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Yamamoto K, Kokubun T, Sato K, Akaishi T, Shimazaki A, Nakamura M, Shiga Y, Tsuda S, Omodaka K, Saya H, Nakazawa T. The DNA topoisomerase II inhibitor amsacrine as a novel candidate adjuvant in a model of glaucoma filtration surgery. Sci Rep 2019; 9:19288. [PMID: 31848363 PMCID: PMC6917768 DOI: 10.1038/s41598-019-55365-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/06/2019] [Indexed: 12/22/2022] Open
Abstract
Treatments for refractory glaucoma include trabeculectomy, in which a filtering bleb is created to reduce aqueous pressure. Mitomycin C (MMC) is often used as an adjuvant to reduce post-trabeculectomy bleb scarring and consequent failure. However, scarring sometimes still occurs. Thus, we searched for more effective trabeculectomy adjuvants with high-throughput screening (HTS) of a library of 1,165 off-patent drug compounds. This revealed that amsacrine (AMSA), a DNA topoisomerase II (TOP2) inhibitor, was the top candidate. Compared to MMC, rabbits that underwent trabeculectomy with 10% AMSA had lower IOP at 42, 56, and 70 days (P < 0.01 at all measurement points) and a higher bleb score at 28, 42, 56, and 70 days (P = < 0.01, 0.04, 0.04, and < 0.01, respectively). Compared to saline, rabbits that received 1% AMSA also had lower IOP and better bleb score at all time points, without a sharp drop in IOP just after surgery (all P < 0.01). Both effects were milder than MMC at 7 days (P = 0.02 and <0.01, respectively). Thus, this study showed that HTS may help identify new, promising uses for off-patent drugs. Furthermore, trabeculectomy with AMSA at a suitable concentration may improve the prognosis after trabeculectomy compared to MMC.
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Affiliation(s)
- Kotaro Yamamoto
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Taiki Kokubun
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Kota Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
- Department of Collaborative Program for Ophthalmic Drug Discovery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Takahiro Akaishi
- Research and Development Division, Santen Pharmaceutical Co. Ltd., Ikoma, Nara, 630-0101, Japan
| | - Atsushi Shimazaki
- Research and Development Division, Santen Pharmaceutical Co. Ltd., Ikoma, Nara, 630-0101, Japan
| | - Masatsugu Nakamura
- Research and Development Division, Santen Pharmaceutical Co. Ltd., Ikoma, Nara, 630-0101, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Hideyuki Saya
- Division of Gene Regulation, Institute for Advanced Medical Research, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan.
- Department of Collaborative Program for Ophthalmic Drug Discovery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan.
- Department of Retinal Disease Control, Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan.
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, 980-8574, Japan.
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Zada M, Pattamatta U, White A. Modulation of Fibroblasts in Conjunctival Wound Healing. Ophthalmology 2017; 125:179-192. [PMID: 29079272 DOI: 10.1016/j.ophtha.2017.08.028] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/18/2017] [Accepted: 08/21/2017] [Indexed: 12/20/2022] Open
Abstract
Modulating conjunctival wound healing has the potential to improve outcomes after glaucoma filtration surgery and for several ocular disorders, including ocular cicatrial pemphigoid, vernal keratoconjunctivitis, and pterygium. Although anti-inflammatories and antimetabolites have been used with success, these nonspecific agents are not without their complications. The search for novel and more targeted means to control conjunctival fibrosis without such limitations has brought much attention to the regulation of fibroblast proliferation, differentiation, extracellular matrix production, and apoptosis. This review provides an update on where we stand with current antifibrotic agents and outlines the strategies that novel agents use, as they evolve from the bench to the bedside.
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Affiliation(s)
- Mark Zada
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia.
| | - Ushasree Pattamatta
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia
| | - Andrew White
- Glaucoma Cell Biology Group, The Westmead Institute for Medical Research, NSW, Australia; Discipline of Ophthalmology, Sydney Medical School, University of Sydney, NSW, Australia; Save Sight Institute, University of Sydney, NSW, Australia
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Erol YO, Atilla P, Acaroglu G, Muftuoglu S, Karakaya J. A histopathological investigation of Tenon's capsule in diabetic eyes. Int Ophthalmol 2016; 37:627-633. [PMID: 27515167 DOI: 10.1007/s10792-016-0316-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study is to investigate the histopathological features of Tenon's capsule in eyes with diabetic macular oedema and to compare them between diabetic eyes and healthy subjects. The study included 26 eyes with diabetic oedema and 17 healthy eyes as healthy controls. Tenon's capsule biopsy specimens were processed with the routine electron microscopic analysis technique. Type I and III collagen fibres were labelled immunohistochemically to determine the amounts of predominating collagen fibres. Leica Q-Win program was used to calculate the amounts of collagen fibres type I and type III and independent-t test was utilized to compare the obtained results between the groups. Statistical significance was set at p < 0.05. Demographic characteristics of both groups were similar (p > 0.05). Collagen type I and type III immunoreactivity was observed both in the control and the diabetic groups. The Amounts of collagen fibres type I and type III were significantly higher in the diabetic group than in the control group (mean collagen type I area: 13.410 ± 0.99 and mean collagen type III area: 23.692 ± 0.17 in the control group; mean collagen type I area: 25.270 ± 6.48 and mean collagen type III area: 28.192 ± 0.82 in the diabetic group. p = 0.0037 for type I and p = 0.0000 for type III). In light of the findings of this study, it can be assumed that diabetes mellitus may engender increased amounts of collagen in Tenon's capsule. This alteration affecting the success of filtration surgery should be kept in mind especially in diabetic eyes with glaucoma.
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Affiliation(s)
- Yasemin Ozdamar Erol
- Ankara Ulucanlar Eye Research Hospital, Ulucanlar cad. No: 59 Altındağ, 06100, Ankara, Turkey.
| | - Pergin Atilla
- Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Golge Acaroglu
- Ankara Ulucanlar Eye Research Hospital, Ulucanlar cad. No: 59 Altındağ, 06100, Ankara, Turkey
| | - Sevda Muftuoglu
- Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Gu D, Atencio I, Kang DW, Looper LD, Ahmed CMI, Levy A, Maneval D, Zepeda ML. Recombinant adenovirus-p21 attenuates proliferative responses associated with excessive scarring. Wound Repair Regen 2005; 13:480-90. [PMID: 16176456 DOI: 10.1111/j.1067-1927.2005.00068.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Excessive cutaneous scarring is an important clinical disorder resulting in adverse tissue growth and function as well as undesirable cosmetic appearance. p21WAF-1/Cip-1 is a cyclin-dependent kinase inhibitor that blocks cell cycle progression and inhibits cell proliferation. We used a recombinant adenovirus containing the human p21WAF-1/Cip-1 cDNA (rAd-p21) to evaluate proliferative responses in skin models. In vitro dose-response studies using primary human dermal fibroblasts resulted in a dose-dependent expression of p21WAF-1/Cip-1 protein and a 3- to 80-fold reduction in cell proliferation as measured by 5-bromodeoxyuridine incorporation. Further, rAd-p21 reduced type I procollagen production when compared to control virus. A rat polyvinyl alcohol sponge model was used to determine rAd-p21 effects on granulation tissue formation in vivo. Sponges pretreated with a granulation tissue stimulator, rAd-PDGF-B and subsequently rAd-p21 on a second injection, showed a p21WAF-1/Cip-1 specific dose-dependent decrease in percent granulation fill as the rAd-p21 dose increased (p < 0.001). Immunohistochemistry identified human p21WAF-1/Cip-1 expression in sponges treated with rAd-p21 5 days postinjection. Additionally, 5-bromodeoxyuridine and Ki67 staining in sponges treated with rAd-p21 showed a significant decrease in proliferation when compared to rAd-platelet-derived growth factor-B alone or vehicle control groups (p < 0.01). These data support the utility of p21WAF-1/Cip-1 in targeting hyperproliferative disorders of the skin.
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Affiliation(s)
- Danling Gu
- Department of Pharmacology, Canji Inc., San Diego, California 92121, USA
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Sodhi PK, Verma L, Pandey RM, Ratan S. Comparison between the Role of Intraoperative Mitomycin C and Doxorubicin in Preventing the Recurrence of Primary Pterygium. Ophthalmic Res 2005; 37:1-6. [PMID: 15604592 DOI: 10.1159/000082763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to compare the role of intraoperative mitomycin C (MMC) and doxorubicin in preventing the recurrence of primary pterygium. MATERIALS AND METHODS Fifty-six patients including 22 males and 34 females in the age range of 22-55 years (mean age 38.1 years +/- 10.7) having primary pterygium of progressive type were randomly divided into two groups. The first group of patients was treated with intraoperative MMC (0.02% for 3 min) and in the second group intraoperative doxorubicin (0.02% for 3 min) was used. The patients were regularly followed until 1 year postoperatively for examining visual acuity, wound condition, adverse events and recurrence of pterygium. RESULTS The mean age of patients of MMC group was 37.4 +/- 11.0 years and of doxorubicin group was 38.8 +/- 10.8 years (difference statistically not significant). All these patients had pterygium on the medial side of cornea. The side effects experienced by our patients from the use of these agents were conjunctival hyperemia, conjunctival necrosis, corneal epithelial defect, subconjunctival hemorrhage, episcleritis, increased pain, foreign body sensation, lacrimation, irritation, diminution of vision and photophobia. Recurrence was seen in 4 patients of MMC group (14.3%) and 3 patients of doxorubicin group (10.7%) (difference statistically not significant; chi(2) = 0.16, p = 0.68). The recurrence of pterygium was not associated with age of patients, laterality of eye involved, amount of encroachment of pterygium over cornea, width of pterygium, preoperative complaints and postoperative adverse events. CONCLUSIONS The two antimitotic agents, MMC and doxorubicin, when used intraoperatively along with primary pterygium excision, had a comparable role both in terms of adverse events and prevention of recurrence of pterygium.
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Taban M, Spoor TC, McHenry JG, Sadun AA. Histopathology and ultrastructural examination of optic nerve sheath biopsies after optic nerve sheath decompression with and without mitomycin. Ophthalmic Plast Reconstr Surg 2001; 17:332-7. [PMID: 11642489 DOI: 10.1097/00002341-200109000-00007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE We chose to compare histologically and ultrastructurally changes in the optic nerve sheath after optic nerve sheath decompression, initially after a second surgery and after treatment with mitomycin-C. The mechanism by which optic nerve sheath decompression alleviates papilledema can be further understood in consideration of the results. METHODS Tissue was obtained by biopsy from 3 first-time surgical and 4 reoperative cases with and without mitomycin-C in patients with idiopathic intracranial hypertension. The sheaths were fixed in a mixture of 2% paraformaldehyde and 2% glutaraldehyde, osmicated and dehydrated in a series of ethanol, and finally embedded in epon. Tissue blocks were sectioned at 1 microm and stained with both PPD and toluidine blue. Thin sections were examined by transmission electron microscopy. RESULTS Normal meningeal tissue obtained at the time at optic nerve sheath decompression consisted mainly of collagen, closely packed and roughly parallel to the axis of the optic nerve. Collagen deposition seen in scar tissue after secondary optic nerve sheath decompression was extremely disorganized and irregular, with the individual fibers laid down seemingly at random. There was little sense of layering or of parallel arrays. Mitomycin-C appeared to influence collagen deposition in such a way that the collagen was more regularly packed and more closely resembled unoperated tissue. CONCLUSIONS The regular well-organized collagen packing seen in normal sheath tissue is disrupted and replaced by less organized but compact scar tissue after optic nerve sheath decompression. With mitomycin use, more regular collagen packing closely approximating that found in unoperated sheath occurs. This configuration of fibers lends support for the filtration mechanism of optic nerve sheath decompression in treating papilledema.
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Affiliation(s)
- M Taban
- Doheny Eye Institute, USC School of Medicine, Los Angeles, California 90033, USA
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