochester, MI), were obtained and converted to lyophilized powder. After redissolution, lyophilized powder HPLs were compared with liquid HPLs, as well as human peripheral serum (HPS) and fetal bovine serum (FBS) in liquid or redissolved lyophilized powder forms. Concentrations of epidermal growth factor (EGF), transforming growth factor-β1 (TGF-β1), platelet-derived growth factor-AB (PDGF-AB) and platelet-derived growth factor-BB (PDGF-BB) were evaluated by enzyme-linked immunosorbent assay (ELISA). Human corneal epithelial cell line was incubated with the blood derivatives and evaluated for cell migration with scratch-induced directional wounding and proliferation with MTS assays. Cell differentiation was examined by transepithelial electrical resistance (TEER). Fluorescein staining and in vivo confocal microscopy were used to evaluate in vivo corneal epithelial wound healing in Sprague-Dawley rats that underwent corneal debridement and topical application of liquid and redissolved powder HPLs. Results Liquid form and redissolved lyophilized powder form HPLs had similar concentrations of EGF, TGF-β1, PDGF-AB and PDGF-BB. In vitro experiments on cell migration, proliferation and differentiation and rat models on wound healing demonstrated no significant difference between the liquid and redissolved lyophilized powder forms for HPLs, HPS and FBS. In vivo confocal microscopy revealed similar wound healing process at different layers of cornea after corneal epithelial debridement between liquid form and redissolved lyophilized power form of HPLs. Conclusions The redissolved lyophilized powder form of both commercialized HPLs showed similar growth factor concentrations and corneal epitheliotrophic abilities compared to the liquid form. Results suggest that the properties of liquid HPLs can be retained despite lyophilization and that lyophilized HPLs can be a treatment option for corneal epithelial disorders.
Collapse
|
10
|
Treatment of patients with neurotrophic keratitis stages 2 and 3 with plasma rich in growth factors (PRGF-Endoret) eye-drops. Int Ophthalmol 2017; 38:1193-1204. [DOI: 10.1007/s10792-017-0582-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
|
11
|
Huang CJ, Sun YC, Christopher K, Pai ASI, Lu CJ, Hu FR, Lin SY, Chen WL. Comparison of corneal epitheliotrophic capacities among human platelet lysates and other blood derivatives. PLoS One 2017; 12:e0171008. [PMID: 28152010 PMCID: PMC5289502 DOI: 10.1371/journal.pone.0171008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/13/2017] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To evaluate the corneal epitheliotropic abilities of two commercialized human platelet lysates (HPLs) and to compare the results with other blood derivatives, including human peripheral serum (HPS) and bovine fetal serum (FBS). METHODS In vitro, human corneal epithelial cells were incubated in various concentrations (0%, 3%, 5% and 10%) of blood derivatives. Two commercialized HPLs, including UltraGRO TM (Helios, Atlanta, GA) and PLTMax (Mill Creek, Rochester, MI), were tested and compared with HPS and FBS. Scratch-induced directional wounding assay was performed to evaluate cellular migration. MTS assay was used to evaluate cellular proliferation. Cellular differentiation was examined by scanning electron microscopy, inverted microscopy and transepithelial electrical resistance. Sprague-Dawley rats were used to evaluate the effects of the blood derivatives on corneal epithelial wound healing in vivo. Different blood derivatives were applied topically every 2 hours for 2 days after corneal epithelial debridement. The concentrations of epidermal growth factor (EGF), transforming growth factor -β1 (TGF-β1), fibronectin, platelet-derived growth factor-AB (PDGF-AB), PDGF-BB, and hyaluronic acid in different blood derivatives were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS In vitro experiments demonstrated statistically comparable epitheliotropic characteristics in cellular proliferation, migration, and differentiation for the two commercialized HPLs compared to FBS and HPS. Cells cultured without any serum were used as control group. The epitheliotropic capacities were statistically higher in the two commercialized HPLs compared to the control group (p<0.05). Among the different concentrations of blood derivatives, the preparations with 3% yielded better outcomes compared to 5% and 10%. In rats, HPLs also caused improved but not statistically significant wound healing compared to HPS. All the blood derivatives had better wound healing ratios than the control group (p<0.05). In the quantification of epitheliotropic factors, UltraGRO and PLTMax had significantly higher levels of EGF, TGF- β1, fibronectin than human peripheral serum (p<0.05). CONCLUSIONS Both commercialized HPLs showed comparable corneal epitheliotropic abilities and wound healing rates compared to HPS and FBS in the in vivo and in vitro studies. Our results suggest that HPLs may have the potential to replace HPS in the treatment of corneal epithelial problems.
Collapse
Affiliation(s)
- Chien-Jung Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Chen Sun
- Department of Ophthalmology, Taipei Tzu Chi General Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Karen Christopher
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Amy Shih-I Pai
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Chia-Ju Lu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Center of Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan
| | - Szu-Yuan Lin
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
- * E-mail: (WC); (SL)
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Center of Corneal Tissue Engineering and Stem Cell Biology, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (WC); (SL)
| |
Collapse
|
12
|
Yoo A, Park HM, Kang SS, Kim ES, Tchah H, Kim JY. RNA Interference-based Investigation of the Function of Heat Shock Protein 27 during Corneal Epithelial Wound Healing. J Vis Exp 2016. [PMID: 27768052 DOI: 10.3791/54280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Small interfering RNA (siRNA) is among the most widely used RNA interference methods for the short-term silencing of protein-coding genes. siRNA is a synthetic RNA duplex created to specifically target a mRNA transcript to induce its degradation and it has been used to identify novel pathways in various cellular processes. Few reports exist regarding the role of phosphorylated heat shock protein 27 (HSP27) in corneal epithelial wound healing. Herein, cultured human corneal epithelial cells were divided into a scrambled control-siRNA transfected group and a HSP27-specific siRNA-transfected group. Scratch-induced directional wounding assays, and western blotting, and flow cytometry were then performed. We conclude that HSP27 has roles in corneal epithelial wound healing that may involve epithelial cell apoptosis and migration. Here, step-by-step descriptions of sample preparation and the study protocol are provided.
Collapse
Affiliation(s)
- Aeri Yoo
- Department of Ophthalmology, Saevit Eye Hospital
| | - Hyun-Min Park
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center
| | - Soon-Suk Kang
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center
| | - Eun-Soon Kim
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center
| | - Hungwon Tchah
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center
| | - Jae Yong Kim
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center;
| |
Collapse
|
13
|
Targeting growth factor supply in keratopathy treatment: comparison between maternal peripheral blood and cord blood as sources for the preparation of topical eye drops. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:145-51. [PMID: 26192781 DOI: 10.2450/2015.0020-15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/05/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Epitheliotrophic growth factors (GF) can be supplied topically to patients with severe keratopathy through a variety of blood-derived products. We compared GF content in adult peripheral blood serum (PB-S) and cord blood serum (CB-S) as potential sources of GF. To limit inter-individual variability the assessment was performed in maternal-child pairs at the time of delivery. MATERIAL AND METHODS The amounts of epidermal GF (EGF), insulin-like GF (IGF), transforming GF-beta (TGF-β), vascular endothelial GF (VEGF) in CB units collected from the umbilical vein and PB from mothers (each group n=30) were estimated by enzyme-linked immunosorbent assays. Obstetric characteristics and haematological data were recorded from the archives of the Emilia Romagna Cord Blood Bank. Statistical evaluations were performed by Wilcoxon's test and correlations between variables were determined using Spearman's (ρ) coefficient; p-values <0.05 were considered statistically significant. RESULTS EGF, TGF-β and VEGF levels were significantly higher in CB-S than in PB-S (median 1,254.4 vs 646.0 pg/mL, 51.3 vs 38.4 μg/mL and 686.8 vs 30 pg/mL, respectively; all p<0.0001) whereas IGF content was significantly higher in PB-S than in CB-S (159.9 vs 53.5 pg/mL, respectively; p<0.0001). In CB-S, the CD34(+) cell concentration appeared to be related to EGF, IGF and TGF-β levels whereas white blood cell count appeared to be related to EGF and TGF-β levels. VEGF levels showed no relation to the haematological parameters considered. Platelet counts were not related to GF level in either CB or PB. DISCUSSION The GF content in the two blood sources was different, with CB containing larger amounts. Each GF selectively regulates cellular processes involved in corneal healing, so the use of PB or CB should be targeted to supply specific GF on the basis of the type and severity of the keratopathy.
Collapse
|
14
|
Nugent RB, Lee GA. Ophthalmic use of blood-derived products. Surv Ophthalmol 2015; 60:406-34. [PMID: 26077627 DOI: 10.1016/j.survophthal.2015.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 12/23/2022]
Abstract
There is a wide spectrum of blood-derived products that have been used in many different medical and surgical specialties with success. Blood-derived products for clinical use can be extracted from autologous or allogeneic specimens of blood, but recombinant products are also commonly used. A number of blood derivatives have been used for a wide range of ocular conditions, from the ocular surface to the retina. With stringent preparation guidelines, the potential risk of transmission of blood-borne diseases is minimized. We review blood-derived products and how they are improving the management of ocular disease.
Collapse
Affiliation(s)
| | - Graham A Lee
- City Eye Centre, Brisbane, Queensland, Australia; Department of Ophthalmology, University of Queensland, Brisbane, Queensland, Australia.
| |
Collapse
|
15
|
Corneal wound healing promoted by 3 blood derivatives: an in vitro and in vivo comparative study. Cornea 2014; 33:614-20. [PMID: 24727633 DOI: 10.1097/ico.0000000000000109] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of this study was to compare the effect on corneal wound healing of 3 differently manufactured blood derivatives [autologous serum (AS), platelet-rich plasma, and serum derived from plasma rich in growth factors (s-PRGF)]. METHODS Scratch wound-healing assays were performed on rabbit primary corneal epithelial cultures and human corneal epithelial cells. Additionally, mechanical debridement of rabbit corneal epithelium was performed. Wound-healing progression was assessed by measuring the denuded areas remaining over time after treatment with each of the 3 blood derivatives or a control treatment. RESULTS In vitro data show statistically significant differences in the healing process with all the derivatives compared with the control, but 2 of them (AS and s-PRGF) induced markedly faster wound healing. In contrast, although the mean time required to complete in vivo reepithelization was similar to that of AS and s-PRGF treatment, only wounds treated with s-PRGF were significantly smaller in size from 2.5 days onward with respect to the control treatment. CONCLUSIONS All 3 blood derivatives studied are promoters of corneal reepithelization. However, the corneal wound-healing progresses differently with each derivative, being faster in vitro under AS and s-PRGF treatment and producing in vivo the greatest decrease in wound size under s-PRGF treatment. These findings highlight that the manufacturing process of the blood derivatives may modulate the efficacy of the final product.
Collapse
|
16
|
Erdem E, Yagmur M, Harbiyeli I, Taylan-Sekeroglu H, Ersoz R. Umbilical cord blood serum therapy for the management of persistent corneal epithelial defects. Int J Ophthalmol 2014; 7:807-10. [PMID: 25349797 DOI: 10.3980/j.issn.2222-3959.2014.05.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/09/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the role of umbilical cord blood serum (CBS) therapy in cases with persistent corneal epithelial defects (PED). METHODS Sixteen eyes of 14 patients with PED who were resistant to conventional treatment were treated with 20% umbilical cord serum eye drops. Patients were followed-up weekly until epithelization was complete. The collected data included the grade of corneal lesion (Grade I: epithelial defect+superficial vascularization, Grade II: epithelial defect+stromal edema, Grade III: corneal ulcer+stromal melting), the size of epithelial defect (pretreatment, 7(th), 14(th) and 21(st) days of treatment), and follow-up time was evaluated retrospectively. RESULTS The mean size of epithelial defect on two perpendicular axes was 5.2×4.6-mm(2) (range: 2.5-8×2.2-9 mm(2)). Mean duration of treatment was 8.3±5wk. CBS therapy was effective in 12 eyes (75%) and ineffective in 4 eyes (25%). The epithelial defects in 4 ineffective eyes were healed with amniotic membrane transplantation and tarsorrhaphy. The rate of complete healing was 12.5% by 7d, 25% by 14d, and 75% by 21d. The healing time was prolonged in Grade III eyes in comparison to eyes in Grade I or Grade II. CONCLUSION The results of the current study indicated the safety effectiveness of CBS drops in the management of PED. The grade of disease seems have a role on the healing time.
Collapse
Affiliation(s)
- Elif Erdem
- Department of Ophthalmology, Faculty of Medicine, Cukurova University, Saricam, Adana 01380, Turkey
| | - Meltem Yagmur
- Department of Ophthalmology, Faculty of Medicine, Cukurova University, Saricam, Adana 01380, Turkey
| | | | - Hande Taylan-Sekeroglu
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Altindag, Ankara 01100, Turkey
| | - Reha Ersoz
- Department of Ophthalmology, Faculty of Medicine, Cukurova University, Saricam, Adana 01380, Turkey
| |
Collapse
|
17
|
Cord blood serum-based eye drops: the impact of donor haematological and obstetric factors on the variability of epidermal growth factor levels. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12 Suppl 1:s44-50. [PMID: 24120597 DOI: 10.2450/2013.0115-13] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/12/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cord blood serum (CBS)-based eye drops are successfully used in corneal epithelial wound healing and are prepared to supply a known amount of epidermal growth factor (EGF). Product standardisation includes expensive EGF dosage in all cord blood (CB) units. The influence of donor obstetric and haematological characteristics on EGF content was evaluated, to exclude unsuitable CBS and pre-select those CB units able to provide the correct EGF supply for healing corneal wounds. MATERIALS AND METHODS Data were retrospectively collected from 135 donors included in the Emilia Romagna Cord Blood Bank records. Obstetric characteristics, parity and gestational age of the mother, sex, birth weight and Apgar score of the neonate, placental weight, duration of labour and mode of delivery were considered. Haematological characteristics, CD34+ cell number, and total nucleated cell, white blood cell and platelet counts were recorded. EGF content in CB units was estimated by enzyme-linked immunosorbent assay. Statistical evaluation was performed by Mann-Whitney unpaired and Student's t tests. Correlations between variables were evaluated by using Pearson's (r) or Spearman's (ρ) correlation coefficients. RESULTS EGF content was significantly higher in CBS from donors aged <30 years and after vaginal deliveries as compared with scheduled Caesarean sections (1,386±580 vs 1,106±391 pg/mL; P=0.002). EGF content was significantly correlated with duration of labour (r=0.45; P=0.0001), number of CD34+ cells/mL (r=0.3; P=0.002) particularly in vaginal deliveries (r=0.36; P=0.003), mother's age (-0.25; P=0.005), neonate's birth weight (r=0.27; P=0.005), and total nucleated cell (r=0.25; P=0.006), white cell (r=0.29; P=0.001) and platelet (r=0.24; P=0.009) counts. No significant correlations were found between EGF content and parity, gestational age, placental weight, neonate's sex or Apgar scores. DISCUSSION EGF levels are higher in CB units from younger mothers (<30 years), with longer labour duration (>6 hours), and higher CD34+ cell content (>0.05×10(6)/mL). In order to optimise the preparation and costs of CBS-based eye drops, pre-selection of CB units is recommended.
Collapse
|
18
|
Efficacy of Standardized and Quality-Controlled Cord Blood Serum Eye Drop Therapy in the Healing of Severe Corneal Epithelial Damage in Dry Eye. Cornea 2013; 32:412-8. [DOI: 10.1097/ico.0b013e3182580762] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Yoon KC, Oh HJ, Park JW, Choi J. Application of umbilical cord serum eyedrops after laser epithelial keratomileusis. Acta Ophthalmol 2013; 91:e22-8. [PMID: 22994307 DOI: 10.1111/j.1755-3768.2012.02538.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the efficacy of umbilical cord serum eyedrops after laser epithelial keratomileusis (LASEK). METHODS Sixty patients (120 eyes) with myopia who underwent LASEK were studied. Thirty-two patients (64 eyes) were treated with 20% umbilical cord serum eyedrops in combination with conventional treatment (group A), and 28 patients (56 eyes) received conventional treatment only (group B). Epithelial healing time was analysed. Visual acuity, refraction, haze score (0-4) and tear film and ocular surface parameters were evaluated at 1, 2, 4 and 12 weeks after LASEK. The concentration of transforming growth factor (TGF)-β1 in tears was measured with ELISA at 1 week after LASEK. RESULTS No significant differences in visual acuity and refraction were found between groups. The mean time to epithelial healing was 3.53 ± 1.19 days in group A and 3.91 ± 1.41 days in group B (p = 0.18). The mean haze scores at 2 and 4 weeks were 0.59 ± 0.80 and 0.31 ± 0.54 in group A and 1.06 ± 0.91 (p = 0.02) and 0.69 ± 0.78 (p = 0.03) in group B. Four and 12 weeks after LASEK, tear film break-up time was longer and keratoepitheliopathy score was lower in group A compared with group B. The mean concentration of TGF-β1 was lower in group A compared with group B (p = 0.01). CONCLUSION Application of 20% umbilical cord serum eyedrops in addition to conventional treatment after LASEK can reduce early postoperative corneal haze and improve tear film and ocular surface parameters.
Collapse
Affiliation(s)
- Kyung-Chul Yoon
- Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju, Korea.
| | | | | | | |
Collapse
|