1
|
Zhu Q, Wang Y, Wang L, Su G. Elucidating acceptance and clinical indications to support the rational design of drug-eluting contact lenses. Int J Pharm 2024; 665:124702. [PMID: 39270761 DOI: 10.1016/j.ijpharm.2024.124702] [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: 06/06/2024] [Revised: 08/22/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
The advent of drug-eluting contact lenses (DECLs) has opened up new avenues for the treatment of eye diseases. DECLs is expected to partially overcome the shortcomings of eye drops due to single-dose packaging, accurate dosing, prolonged drug elution behavior, and simplified dosing procedures. Currently, a significant proportion of the DECLs design effort has been directed towards enhancing the compatibility of contact lenses with drugs. The appropriate elution time for the drug remains unclear. Additionally, it is ambiguous for which ophthalmic diseases DECLs offers the greatest therapeutic advantage. To rationally design DECLs in practice, it is necessary to understand the acceptance of DECLs by patients and practitioners and to clarify the indications for DECLs. This review will first focus on the acceptance of DECLs by different patients and practitioners and discuss the factors that influence its acceptance. Secondly, this review presents an overview of the current effectiveness of DECLs treatments in animals and in the clinical phase, with a particular focus on the suitability of DECLs for the treatment of ophthalmic diseases. Overall, patients and practitioners expressed positive attitudes towards DECLs. However, this is related to factors such as DECLs' treatment cycle, safety, and price. In addition, DECLs has good application prospects for ocular wound healing, postoperative management, and treatment of contact lenses-related complications. Furthermore, chronic diseases such as glaucoma that necessitate long-term medication and intraocular diseases that require implants or injections represent additional potential applications for DECLs. It is hoped that this review will facilitate a deeper understanding of DECLs acceptance and indications, thereby supporting the rational design of DECLs. At the same time, this review provides a reference for the design of other drug-device combination products.
Collapse
Affiliation(s)
- Qiang Zhu
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong 226001, China
| | - Yong Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Nantong University and First People's Hospital of Nantong City, Nantong 226001, China
| | - Linlin Wang
- Department of Food Engineering, Shandong Business Institute, Yantai 264670, China
| | - Gaoxing Su
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong 226001, China.
| |
Collapse
|
2
|
Heljak MK, Cesur S, Ilhan E, Swieszkowski W, Gunduz O, Kijeńska-Gawrońska E. In silico evaluation of corneal patch eluting anti-VEGF agents concept. Eur J Pharm Biopharm 2024; 204:114494. [PMID: 39255920 DOI: 10.1016/j.ejpb.2024.114494] [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: 06/22/2024] [Revised: 08/30/2024] [Accepted: 09/06/2024] [Indexed: 09/12/2024]
Abstract
This study introduces a novel approach utilizing a temporary drug-eluting hydrogel corneal patch to prevent neovascularization, alongside a numerical predictive tool for assessing the release and transport kinetics of bevacizumab (BVZ) after the keratoplasty. A key focus was investigating the impact of tear film clearance on the release kinetics and drug transport from the designed corneal patch. The proposed tear drug clearance model incorporates the physiological mechanism of lacrimal flow (tear turnover), distinguishing itself from previous models. Validation against experimental data confirms the model's robustness, despite limitations such as a 2D axisymmetrical framework and omission of blink frequency and saccadic eye movements potential effects. Analysis highlights the significant influence of lacrimal flow on ocular drug transport, with the corneal patch extending BVZ residence time compared to topical administration. This research sets the stage for exploring multi-layer drug-eluting corneal patches as a promising therapeutic strategy in ocular health.
Collapse
Affiliation(s)
- Marcin K Heljak
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Poland.
| | - Sumeyye Cesur
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Marmara University, Turkiye; Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Turkiye
| | - Elif Ilhan
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Marmara University, Turkiye
| | - Wojciech Swieszkowski
- Faculty of Materials Science and Engineering, Warsaw University of Technology, Poland
| | - Oguzhan Gunduz
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Marmara University, Turkiye; Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Turkiye
| | - Ewa Kijeńska-Gawrońska
- Centre for Advanced Materials and Technologies CEZAMAT, Warsaw University of Technology, Poland.
| |
Collapse
|
3
|
Xie M, Wang L, Deng Y, Ma K, Yin H, Zhang X, Xiang X, Tang J. Sustained and Efficient Delivery of Antivascular Endothelial Growth Factor by the Adeno-associated Virus for the Treatment of Corneal Neovascularization: An Outlook for Its Clinical Translation. J Ophthalmol 2024; 2024:5487973. [PMID: 39286553 PMCID: PMC11405113 DOI: 10.1155/2024/5487973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 06/16/2024] [Accepted: 08/17/2024] [Indexed: 09/19/2024] Open
Abstract
Corneal diseases represent 5.1% of all eye defects and are the fourth leading cause of blindness globally. Corneal neovascularization can arise from all conditions of chronic irritation or hypoxia, which disrupts the immune-privileged state of the healthy cornea, increases the risk of rejection after keratoplasty, and leads to opacity. In the past decades, significant progress has been made for neovascular diseases of the retina and choroid, with plenty of drugs getting commercialized. In addition, to overcome the barriers of the short duration and inadequate penetration of conventional formulations of antivascular endothelial growth factor (VEGF), multiple novel drug delivery systems, including adeno-associated virus (AAV)-mediated transfer have gone through the full process of bench-to-bedside translation. Like retina neovascular diseases, corneal neovascularization also suffers from chronicity and a high risk of recurrence, necessitating sustained and efficient delivery across the epithelial barrier to reach deep layers of the corneal stroma. Among the explored methods, adeno-associated virus-mediated delivery of anti-VEGF to treat corneal neovascularization is the most extensively researched and most promising strategy for clinical translation although currently although, it remains predominantly at the preclinical stage. This review comprehensively examines the necessity, benefits, and risks of applying AAV vectors for anti-VEGF drug delivery in corneal vascularization, including its current progress and challenges in clinical translation.
Collapse
Affiliation(s)
- Mengzhen Xie
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
- Beijing Institute of Ophthalmology Beijing Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Lixiang Wang
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| | - Yingping Deng
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| | - Ke Ma
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| | - Hongbo Yin
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| | - Xiaolan Zhang
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| | - Xingye Xiang
- School of Life Science and Engineering Southwest Jiaotong University, Chengdu, Sichuan, China
- Georgia State University, Atlanta, GA 30302, USA
| | - Jing Tang
- Department of Ophthalmology West China Hospital Sichuan University, Chengdu 610041, China
| |
Collapse
|
4
|
Meng T, Zheng J, Shin CS, Gao N, Bande D, Sudarjat H, Chow W, Halquist MS, Yu FS, Acharya G, Xu Q. Combination Nanomedicine Strategy for Preventing High-Risk Corneal Transplantation Rejection. ACS NANO 2024; 18:20679-20693. [PMID: 39074146 PMCID: PMC11308920 DOI: 10.1021/acsnano.4c06595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 07/31/2024]
Abstract
High-risk (HR) corneal transplantation presents a formidable challenge, with over 50% of grafts experiencing rejection despite intensive postoperative care involving frequent topical eyedrop administration up to every 2 h, gradually tapering over 6-12 months, and ongoing maintenance dosing. While clinical evidence underscores the potential benefits of inhibiting postoperative angiogenesis, effective antiangiogenesis therapy remains elusive in this context. Here, we engineered controlled-release nanomedicine formulations comprising immunosuppressants (nanoparticles) and antiangiogenesis drugs (nanowafer) and demonstrated that these formulations can prevent HR corneal transplantation rejection for at least 6 months in a clinically relevant rat model. Unlike untreated corneal grafts, which universally faced rejection within 2 weeks postsurgery, a single subconjunctival injection of the long-acting immunosuppressant nanoparticle alone effectively averted graft rejection for 6 months, achieving a graft survival rate of ∼70%. Notably, the combination of an immunosuppressant nanoparticle and an anti-VEGF nanowafer yielded significantly better efficacy with a graft survival rate of >85%. The significantly enhanced efficacy demonstrated that a combination nanomedicine strategy incorporating immunosuppressants and antiangiogenesis drugs can greatly enhance the ocular drug delivery and benefit the outcome of HR corneal transplantation with increased survival rate, ensuring patient compliance and mitigating dosing frequency and toxicity concerns.
Collapse
Affiliation(s)
- Tuo Meng
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
| | - Jinhua Zheng
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
- Department
of Ophthalmology, Affiliated Hospital of
Guizhou Medical University, Guiyang, Guizhou 550004, China
| | - Crystal S. Shin
- Michale
E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, Texas 77030, United States
| | - Nan Gao
- Departments
of Ophthalmology, Anatomy and Cell Biology, Wayne State University School of Medicine, Detroit, Michigan 48201, United States
| | - Divya Bande
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
| | - Hadi Sudarjat
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
| | - Woon Chow
- Department
of Ophthalmology, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
- Department
of Pathology, Virginia Commonwealth University, Richmond, Virginia 23298, United States
| | - Matthew Sean Halquist
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
| | - Fu-Shin Yu
- Departments
of Ophthalmology, Anatomy and Cell Biology, Wayne State University School of Medicine, Detroit, Michigan 48201, United States
| | - Ghanashyam Acharya
- Michale
E. DeBakey Department of Surgery, Baylor
College of Medicine, Houston, Texas 77030, United States
- Department
of Materials Science and Nanoengineering, Rice University, Houston, Texas 77005, United States
| | - Qingguo Xu
- Department
of Pharmaceutics, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
- Department
of Ophthalmology, Virginia Commonwealth
University, Richmond, Virginia 23298, United States
- Center
for Pharmaceutical Engineering; Institute for Structural Biology,
Drug Discovery & Development (ISB3D); and Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia 23298, United States
| |
Collapse
|
5
|
Zhong C, Shi Z, Binzel DW, Jin K, Li X, Guo P, Li SK. Posterior eye delivery of angiogenesis-inhibiting RNA nanoparticles via subconjunctival injection. Int J Pharm 2024; 657:124151. [PMID: 38657717 PMCID: PMC11221552 DOI: 10.1016/j.ijpharm.2024.124151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Neovascularization contributes to various posterior eye segment diseases such as age-related macular degeneration and diabetic retinopathy. RNA nanoparticles were demonstrated previously to enter the corneal and retinal cells after subconjunctival injection for ocular delivery. In the present study, antiangiogenic aptamers (anti-vascular endothelial growth factor (VEGF) and anti-angiopoietin-2 (Ang2) aptamers) were conjugated to RNA nanoparticles. The objectives were to investigate the clearance and distribution of these angiogenesis-inhibiting RNA nanoparticles after subconjunctival injection in vivo and their antiangiogenic effects for inhibiting ocular neovascularization in vitro. The results in the whole-body fluorescence imaging study showed that the clearance of RNA nanoparticles was size-dependent with no significant differences between RNA nanoparticles with and without the aptamers except for pRNA-3WJ. The distribution study of RNA nanoparticles by confocal microscopy of the dissected eye tissues in vivo indicated cell internalization of the larger RNA nanoparticles in the retina and retinal pigment epithelium after subconjunctival injection, and the larger nanoparticles with aptamers showed higher levels of cell internalization than those without. In the cell proliferation assay in vitro, RNA nanoparticles with multiple aptamers had higher antiangiogenic effects. With both longer retention time and high antiangiogenic effect, SQR-VEGF-Ang2 could be a promising RNA nanoparticle for posterior eye delivery.
Collapse
Affiliation(s)
- Cheng Zhong
- Division of Pharmaceutical Sciences, James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH 45267, USA.
| | - Zhanquan Shi
- Division of Pharmaceutical Sciences, James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Daniel W Binzel
- Center for RNA Nanobiotechnology and Nanomedicine, College of Pharmacy, James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Kai Jin
- Center for RNA Nanobiotechnology and Nanomedicine, College of Pharmacy, James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Xin Li
- Center for RNA Nanobiotechnology and Nanomedicine, College of Pharmacy, James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Peixuan Guo
- Center for RNA Nanobiotechnology and Nanomedicine, College of Pharmacy, James Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; Dorothy M. Davis Heart and Lung Research Institute, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - S Kevin Li
- Division of Pharmaceutical Sciences, James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH 45267, USA
| |
Collapse
|
6
|
Wu D, Chan KE, Lim BXH, Lim DKA, Wong WM, Chai C, Manotosh R, Lim CHL. Management of corneal neovascularization: Current and emerging therapeutic approaches. Indian J Ophthalmol 2024; 72:S354-S371. [PMID: 38648452 PMCID: PMC467007 DOI: 10.4103/ijo.ijo_3043_23] [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: 11/17/2022] [Revised: 12/16/2023] [Accepted: 12/25/2023] [Indexed: 04/25/2024] Open
Abstract
Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties. CoNV occurs due to a disequilibrium in proangiogenic and antiangiogenic mediators, involving a complex system of molecular interactions. Treatment of CoNV is challenging, and no therapy thus far has been curative. Anti-inflammatory agents such as corticosteroids are the mainstay of treatment due to their accessibility and well-studied safety profile. However, they have limited effectiveness and are unable to regress more mature neovascularization. With the advent of advanced imaging modalities and an expanding understanding of its pathogenesis, contemporary treatments targeting a wide array of molecular mechanisms and surgical options are gaining traction. This review aims to summarize evidence regarding conventional and emerging therapeutic options for CoNV.
Collapse
Affiliation(s)
- Duoduo Wu
- Department of Ophthalmology, National University Hospital, Singapore
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Blanche Xiao Hong Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dawn Ka-Ann Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wendy Meihua Wong
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charmaine Chai
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ray Manotosh
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chris Hong Long Lim
- Department of Ophthalmology, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Singapore Eye Research Institute, Singapore
| |
Collapse
|
7
|
Blohm KO, Nell B. Adjunctive bevacizumab therapy in an equine corneal stromal invasive squamous cell carcinoma with a 53-months follow-up. Tierarztl Prax Ausg G Grosstiere Nutztiere 2024; 52:108-114. [PMID: 38701802 PMCID: PMC11068419 DOI: 10.1055/a-2253-8103] [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: 06/13/2023] [Accepted: 11/28/2023] [Indexed: 05/05/2024]
Abstract
A 17-year-old Appaloosa mare was referred for evaluation of presumed refractory keratitis of the left eye. Gross examination revealed ocular discomfort and corneal neovascularization with a nasal focal opacification affecting approximately 40% of the corneal surface. On ophthalmic examination, extensive subepithelial to mid-stromal vascular branching accompanied by a homogeneous white, dense opacification, which affected up to 80% of the total corneal thickness, were apparent. Signs of concurrent uveitis were absent. Deep-stromal lamellar keratectomy with a conjunctival pedicle graft was performed under general anesthesia. Histopathology confirmed a poorly differentiated corneal stromal invasive squamous cell carcinoma (SI-SCC) with neoplastic cell extension to the surgical margins. Postoperatively, 4 topical mitomycin C 0.04% chemotherapy cycles combined with oral firocoxib therapy were initiated. Seven months after surgery, regrowth of the SI-SCC was clinically suspected. A total volume of 1 ml bevacizumab 2.5% was administered in the standing sedated horse via 3 mid-stromal corneal injections. Four weeks later, intrastromal bevacizumab injections (ISBIs) were repeated, however, this time the solution was injected directly into the main corneal vessel branches.Seven weeks after the second ISBIs, the left eye was comfortable and significant remission of corneal vascularization and opacity was recognized. No recurrence has been noted for a follow-up period of more than 53 months.Equine SI-SCC usually has a very poor prognosis for globe maintenance. To the authors' knowledge this is the first report of well-tolerated intrastromal antivascular endothelial growth factor adjunctive therapy with bevazicumab 2.5% and SI-SCC resolution after a multimodal treatment approach.
Collapse
Affiliation(s)
- Klaas-Ole Blohm
- Tierklinik Lüsche im SANAKENA, Appen-Etz, Germany
- Tierarztpraxis Schönhoff, Stendal, Germany
- Department for Companion Animals and Horses, Ophthalmology Unit, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, Ophthalmology Unit, University of Veterinary Medicine, Vienna, Austria
| |
Collapse
|
8
|
Allison C, Jiménez A, Ramajayam K, Haemmerich D, Zderic V. Therapeutic Ultrasound for Enhanced Corneal Permeability to Macromolecules. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:127-136. [PMID: 37842972 DOI: 10.1002/jum.16346] [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: 06/06/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES Topically applied macromolecules have the potential to provide vision-saving treatments for many of the leading causes of blindness in the United States. The aim of this study was to determine if ultrasound can be applied to increase transcorneal drug delivery of macromolecules without dangerously overheating surrounding ocular tissues. METHODS Dissected corneas of adult rabbits were placed in a diffusion cell between a donor compartment filled with a solution of macromolecules (40, 70 kDa, or 150 kDa) and a receiver compartment. Each cornea was exposed to the drug solution for 60 minutes, with the experimental group receiving 5 minutes of continuous ultrasound or 10 minutes of pulsed ultrasound at a 50% duty cycle (pulse repetition frequency of 500 ms on, 500 ms off) at the beginning of treatment. Unfocused circular ultrasound transducers were operated at 0.5 to 1 W/cm2 intensity and at 600 kHz frequency. RESULTS The greatest increase in transcorneal drug delivery seen was 1.2 times (P < .05) with the application of pulsed ultrasound at 0.5 W/cm2 and 600 kHz for 10 minutes with 40 kDa macromolecules. Histological analysis revealed structural damage mostly in the corneal epithelium, with most damage occurring at the epithelial surface. CONCLUSIONS This study suggests that ultrasound may be used for enhancing transcorneal delivery of macromolecules of lower molecular weights. Further research is needed on the long-term effects of ultrasound parameters used in this study on human ocular tissues.
Collapse
Affiliation(s)
- Claire Allison
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - Annette Jiménez
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - Krishna Ramajayam
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Dieter Haemmerich
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Vesna Zderic
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| |
Collapse
|
9
|
Alió JL, Niazi S, Doroodgar F, Barrio JLAD, Hashemi H, Javadi MA. Main issues in penetrating keratoplasty. Taiwan J Ophthalmol 2024; 14:50-58. [PMID: 38654981 PMCID: PMC11034681 DOI: 10.4103/tjo.tjo-d-24-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 04/26/2024] Open
Abstract
This review explores contemporary challenges in penetrating keratoplasty (PK), focusing on technical intricacies, technological advancements, and strategies for preventing graft rejection. A systematic literature search from January 2018 to July 2023 was conducted across PubMed, Cochrane, Web of Science, Scopus, and EMBASE. The inclusion criteria comprised studies on PK and its comparison with other corneal pathologies, with emphasis on keratoconus (KC). Two independent reviewers screened studies, extracting relevant data. The review covers PK evolution, highlighting infra-red femtosecond lasers' impact on graft shapes, minimizing astigmatism, and enhancing wound healing. Graft rejection, a primary complication, is examined, detailing risk factors and preventive measures. Preoperative considerations, diagnostic techniques for rejection, and PK in KC are discussed. Postoperative care's significance, including intraocular pressure monitoring and steroid administration, is emphasized. The paper concludes with a comprehensive approach to prevent graft rejection, involving topical and systemic medications. An outlook on evolving monoclonal antibody research is presented. As the field progresses, personalized approaches and ongoing therapeutic exploration are expected to refine strategies, enhancing PK outcomes.
Collapse
Affiliation(s)
- Jorge L. Alió
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
- Vissum Miranza Alicante, Alicante, Spain
| | - Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Huang X, Li L, Chen Z, Yu H, You X, Kong N, Tao W, Zhou X, Huang J. Nanomedicine for the Detection and Treatment of Ocular Bacterial Infections. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023; 35:e2302431. [PMID: 37231939 DOI: 10.1002/adma.202302431] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/15/2023] [Indexed: 05/27/2023]
Abstract
Ocular bacterial infection is a prevalent cause of blindness worldwide, with substantial consequences for normal human life. Traditional treatments for ocular bacterial infections areless effective, necessitating the development of novel techniques to enable accurate diagnosis, precise drug delivery, and effective treatment alternatives. With the rapid advancement of nanoscience and biomedicine, increasing emphasis has been placed on multifunctional nanosystems to overcome the challenges posed by ocular bacterial infections. Given the advantages of nanotechnology in the biomedical industry, it can be utilized to diagnose ocular bacterial infections, administer medications, and treat them. In this review, the recent advancements in nanosystems for the detection and treatment of ocular bacterial infections are discussed; this includes the latest application scenarios of nanomaterials for ocular bacterial infections, in addition to the impact of their essential characteristics on bioavailability, tissue permeability, and inflammatory microenvironment. Through an in-depth investigation into the effect of sophisticated ocular barriers, antibacterial drug formulations, and ocular metabolism on drug delivery systems, this review highlights the challenges faced by ophthalmic medicine and encourages basic research and future clinical transformation based on ophthalmic antibacterial nanomedicine.
Collapse
Affiliation(s)
- Xiaomin Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200030, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200030, China
- Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Luoyuan Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200030, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200030, China
- The Eighth Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, 518033, P. R. China
| | - Zhongxing Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200030, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200030, China
| | - Haoyu Yu
- The Eighth Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, 518033, P. R. China
| | - Xinru You
- Center for Nanomedicine and Department of Anesthesiology Brigham and Women's Hospital Harvard Medical School, Boston, MA, 02115, USA
| | - Na Kong
- Center for Nanomedicine and Department of Anesthesiology Brigham and Women's Hospital Harvard Medical School, Boston, MA, 02115, USA
| | - Wei Tao
- Center for Nanomedicine and Department of Anesthesiology Brigham and Women's Hospital Harvard Medical School, Boston, MA, 02115, USA
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200030, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200030, China
| | - Jinhai Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200030, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200030, China
| |
Collapse
|
11
|
Lai SC, Loh EW, Chiou DI, Hong CT. Efficacy and safety of anti-vascular endothelial growth factor agents on corneal neovascularization: A meta-analysis. World J Clin Cases 2023; 11:7337-7349. [PMID: 37969435 PMCID: PMC10643059 DOI: 10.12998/wjcc.v11.i30.7337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Corneal neovascularization (CoNV) is the second major cause of blindness. Vascular endothelial growth factor (VEGF) inhibitors, e.g., bevacizumab, have been used to prevent CoNV. AIM We conducted an updated systematic review and meta-analysis of clinical trials to examine the efficacy and safety of anti-VEGF in CoNV. METHODS A literature search was conducted using three electronic databases. Mean difference (MD), standard mean difference (SMD), and relative risk (RR) are used to estimate the effect size. RESULTS Nine randomized controlled and three non-randomized trials were obtained. The pooled results demonstrated a significant reduction of CoNV area/Length (SMD = -1.17, 95%CI: -1.58 to -0.75), best corrected visual acuity (MD = -0.54, 95%CI: -0.91 to -0.17), and graft rejection (RR = 0.44, 95%CI: 0.24 to 0.8) and failure (RR = 0.39, 95%CI: 0.19 to 0.78) rates in the anti-VEGF group than the placebo group. A non-significant reduction of the epithelial defect was also observed in the bevacizumab group compared with the placebo (RR = 0.56, 95%CI: 0.30 to 1.06). Compared with a placebo, the unsynthesizable trials also support that bevacizumab improves visual acuity, CoNV, graft rejection, and failure rates. Trials reporting other comparisons revealed the superiority of combined remedy with bevacizumab compared to other treatments in reducing CoNV. CONCLUSION Anti-VEGF agents, mainly bevacizumab, are an effective and safe treatment for CoNV of all causes and prevent corneal graft rejection and failure in corneal transplantation.
Collapse
Affiliation(s)
- Shih-Chung Lai
- Department of Ophthalmology, Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - El-Wui Loh
- Center for Evidence-Based Health Care, Department of Medical Research, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei 110, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Medical Imaging, Taipei Medical University Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Du-I Chiou
- Department of Ophthalmology, Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Chien-Tai Hong
- Department of Neurology, Taipei Medical University-Shuang Ho Hospital, New Taipei 23561, Taiwan
| |
Collapse
|
12
|
Rajendran R, Arunachalam JP, Chidambaram S, Krishnagopal S, Krishnamurthy B, Vinayagam S, Veeravarmal V, Prasad H, Verma K, U R A. Protein Drug Delivery Using a Novel Maxillofacial Technique Targeting the Visual Pathway in the Brain, the Optic Nerve, and the Retina. ACS Chem Neurosci 2023; 14:3368-3384. [PMID: 37665674 DOI: 10.1021/acschemneuro.3c00184] [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] [Indexed: 09/06/2023] Open
Abstract
Protein drugs are used for treating many diseases of the eye and the brain. The formidable blood neural barriers prevent the delivery of these drugs into the eye and the brain. Hence, there is a need for a protein drug delivery system to deliver large proteins across blood-neural barriers. Low half-life, poor penetration of epithelial barriers, low stability, and immunogenicity limit the use of non-invasive systemic routes for delivering proteins. In this pre-clinical study, the efficacy of a new maxillofacial route for administering protein drugs using a novel drug delivery system is compared with systemic administration through intra-peritoneal injection and ocular administration through topical eye drops and subconjunctival and intravitreal injections. Bevacizumab and retinoschisin proteins were administered using the maxillofacial technique along with systemic and ocular routes in wild-type male C57BL/6J mice. Liquid chromatography with tandem mass spectrometry and western blot was used to detect bevacizumab in tissue samples. Furthermore, immunohistochemistry was performed to detect the presence and localization of bevacizumab and retinoschisin in the retina and brain. The maxillofacial route of delivery could target the brain including regions involved in the visual pathway and optic nerve. The maxillofacial technique and intravitreal injection were effective in delivering the drugs into the retina. A new concept based on the glymphatic pathway, cerebrospinal fluid drug distribution, and the crossover of ipsilateral optic nerve fibers at optic chiasma is proposed to explain the presence of the drug in contralateral eye following maxillofacial administration and intravitreal injection.
Collapse
Affiliation(s)
- Rahini Rajendran
- Central Inter-Disciplinary Research Facility, Sri Balaji Vidyapeeth [Deemed to be University], SBV-Mahatma Gandhi Medical College & Research Institute Campus, Puducherry 607402, India
| | - Jayamuruga Pandian Arunachalam
- Central Inter-Disciplinary Research Facility, Sri Balaji Vidyapeeth [Deemed to be University], SBV-Mahatma Gandhi Medical College & Research Institute Campus, Puducherry 607402, India
| | - Subbulakshmi Chidambaram
- Sensory Neural Engineering and Cell Therapeutics Lab, Department of Biochemistry and Molecular Biology, Pondicherry University, Puducherry 605014, India
| | - Srikanth Krishnagopal
- Department of Ophthalmology, Sri Balaji Vidyapeeth [Deemed to be University], Mahatma Gandhi Medical College & Research Institute, Puducherry 607402, India
| | - Bhavani Krishnamurthy
- Department of Pathology, Sri Balaji Vidyapeeth [Deemed to be University], Mahatma Gandhi Medical College & Research Institute, Puducherry 607402, India
| | - Subha Vinayagam
- Department of Pharmacology, Sri Balaji Vidyapeeth [Deemed to be University], Mahatma Gandhi Medical College & Research Institute, Puducherry 607402, India
| | - Veeran Veeravarmal
- Department of Oral & Maxillofacial Pathology and Oral Microbiology, Government Dental College, Cuddalore, Annamalai Nagar, Chidambaram 608002, Tamil Nadu, India
| | - Harikrishnan Prasad
- Department of Oral Pathology and Microbiology, KSR Institute of Dental Science and Research, Tiruchengode 637215, Tamil Nadu, India
| | - Kavita Verma
- UR Anoop Research Group, Puducherry 605008, India
| | - Anoop U R
- UR Anoop Research Group, Puducherry 605008, India
| |
Collapse
|
13
|
Bauer A, Klassa S, Herbst A, Maccioni C, Abhamon W, Segueni N, Kaluzhny Y, Hunter MC, Halin C. Optimization and Characterization of Novel ALCAM-Targeting Antibody Fragments for Transepithelial Delivery. Pharmaceutics 2023; 15:1841. [PMID: 37514028 PMCID: PMC10385607 DOI: 10.3390/pharmaceutics15071841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Activated leukocyte cell adhesion molecule (ALCAM) is a cell adhesion molecule that supports T cell activation, leukocyte migration, and (lymph)angiogenesis and has been shown to contribute to the pathology of various immune-mediated disorders, including asthma and corneal graft rejection. In contrast to monoclonal antibodies (mAbs) targeting ALCAM's T cell expressed binding partner CD6, no ALCAM-targeting mAbs have thus far entered clinical development. This is likely linked with the broad expression of ALCAM on many different cell types, which increases the risk of eliciting unwanted treatment-induced side effects upon systemic mAb application. Targeting ALCAM in surface-exposed tissues, such as the lungs or the cornea, by a topical application could circumvent this issue. Here, we report the development of various stability- and affinity-improved anti-ALCAM mAb fragments with cross-species reactivity towards mouse, rat, monkey, and human ALCAM. Fragments generated in either mono- or bivalent formats potently blocked ALCAM-CD6 interactions in a competition ELISA, but only bivalent fragments efficiently inhibited ALCAM-ALCAM interactions in a leukocyte transmigration assay. The different fragments displayed a clear size-dependence in their ability to penetrate the human corneal epithelium. Furthermore, intranasal delivery of anti-ALCAM fragments reduced leukocyte infiltration in a mouse model of asthma, confirming ALCAM as a target for topical application in the lungs.
Collapse
Affiliation(s)
- Aline Bauer
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - Sven Klassa
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - Anja Herbst
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - Cristina Maccioni
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - William Abhamon
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - Noria Segueni
- Artimmune SAS, 13 Avenue Buffon, 45100 Orleans, France
| | - Yulia Kaluzhny
- MatTek Corporation, 200 Homer Avenue, Ashland, MA 01721, USA
| | - Morgan Campbell Hunter
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| | - Cornelia Halin
- Institute of Pharmaceutical Sciences, ETH Zurich, 1-5/10 Vladimir-Prelog-Weg, 8093 Zurich, Switzerland
| |
Collapse
|
14
|
Peng WY, He LW, Yin XF, Zhou BB, Zhou T, Zhou SY. Successful regression of newly formed corneal neovascularization by subconjunctival injection of bevacizumab in patients with chemical burns. Front Med (Lausanne) 2023; 10:1210765. [PMID: 37425330 PMCID: PMC10324651 DOI: 10.3389/fmed.2023.1210765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Purpose To investigate the effect and timing of subconjunctival bevacizumab injection on inhibiting corneal neovascularization (CorNV) in patients after chemical burns. Methods Patients with CorNV secondary to chemical burns were involved. Two subconjunctival injections of bevacizumab (2.5 mg/0.1 mL per involved quadrant) with an interval of 4 weeks were administered, and followed up a year. The area occupied by neovascular vessels (NA), accumulative neovascular length (NL), mean neovascular diameter (ND), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were evaluated. Complication was also recorded. Results Eleven patients with CorNV were involved. Eight patients had a history of surgery (four had amniotic grafts, one had keratoplasty, and three had amniotic grafts and keratoplasty). Decreasing in NA, NL, and ND were statistically significant at each time point compared to the baseline (p < 0.01). CorNV that developed within 1 month was considerably regressed, and vessels with fibrovascular membranes were found to be narrower and shorter than pretreatment. BCVA improved in five patients (from one to five lines), remained unchanged in five patients, and decreased in one patient compared to pretreatment. Conclusion Subconjunctival bevacizumab injection has a particular potential for the regression of CorNV, especially newly formed within 1 month in patients after chemical burns.
Collapse
Affiliation(s)
- Wen-yan Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Li-wen He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiao-fang Yin
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, China
| | - Bin-Bing Zhou
- Department of Ophthalmology, The Affiliated First Hospital of Guangdong Pharmaceutical University, Guangzhou, China
| | - Tao Zhou
- Department of Ophthalmology, First People’s Hospital of Guiyang, Guiyang, China
| | - Shi-you Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| |
Collapse
|
15
|
Patnam M, Dommaraju SR, Masood F, Herbst P, Chang JH, Hu WY, Rosenblatt MI, Azar DT. Lymphangiogenesis Guidance Mechanisms and Therapeutic Implications in Pathological States of the Cornea. Cells 2023; 12:319. [PMID: 36672254 PMCID: PMC9856498 DOI: 10.3390/cells12020319] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/22/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Corneal lymphangiogenesis is one component of the neovascularization observed in several inflammatory pathologies of the cornea including dry eye disease and corneal graft rejection. Following injury, corneal (lymph)angiogenic privilege is impaired, allowing ingrowth of blood and lymphatic vessels into the previously avascular cornea. While the mechanisms underlying pathological corneal hemangiogenesis have been well described, knowledge of the lymphangiogenesis guidance mechanisms in the cornea is relatively scarce. Various signaling pathways are involved in lymphangiogenesis guidance in general, each influencing one or multiple stages of lymphatic vessel development. Most endogenous factors that guide corneal lymphatic vessel growth or regression act via the vascular endothelial growth factor C signaling pathway, a central regulator of lymphangiogenesis. Several exogenous factors have recently been repurposed and shown to regulate corneal lymphangiogenesis, uncovering unique signaling pathways not previously known to influence lymphatic vessel guidance. A strong understanding of the relevant lymphangiogenesis guidance mechanisms can facilitate the development of targeted anti-lymphangiogenic therapeutics for corneal pathologies. In this review, we examine the current knowledge of lymphatic guidance cues, their regulation of inflammatory states in the cornea, and recently discovered anti-lymphangiogenic therapeutic modalities.
Collapse
Affiliation(s)
- Mehul Patnam
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Sunil R. Dommaraju
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Faisal Masood
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Paula Herbst
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Jin-Hong Chang
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Wen-Yang Hu
- Department of Urology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Mark I. Rosenblatt
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Dimitri T. Azar
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| |
Collapse
|
16
|
Chu YC, Fang HW, Wu YY, Tang YJ, Hsieh EH, She Y, Chang CY, Lin IC, Chen YJ, Liu GS, Tseng CL. Functional Peptide-Loaded Gelatin Nanoparticles as Eyedrops for Cornea Neovascularization Treatment. Int J Nanomedicine 2023; 18:1413-1431. [PMID: 36992821 PMCID: PMC10042260 DOI: 10.2147/ijn.s398769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
Background Corneal neovascularization (NV) is a process of abnormal vessel growth into the transparent cornea from the limbus and can disturb the light passing through the cornea, resulting in vision loss or even blindness. The use of nanomedicine as an effective therapeutic formulation in ophthalmology has led to higher drug bioavailability and a slow drug release rate. In this research, we designed and explored the feasibility of a new nanomedicine, gp91 ds-tat (gp91) peptide-encapsulated gelatin nanoparticles (GNP-gp91), for inhibiting corneal angiogenesis. Methods GNP-gp91 were prepared by a two-step desolvation method. The characterization and cytocompatibility of GNP-gp91 were analyzed. The inhibition effect of GNP-gp91 on HUVEC cell migration and tube formation was observed by an inverted microscope. The drug retention test in mouse cornea was observed by in vivo imaging system, fluorescence microscope, and DAPI/TAMRA staining. Finally, the therapeutic efficacy and evaluation of neovascularization-related factors were conducted through the in vivo corneal NV mice model via topical delivery. Results The prepared GNP-gp91 had a nano-scale diameter (550.6 nm) with positive charge (21.7 mV) slow-release behavior (25%, 240hr). In vitro test revealed that GNP-gp91 enhanced the inhibition of cell migration and tube formation capacity via higher internalization of HUVEC. Topical administration (eyedrops) of the GNP-gp91 significantly prolongs the retention time (46%, 20 min) in the mouse cornea. In chemically burned corneal neovascularization models, corneal vessel area with a significant reduction in GNP-gp91 group (7.89%) was revealed when compared with PBS (33.99%) and gp91 (19.67%) treated groups via every two days dosing. Moreover, GNP-gp91 significantly reduced the concentration of Nox2, VEGF and MMP9 in NV's cornea. Conclusion The nanomedicine, GNP-gp91, was successfully synthesized for ophthalmological application. These data suggest that GNP-gp91 contained eyedrops that not only have a longer retention time on the cornea but also can treat mice corneal NV effectively delivered in a low dosing frequency, GNP-gp91 eyedrops provides an alternative strategy for clinical ocular disease treatment in the culture.
Collapse
Affiliation(s)
- Ya-Chun Chu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei City, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei City, Taiwan
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County, Taiwan
| | - Yu-Yi Wu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - Yu-Jun Tang
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - Erh-Hsuan Hsieh
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - YiZhou She
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - Che-Yi Chang
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
| | - I-Chan Lin
- Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Yin-Ju Chen
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei City, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Center for Precision Medicine and Translational Cancer Research, Taipei Medical University Hospital, Taipei City, Taiwan
| | - Guei-Sheung Liu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Center for Precision Medicine and Translational Cancer Research, Taipei Medical University Hospital, Taipei City, Taiwan
- Research Center of Biomedical Device, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan
- Correspondence: Ching-Li Tseng, Tel +886 2 2736 1661 (ext. 5214), Email
| |
Collapse
|
17
|
Gu D, Pan H, Xu S, Chen W, Zhu R, Jiang W, Pan W. Construction and Evaluation of Hyaluronic Acid-Coated Flurbiprofen-Layered Double Hydroxide Ocular Drug Delivery System. AAPS PharmSciTech 2022; 23:287. [PMID: 36266593 DOI: 10.1208/s12249-022-02418-2] [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: 06/23/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
In this study, flurbiprofen (FB) was selected as the model drug, and hyaluronic acid-coated flurbiprofen-layered double hydroxide ophthalmic drug delivery system (HA-FB-LDH) was designed and prepared. In this system, the model drug flurbiprofen was intercalated in layered double hydroxide and coated with hyaluronic acid (HA), so as to prolong the corneal residence time and increase the corneal permeability of the drug. Layered double hydroxide (LDH) was prepared by alcohol-water coprecipitation method. Through single factor investigation, the optimum preparation conditions were obtained as follows: The Mg/Al ratio was 2:1, the reaction pH was 11.0, the hydrothermal reaction time was 24 h, and the hydrothermal reaction temperature was 100°C. Under these conditions, the particle size of LDH was 116.4 ± 0.8 nm, the potential was 42.2 ± 1.2 mV, and a relatively regular crystal structure could be had. Then FB was intercalated into the LDH layer to prepare flurbiprofen-layered double hydroxide (FB-LDH). In the end, HA-FB-LDH was prepared by the stirring-ultrasonic method, in which through prescription screening, the molecular weight of HA was 200-400 kDa and the concentration of HA solution was 1.25 mg·mL -1, the final particle size of HA-FB-LDH was 185.8 ± 3.3 nm, and potential of - 31.4 ± 0.7 mV. The successful loading of FB and the coating of HA were verified by XRD, FTIR, TGA, TEM, and other characterization methods. The results of in vitro stability experiment indicated that the coating of HA could significantly enhance the stability of LDH in the presence of electrolytes. The in vitro release results suggested that the cumulative release amounts of FB-LDH and HA-FB-LDH within 12 h were 92.99 ± 0.37% and 74.82 ± 0.29% respectively, showing a certain sustained release effect. At the same time, the release mechanism of FB-LDH was preliminarily explored by in vitro release experiment, which proved that the release mechanism of FB-LDH was mainly ion exchange. The results of in vivo ocular irritation experiments demonstrated that the ophthalmic preparation studied in this paper was safe and non-irritating. The results of tear pharmacokinetics in rabbits showed that the area under the curve(AUC), the average residence time (MRT), and the highest concentration (Cmax) in tears in the HA-FB-LDH group were 4.43, 4.48, and 2.27 times higher than those in eye drops group separately. Furthermore, the AUC of the HA-FB-LDH group was 1.48 times higher than that of the FB-LDH group. The above results suggested that HA-FB-LDH could improve the precorneal residence time. The results of aqueous humor pharmacokinetics in rabbits indicated that the AUC, MRT, and maximum concentration (Cmax) in aqueous humor in the HA-FB-LDH group were 6.88, 2.15, and 4.08 times of those in the eye drop group respectively. Additionally, the AUC and MRT of the HA-FB-LDH group were 1.55 and 1.63 times those of the FB-LDH group separately. These mentioned findings verified that HA-FB-LDH could enhance the corneal permeability of the drug. The fluorescent substance-fluoresce isothiocyanate (FITC) was substituted for FB intercalation in LDH for in vitro tissue imaging study of rabbits, whose results stated clearly that FITC-LDH and HA-FITC-LDH could both prolong the precorneal residence time of drugs, and HA-FITC-LDH could increase the corneal permeability of the drug to a certain extent. To sum up, HA-FB-LDH, which can overcome the shortcomings of low bioavailability of traditional eye drops to a certain degree, is a safe and effective ophthalmic drug delivery system.
Collapse
Affiliation(s)
- Donghao Gu
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Hao Pan
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Shuo Xu
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Wenyue Chen
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Renfang Zhu
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Wenjing Jiang
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China.,Liaoning University, Shenyang, 110036, China
| | - Weisan Pan
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road, 1, Shenyang, 110016, China. .,Liaoning University, Shenyang, 110036, China.
| |
Collapse
|
18
|
Huang W, Wang L, Yang R, Hu R, Zheng Q, Zan X. Combined delivery of small molecule and protein drugs as synergistic therapeutics for treating corneal neovascularization by a one-pot coassembly strategy. Mater Today Bio 2022; 17:100456. [PMID: 36281304 PMCID: PMC9587374 DOI: 10.1016/j.mtbio.2022.100456] [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: 08/06/2022] [Revised: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Combined drug administration is a potential strategy to increase efficacy through therapeutic synergy. Small molecule drugs and protein drugs are the two most popular kinds of drugs in medicine. However, efficiently encapsulating these two drugs still have key challenges due to their distinct properties (molecular weight, hydrophilicity, chemical groups, etc.), weak ability to penetrate through various biobarriers (cell membrane, endosome escape, tissue barriers dependent on the method of administration, etc.) and the easy deactivation of protein drugs during the construction of carrier and delivery process. Here, we utilize the hexahistidine-metal assembly (HmA), which can encapsulate a wide spectrum of drugs with high loading efficiency, to coencapsulate Dexp (a small molecule drug) and BVZ (protein drug) by a one-pot coassembly strategy. Our data demonstrated that Dexp and BVZ were coloaded into Dexp&BVZ@HmA with high efficiency, while the bioactivity of BVZ was well-maintained. Most importantly, when evaluating the therapeutic outcomes of drugs@HmA in a corneal neovascularization (CNV) model in vitro and in vivo, the combination group presented overwhelming efficacy compared to the monotherapy group. This strategy offers a platform to codeliver protein and small drugs and has the potential for treating anterior segment diseases as well as other diseases that need combination therapy.
Collapse
Affiliation(s)
- Wenjuan Huang
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China,School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Liwen Wang
- Huzhou Central Hospital, Affliated Central Hospital of Huzhou University, Huzhou, Zhejiang Province, China
| | - Ruhui Yang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Ronggui Hu
- Department of Anesthesiology, Wenzhou Key Laboratory of Perioperative Medicine,the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China,State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
| | - Qinxiang Zheng
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China,Corresponding author. The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China.
| | - Xingjie Zan
- Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China,School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, China,Department of Anesthesiology, Wenzhou Key Laboratory of Perioperative Medicine,the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China,Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou China,Corresponding author. Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, China.
| |
Collapse
|
19
|
Dohlman TH, McSoley M, Amparo F, Carreno-Galeano T, Wang M, Dastjerdi M, Singh RB, Coco G, Di Zazzo A, Shikari H, Saboo U, Sippel K, Ciralsky J, Yoo SH, Sticca M, Wakamatsu TH, Murthy S, Hamrah P, Jurkunas U, Ciolino JB, Gomes JAP, Perez VL, Yin J, Dana R. Bevacizumab in High-Risk Corneal Transplantation: A Pilot Multicenter Prospective Randomized Control Trial. Ophthalmology 2022; 129:865-879. [PMID: 35358592 PMCID: PMC10742165 DOI: 10.1016/j.ophtha.2022.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/06/2022] [Accepted: 03/23/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To determine the efficacy of local (subconjunctival and topical) bevacizumab (Avastin) treatment in patients undergoing vascularized high-risk corneal transplantation. DESIGN Pilot, prospective, randomized, double-blind, placebo-controlled clinical trial conducted at 5 clinical centers in the United States, India, and Brazil. PARTICIPANTS Patients aged > 18 years undergoing high-risk penetrating keratoplasty, defined as corneal neovascularization (NV) in 1 or more quadrants ≥2 mm from the limbus or extension of corneal NV to the graft-host junction in a previously failed graft. METHODS Patients were randomized to receive subconjunctival bevacizumab (2.5 mg/0.1 ml) or placebo at the time of surgery, followed by topical bevacizumab (10 mg/ml) or topical placebo, administered 4 times per day for 4 weeks. MAIN OUTCOME MEASURE The 52-week endothelial immune rejection rate. RESULTS Ninety-two patients were randomized to receive bevacizumab (n = 48) or control (n = 44). The 52-week endothelial rejection rate was 10% in the bevacizumab group and 19% in the control group (P = 0.20). Post hoc, extended follow-up at the lead study site showed an endothelial rejection rate of 3% in the bevacizumab group and 38% in the control group (P = 0.003). Treatment with bevacizumab was found to have a hazard ratio of 0.15 (95% confidence interval, 0.03-0.65, P = 0.01) in a post hoc Cox regression analysis. CONCLUSIONS In patients undergoing vascularized high-risk corneal transplantation, there was no statistically significant difference in the rate of endothelial rejection at 1 year in the bevacizumab treatment group compared with the control group. This study may have been underpowered to detect a difference between treatment groups, and taken together, our data suggest that, in the current trial design, bevacizumab has a positive but not (yet) significant effect on endothelial rejection.
Collapse
Affiliation(s)
- Thomas H Dohlman
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Matthew McSoley
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Francisco Amparo
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Tatiana Carreno-Galeano
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Mengyu Wang
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Mohammad Dastjerdi
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Rohan Bir Singh
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Giulia Coco
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Antonio Di Zazzo
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Hasanain Shikari
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Ujwala Saboo
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Kimberly Sippel
- Department of Ophthalmology, Weill Cornell Medicine, New York, New York
| | - Jessica Ciralsky
- Department of Ophthalmology, Weill Cornell Medicine, New York, New York
| | - Sonia H Yoo
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Matheus Sticca
- Cornea and External Disease Service, Paulista Medical School/Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tais H Wakamatsu
- Cornea and External Disease Service, Paulista Medical School/Universidade Federal de São Paulo, São Paulo, Brazil
| | - Somasheila Murthy
- Cornea Service, The Cornea Institute, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| | - Pedram Hamrah
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Ula Jurkunas
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Joseph B Ciolino
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Jose A P Gomes
- Cornea and External Disease Service, Paulista Medical School/Universidade Federal de São Paulo, São Paulo, Brazil
| | - Victor L Perez
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Foster Center for Ocular Immunology, Duke Eye Center, Duke University School of Medicine, Durham, North Carolina
| | - Jia Yin
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Reza Dana
- Cornea Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
20
|
Almogbil HH, Montecinos-Franjola F, Daszynski C, Conlon WJ, Hachey JS, Corazza G, Rodriguez EA, Zderic V. Therapeutic Ultrasound for Topical Corneal Delivery of Macromolecules. Transl Vis Sci Technol 2022; 11:23. [PMID: 35998058 PMCID: PMC9424970 DOI: 10.1167/tvst.11.8.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/23/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The objective of this study was to utilize therapeutic ultrasound in enhancing delivery of topical macromolecules into the cornea. Methods Rabbit corneas were dissected and placed in a diffusion cell with a small ultra-red fluorescent protein (smURFP; molecular weight of 32,000 Da) as a macromolecule solution. The corneas were treated with continuous ultrasound application at frequencies of 400 or 600 kHz and intensities of 0.8 to 1.0 W/cm2 for 5 minutes, or sham-treated. Fluorescence imaging of the cornea sections was used to observe the delivery of macromolecules into individual epithelial cells. Spectrophotometric analysis at smURFP maximal absorbance of 640 nm was done to determine the presence of macromolecules in the receiver compartment. Safety of ultrasound application was studied through histology analysis. Results Ultrasound-treated corneas showed smURFP delivery into epithelial cells by fluorescence in the cytoplasm, whereas sham-treated corneas lacked any appreciable fluorescence in the individual cells. The sham group showed 0% of subcellular penetration, whereas the 400 kHz ultrasound-treated group and 600 kHz ultrasound-treated group showed 31% and 57% of subcellular penetration, respectively. Spectrophotometry measurements indicated negligible presence of smURFP macromolecules in the receiver compartment solution in both the sham and ultrasound treatment groups, and these macromolecules did not cross the entire depth of the cornea. Histological studies showed no significant corneal damage due to ultrasound application. Conclusions Therapeutic ultrasound application was shown to increase the delivery of smURFP macromolecules into the cornea. Translational Relevance Our study offers a clinical potential for a minimally invasive macromolecular treatment of corneal diseases.
Collapse
Affiliation(s)
- Hanaa H. Almogbil
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | | | - Camille Daszynski
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - William J. Conlon
- Department of Chemistry, The George Washington University, Washington, DC, USA
| | - Justin S. Hachey
- Department of Chemistry, The George Washington University, Washington, DC, USA
| | - Giavanna Corazza
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| | - Erik A. Rodriguez
- Department of Chemistry, The George Washington University, Washington, DC, USA
| | - Vesna Zderic
- Department of Biomedical Engineering, The George Washington University, Washington, DC, USA
| |
Collapse
|
21
|
Bhandari M, Nguyen S, Yazdani M, Utheim TP, Hagesaether E. The Therapeutic Benefits of Nanoencapsulation in Drug Delivery to the Anterior Segment of the Eye: A Systematic Review. Front Pharmacol 2022; 13:903519. [PMID: 35645827 PMCID: PMC9136980 DOI: 10.3389/fphar.2022.903519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Although numerous nanoparticle formulations have been developed for ocular administration, concerns are being raised about a possible mismatch between potential promises made by the field of nanoparticle research and demonstration of actual therapeutic benefit. Therefore, the primary focus of this present review was to critically assess to what extent nanoencapsulation of ocular drugs improved the therapeutic outcome when treating conditions in the anterior segment of the eye. Methods: A systematic search was conducted using Medline, PubMed, and Embase databases as well as Google Scholar for published peer-reviewed articles in English focusing on conventional nanoparticles used as drug delivery systems to the anterior segment of the eye in in vivo studies. The major therapeutic outcomes were intraocular pressure, tear secretion, number of polymorphonuclear leucocytes and pupil size. The outcome after encapsulation was compared to the non-encapsulated drug. Results: From the search, 250 results were retrieved. Thirty-eight studies met the inclusion criteria. Rabbits were used as study subjects in all but one study, and the number of animals ranged from 3 to 10. Coated and uncoated liposomes, lipid-based and polymeric nanoparticles, as well as micelles, were studied, varying in both particle size and surface charge, and encapsulating a total of 24 different drugs, including 6 salts. The majority of the in vivo studies demonstrated some improvement after nanoencapsulation, but the duration of the benefit varied from less than 1 h to more than 20 h. The most common in vitro methods performed in the studies were drug release, transcorneal permeation, and mucin interaction. Discussion: Nanoparticles that are small and mucoadhesive, often due to positive surface charge, appeared beneficial. Although in vitro assays can unravel more of the hidden and sophisticated interplay between the encapsulated drug and the nanoparticle structure, they suffered from a lack of in vitro—in vivo correlation. Therefore, more research should be focused towards developing predictive in vitro models, allowing rational design and systematic optimization of ocular nanoparticles with minimal animal experimentation.
Collapse
Affiliation(s)
- Madhavi Bhandari
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- *Correspondence: Madhavi Bhandari,
| | - Sanko Nguyen
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mazyar Yazdani
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Tor Paaske Utheim
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Ellen Hagesaether
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
22
|
Zhang W, Schönberg A, Bock F, Cursiefen C. Posttransplant VEGFR1R2 Trap Eye Drops Inhibit Corneal (Lymph)angiogenesis and Improve Corneal Allograft Survival in Eyes at High Risk of Rejection. Transl Vis Sci Technol 2022; 11:6. [PMID: 35533080 PMCID: PMC9100603 DOI: 10.1167/tvst.11.5.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess whether topical application of VEGFR1R2 Trap after corneal transplantation can impair corneal (lymph)angiogenesis and promote murine corneal allograft survival in eyes at high risk of rejection. Methods We used the murine model of suture-induced neovascularization and subsequent keratoplasty in eyes at high risk of rejection, which is an established model for local drug application. After transplantation, the mice were treated with either VEGFR1R2 Trap (aflibercept) or human IgG Fc as eye drops for 2 weeks (three times/d). Deposition of VEGFR1R2 Trap in corneal tissue was detected by immunohistochemistry. Two and 8 weeks after transplantation, corneal (lymph)angiogenesis was assessed morphometrically. Dendritic cells (DCs) and regulatory T cells (Tregs) in the draining lymph nodes (dLNs) were examined by flow cytometry. Allograft survival was determined by corneal graft opacity scores. Results Topically applied VEGFR1R2 Trap penetrated into corneal host and graft stroma after keratoplasty in eyes at high risk of rejection. Additional postsurgical corneal hemangiogenesis (P < 0.0001) and lymphangiogenesis (P < 0.01) as well as infiltrating CD45+ leukocytes (P < 0.001) and macrophages (P < 0.01) were significantly reduced in the VEGFR1R2 Trap group compared to controls. VEGFR1R2 Trap eye drops significantly decreased the frequency of total CD11c+ DCs (P < 0.01), as well as activated CD11c+MHC II+ DCs (P < 0.01) and CD11c+CD40+ DCs (P < 0.05). In contrast, the frequency of CD200R+ regulatory DCs (P < 0.05) and Tregs in dLNs (P < 0.01) was enhanced. Moreover, long-term allograft survival was also improved (P < 0.05). Conclusions Temporary, topical application of VEGFR1R2 Trap after corneal transplantation can achieve sufficient anti-VEGF activity, inhibit additional (lymph)angiogenesis, and significantly improve corneal allograft survival in eyes at high risk of rejection. Translational Relevance VEGFR1R2 Trap eye drops after transplantation present a new therapeutic option for patients undergoing corneal transplantation and are at high risk of graft rejection.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Alfrun Schönberg
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Felix Bock
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Claus Cursiefen
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| |
Collapse
|
23
|
Suppression of lipopolysaccharide-induced corneal opacity by hepatocyte growth factor. Sci Rep 2022; 12:494. [PMID: 35017561 PMCID: PMC8752742 DOI: 10.1038/s41598-021-04418-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/22/2021] [Indexed: 12/21/2022] Open
Abstract
Keratitis induced by bacterial toxins, including lipopolysaccharide (LPS), is a major cause of corneal opacity and vision loss. Our previous study demonstrates hepatocyte growth factor (HGF) promotes epithelial wound healing following mechanical corneal injury. Here, we investigated whether HGF has the capacity to suppress infectious inflammatory corneal opacity using a new model of LPS-induced keratitis. Keratitis, induced by two intrastromal injections of LPS on day 1 and 4 in C57BL/6 mice, resulted in significant corneal opacity for up to day 10. Following keratitis induction, corneas were topically treated with 0.1% HGF or PBS thrice daily for 5 days. HGF-treated mice showed a significantly smaller area of corneal opacity compared to PBS-treated mice, thus improving corneal transparency. Moreover, HGF treatment resulted in suppression of α-SMA expression, compared to PBS treatment. HGF-treated corneas showed normalized corneal structure and reduced expression of pro-inflammatory cytokine, demonstrating that HGF restores corneal architecture and immune quiescence in corneas with LPS-induced keratitis. These findings offer novel insight into the potential application of HGF-based therapies for the prevention and treatment of infection-induced corneal opacity.
Collapse
|
24
|
Vaneev A, Tikhomirova V, Chesnokova N, Popova E, Beznos O, Kost O, Klyachko N. Nanotechnology for Topical Drug Delivery to the Anterior Segment of the Eye. Int J Mol Sci 2021; 22:12368. [PMID: 34830247 PMCID: PMC8621153 DOI: 10.3390/ijms222212368] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/06/2021] [Accepted: 11/15/2021] [Indexed: 02/07/2023] Open
Abstract
Topical drug delivery is one of the most challenging aspects of eye therapy. Eye drops are the most prevalent drug form, especially for widely distributed anterior segment eye diseases (cataracts, glaucoma, dry eye syndrome, inflammatory diseases, etc.), because they are convenient and easy to apply by patients. However, conventional drug formulations are usually characterized by short retention time in the tear film, insufficient contact with epithelium, fast elimination, and difficulties in overcoming ocular tissue barriers. Not more than 5% of the total drug dose administered in eye drops reaches the interior ocular tissues. To overcome the ocular drug delivery barriers and improve drug bioavailability, various conventional and novel drug delivery systems have been developed. Among these, nanosize carriers are the most attractive. The review is focused on the different drug carriers, such as synthetic and natural polymers, as well as inorganic carriers, with special attention to nanoparticles and nanomicelles. Studies in vitro and in vivo have demonstrated that new formulations could help to improve the bioavailability of the drugs, provide sustained drug release, enhance and prolong their therapeutic action. Promising results were obtained with drug-loaded nanoparticles included in in situ gel.
Collapse
Affiliation(s)
- Alexander Vaneev
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
- Research Laboratory of Biophysics, National University of Science and Technology “MISIS”, 119991 Moscow, Russia
| | - Victoria Tikhomirova
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Natalia Chesnokova
- Department of Pathophysiology and Biochemistry, Helmholtz National Medical Research Center of Eye Diseases, 105062 Moscow, Russia; (N.C.); (O.B.)
| | - Ekaterina Popova
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Olga Beznos
- Department of Pathophysiology and Biochemistry, Helmholtz National Medical Research Center of Eye Diseases, 105062 Moscow, Russia; (N.C.); (O.B.)
| | - Olga Kost
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
| | - Natalia Klyachko
- Chemistry Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia; (A.V.); (V.T.); (E.P.); (O.K.)
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Research Institute “Nanotechnology and Nanomaterials”, G.R. Derzhavin Tambov State University, 392000 Tambov, Russia
| |
Collapse
|
25
|
Muellerleile LM, Bernkopf M, Wambacher M, Nell B. Topical bevacizumab for the treatment of corneal vascularization in dogs: A case series. Vet Ophthalmol 2021; 24:554-568. [PMID: 34487608 PMCID: PMC9292418 DOI: 10.1111/vop.12931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/11/2021] [Accepted: 08/23/2021] [Indexed: 12/27/2022]
Abstract
Objective To evaluate the effect and safety of topical anti‐human vascular endothelial growth factor bevacizumab in dogs with persistent corneal vascularization. Animals studied Prospective case series of 15 adult dogs (20 eyes). Procedures Dogs received 0.25% bevacizumab eye drops BID for 28 days. Follow‐ups were scheduled 28 days and 6–7 months after treatment start. Macroscopic findings were scored for conjunctival hyperemia, chemosis, ocular discharge, corneal edema, vascularization, and pigmentation. Vascularized area was assessed by analyzing photographs using an imaging software. Results The treatment response was variable. Some cases showed a marked reduction in vascularized area and edema, while other eyes had subtle signs of improvement. Vascularization score decreased from 1.5 to 1.1 and vascularized area was reduced by 48.8% after 28 days. A thinning of vessels, consolidation of areal bleedings into fine vascular networks, decrease in distal vessel branching, and a change from blurry vascularized beds into demarcated thin vessels were observed. One dog developed a SCCED 6 months after the last bevacizumab administration. Two dogs died 4 and 4.5 months after the last bevacizumab administration, aged 16 and 12 years, respectively. In all events, a causal relationship is unlikely but cannot be ruled out with certainty. Conclusions Our findings suggest that topical 0.25% bevacizumab may be an effective treatment option for corneal vascularization in dogs. Further long‐term placebo‐controlled studies with larger patient cohorts are recommended to provide scientific evidence of efficacy and to investigate dosage, safety, possible use as a single treatment, and routes of administration.
Collapse
Affiliation(s)
- Lisa-Marie Muellerleile
- Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Michael Bernkopf
- E-Learning and New Media, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Michael Wambacher
- Hospital Pharmacy, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Barbara Nell
- Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| |
Collapse
|
26
|
Silva M, Peng T, Zhao X, Li S, Farhan M, Zheng W. Recent trends in drug-delivery systems for the treatment of diabetic retinopathy and associated fibrosis. Adv Drug Deliv Rev 2021; 173:439-460. [PMID: 33857553 DOI: 10.1016/j.addr.2021.04.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/05/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022]
Abstract
Diabetic retinopathy is a frequent microvascular complication of diabetes and a major cause of visual impairment. In advanced stages, the abnormal neovascularization can lead to fibrosis and subsequent tractional retinal detachment and blindness. The low bioavailability of the drugs at the target site imposed by the anatomic and physiologic barriers within the eye, requires long term treatments with frequent injections that often compromise patient's compliance and increase the risk of developing more complications. In recent years, much effort has been put towards the development of new drug delivery platforms aiming to enhance their permeation, to prolong their retention time at the target site and to provide a sustained release with reduced toxicity and improved efficacy. This review provides an overview of the etiology and pathophysiology of diabetic retinopathy and current treatments. It addresses the specific challenges associated to the different ocular delivery routes and provides a critical review of the most recent developments made in the drug delivery field.
Collapse
Affiliation(s)
- Marta Silva
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau
| | - Tangming Peng
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau
| | - Xia Zhao
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau
| | - Shuai Li
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau
| | - Mohd Farhan
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau
| | - Wenhua Zheng
- Centre of Reproduction, Development and Aging, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau.
| |
Collapse
|
27
|
Peira E, Chindamo G, Chirio D, Sapino S, Oliaro-Bosso S, Rebba E, Ivanchenko P, Gallarate M. Assessment of In-Situ Gelling Microemulsion Systems upon Temperature and Dilution Condition for Corneal Delivery of Bevacizumab. Pharmaceutics 2021; 13:258. [PMID: 33668475 PMCID: PMC7918509 DOI: 10.3390/pharmaceutics13020258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 01/29/2023] Open
Abstract
Bevacizumab (BVZ), a recombinant humanized monoclonal antibody, has recently been proposed as a topical application in the treatment of anterior segment neovascularization; however, as there are some disadvantages in the administration of common eye-drops, ophthalmic topical drug delivery systems are under study to improve the precorneal residence time, reducing the frequency of administration. In this work, oil-in-water and water-in-oil BVZ-loaded microemulsions are developed, able to increase their viscosity, either by the formation of a liquid-crystalline structure upon aqueous dilution, thanks to the presence of Epikuron® 200 and polysorbate 80, or by body-temperature-induced jellification for the presence of Pluronic® F127 aqueous solution as an external phase. In oil-in-water microemulsion, hydrophobic ion pairs of BVZ were also prepared, and their incorporation was determined by release studies. Microemulsions were characterized for rheological behavior, corneal opacity, in vitro corneal permeation, and adhesion properties. The studied microemulsions were able to incorporate BVZ (from 1.25 to 1.6 mg/mL), which maintained dose-dependent activity on retinal pigment epithelial ARPE-19 cell lines. BVZ loaded in microemulsions permeated the excised cornea easier (0.76-1.56% BVZ diffused, 4-20% BVZ accumulated) than BVZ commercial solution (0.4% BVZ diffused, 5% accumulated) and only a mild irritation effect on the excised cornea was observed. The good adhesion properties as well the increased viscosity after application, under conditions that mimic the corneal environment (from 1 × 103 to more than 100 × 103 mPa·s), might prolong precorneal residence time, proving these systems could be excellent topical BVZ release systems.
Collapse
Affiliation(s)
- Elena Peira
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| | - Giulia Chindamo
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| | - Daniela Chirio
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| | - Simona Sapino
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| | - Simonetta Oliaro-Bosso
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| | - Erica Rebba
- Department of Chemistry and Interdepartmental Nanostructured Interfaces and Surfaces (NIS) Centre, University of Turin, 10125 Turin, Italy; (E.R.); (P.I.)
| | - Pavlo Ivanchenko
- Department of Chemistry and Interdepartmental Nanostructured Interfaces and Surfaces (NIS) Centre, University of Turin, 10125 Turin, Italy; (E.R.); (P.I.)
| | - Marina Gallarate
- Department of Drug Science and Technology, University of Turin, 10125 Turin, Italy; (G.C.); (S.S.); (S.O.-B.); (M.G.)
| |
Collapse
|
28
|
Intrastromal versus subconjunctival anti-VEGF agents for treatment of corneal neovascularization: a rabbit study. Eye (Lond) 2021; 35:3123-3130. [PMID: 33469129 DOI: 10.1038/s41433-020-01347-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/14/2020] [Accepted: 11/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To determine whether subconjunctival or intrastromal administration of anti-VEGF agents is more effective on suture-induced corneal neovascularization (CoNV) in rabbits. METHODS CoNV was induced in 48 eyes of 24 New Zealand white rabbits by using an 8/0 silk suture. On the 7th day after suturing, the rabbits were divided into four treatment groups as follows: six rabbits received subconjunctival bevacizumab (group 1), six rabbits received subconjunctival aflibercept (group 2), six rabbits received intrastromal bevacizumab (group 3) and six rabbits received intrastromal aflibercept (group 4). On the 7th and 14th days after suturing, the CoNV area was calculated by standardised analysis of photographs using the Image-J program. On the 14th day after suturing, all rabbits were sacrificed and then corneal tissue was harvested for the analysis of vascular endothelial growth factor (VEGF)-A, VEGF-B and placental growth factor (PIGF) levels. RESULTS On the 7th day after suturing, CoNV areas were 17.10 ± 2.98, 18.88 ± 3.78, 17.36 ± 4.52, 18.57 ± 4.16 and 17.31 ± 2.81 mm2 in the groups 1-4 and control group, respectively. On the 7th day after intervention and removal of suture, CoNV areas were 4.85 ± 1.99, 6.66 ± 1.73, 2.83 ± 1.08, 2.63 ± 1.16 and 11.93 ± 2.64 mm2 in the group 1-4 and control group, respectively. CoNV area was reduced by 88.1% and 82.5% in eyes receiving intrastromal aflibercept and bevacizumab, respectively (both p < 0.001), and by 64.5% and 69.9% in eyes receiving subconjunctival aflibercept and bevacizumab, respectively (both p = 0.001). CONCLUSION Intrastromal anti-VEGF therapy regressed CoNV more effectively than subconjunctival therapy regardless of the type of anti-VEGF agent.
Collapse
|
29
|
Ciprofloxacin self-dissolvable Soluplus based polymeric films: a novel proposal to improve the management of eye infections. Drug Deliv Transl Res 2021; 11:608-625. [PMID: 33528829 PMCID: PMC7852484 DOI: 10.1007/s13346-020-00887-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 01/31/2023]
Abstract
Infections of the eye are among the leading causes of vision impairment and vision loss worldwide. The ability of a drug to access the anterior parts of the eye is negligible after systemic administration. Effective drug delivery to the eye is a major challenge due to the presence of protective mechanisms and physiological barriers that result in low ocular availability after topical application. The main purpose of this work was the improvement of the corneal and conjunctival permeation of the antibiotic Ciprofloxacin, a wide spectrum antibiotic used for the most common eye infection, using a self-dissolving polymeric film. Films were prepared by the solvent casting technique, using polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft co-polymer (Soluplus), polyvynyl alcohol, and propylene glycol. Films were homogeneous in drug content and thickness, as demonstrated by adapting the Swiss Roll technique followed by microscopy observation. These films proved in vitro to control the release of the Ciprofloxacin. Ex vivo permeability studies using Franz diffusion cells and porcine cornea and sclera showed an effective permeability of the drug without inducing irritation of the tissues. Films swelled in contact with artificial tears forming an in situ gel over 20 min, which will improve drug contact and reduce the need of multiple dosing. The antibiotic activity was also tested in vitro in five types of bacterial cultures, assuring the pharmacological efficacy of the films. The developed films are a promising drug delivery system to topically treat or prevent ocular infections.
Collapse
|
30
|
Hall MN, Moshirfar M, Amin-Javaheri A, Ouano DP, Ronquillo Y, Hoopes PC. Lipid Keratopathy: A Review of Pathophysiology, Differential Diagnosis, and Management. Ophthalmol Ther 2020; 9:833-852. [PMID: 33058067 PMCID: PMC7708541 DOI: 10.1007/s40123-020-00309-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Lipid keratopathy is a disease in which fat deposits accumulate in the cornea, leading to opacification and decrease of visual acuity. This condition can be idiopathic without signs of previous corneal disease or secondary to ocular or systemic diseases. Lipid keratopathy is usually associated with abnormal vascularization of the cornea, and the lipid classically deposits adjacent to these vessels. Treatment of this condition usually aims to eliminate or prevent abnormal vessel formation, and several modalities have been described. In this review we summarize the etiology, pathophysiology, and clinical presentation of lipid keratopathy and describe current and emerging treatment regimens.
Collapse
Affiliation(s)
- MacGregor N Hall
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
| | | | | | | | | |
Collapse
|
31
|
Le VNH, Hos D, Hou Y, Witt M, Barkovskiy M, Bock F, Cursiefen C. VEGF Trap R1R2 Suspended in the Semifluorinated Alkane F6H8 Inhibits Inflammatory Corneal Hem- and Lymphangiogenesis. Transl Vis Sci Technol 2020; 9:15. [PMID: 33117607 PMCID: PMC7571278 DOI: 10.1167/tvst.9.11.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/18/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Semifluorinated alkanes (SFAs) are used at the ocular surface as lubricants or vehicles for drugs. The purpose of this study was to test the effect of vascular endothelial growth factor (VEGF) TrapR1R2 suspended in the SFA perfluorohexyloctane (Trap/F6H8) on corneal neovascularization. Methods Suture placement was used to induce inflammatory corneal neovascularization in mice. Treatment groups were: Trap/F6H8, VEGF TrapR1R2 as aqueous formulation dissolved in phosphate buffer (Trap), F6H8, and phosphate buffer (controls). Eye drops were applied 3×/daily for 2 weeks. Afterward, corneas were stained with CD31 and LYVE-1 to analyze corneal hem- and lymphangiogenesis. To investigate the effect of on inflammatory cell recruitment, corneal CD45+ cells were quantified. In addition, epithelial wound closure after debridement was assessed by corneal fluorescein staining. Results Trap/F6H8 was as effective as Trap in inhibiting corneal hemangiogenesis and lymphangiogenesis after 2 weeks of treatment. After 3 days of treatment, Trap/F6H8 was even more effective than Trap in inhibiting corneal hemangiogenesis. Both treatment groups (Trap/F6H8 and Trap) significantly reduced corneal CD45+ cell recruitment. Epithelial closure after debridement was unaffected by Trap/F6H8 or Trap. Conclusions In this study, we demonstrate that F6H8 is a potential carrier for VEGF TrapR1R2 to topically treat corneal neovascularization. Our findings might open new treatment avenues for local anti-angiogenic therapy at the cornea, as F6H8 is already approved for the usage at the ocular surface. Translational Relevance With this study we show for the first time that SFAs can serve as carriers for anti-angiogenic drugs at the ocular surface.
Collapse
Affiliation(s)
- Viet Nhat Hung Le
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.,Department of Ophthalmology, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | - Deniz Hos
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Germany
| | - Yanhong Hou
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China
| | | | | | - Felix Bock
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany
| | - Claus Cursiefen
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Germany
| |
Collapse
|
32
|
Yildirim H, Aydemir O, Balbaba M, Özercan İH, İlhan N. Comparison of the effect of topical bevacizumab and sorafenib in experimental corneal neovascularization. Cutan Ocul Toxicol 2020; 39:223-228. [PMID: 32338080 DOI: 10.1080/15569527.2020.1760877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to compare the neovascularization inhibiting the effect of topical bevacizumab and sorafenib and to determine the effective dose of sorafenib. MATERIAL AND METHODS Forty-two healthy Wistar albino rats were randomly divided into six groups. The right corneas of all rats except group 1 were cauterised with silver nitrate. Group 2 received DMSO, group 3 received topical bevacizumab (5 mg/dL, 3 times a day) and group 4, 5 and 6 received topical sorafenib (2.5 mg/dl, 5 mg/dL, 7.5 mg/dL, 2 times a day respectively), between days 1 and 7. Corneal photographs were taken on day 8 and the corneal neovascular area percentage was calculated. Following decapitation, the corneas were removed to determine the levels of VEGF ELİSA and corneal immune staining. The Mann-Whitney U-test was used for statistical analysis. RESULTS The neovascular corneal area percentage was statistically significantly lower in the treatment groups than group 2 (p < 0.05). The intensity of VEGF immune staining was also lower in groups 3, 5 and 6 from the group 2. Group 3, 5 and 6 were no significant differences compared to group 1. The VEGF ELİSA levels were statistically significantly lower in group 3, 5 and 6 compared to group 2 (p < 0.05). There was no statistically difference between VEGF ELİSA levels of group 2 and 4 (p > 0.05). CONCLUSIONS Sorafenib was as effective as bevacizumab in the regression of corneal neovascularization. The effect of sorafenib seems to be dose-dependent. The low doses and twice a day administration are important advantages of sorafenib.
Collapse
Affiliation(s)
- Hakan Yildirim
- Faculty of Medicine, Department of Ophthalmology, Firat University, Elazig, Turkey
| | - Orhan Aydemir
- Faculty of Medicine, Department of Ophthalmology, Firat University, Elazig, Turkey
| | - Mehmet Balbaba
- Faculty of Medicine, Department of Ophthalmology, Firat University, Elazig, Turkey
| | | | - Nevin İlhan
- Faculty of Medicine, Department of Biochemistry, Firat University, Elazig, Turkey
| |
Collapse
|
33
|
Jamali A, Seyed-Razavi Y, Chao C, Ortiz G, Kenyon B, Blanco T, Harris DL, Hamrah P. Intravital Multiphoton Microscopy of the Ocular Surface: Alterations in Conventional Dendritic Cell Morphology and Kinetics in Dry Eye Disease. Front Immunol 2020; 11:742. [PMID: 32457740 PMCID: PMC7227427 DOI: 10.3389/fimmu.2020.00742] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/01/2020] [Indexed: 01/07/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of the ocular surface, characterized by loss of tear film homeostasis and ocular symptoms, in which neurosensory abnormalities have recently been shown to play an etiological role. Although the role of inflammation has been widely studied in DED, the kinetics of immune cells of the ocular surface in this complex disease are hereto unclear. Herein, we utilized intravital multiphoton imaging on transgenic mice to investigate the 3D morphology and kinetics of conventional dendritic cells (cDCs) and the role of ocular surface sensory nerves in regulating them in both the naïve state and experimental DED. Mice with DED had significantly lower tear secretion (p < 0.01), greater corneal fluorescein staining (p < 0.001), and higher cDC density in the ocular surface (p < 0.05), compared to naïve mice. cDCs in DED mice showed morphological alterations in the limbus, exhibiting smaller surface area (p < 0.001) and volume (p < 0.001) compared to naïve mice. Furthermore, corneal cDCs showed greater sphericity in DED mice compared to naïve mice (p < 0.01). In addition, limbal cDCs displayed significantly increased migratory kinetics in DED, including mean track speed, 3D instantaneous velocity, track length, and displacement, compared to naïve mice (all p < 0.05). In mice with DED, cDCs showed a higher meandering index in the limbus compared to central cornea (p < 0.05). In DED, cDCs were less frequently found in contact with nerves in the limbus, peripheral, and central cornea (p < 0.05). cDCs in contact with nerves demonstrated a larger surface area (p < 0.001) and volume (p < 0.001), however, they exhibited less sphericity (p < 0.05) as compared to cDCs not in contact with nerves in naïve mice. Importantly, cDCs in contact with nerves during DED had a decreased track length, displacement, mean track speed, and 3D instantaneous velocity compared to those not in contact with nerves (all p < 0.05). Taken together, we present in vivo evidence of altered cDC kinetics and 3D morphology in DED. Furthermore, apparent neuronal contact significantly alters cDC kinetics and morphological characteristics, suggesting that ocular surface nerves may play a direct role in mediating immune responses in DED.
Collapse
Affiliation(s)
- Arsia Jamali
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Yashar Seyed-Razavi
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Cecilia Chao
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Gustavo Ortiz
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Brendan Kenyon
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Program in Neuroscience, School of Graduate Biomedical Sciences, Tufts University, Boston, MA, United States
| | - Tomas Blanco
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Deshea L Harris
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Pedram Hamrah
- Center for Translational Ocular Immunology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States.,Program in Neuroscience, School of Graduate Biomedical Sciences, Tufts University, Boston, MA, United States.,Program in Immunology, School of Graduate Biomedical Sciences, Tufts University, Boston, MA, United States
| |
Collapse
|
34
|
Spertus CB, Espinheira Gomes F, Martin-Flores M, Parry SA, Ledbetter EC. Analgesic effect of topical and subconjunctival morphine in dogs after phacoemulsification: A pilot study. Vet Ophthalmol 2020; 23:674-681. [PMID: 32369267 DOI: 10.1111/vop.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/07/2020] [Accepted: 04/07/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the efficacy of a single treatment of topical and subconjunctival 0.1% preservative-free morphine sulfate (PFMS) in providing analgesia following phacoemulsification in dogs. ANIMALS STUDIED Ten diabetic and ten non-diabetic client-owned dogs treated with bilateral phacoemulsification. PROCEDURES A prospective, randomized, masked, negative-controlled clinical trial was performed. All dogs received topical (0.2 mL) and subconjunctival (0.1 mL) 0.1% PFMS in one eye following phacoemulsification. The other eye received an equal volume and mode of administration of balanced salt solution (BSS). Ophthalmic examination, blinking rates, tearing, conjunctival hyperemia, aqueous flare, and central corneal esthesiometry (CCE) were evaluated in all eyes 1 day prior to surgery and at 4, 24, and 48 hours after surgery. Complete physical examination, ocular ultrasound, electroretinogram, hemogram, and serum biochemistry panel were performed in all dogs prior to phacoemulsification. All dogs received the standard of care treatment before and after surgery, including uniform anesthetic protocol. RESULTS Baseline ophthalmic exams were unremarkable, except for the presence of cataracts, in all dogs. The mean CCE (±SD) at 4 hours post-operatively was 1.76 ± 1.27 g/mm2 and 1.85 ± 1.5 g/mm2 for the negative control and PFMS groups, respectively. There were no statistical differences in blepharospasm, conjunctival hyperemia, tearing, aqueous flare, blinking rates, CCE, or intraocular pressure (IOP) between the treatment groups for any of the time points for the non-diabetic and diabetic dogs, or for all dogs combined (P > .05). CONCLUSIONS Topical and subconjunctival 0.1% PFMS did not affect the evaluated parameters after phacoemulsification in the study dogs at the timepoints assessed.
Collapse
Affiliation(s)
- Chloe B Spertus
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Filipe Espinheira Gomes
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Stephen A Parry
- Statistical Consulting Unit, College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - Eric C Ledbetter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| |
Collapse
|
35
|
Mora-Pereira M, Abarca EM, Duran S, Ravis W, McMullen RJ, Fischer BM, Lee YHP, Wooldridge AA. Sustained-release voriconazole-thermogel for subconjunctival injection in horses: ocular toxicity and in-vivo studies. BMC Vet Res 2020; 16:115. [PMID: 32295599 PMCID: PMC7160932 DOI: 10.1186/s12917-020-02331-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Keratomycosis is a relatively common, sight threatening condition in horses, where treatment is often prolonged and costly. Subconjunctival (SCo) injections offer less resistance to drug diffusion than the topical route, resulting in better penetration to the ocular anterior segment. Voriconazole, a second generation triazole antifungal, is effective against common fungal organisms causing keratomycosis. If combined with a thermogel biomaterial, voriconazole can be easily injected in the SCo space to provide sustained drug release. The purpose of this study was to evaluate the drug concentrations in the anterior segment and clinical effects after SCo injections of voriconazole-containing thermogel: poly (DL-lactide-co-glycolide-b-ethylene glycol-b-DL-lactide-co-glycolide) (PLGA-PEG-PLGA) in healthy equine eyes. Results Voriconazole aqueous humor (AH) and tear concentrations were compared between 6 horses, receiving 1% voriconazole applied topically (0.2 mL, q4h) (Vori-Top) or 1.7% voriconazole-thermogel (0.3 mL) injected SCo (Vori-Gel). For the Vori-Gel group, voriconazole concentrations were measured in AH and tears at day 2 and then weekly for 23 days, and at day 2 only for the Vori-Top group. Ocular inflammation was assessed weekly (Vori-Gel) using the modified Hackett-McDonald scoring system. Ocular tissue concentrations of voriconazole following SCo 1.7% voriconazole-thermogel (0.3 mL) injections were evaluated post euthanasia in 6 additional horses at 3 different time points. Three horses received bilateral injections at 2 h (n = 3, right eye (OD)) and 48 h (n = 3, left eye (OS)) prior to euthanasia, and 3 horses were injected unilaterally (OS), 7 days prior to euthanasia. Voriconazole-thermogel was easily injected and well tolerated in all cases, with no major adverse effects. On day 2, drug concentrations in tears were higher in the Vori-Top, but not statistically different from Vori-Gel groups. For the Vori-Gel group, voriconazole was non-quantifiable in the AH at any time point. Total voriconazole concentrations in the cornea were above 0.5 μg/g (the target minimum inhibitory concentration (MIC) for Aspergillus sp.) for up to 48 h; however, concentrations were below this MIC at 7 days post treatment. Conclusions Voriconazole-thermogel was easily and safely administered to horses, and provided 48 h of sustained release of voriconazole into the cornea. This drug delivery system warrants further clinical evaluation.
Collapse
Affiliation(s)
- Mariano Mora-Pereira
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA
| | - Eva M Abarca
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA.
| | - Sue Duran
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA
| | - William Ravis
- Department of Drug Discovery and Development, Auburn University, Auburn, AL, USA
| | - Richard J McMullen
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA
| | - Britta M Fischer
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA
| | | | - Anne A Wooldridge
- J. T. Vaughan Large Animal Teaching Hospital, Auburn University, Auburn, AL, USA
| |
Collapse
|
36
|
Jumelle C, Gholizadeh S, Annabi N, Dana R. Advances and limitations of drug delivery systems formulated as eye drops. J Control Release 2020; 321:1-22. [PMID: 32027938 DOI: 10.1016/j.jconrel.2020.01.057] [Citation(s) in RCA: 180] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/12/2022]
Abstract
Topical instillation of eye drops remains the most common and easiest route of ocular drug administration, representing the treatment of choice for many ocular diseases. Nevertheless, low ocular bioavailability of topically applied drug molecules can considerably limit their efficacy. Over the last several decades, numerous drug delivery systems (DDS) have been developed in order to improve drug bioavailability on the ocular surfaces. This review systematically covers the most recent advances of DDS applicable by topical instillation, that have shown better performance in in vivo models compared to standard eye drop formulations. These delivery systems are based on in situ forming gels, nanoparticles and combinations of both. Most of the DDS have been developed using natural or synthetic polymers. Polymers offer many advantageous properties for designing advanced DDS including biocompatibility, gelation properties and/or mucoadhesiveness. However, despite the high number of studies published over the last decade, there are several limitations for clinical translation of DDS. This review article focuses on the recent advances for the development of ocular drug delivery systems. In addtion, the potential challenges for commercialization of new DDS are presented.
Collapse
Affiliation(s)
- Clotilde Jumelle
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Shima Gholizadeh
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, USA
| | - Nasim Annabi
- Chemical and Biomolecular Engineering, University of California - Los Angeles, Los Angeles, CA, USA; Center for Minimally Invasive Therapeutics (C-MIT), California NanoSystems Institute (CNSI), University of California - Los Angeles, Los Angeles, CA, USA.
| | - Reza Dana
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
37
|
Devarajan K, Ong HS, Lwin NC, Chua J, Schmetterer L, Mehta JS, Ang M. Optical Coherence Tomography Angiography Imaging to monitor Anti-VEGF treatment of Corneal Vascularization in a Rabbit Model. Sci Rep 2019; 9:17576. [PMID: 31772259 PMCID: PMC6879475 DOI: 10.1038/s41598-019-54171-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 10/30/2019] [Indexed: 12/02/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) is a well-established non-invasive retinal vascular imaging technique. It has been recently adapted to image the anterior segment and has shown good potential to image corneal vascularisation. The purpose of the study is to evaluate the usefulness of OCTA to monitor regression of corneal vessels following anti-VEGF (vascular endothelial growth factor) treatment using a previously established corneal vascularisation rabbit model. The regression of vessels following the treatment with aflibercept and ranibizumab anti-VEGFs using both topical instillation and sub-conjunctival injection was quantified using OCTA and compared with ICGA (indocyanine green angiography). Overall vessel density measurements using OCTA showed good correlation (r = 0.988, p < 0.001) with ICGA, with no significant difference between the two treatment groups (p = 0.795). It was also shown that OCTA provided good repeatability outcomes of the quantitative measurements. Using Bland-Altman plots, vessel growth density values between anti-VEGF treatments were compared to control saline group. It was observed that aflibercept provided longer lasting effect than ranibizumab. We also observed that in both drugs, the topical route of administration topical provided longer regression outcomes compared to one-time sub-conjunctival injection. Thereby, with this pilot study, it was demonstrated that OCTA is a reliable imaging technique to follow-up and monitor corneal vascularisation and its treatment quantitatively.
Collapse
Affiliation(s)
- Kavya Devarajan
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Hon Shing Ong
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Nyein C Lwin
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Jacqueline Chua
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore.,Eye-ACP, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore.,Eye-ACP, Duke-NUS Graduate Medical School, Singapore, Singapore.,Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.,Nanyang Technological University, Singapore, Singapore
| | - Jodhbir S Mehta
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore.,Eye-ACP, Duke-NUS Graduate Medical School, Singapore, Singapore.,Nanyang Technological University, Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore. .,Eye-ACP, Duke-NUS Graduate Medical School, Singapore, Singapore.
| |
Collapse
|
38
|
Baradaran-Rafii A, Ashnagar A, Heidari Keshel S, Jabbehdari S, Baradaran-Rafii G. Regression of corneal neovascularization: Adiponectin versus bevacizumab eye drops. Eur J Ophthalmol 2019; 31:78-82. [PMID: 31523981 DOI: 10.1177/1120672119874947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE Comparing the effect of adiponectin versus bevacizumab in decreasing corneal neovascularization. METHODS This study was conducted on 30 eyes of 30 New Zealand Albino male rabbits. Corneal neovascularization was induced by a single 7-0 silk suture 2 mm long and 1 mm in front of the limbus for 2 weeks. Rabbits were randomly divided into three groups of adiponectin (20 µg/mL), bevacizumab (5 mg/mL) and artificial tears. The treatments continued up to 14 days. RESULTS At the end of 14 days, the average length of vessels in rabbits treated with adiponectin, bevacizumab and control groups decreased from 2.12 ± 0.32 mm to 0.89 ± 0.46 mm (57.68% ± 19.98%) (P < 0.001), 2.30 ± 0.41 mm to 1.30 ± 0.58 mm (42.49% ± 27.17%) (P = 0.048) and from 2.12 ± 0.44 mm to 1.81 ± 0.42 mm (14.81% ± 5.64%) (P = 0.112), respectively. The length of vessels decreased 57.68% ± 19.98% and 42.49% ± 27.17% in adiponectin versus bevacizumab groups, respectively (P = 0.527). The average surface area of vessels in rabbits treated with adiponectin, bevacizumab and control groups reduced from 5.02 ± 1.50 mm2 to 1.40 ± 0.75 mm2 (70.64% ± 17.76%) (P < 0.001) 0.34 ± 1.1 mm2 to 2.80 ± 1.04 mm2 (48.24% ± 19.23%) (P = 0.039) and 5.12 ± 2.92 mm2 to 4.4 ± 2.55 mm2 (14.68% ± 4.19%) (P = 0.117). Mean surface area of vascularization decreased 70.64% ± 17.76% and 48.24% ± 19.23% in adiponectin versus bevacizumab, respectively (P = 0.013). CONCLUSIONS The results of this study suggest that topical adiponectin can decrease recent corneal neovascularization.
Collapse
Affiliation(s)
- Alireza Baradaran-Rafii
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azin Ashnagar
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Heidari Keshel
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayena Jabbehdari
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | | |
Collapse
|
39
|
Ogawa M, Inomata T, Shiang T, Tsubota K, Murakami A. Method for selective quantification of immune and inflammatory cells in the cornea using flow cytometry. J Biol Methods 2018; 5:e102. [PMID: 31453252 PMCID: PMC6706157 DOI: 10.14440/jbm.2018.237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/23/2018] [Accepted: 08/23/2018] [Indexed: 01/19/2023] Open
Abstract
The cornea serves as a protective surface against the environment (i.e., allergens, pollutants, desiccation and microorganisms) and promotes vision, made possible by corneal transparency. This protocol describes corneal preparation for flow cytometry to assess cells localized in the cornea. Our model details the process, from determining how many corneas are needed in the experiment to corneal excision to digestion and staining of the cornea cells. The simplicity of the model allows for systematic analysis of different corneal mechanisms of immunity, inflammation, angiogenesis and wound healing. In corneal transplantation, residential immune and inflammatory cells are key to the mechanisms that underlie angiogenesis, opacity, and graft rejection. In addition, this model can also elucidate cellular mechanisms mediating corneal graft outcomes and wound healing. Lastly, this model can be used to analyze the efficacy of new medications such as instillation and subconjunctival injections and assess the potential of therapeutic molecules to enhance graft survival and wound healing in vivo.
Collapse
Affiliation(s)
- Mamoru Ogawa
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama 230-0045, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, 113-0033, Japan.,Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Tokyo, 113-0033, Japan
| | - Tina Shiang
- University of Massachusetts Medical School, Department of Radiology, MA 01655, USA
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, 113-0033, Japan
| |
Collapse
|
40
|
|
41
|
Roshandel D, Eslani M, Baradaran-Rafii A, Cheung AY, Kurji K, Jabbehdari S, Maiz A, Jalali S, Djalilian AR, Holland EJ. Current and emerging therapies for corneal neovascularization. Ocul Surf 2018; 16:398-414. [PMID: 29908870 DOI: 10.1016/j.jtos.2018.06.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/10/2018] [Accepted: 06/12/2018] [Indexed: 02/08/2023]
Abstract
The cornea is unique because of its complete avascularity. Corneal neovascularization (CNV) can result from a variety of etiologies including contact lens wear; corneal infections; and ocular surface diseases due to inflammation, chemical injury, and limbal stem cell deficiency. Management is focused primarily on the etiology and pathophysiology causing the CNV and involves medical and surgical options. Because inflammation is a key factor in the pathophysiology of CNV, corticosteroids and other anti-inflammatory medications remain the mainstay of treatment. Anti-VEGF therapies are gaining popularity to prevent CNV in a number of etiologies. Surgical options including vessel occlusion and ocular surface reconstruction are other options depending on etiology and response to medical therapy. Future therapies should provide more effective treatment options for the management of CNV.
Collapse
Affiliation(s)
- Danial Roshandel
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Medi Eslani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; Cincinnati Eye Institute, Edgewood, KY/ University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA
| | - Alireza Baradaran-Rafii
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Albert Y Cheung
- Cincinnati Eye Institute, Edgewood, KY/ University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA
| | - Khaliq Kurji
- Cincinnati Eye Institute, Edgewood, KY/ University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA
| | - Sayena Jabbehdari
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Alejandra Maiz
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Setareh Jalali
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Edward J Holland
- Cincinnati Eye Institute, Edgewood, KY/ University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA.
| |
Collapse
|
42
|
Camacho-Villegas TA, Mata-González MT, García-Ubbelohd W, Núñez-García L, Elosua C, Paniagua-Solis JF, Licea-Navarro AF. Intraocular Penetration of a vNAR: In Vivo and In Vitro VEGF 165 Neutralization. Mar Drugs 2018; 16:md16040113. [PMID: 29614715 PMCID: PMC5923400 DOI: 10.3390/md16040113] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/22/2018] [Accepted: 03/26/2018] [Indexed: 01/09/2023] Open
Abstract
Variable new antigen receptor domain (vNAR) antibodies are novel, naturally occurring antibodies that can be isolated from naïve, immune or synthetic shark libraries. These molecules are very interesting to the biotechnology and pharmaceutical industries because of their unique characteristics related to size and tissue penetrability. There have been some approved anti-angiogenic therapies for ophthalmic conditions, not related to vNAR. This includes biologics and chimeric proteins that neutralize vascular endothelial growth factor (VEGF)165, which are injected intravitreal, causing discomfort and increasing the possibility of infection. In this paper, we present a vNAR antibody against human recombinant VEGF165 (rhVEGF165) that was isolated from an immunized Heterodontus francisci shark. A vNAR called V13, neutralizes VEGF165 cytokine starting at 75 μg/mL in an in vitro assay based on co-culture of normal human dermal fibroblasts (NHDFs) and green fluorescence protein (GFP)-labeled human umbilical vein endothelial cells (HUVECs) cells. In the oxygen-induced retinopathy model in C57BL/6:Hsd mice, we demonstrate an endothelial cell count decrease. Further, we demonstrate the intraocular penetration after topical administration of 0.1 μg/mL of vNAR V13 by its detection in aqueous humor in New Zealand rabbits with healthy eyes after 3 h of application. These findings demonstrate the potential of topical application of vNAR V13 as a possible new drug candidate for vascular eye diseases.
Collapse
Affiliation(s)
- Tanya A Camacho-Villegas
- CONACYT-Medical and Pharmaceutical Biotechnology, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco (CIATEJ), Guadalajara, Jalisco, C.P. 44270, Mexico.
- Biomedical Innovation Department, Centro de Investigación Científica y Educación Superior de Ensenada, (CICESE), Ensenada, Baja California, C.P. 22860, Mexico.
| | - María Teresa Mata-González
- Research and Development Department, Laboratorios Silanes S.A. de C.V., Ciudad de México, C. P. 03100, Mexico.
| | - Walter García-Ubbelohd
- Research and Development Department, Laboratorios Silanes S.A. de C.V., Ciudad de México, C. P. 03100, Mexico.
| | - Linda Núñez-García
- Research and Development Department, Laboratorios Silanes S.A. de C.V., Ciudad de México, C. P. 03100, Mexico.
| | - Carolina Elosua
- Research and Development Department, Teraclón IDF S.L., Calle de Santiago Grisolía, Tres Cantos, 28020 Madrid, Spain.
| | - Jorge F Paniagua-Solis
- Research and Development Department, Laboratorios Silanes S.A. de C.V., Ciudad de México, C. P. 03100, Mexico.
| | - Alexei F Licea-Navarro
- Biomedical Innovation Department, Centro de Investigación Científica y Educación Superior de Ensenada, (CICESE), Ensenada, Baja California, C.P. 22860, Mexico.
| |
Collapse
|
43
|
Mandal A, Pal D, Agrahari V, Trinh HM, Joseph M, Mitra AK. Ocular delivery of proteins and peptides: Challenges and novel formulation approaches. Adv Drug Deliv Rev 2018; 126:67-95. [PMID: 29339145 DOI: 10.1016/j.addr.2018.01.008] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 12/21/2017] [Accepted: 01/10/2018] [Indexed: 12/12/2022]
Abstract
The impact of proteins and peptides on the treatment of various conditions including ocular diseases over the past few decades has been advanced by substantial breakthroughs in structural biochemistry, genetic engineering, formulation and delivery approaches. Formulation and delivery of proteins and peptides, such as monoclonal antibodies, aptamers, recombinant proteins and peptides to ocular tissues poses significant challenges owing to their large size, poor permeation and susceptibility to degradation. A wide range of advanced drug delivery systems including polymeric controlled release systems, cell-based delivery and nanowafers are being exploited to overcome the challenges of frequent administration to ocular tissues. The next generation systems integrated with new delivery technologies are anticipated to generate improved efficacy and safety through the expansion of the therapeutic target space. This review will highlight recent advances in formulation and delivery strategies of protein and peptide based biopharmaceuticals. We will also describe the current state of proteins and peptides based ocular therapy and future therapeutic opportunities.
Collapse
|
44
|
Huang J, Wang W, Yu J, Yu X, Zheng Q, Peng F, He Z, Zhao W, Zhang Z, Li X, Wang Q. Combination of dexamethasone and Avastin® by supramolecular hydrogel attenuates the inflammatory corneal neovascularization in rat alkali burn model. Colloids Surf B Biointerfaces 2017; 159:241-250. [DOI: 10.1016/j.colsurfb.2017.07.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/15/2017] [Accepted: 07/24/2017] [Indexed: 02/07/2023]
|
45
|
Bauer D, Alt M, Dirks M, Buch A, Heilingloh CS, Dittmer U, Giebel B, Görgens A, Palapys V, Kasper M, Eis-Hübinger AM, Sodeik B, Heiligenhaus A, Roggendorf M, Krawczyk A. A Therapeutic Antiviral Antibody Inhibits the Anterograde Directed Neuron-to-Cell Spread of Herpes Simplex Virus and Protects against Ocular Disease. Front Microbiol 2017; 8:2115. [PMID: 29163407 PMCID: PMC5671610 DOI: 10.3389/fmicb.2017.02115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/17/2017] [Indexed: 12/17/2022] Open
Abstract
Herpes simplex virus (HSV) is a leading cause of blindness and viral encephalitis in the developed world. Upon reactivation from sensory neurons, HSV returns via axonal transport to peripheral tissues where it causes, e.g., severe, potentially blinding ocular diseases. In the present study we investigated whether the HSV-1/2 glycoprotein B-specific antibody mAb 2c or its humanized counterpart mAb hu2c can protect from ocular disease in a mouse model of HSV-1-induced acute retinal necrosis (ARN). In this model the viral spread from the initially infected to the contralateral eye resembles the routes taken in humans upon HSV reactivation. Systemic antibody treatment prior or early after infection effectively protected the mice from the development of ARN. These observations suggest that the antibody potently neutralized the infection and inhibited the viral transmission, since there was almost no virus detectable in the contralateral eyes and trigeminal ganglia of antibody treated mice. Besides of neutralizing free virus or limiting the infection via activating the complement or cellular effector functions, blocking of the anterograde directed neuron-to-cell spread of HSV represents a viable mode of action how mAb 2c protected the mice from ARN. We proved this hypothesis using a microfluidic chamber system. Neurons and epithelial cells were cultured in two separate compartments where the neurons sent axons via connecting microgrooves to the epithelial cells. Neurons were infected with a reporter HSV-1 strain expressing mCherry, and the co-culture was treated with neutralizing antibodies. In contrast to commercial polyclonal human HSV-neutralizing immunoglobulins, mAb 2c effectively blocked the anterograde directed neuron-to-cell transmission of the virus. Our data suggest that the humanized HSV-1/2-gB antibody protects mice from ocular disease by blocking the neuronal spread of HSV. Therefore, mAb hu2c may become a potent novel therapeutic option for severe ocular HSV infections.
Collapse
Affiliation(s)
- Dirk Bauer
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany
| | - Mira Alt
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Miriam Dirks
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Buch
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | | | - Ulf Dittmer
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - André Görgens
- Institute for Transfusion Medicine, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Vivien Palapys
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Maren Kasper
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany
| | | | - Beate Sodeik
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Arnd Heiligenhaus
- Department of Ophthalmology, Ophtha Lab, St. Franziskus-Hospital, Münster, Germany.,Department of Ophthalmology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Roggendorf
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Adalbert Krawczyk
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
46
|
Cakmak H, Gokmen E, Bozkurt G, Kocaturk T, Ergin K. Effects of sunitinib and bevacizumab on VEGF and miRNA levels on corneal neovascularization. Cutan Ocul Toxicol 2017; 37:191-195. [DOI: 10.1080/15569527.2017.1375943] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Harun Cakmak
- Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Esra Gokmen
- Department of Histology and Embryology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Gokay Bozkurt
- Department of Medical Genetics, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Tolga Kocaturk
- Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| | - Kemal Ergin
- Department of Histology and Embryology, Adnan Menderes University Medical Faculty, Aydin, Turkey
| |
Collapse
|
47
|
Al-Debasi T, Al-Bekairy A, Al-Katheri A, Al Harbi S, Mansour M. Topical versus subconjunctival anti-vascular endothelial growth factor therapy (Bevacizumab, Ranibizumab and Aflibercept) for treatment of corneal neovascularization. Saudi J Ophthalmol 2017; 31:99-105. [PMID: 28559722 PMCID: PMC5436388 DOI: 10.1016/j.sjopt.2017.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/28/2017] [Indexed: 12/01/2022] Open
Abstract
In order to evaluate the effect of topical and subconjunctival anti-vascular endothelial growth factor (anti-VEGF) therapy, Ranibizumab, Bevacizumab and Aflibercept as a therapy for corneal neovascularization (NV) treatment, the aim of this study was to review all data related to some of anti-VEGF as a promising therapies for corneal NV treatment. Corneal NV is a dangerous condition leading to a marked reduction in vision due to angiogenesis of abnormal vessels that block light. During the recent years, we have recognized new drug proliferation for corneal NV treatment. Recently, anti-VEGF therapies are one of the most important drugs used for corneal NV treatment. Several growth factors are involved in angiogenesis. The most important growth factor in corneal angiogenesis is VEGF. VEGF can be considered as key mediators in corneal angiogenesis. It is upregulated during corneal NV. In fact, anti-VEGF therapies have shown efficacy in attenuation of corneal NV in both animal models and clinical trials. A promising therapeutic success has been achieved using antibodies directed against VEGF. Bevacizumab has demonstrated efficacy and efficiency in the treatment of different neo-vascular ocular diseases and it has partially reduced corneal NV through different routes of administrations: topical, subconjunctival, and intraocular application. A similar efficacy to bevacizumab profiles in the treatment of neo-vascular age-related macular degeneration was induced by ranibizumab. Moreover, at worse levels of initial visual acuity of diabetic macular edema, aflibercept was more effective at improving vision. Anti-VEGF agents (Bevacizumab, Ranibizumab and Aflibercept) seem to have a higher efficiency and efficacy for corneal NV treatment. Both subconjunctival therapy and topical therapy of bevacizumab prohibit corneal NV, while early treatment with subconjunctival administration of ranibizumab may successfully reduce corneal NV. Therefore, establishment of safe doses is highly important before these drugs can be involved in the clinical setting. Further investigations and studies are highly warranted to adjust the dose and route of administration for the antibodies directed against VEGF to be the key therapeutic agents in the corneal NV treatment.
Collapse
Affiliation(s)
- Tariq Al-Debasi
- Division of Ophthalmology, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia
| | - Abdulkareem Al-Bekairy
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Abdulmalik Al-Katheri
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Shmeylan Al Harbi
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, MC 1445, Saudi Arabia.,Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| | - Mahmoud Mansour
- Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O Box 3660, Riyadh 11426, Saudi Arabia
| |
Collapse
|
48
|
Efficacy of Subconjunctival Aflibercept Versus Bevacizumab for Prevention of Corneal Neovascularization in a Rat Model. Cornea 2017; 35:991-6. [PMID: 27124775 DOI: 10.1097/ico.0000000000000849] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE We aimed to evaluate the efficacy of subconjunctival aflibercept, a vascular endothelial growth factor trap compound, for the treatment of corneal neovascularization in a rat model. METHODS Chemical burn was produced in the central cornea of 31 male Sprague-Dawley rats. Animals were randomized to receive treatment with subconjunctival injection of 0.08 mL aflibercept (25 mg/mL), 0.05 mL bevacizumab (25 mg/mL), or 0.05 mL physiologic saline. Corneal neovascularization was evaluated on postinjury days 1, 3, 7, 9, and 13 by corneal photographs. The rats were killed on day 21 and samples were collected for histological and flat-mount immunofluorescence analyses. RESULTS In all rats, vascular sprouting began on day 3, reached maximum density on days 7-9, and spontaneously regressed thereafter. Mean burn area in the central cornea comprised ∼15% of the total corneal area. The aflibercept group had a significantly smaller relative area of neovascularization than both control group (P < 0.05, 12.27 ± 9.91, 29.66 ± 9.96 days 7) and bevacizumab group (P < 0.05, 12.27 ± 9.91, 21.27 ± 8.19 days 7 and 15.5 ± 10.25, 32.38 ± 9.44 days 9; Mann-Whitney test). On histological study, hematoxylin and eosin staining revealed blood vessels extending to the central cornea in the control and bevacizumab groups and limited to the periphery in the aflibercept group. Immunofluorescence study with an endothelial marker revealed a smaller area of staining in the aflibercept group. CONCLUSIONS Aflibercept effectively inhibits corneal neovascularization in a rat model of chemical burn-induced neovascularization and warrants further study for potential use in humans.
Collapse
|
49
|
Anitua E, Muruzabal F, de la Fuente M, Riestra A, Merayo-Lloves J, Orive G. PRGF exerts more potent proliferative and anti-inflammatory effects than autologous serum on a cell culture inflammatory model. Exp Eye Res 2016; 151:115-21. [DOI: 10.1016/j.exer.2016.08.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 07/26/2016] [Accepted: 08/23/2016] [Indexed: 01/15/2023]
|
50
|
Moosajee M, Tracey-White D, Harbottle RP, Ferguson V. Safety Profile of Stromal Hydration of Clear Corneal Incisions with Cefuroxime in the Mouse Model. J Ocul Pharmacol Ther 2016; 32:469-75. [PMID: 27294975 DOI: 10.1089/jop.2016.0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The use of sutureless clear corneal incisions (CCIs) for phacoemulsification is an established surgical technique, but the dynamic morphology of the wound and poor construction can lead to an increased risk of postoperative endophthalmitis. Stromal hydration with balanced salt solution (BSS) can improve the self-sealing status. Intracameral cefuroxime has reduced endophthalmitis rates. This study investigates the safety profile of stromal hydration with cefuroxime, as sequestering antibiotic at the wound may potentially provide added protection against infection. METHODS MF-1 mice underwent bilateral CCI, followed by stromal hydration with 5 μL of 10 mg/mL cefuroxime, cefuroxime-texas red conjugate (for detection using confocal microscopy), or BSS. Corneas were harvested from 1 h to 12 weeks postoperatively; gross morphology, histology, and apoptotic cell death levels were investigated to determine the safety profile. Bactericidal activity of cefuroxime was assayed using homogenized whole cornea following stromal hydration at 1 h, 24 h, and day 7 against gram-negative Escherichia coli. RESULTS Cefuroxime stromal hydration did not alter corneal morphology, with no evidence of corneal scarring or vascularization. Corneal histology and levels of apoptosis were minimal and comparable to the BSS groups up to 12 weeks. Confocal microscopy detected cefuroxime-texas red up to 1 week surrounding the corneal wound. Whole corneal tissue homogenates displayed bactericidal activity up to 24 h postoperatively. CONCLUSIONS Stromal hydration of CCI with cefuroxime is safe in mouse corneas. A reservoir of antibiotic at the wound can potentially act as a barrier of defense against infection following cataract and associated ocular surgery.
Collapse
Affiliation(s)
- Mariya Moosajee
- 1 Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology , London, United Kingdom .,2 Moorfields Eye Hospital NHS Foundation Trust , London, United Kingdom
| | - Dhani Tracey-White
- 1 Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology , London, United Kingdom
| | | | | |
Collapse
|