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Pegalajar-García MD, Coronel-González BA, Navarro-Triviño FJ. [Translated article] Allergic Contact Dermatitis to Topical Ophthalmic Drugs: Review of Frequently Used Allergens in Spain. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T572-T582. [PMID: 38648926 DOI: 10.1016/j.ad.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/06/2024] [Indexed: 04/25/2024] Open
Abstract
Allergic contact dermatitis induced by the use of ophthalmic topical drugs is one of the most common causes of eyelid dermatitis. The introduction of new formulations, both of active ingredients and excipients, and the lack of marketing in some of them, makes patch testing in patients whose source of contact are topical ophthalmic drugs truly challenging. Across this manuscript, most, if not all, topical ophthalmic drugs used in our national health system have been collected, including information on the allergens available, and the concentration and vehicle advised for those that still remain unavailable.
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Affiliation(s)
| | | | - F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain.
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Pegalajar-García MD, Coronel-González BA, Navarro-Triviño FJ. Allergic Contact Dermatitis to Topical Ophthalmic Drugs: Review of Frequently Used Allergens in Spain. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:572-582. [PMID: 38395223 DOI: 10.1016/j.ad.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Allergic contact dermatitis induced by the use of ophthalmic topical drugs is one of the most common causes of eyelid dermatitis. The introduction of new formulations, both of active ingredients and excipients, and the lack of marketing in some of them, makes patch testing in patients whose source of contact are topical ophthalmic drugs truly challenging. Across this manuscript, most, if not all, topical ophthalmic drugs used in our national health system have been collected, including information on the allergens available, and the concentration and vehicle advised for those that still remain unavailable.
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Affiliation(s)
| | | | - F J Navarro-Triviño
- Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España.
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Ashton SJ, Mughal AA. Contact Dermatitis to Ophthalmic Solutions: An Update. Dermatitis 2023; 34:480-483. [PMID: 37327018 DOI: 10.1089/derm.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Eyelid and periorbital dermatitis remains a distressing and recalcitrant disease. Contact dermatitis remains the most common cause of eyelid and periorbital dermatitis. Ophthalmic solutions used in the treatment of ophthalmic conditions can often be the cause. This article is an update of our previous study, summarizing the contact allergens involved and the new test concentrations reported to investigate through patch testing. New insights found during the review are also documented.
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Affiliation(s)
| | - Avad A Mughal
- Department of Dermatology, Neath and Port Talbot Hospital, Port Talbot, United Kingdom
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Bonelli F, Demirsoy I, Lasagni Vitar RM, Fonteyne P, Ferrari G. Topical formulations of Aprepitant are safe and effective in relieving pain and inflammation, and drive neural regeneration. Ocul Surf 2023; 30:92-103. [PMID: 37690516 DOI: 10.1016/j.jtos.2023.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE To test long-term ocular toxicity and analgesic/anti-inflammatory efficacy of two novel ocular formulations of neurokinin 1 receptor (NK1R) antagonist Aprepitant. METHODS for toxicity studies, two Aprepitant formulations (X and Y) were tested on C57BL/6 N mice. Gold standards were 0.4% Oxybuprocaine, 0.1% Diclofenac, or saline. For efficacy studies, C57BL/6 N mice underwent corneal alkali burn, and then received Aprepitant formulation X, Dexamethasone or saline. Eye-drops were applied 3 times/day for 90 days (toxicity) and 14 days (efficacy). Stromal opacity, corneal epithelial damage, nociception and sensitivity were assessed in vivo. The eye-wiping test and corneal sensitivity were assessed to evaluate analgesic efficacy and nerve function. At the end of the experiments mice were euthanized, and corneas were dissected for immunohistochemistry and RT-PCR analyses. RESULTS In normal mice, formulation X was not toxic when topically administered for 90 days. Formulation Y was associated with increased leukocyte infiltration in the cornea (p < 0.001). X1 and X2 formulations significantly reduced corneal pain, as Diclofenac and Oxybuprocaine, but did not reduce corneal sensitivity. Formulation Y, instead, was not analgesic at any time point. In the alkali burn model, X1 and X2 formulation enhanced epithelial damage recovery, and reduced inflammation both at day 7 and 14. Moreover, formulation X showed a stronger analgesic effect when compared to the saline and Dexamethasone groups (p < 0.01). Finally, formulation X1 and X2 restored corneal sensitivity by promoting corneal nerve regeneration. CONCLUSIONS Aprepitant X formulation is a promising candidate for the treatment of pain associated with inflammation of the ocular surface.
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Affiliation(s)
- Filippo Bonelli
- Cornea and Ocular Surface Disease Unit, Eye Repair Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy; Fondazione Banca degli Occhi del Veneto, Venice, Italy
| | - Ibrahim Demirsoy
- Cornea and Ocular Surface Disease Unit, Eye Repair Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Romina Mayra Lasagni Vitar
- Cornea and Ocular Surface Disease Unit, Eye Repair Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Philippe Fonteyne
- Cornea and Ocular Surface Disease Unit, Eye Repair Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulio Ferrari
- Cornea and Ocular Surface Disease Unit, Eye Repair Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Liu D, Zhao S, Jiang Y, Gao C, Wu Y, Liu Y. Biocompatible Dual Network Bovine Serum Albumin-Loaded Hydrogel-Accelerates Wound Healing. Eur Polym J 2023. [DOI: 10.1016/j.eurpolymj.2023.111820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Sathishkumar P, Mohan K, Meena RAA, Balasubramanian M, Chitra L, Ganesan AR, Palvannan T, Brar SK, Gu FL. Hazardous impact of diclofenac on mammalian system: Mitigation strategy through green remediation approach. JOURNAL OF HAZARDOUS MATERIALS 2021; 419:126135. [PMID: 34157463 DOI: 10.1016/j.jhazmat.2021.126135] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/24/2021] [Accepted: 05/12/2021] [Indexed: 05/22/2023]
Abstract
Diclofenac is an anti-inflammatory drug used as an analgesic. It is often detected in various environmental sources around the world and is considered as one of the emerging contaminants (ECs). This paper reviews the distribution of diclofenac at high concentrations in diverse environments and its adverse ecological impact. Recent studies observed strong evidence of the hazardous effect of diclofenac on mammals, including humans. Diclofenac could cause gastrointestinal complications, neurotoxicity, cardiotoxicity, hepatotoxicity, nephrotoxicity, hematotoxicity, genotoxicity, teratogenicity, bone fractures, and skin allergy in mammals even at a low concentration. Collectively, this comprehensive review relates the mode of toxicity, level of exposure, and route of administration as a unique approach for addressing the destructive consequence of diclofenac in mammalian systems. Finally, the mitigation strategy to eradicate the diclofenac toxicity through green remediation is critically discussed. This review will undoubtedly shed light on the toxic effects of pseudo-persistent diclofenac on mammals as well as frame stringent guidelines against its common usage.
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Affiliation(s)
- Palanivel Sathishkumar
- Key Laboratory of Theoretical Chemistry of Environment, Ministry of Education; School of Chemistry, South China Normal University, Guangzhou 510006, PR China
| | - Kannan Mohan
- PG and Research Department of Zoology, Sri Vasavi College, Erode, Tamil Nadu 638 316, India
| | | | - Murugesan Balasubramanian
- Department of Biotechnology, K.S. Rangasamy College of Technology, Tiruchengode 637 215, Tamil Nadu, India
| | - Loganathan Chitra
- Department of Biochemistry, Periyar University, Salem 636 011, Tamil Nadu, India
| | - Abirami Ramu Ganesan
- Group of Fermentation and Distillation, Laimburg Research Center, Vadena (BZ), Italy
| | | | - Satinder Kaur Brar
- Department of Civil Engineering, Lassonde School of Engineering, York University, North York, Toronto, Ontario M3J 1P3, Canada
| | - Feng Long Gu
- Key Laboratory of Theoretical Chemistry of Environment, Ministry of Education; School of Chemistry, South China Normal University, Guangzhou 510006, PR China.
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Contact Allergy to Topical Drugs. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_38] [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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Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Goossens A, Gonçalo M. Contact Allergy to Topical Drugs. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_38-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alka K, Casey JR. Ophthalmic Nonsteroidal Anti-Inflammatory Drugs as a Therapy for Corneal Dystrophies Caused by SLC4A11 Mutation. Invest Ophthalmol Vis Sci 2019; 59:4258-4267. [PMID: 30140924 DOI: 10.1167/iovs.18-24301] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose SLC4A11 is a plasma membrane protein of corneal endothelial cells. Some mutations of the SLC4A11 gene result in SLC4A11 protein misfolding and failure to mature to the plasma membrane. This gives rise to some cases of Fuchs' endothelial corneal dystrophy (FECD) and congenital hereditary endothelial dystrophy (CHED). We screened ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) for their ability to correct SLC4A11 folding defects. Methods Five ophthalmic NSAIDs were tested for their therapeutic potential in some genetic corneal dystrophy patients. HEK293 cells expressing CHED and FECD-causing SLC4A11 mutants were grown on 96-well dishes in the absence or presence of NSAIDs. Ability of NSAIDs to correct mutant SLC4A11 cell-surface trafficking was assessed with a bioluminescence resonance energy transfer (BRET) assay and by confocal microscopy. The ability of mutant SLC4A11-expressing cells to mediate water flux (SLC4A11 mediates water flux across the corneal endothelial cell basolateral membrane as part of the endothelial water pump) was measured upon treatment with ophthalmic NSAIDs. Results BRET-assays revealed significant rescue of SLC4A11 mutants to the cell surface by 4 of 5 NSAIDs tested. The NSAIDs, diclofenac and nepafenac, were effective in moving endoplasmic reticulum-retained missense mutant SLC4A11 to the cell surface, as measured by confocal immunofluorescence. Among intracellular-retained SLC4A11 mutants, 20 of 30 had significant restoration of cell surface abundance upon treatment with diclofenac. Diclofenac restored mutant SLC4A11 water flux activity to the level of wild-type SLC4A11 in some cases. Conclusions These results encourage testing diclofenac eye drops as a treatment for corneal dystrophy in patients whose disease is caused by some SLC4A11 missense mutations.
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Affiliation(s)
- Kumari Alka
- Department of Biochemistry, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph R Casey
- Department of Biochemistry, University of Alberta, Edmonton, Alberta, Canada
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Affiliation(s)
- Yue Zheng
- Department of Dermato-Venereology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China,
| | - Paru R. Chaudhari
- Department of Dermatology, Mount Sinai School of Medicine, New York, NY, USA, and
| | - Howard I. Maibach
- Department of Dermatology, University of California at San Francisco Medical School, San Francisco, CA, USA
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Farkouh A, Frigo P, Czejka M. Systemic side effects of eye drops: a pharmacokinetic perspective. Clin Ophthalmol 2016; 10:2433-2441. [PMID: 27994437 PMCID: PMC5153265 DOI: 10.2147/opth.s118409] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
When administering eye drops, even when completely correctly applied, several routes of absorption are possible and excess amounts can sometimes cause an unwanted systemic bioavailability of the drops when not completely absorbed into the eye. Furthermore, the concentration of active ingredients in such medicinal preparations is usually very high, so that despite the correct application of the recommended dose, considerable amounts may be absorbed in an unwanted manner through various routes. Children are subject to a much higher risk of systemic side effects because ocular dosing is not weight adjusted and physiological development (eg, liver status) differs from that of adults. There is a lack of information about pediatric dosing in the current literature. This review summarizes the most important clinically relevant systemic side effects that may occur during ophthalmic eye treatments. In this review, we discuss general pharmacokinetic considerations as well as the advantages, disadvantages, and consequences of administering drugs from some important drug groups to the eye.
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Affiliation(s)
- Andre Farkouh
- Division of Clinical Pharmacy and Diagnostics, Faculty of Life Sciences, University of Vienna
| | - Peter Frigo
- Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna
| | - Martin Czejka
- Division of Clinical Pharmacy and Diagnostics, Faculty of Life Sciences, University of Vienna; Austrian Society of Applied Pharmacokinetics, Vienna, Austria
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Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods. Dermatitis 2016; 27:333-347. [DOI: 10.1097/der.0000000000000224] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Akat PB. Severe photosensitivity reaction induced by topical diclofenac. Indian J Pharmacol 2014; 45:408-9. [PMID: 24014923 PMCID: PMC3757616 DOI: 10.4103/0253-7613.114999] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 01/23/2013] [Accepted: 05/14/2013] [Indexed: 11/18/2022] Open
Abstract
Albeit uncommon, photosensitivity reaction induced by diclofenac can be an unfortunate adverse reaction complicating its use as a topical analgesic. We here present a case of a patient who suffered such a reaction as a result of exposure to diclofenac, employed as a topical analgesic for low backache. The lesions healed with conservative management without extensive scarring or other complications.
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Affiliation(s)
- Pramod B Akat
- Consultant Physician, Akat Hospital, Partur, Jalna, Maharashtra, India
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Byrom L, Zappala T, Muir J. Dermatological reactions to ophthalmic preparations: More than meets the eye. Australas J Dermatol 2014; 55:95-8. [DOI: 10.1111/ajd.12152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Lisa Byrom
- Department of Dermatology; Mater Hospital; Brisbane Australia
| | - Tania Zappala
- Department of Dermatology; Mater Childrens Hospital; Brisbane Australia
| | - Jim Muir
- Department of Dermatology; Mater Hospital and Belmont Specialist Centre; Brisbane Australia
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