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Gagliano C, Zeppieri M, Longo A, Rubegni G, Amato R, Foti R, Cappellani F, Cocuzza M, Visalli F, Cannizzaro L, Avitabile A, Gagliano G, Lapenna L, D’Esposito F. Efficacy and Safety of Artificial Tears Containing Lipidure and Hypromellose for the Treatment of Moderate Dry Eye Disease in Contact Lens Wearers. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:287. [PMID: 38399574 PMCID: PMC10890511 DOI: 10.3390/medicina60020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Dry eye disease (DED) affects 5-50% of the global population and deeply influences everyday life activities. This study compared the efficacy, tolerability, and safety of novel Respilac artificial tears containing lipidure and hypromellose (HPMC) with the widely used Nextal artificial tears, which are also HPMC-based, for the treatment of moderate DED in contact lenses (CL) wearers. Materials and Methods: In a prospective, single-center, randomized investigation, 30 patients aged ≥18 years, diagnosed with moderate DED, and wearing CL were randomly assigned to the Respilac (n = 15) or Nextal group (n = 15). Patients self-administrated one drop of Respilac or Nextal in both eyes three times daily for 21 days. Changes in the endpoint (visual analogue scale (VAS) score for ocular tolerability, symptom assessment in dry eye (SANDE) score, non-invasive first break-up time (NIF-BUT) results, tear analysis value, meibography results, and CL tolerability results were assessed, comparing treatment groups and time-point evaluations. Adverse events (AEs) were also recorded and evaluated. Results: VAS scores decreased with time (p < 0.001) in both groups, showing no statistically significant difference among them (p = 0.13). Improvements were also detected from screening to end-of-treatment, which were indicated by the SANDE scores for severity and frequency (p < 0.001) and by tear analysis results (p < 0.001) with no observed difference between the Nextal and Respilac arms. NIF-BUT, meibography, and CL tolerability values were shown to be non-significantly affected by treatment and time. There were no AEs detected in this study cohort. Conclusions: Respilac was confirmed to be effective, safe, and well-tolerated. Lipidure-based ophthalmic solution was shown not to be inferior to the currently used Nextal, however, showing improvements in DED symptoms. Within the existing literature, our study is one of the first to report that MPC plus HPMC-containing eye drops are an effective option for the treatment of moderate dry eye disease and desiccation damage prevention in contact lens wearers.
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Affiliation(s)
- Caterina Gagliano
- Faculty of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy;
- Eye Clinic, Catania University, San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Antonio Longo
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Giovanni Rubegni
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
- Ophthalmology Unit, University of Siena, 53100 Siena, Italy
| | - Roberta Amato
- Eye Clinic, Catania University, San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Roberta Foti
- Eye Clinic, Catania University, San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Francesco Cappellani
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
- Willis Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Massimiliano Cocuzza
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Federico Visalli
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Ludovica Cannizzaro
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Alessandro Avitabile
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Giuseppe Gagliano
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy (L.C.); (A.A.)
| | - Lucia Lapenna
- Department of Ophthalmology, Di Venere’s Hospital of Bari, Via Ospedale di Venere, 1, 70012 Bari, Italy
| | - Fabiana D’Esposito
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK
- GENOFTA Srl, Sant’Agnello, 80065 Naples, Italy
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Zhu Q, Zhang Q, Fu DY, Su G. Polysaccharides in contact lenses: From additives to bulk materials. Carbohydr Polym 2023; 316:121003. [PMID: 37321708 DOI: 10.1016/j.carbpol.2023.121003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 06/17/2023]
Abstract
As the number of applications has increased, so has the demand for contact lenses comfort. Adding polysaccharides to lenses is a popular way to enhance comfort for wearers. However, this may also compromise some lens properties. It is still unclear how to balance the variation of individual lens parameters in the design of contact lenses containing polysaccharides. This review provides a comprehensive overview of how polysaccharide addition impacts lens wear parameters, such as water content, oxygen permeability, surface wettability, protein deposition, and light transmittance. It also examines how various factors, such as polysaccharide type, molecular weight, amount, and mode of incorporation into lenses modulate these effects. Polysaccharide addition can improve some wear parameters while reducing others depending on the specific conditions. The optimal method, type, and amount of added polysaccharides depend on the trade-off between various lens parameters and wear requirements. Simultaneously, polysaccharide-based contact lenses may be a promising option for biodegradable contact lenses as concerns regarding environmental risks associated with contact lens degradation continue to increase. It is hoped that this review will shed light on the rational use of polysaccharides in contact lenses to make personalized lenses more accessible.
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Affiliation(s)
- Qiang Zhu
- School of Pharmacy, Nantong University, Nantong 226001, China
| | - Qiao Zhang
- Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ding-Yi Fu
- School of Pharmacy, Nantong University, Nantong 226001, China
| | - Gaoxing Su
- School of Pharmacy, Nantong University, Nantong 226001, China.
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Vivero-Lopez M, Pereira-da-Mota AF, Carracedo G, Huete-Toral F, Parga A, Otero A, Concheiro A, Alvarez-Lorenzo C. Phosphorylcholine-Based Contact Lenses for Sustained Release of Resveratrol: Design, Antioxidant and Antimicrobial Performances, and In Vivo Behavior. ACS APPLIED MATERIALS & INTERFACES 2022; 14:55431-55446. [PMID: 36495267 PMCID: PMC9782386 DOI: 10.1021/acsami.2c18217] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Design of advanced contact lenses (CLs) demands materials that are safe and comfortable for the wearers and that preserve the normal eye microbiota, avoiding chronic inflammation and biofilm development. This work aimed to combine the natural antibiofouling phosphorylcholine and the antioxidant and prebiotic resveratrol as integral components of CLs that may have the additional performance of preventing oxidative-stress related eye diseases. Different from previous uses of 2-methacryloyloxyethyl phosphorylcholine (MPC) as coating, we explored the feasibility of adding MPC at high proportions as a comonomer of 2-hydroxyethyl methacrylate (HEMA)-based hydrogels while still allowing for the loading of the hydrophobic resveratrol. Homogeneous distribution of MPC along the hydrogel depth (confirmed by Raman spectroscopy) notably increased solvent uptake and the proportion of free water while it decreased Young's modulus. Relevantly, MPC did not hinder the uptake of resveratrol by CLs (>10 mg/g), which indeed showed network/water partition coefficients of >100. Protocols for CLs sterilization and loading of resveratrol under aseptic conditions were implemented, and the effects of tear proteins on resveratrol release rate were investigated. CLs sustained resveratrol release for more than 24 h in vitro, and sorption of albumin onto the hydrogel, although attenuated by MPC, slowed down the release. The combination of MPC and resveratrol reduced P. aeruginosa and S. aureus growth as tested in a novel hydrogel disk-agar interface biofilm growth setup. The developed CLs showed excellent anti-inflammatory properties and biocompatibility in in ovo and rabbit tests and provided higher and more prolonged levels of resveratrol in tear fluid, which favored resveratrol biodistribution in anterior and posterior eye segments compared to eye drops. Correlations between the release profiles of resveratrol in vitro and in vivo were assessed. Relevantly, the CLs preserved the antioxidant properties of resveratrol during the entire 8 h of wearing. In sum, CLs prepared with high proportion in MPC may help address safety and comfort requirements while having drug releasing capabilities.
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Affiliation(s)
- Maria Vivero-Lopez
- Departamento
de Farmacología, Farmacia y Tecnología Farmacéutica,
I+D Farma (GI-1645), Facultad de Farmacia, Instituto de Materiales
(iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782Santiago
de Compostela, Spain
| | - Ana F. Pereira-da-Mota
- Departamento
de Farmacología, Farmacia y Tecnología Farmacéutica,
I+D Farma (GI-1645), Facultad de Farmacia, Instituto de Materiales
(iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782Santiago
de Compostela, Spain
| | - Gonzalo Carracedo
- Ocupharm
Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28037Madrid, Spain
- Department
of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28037Madrid, Spain
| | - Fernando Huete-Toral
- Ocupharm
Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28037Madrid, Spain
| | - Ana Parga
- Departamento
de Microbiología y Parasitología, Facultad de Biología,
Edificio CIBUS, Universidade de Santiago
de Compostela, 15782Santiago de Compostela, Spain
| | - Ana Otero
- Departamento
de Microbiología y Parasitología, Facultad de Biología,
Edificio CIBUS, Universidade de Santiago
de Compostela, 15782Santiago de Compostela, Spain
| | - Angel Concheiro
- Departamento
de Farmacología, Farmacia y Tecnología Farmacéutica,
I+D Farma (GI-1645), Facultad de Farmacia, Instituto de Materiales
(iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782Santiago
de Compostela, Spain
| | - Carmen Alvarez-Lorenzo
- Departamento
de Farmacología, Farmacia y Tecnología Farmacéutica,
I+D Farma (GI-1645), Facultad de Farmacia, Instituto de Materiales
(iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, 15782Santiago
de Compostela, Spain
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Hirabayashi T, Shibato J, Kimura A, Yamashita M, Takenoya F, Shioda S. Potential Therapeutic Role of Pituitary Adenylate Cyclase-Activating Polypeptide for Dry Eye Disease. Int J Mol Sci 2022; 23:664. [PMID: 35054857 PMCID: PMC8775530 DOI: 10.3390/ijms23020664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 12/27/2022] Open
Abstract
Dry eye disease (DED) is caused by a reduction in the volume or quality of tears. The prevalence of DED is estimated to be 100 million in the developed world. As aging is a risk factor for DED, the prevalence of DED is expected to grow at a rapid pace in aging populations, thus creating an increased need for new therapies. This review summarizes DED medications currently in clinical use. Most current medications for DED focus on stimulating tear secretion, mucin secretion, or suppressing inflammation, rather than simply replenishing the ocular surface with moisture to improve symptoms. We recently reported that the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide) induces tear secretion and suppresses corneal injury caused by a reduction in tears. Moreover, it has been reported that a PACAP in water and a 0.9% saline solution at +4 °C showed high stability and achieved 80-90% effectiveness after 2 weeks of treatment. These results reveal PACAP as a candidate DED medication. Further research on the clinical applications of PACAP in DED is necessary.
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Affiliation(s)
- Takahiro Hirabayashi
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Junko Shibato
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Ai Kimura
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Michio Yamashita
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Fumiko Takenoya
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Seiji Shioda
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
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