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Yesilirmak N, Saritas O. Comparison of Corneal Biomechanical Efficacy Between Rose Bengal-Green Light and Riboflavin-UVA Crosslinking. Curr Eye Res 2024; 49:942-948. [PMID: 38747449 DOI: 10.1080/02713683.2024.2353267] [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: 01/06/2024] [Revised: 04/15/2024] [Accepted: 05/04/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE To investigate corneal biomechanical changes after corneal cross-linking (CXL) treatments with rose bengal-green light (RB-CXL) and riboflavin-UVA (RF-CXL). METHODS A total of 60 freshly enucleated lamb eyes were obtained for this experimental study. Fifteen eyes were treated with RB-CXL using 0.1% RB solution (Group 1), 15 eyes were treated with RB-CXL using 0.2% RB solution (Group 2), 15 eyes were treated with RF-CXL using 0.1% RF solution (Group 3), and 15 eyes were used as controls (Group 4). The same treatment protocol (10-minute irradiation using a total of 5.4 J/cm2 energy) was applied to all treatment groups. To evaluate corneal biomechanical changes, the stress-strain test was used for both the treated and control corneas. The elastic modulus was calculated using the tension strain curves obtained during the test. RESULTS The average elastic modulus values were calculated to be 18.9, 23.5, 22.3, and 14.1 MPa in Groups 1, 2, 3, and 4, respectively. Statistically significant differences were found between the groups (p < 0.001 for Group 1 vs. 2; p < 0.001 for Group 1 vs. 3; p < 0.001 for Group 1 vs. 4; p = 0.002 for Group 2 vs. 3; p < 0.001 for Group 2 vs. 4; and p < 0.001 for Group 3 vs. 4). CONCLUSIONS In this study, the efficacy of RB-CXL treatment applied using different concentrations of RB solutions at a total energy of 5.4 J/cm2 was investigated, and 0.2% RB solution was found to have at least as much and even more effective than the RF-CXL (0.1% RF) on the corneal elasticity module. These results are encouraging for the treatment of ectatic corneas particularly below 400 μm. It is considered that the findings obtained from this study will guide future experimental and clinical studies.
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Affiliation(s)
- Nilufer Yesilirmak
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
- Department of Biochemistry, Gazi University, Ankara, Turkey
| | - Ozge Saritas
- Department of Ophthalmology, Battalgazi Public Hospital, Malatya, Turkey
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Chai N, Stachon T, Nastaranpour M, Li Z, Seitz B, Ulrich M, Langenbucher A, Szentmáry N. Assessment of Rose Bengal Photodynamic Therapy on Viability and Proliferation of Human Keratolimbal Epithelial and Stromal Cells In Vitro. Klin Monbl Augenheilkd 2024; 241:972-981. [PMID: 36808578 DOI: 10.1055/a-2038-8899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE To investigate the effect of Rose Bengal photodynamic therapy (RB-PDT) on viability and proliferation of human limbal epithelial stem cells (T-LSCs), human corneal epithelial cells (HCE-T), human limbal fibroblasts (LFCs), and human normal and keratoconus fibroblasts (HCFs and KC-HCFs) in vitro. METHODS T-LSCs and HCE-T cell lines were used in this research. LFCs were isolated from healthy donor corneal limbi (n = 5), HCFs from healthy human donor corneas (n = 5), and KC-HCFs from penetrating keratoplasties of keratoconus patients (n = 5). After cell culture, RB-PDT was performed using 0.001% RB concentration and 565 nm wavelength illumination with 0.14 to 0.7 J/cm2 fluence. The XTT and the BrdU assays were used to assess cell viability and proliferation 24 h after RB-PDT. RESULTS RB or illumination alone did not change cell viability or proliferation in any of the cell types (p ≥ 0.1). However, following RB-PDT, viability decreased significantly from 0.17 J/cm2 fluence in HCFs (p < 0.001) and KC-HCFs (p < 0.0001), and from 0.35 J/cm2 fluence in T-LSCs (p < 0.001), HCE-T (p < 0.05), and LFCs ((p < 0.0001). Cell proliferation decreased significantly from 0.14 J/cm2 fluence in T-LSCs (p < 0.0001), HCE-T (p < 0.05), and KC-HCFs (p < 0.001) and from 0.17 J/cm2 fluence in HCFs (p < 0.05). Regarding LFCs proliferation, no values could be determined by the BrdU assay. CONCLUSIONS Though RB-PDT seems to be a safe and effective treatment method in vivo, its dose-dependent phototoxicity on corneal epithelial and stromal cells has to be respected. The data and experimental parameters applied in this study may provide a reliable reference for future investigations.
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Affiliation(s)
- Ning Chai
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Mahsa Nastaranpour
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Zhen Li
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Hospital and Saarland University, Faculty of Medicine, Homburg/Saar, Germany
| | - Myriam Ulrich
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg/Saar, Germany
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Villegas L, Germann JA, Marcos S. Effects of Different Scleral Photo-Crosslinking Modalities on Scleral Stiffness and Hydration. Invest Ophthalmol Vis Sci 2024; 65:8. [PMID: 38958968 PMCID: PMC11223619 DOI: 10.1167/iovs.65.8.8] [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: 02/28/2024] [Accepted: 06/16/2024] [Indexed: 07/04/2024] Open
Abstract
Purpose The purpose of this study was to evaluate the biomechanical and hydration differences in scleral tissue after two modalities of collagen cross-linking. Methods Scleral tissue from 40 adult white rabbit eyes was crosslinked by application of 0.1% Rose Bengal solution followed by 80 J/cm2 green light irradiation (RGX) or by application of 0.1% riboflavin solution followed by 5.4 J/cm2 ultraviolet A irradiation (UVX). Posterior scleral strips were excised from treated and untreated sclera for tensile and hydration-tensile tests. For tensile tests, the strips were subjected to uniaxial extension after excision. For hydration-tensile tests, the strips were dehydrated, rehydrated, and then tested. Young's modulus at 8% strain and swelling rate were estimated. ANOVAs were used to test treated-induced differences in scleral biomechanical and hydration properties. Results Photo-crosslinked sclera tissue was stiffer (Young's modulus at 8% strain: 10.7 ± 4.5 MPa, on average across treatments) than untreated scleral tissue (7.1 ± 4.0 MPa). Scleral stiffness increased 132% after RGX and 90% after UVX compared to untreated sclera. Scleral swelling rate was reduced by 11% after RGX and by 13% after UVX. The stiffness of the treated sclera was also associated with the tissue hydration level. The lower the swelling, the higher the Young's modulus of RGX (-3.8% swelling/MPa) and UVX (-3.5% swelling/MPa) treated sclera. Conclusions Cross-linking with RGX and UVX impacted the stiffness and hydration of rabbit posterior sclera. The Rose Bengal with green light irradiation may be an alternative method to determine the efficacy and suitability of inducing scleral tissue stiffening in the treatment of myopia.
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Affiliation(s)
- Lupe Villegas
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas, Madrid, Spain
- Universidad Politécnica de Madrid, Madrid, Spain
| | - James A. Germann
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Susana Marcos
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas, Madrid, Spain
- The Center for Visual Science, The Institute of Optics; Flaum Eye Institute, University of Rochester, Rochester, New York, United States
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Jarecki Q, Kupinski M. Optimizing near-infrared polariscopic imaging for the living human eye. OPTICS EXPRESS 2024; 32:18113-18126. [PMID: 38858975 DOI: 10.1364/oe.520657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/11/2024] [Indexed: 06/12/2024]
Abstract
Hardware architectures and image interpretation can be simplified by partial polarimetry. Mueller matrix (MM) polarimetry allows the investigation of partial polarimeter designs for a given scientific task. In this work, we use MM measurements to solve for a fixed polarization illumination and analyzer state that maximize polariscopic image contrast of the human eye. The eye MM image acquisition takes place over 15 seconds which motivates the development of a partial polarimeter that has snapshot operation. Within the eye, the birefringent cornea produces spatially-varying patterns of retardance exceeding half of a wave with a fast-axis varying from linear, to circular, and elliptical states in between. Our closed-form polariscopic pairs are a general solution that maximizes contrast between two non-depolarizing pure retarder MMs. For these MMs, there is a family of polariscopic pairs that maximize contrast. This range of solutions creates an opportunity to use the distance from optimal as a criteria to adjust polarimetric hardware architecture. We demonstrate our optimization approach by performing both Mueller and polariscopic imaging of an in vivo human eye at 947 nm using a dual-rotating-retarder polarimeter. Polariscopic images are simulated from Mueller measurements of 19 other human subjects to test the robustness of this optimal solution.
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Chai N, Stachon T, Berger T, Li Z, Seitz B, Langenbucher A, Szentmáry N. Short-Term Effect of Rose Bengal Photodynamic Therapy (RB-PDT) on Collagen I, Collagen V, NF-κB, LOX, TGF-β and IL-6 Expression of Human Corneal Fibroblasts, In Vitro. Curr Eye Res 2024; 49:150-157. [PMID: 37921272 DOI: 10.1080/02713683.2023.2276057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE To investigate collagen I, collagen V, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), lysyl oxidase (LOX), transforming growth factor β1 (TGF-β1) and interleukin-6 (IL-6) expression in healthy and keratoconus human corneal fibroblasts (HCFs and KC-HCFs), 24 h after Rose Bengal photodynamic therapy (RB-PDT). METHODS HCFs were isolated from healthy human corneal donors (n = 5) and KC-HCFs from elective penetrating keratoplasties (n = 5). Both cell cultures underwent RB-PDT (0.001% RB concentration, 0.17 J/cm2 fluence) and 24 h later collagen I, collagen V, NF-κB, LOX, TGF-β1 and IL-6 mRNA and protein expression have been determined using qPCR and Western blot, IL-6 concentration in the cell culture supernatant by ELISA. RESULTS TGF-β1 mRNA expression was significantly lower (p = 0.02) and IL-6 mRNA expression was significantly higher in RB-PDT treated HCFs (p = 0.01), than in HCF controls. COL1A1, COL5A1 and TGF-β1 mRNA expression was significantly lower (p = 0.04; p = 0.02 and p = 0.003) and IL-6 mRNA expression was significantly higher (p = 0.02) in treated KC-HCFs, than in KC-HCF controls. TGF-β1 protein expression in treated HCFs was significantly higher than in HCF controls (p = 0.04). IL-6 protein concentration in the HCF and KC-HCF culture supernatant after RB-PDT was significantly higher than in controls (p = 0.02; p = 0.01). No other analyzed mRNA and protein expression differed significantly between the RB-PDT treated and untreated groups. CONCLUSIONS Our study demonstrates that RB-PDT reduces collagen I, collagen V and TGF-β1 mRNA expression, while increasing IL-6 mRNA and protein expression in KC-HCFs. In HCFs, RB-PDT increases TGF-β1 and IL-6 protein level after 24 h.
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Affiliation(s)
- Ning Chai
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Zhen Li
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | | | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Hafezi NL, Aydemir ME, Lu NJ, Torres-Netto EA, Hillen M, Koppen C. Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion. BMC Ophthalmol 2024; 24:37. [PMID: 38267904 PMCID: PMC10809678 DOI: 10.1186/s12886-024-03293-0] [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: 08/10/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE This study evaluated the effect of high-fluence accelerated corneal cross-linking on the resistance to enzymatic digestion, assessing two chromophore/light combinations: riboflavin/UV-A light (RF/UV-A) and rose bengal/green light (RB/green). METHODS Freshly prepared ex-vivo porcine corneas (n = 189) were divided into 8 groups groups. Group A corneas were unirradiated controls without chromophore soaking (A0), or soaked with riboflavin (A1) or rose bengal (A2). Group B corneas underwent accelerated epi-off RF/UV-A CXL at fluences of 5.4 J/cm² (B1), 10 J/cm² (B2), or 15 J/cm² (B3). Group C corneas underwent accelerated epi-off RB/green CXL at fluences of either 10 J/cm² (C1) or 15 J/cm² (C2). Following CXL, all corneas were digested in 0.3% collagenase-A solution, and the time until complete dissolution was measured. RESULTS Non-irradiated controls exposed to RF and RB enhanced corneal resistance to collagenase digestion, with RB having a stronger effect than RF. RF/UV-A-treated corneas showed significantly increased digestion resistance with increasing fluence levels. RB/green-treated corneas displayed enhanced digestion resistance with each increase in fluence up to 10 J/cm²; a 15 J/cm² fluence yielded similar digestion resistance times to a 10 J/cm² fluence, suggesting a plateau effect in accelerated RB/green CXL protocols. CONCLUSIONS When compared to standard-fluence treatments, high-fluence accelerated epi-off CXL using both riboflavin and rose bengal significantly increases resistance to enzymatic digestion. The optimal settings for clinical protocols might be 15 J/cm² (30 mW/cm² for 8 min 20 s) for RF/UV-A and 10 J/cm² (15 mW/cm² for 11 min 7 s) for RB/Green Light.
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Affiliation(s)
- Nikki L Hafezi
- Faculty of Medicine, University of Antwerp, Wilrijk, Antwerp, Belgium.
- ELZA Institute, Zurich, Switzerland.
| | | | - Nan-Ji Lu
- Faculty of Medicine, University of Antwerp, Wilrijk, Antwerp, Belgium
- ELZA Institute, Zurich, Switzerland
| | | | | | - Carina Koppen
- Faculty of Medicine, University of Antwerp, Wilrijk, Antwerp, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Antwerp, Belgium
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Aydemir ME, Hafezi NL, Lu NJ, Torres-Netto EA, Hillen M, Koppen C, Hafezi F. Combining Riboflavin/UV-A Light and Rose Bengal/Green Light Corneal Cross-Linking Increases the Resistance of Corneal Enzymatic Digestion. Transl Vis Sci Technol 2024; 13:30. [PMID: 38289609 PMCID: PMC10833050 DOI: 10.1167/tvst.13.1.30] [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: 09/06/2023] [Accepted: 12/01/2023] [Indexed: 02/01/2024] Open
Abstract
Purpose The purpose of this study was to determine if concurrent riboflavin/UV-A light (RF/UV-A) and rose Bengal/green light (RB/green) epi-off PACK-CXL enhances corneal resistance to enzymatic digestion compared to separate chromophore/light treatments. Methods Ex vivo porcine corneas were allocated as follows. Group A corneas were soaked with riboflavin (RF) and were either not irradiated (A1, controls) or were irradiated with 10 (A2) or 15 J/cm² (A3) UV-A light at 365 nm, respectively. Group B corneas were soaked with RB and either not irradiated (B1, controls) or were illuminated with 10 (B2) or 15 J/cm² (B3) green light at 525 nm, respectively. Corneas in group C were soaked with both RF and RB and were either not irradiated (C1, controls) or were subjected to the same session consecutive 10 J/cm2 (C2) or 15 J/cm2 (C3) UV-A and green light exposure. Following treatment, all corneas were exposed to 0.3% collagenase A to assess digestion time until corneal button dissolution. Results A1 to A3 digestion times were 21.38, 30.5, and 32.25 hours, respectively, with A2 and A3 showing increased resistance to A1. B1-3 had digestion times of 31.2, 33.81, and 34.38 hours, with B3 resisting more than B1. C1 to C3 times were 33.47, 39.81, and 51.94 hours; C3 exhibited superior resistance to C1 and C2 (both P < 0.05). Conclusions Same-session combined RF/UV-A and RB/green PACK-cross-linking significantly increases corneal enzymatic digestion resistance over standalone treatments. Translational Relevance Combining RF-based and RB-based PACK-CXL considerably increases corneal collagenase digestion resistance, potentially minimizing ulcer size in clinical contexts.
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Affiliation(s)
| | - Nikki L. Hafezi
- ELZA Institute, Dietikon, Switzerland
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Nan-Ji Lu
- ELZA Institute, Dietikon, Switzerland
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Emilio A. Torres-Netto
- ELZA Institute, Dietikon, Switzerland
- Ocular Cell Biology Laboratory, University of Zurich, Zurich, Switzerland
| | | | - Carina Koppen
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Farhad Hafezi
- ELZA Institute, Dietikon, Switzerland
- Ocular Cell Biology Laboratory, University of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Ophthalmology at New York University Grossman School of Medicine, New York University, New York, NY, USA
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Chai N, Stachon T, Berger T, Li Z, Seitz B, Langenbucher A, Szentmáry N. Human corneal epithelial cell and fibroblast migration and growth factor secretion after rose bengal photodynamic therapy (RB-PDT) and the effect of conditioned medium. PLoS One 2023; 18:e0296022. [PMID: 38150488 PMCID: PMC10752507 DOI: 10.1371/journal.pone.0296022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023] Open
Abstract
PURPOSE To investigate human corneal epithelial cell and fibroblast migration and growth factor secretion after rose bengal photodynamic therapy (RB-PDT) and the effect of conditioned medium (CM). METHODS A human corneal epithelial cell line (HCE-T), human corneal fibroblasts (HCF) and keratoconus fibroblasts (KC-HCF) have been used. Twenty-four hours after RB-PDT (0.001% RB concentration, 565 nm wavelength illumination, 0.17 J/cm2 fluence) cell migration rate using scratch assay and growth factor concentrations in the cell culture supernatant using ELISA have been determined. In addition, the effect of CM has been observed. RESULTS RB-PDT significantly reduced migration rate in all cell types, compared to controls (p≤0.02). Migration rate of HCE-T cultures without RB-PDT (untreated) was significantly higher using HCF CM after RB-PDT, than using HCF CM without RB-PDT (p<0.01). Similarly, untreated HCF displayed a significantly increased migration rate with HCE-T CM after RB-PDT, compared to HCE-T CM without treatment (p<0.01). Furthermore, illumination alone and RB-PDT significantly decreased keratinocyte growth factor (KGF) concentration in HCF and KC-HCF supernatant, and RB-PDT significantly decreased soluble N-Cadherin (SN-Cad) concentration in HCF supernatant, compared to controls (p<0.01 for all). In HCE-T CM, RB-PDT increased hepatocyte growth factor (HGF) and basic fibroblast growth factor (FGFb) concentration (p≤0.02), while decreasing transforming growth factor β (TGF-β) concentration (p<0.01). FGFb concentration increased (p<0.0001) and TGF-β concentration decreased (p<0.0001) in HCF CM, by RB-PDT. Epidermal growth factor (EGF), HGF, and TGF-β concentration decreased (p≤0.03) and FGFb concentration increased (p<0.01) in KC-HCF CM, using RB-PDT. CONCLUSIONS HCE-T, HCF and KC-HCF migration rate is reduced 24 hours after RB-PDT. In contrast, HCE-T migration is enhanced using HCF CM after RB-PDT, and HCF migration rate is increased through HCE-T CM following RB-PDT. Modulation of EGF, KGF, HGF, FGFb, TGF-β and N-Cadherin secretion through RB-PDT may play an important role in corneal wound healing.
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Affiliation(s)
- Ning Chai
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - Zhen Li
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | | | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Saar, Germany
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Leanse LG, Marasini S, dos Anjos C, Dai T. Antimicrobial Resistance: Is There a 'Light' at the End of the Tunnel? Antibiotics (Basel) 2023; 12:1437. [PMID: 37760734 PMCID: PMC10525303 DOI: 10.3390/antibiotics12091437] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/30/2023] [Accepted: 08/08/2023] [Indexed: 09/29/2023] Open
Abstract
In recent years, with the increases in microorganisms that express a multitude of antimicrobial resistance (AMR) mechanisms, the threat of antimicrobial resistance in the global population has reached critical levels. The introduction of the COVID-19 pandemic has further contributed to the influx of infections caused by multidrug-resistant organisms (MDROs), which has placed significant pressure on healthcare systems. For over a century, the potential for light-based approaches targeted at combatting both cancer and infectious diseases has been proposed. They offer effective killing of microbial pathogens, regardless of AMR status, and have not typically been associated with high propensities of resistance development. To that end, the goal of this review is to describe the different mechanisms that drive AMR, including intrinsic, phenotypic, and acquired resistance mechanisms. Additionally, the different light-based approaches, including antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light, will be discussed as potential alternatives or adjunct therapies with conventional antimicrobials. Lastly, we will evaluate the feasibility and requirements associated with integration of light-based approaches into the clinical pipeline.
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Affiliation(s)
- Leon G. Leanse
- Health and Sports Sciences Hub, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.d.A.); (T.D.)
| | - Sanjay Marasini
- New Zealand National Eye Centre, Department of Ophthalmology, The University of Auckland, Auckland 1142, New Zealand;
| | - Carolina dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.d.A.); (T.D.)
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; (C.d.A.); (T.D.)
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Gao R, Chen M, Chen X, Liu X, Jiang Q, Meek KM, Wang Q, Chen S, Huang J. Diffusion Depth and Efficacy of Different Infiltration Times for Rose Bengal/Green Light Corneal Cross-linking in Rabbit Eyes. J Refract Surg 2023; 39:620-626. [PMID: 37675907 DOI: 10.3928/1081597x-20230726-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To explore the diffusion depth and green light corneal cross-linking efficacy of different rose bengal (Rb) infiltration times in rabbit eyes. METHODS Twenty-eight fresh rabbit eyes were deepithelialized and infiltrated in 0.1% Rb solution for 2 to 30 minutes. Corneal frozen sections were cut and Rb diffusion depth was observed under the confocal microscope. A further 36 rabbits were randomly divided into eight groups according to the type of treatment (control, Rb infiltration only without irradiation, rose bengal/green light [RGX] for different infiltration times, or riboflavin/ultraviolet radiation [UVX]). The corneas' resistance to keratolysis and biomechanical properties were measured after treatment. RESULTS After 2, 10, 20, and 30 minutes of infiltration, Rb penetration depths in the corneal stroma were 100, 150, 200, and 270 µm, respectively. The times for complete digestion of the RGX 10 minutes (14.0 ± 1.4 hours), RGX 20 minutes (18.8 ± 1.1 hours), and UVX (51.2 ± 7.2 hours) groups were statistically greater than that of the control group (7.2 ± 1.1 hours). At 10% extension, the Young's modulus of the RGX 20 minutes (36.59 ± 4.90 MPa) and UVX (40.89 ± 2.57 MPa) groups was statistically greater than that of the control group (21.76 ± 5.69 MPa). CONCLUSIONS The diffusion depth of Rb in corneal stroma increased by prolonging the infiltration time. The longer the infiltration time, the better the RGX effect. RGX for 20 minutes showed the best cross-linking efficacy among all RGX groups, albeit not as good as UVX. [J Refract Surg. 2023;39(9):620-626.].
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Khan S, Neuhaus K, Thaware O, Ni S, Ju MJ, Redd T, Huang D, Jian Y. Corneal imaging with blue-light optical coherence microscopy. BIOMEDICAL OPTICS EXPRESS 2022; 13:5004-5014. [PMID: 36187260 PMCID: PMC9484440 DOI: 10.1364/boe.465707] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023]
Abstract
Corneal imaging is important for the diagnostic and therapeutic evaluation of many eye diseases. Optical coherence tomography (OCT) is extensively used in ocular imaging due to its non-invasive and high-resolution volumetric imaging characteristics. Optical coherence microscopy (OCM) is a technical variation of OCT that can image the cornea with cellular resolution. Here, we demonstrate a blue-light OCM as a low-cost and easily reproducible system to visualize corneal cellular structures such as epithelial cells, endothelial cells, keratocytes, and collagen bundles within stromal lamellae. Our blue-light OCM system achieved an axial resolution of 12 µm in tissue over a 1.2 mm imaging depth, and a lateral resolution of 1.6 µm over a field of view of 750 µm × 750 µm.
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Affiliation(s)
- Shanjida Khan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Kai Neuhaus
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - Omkar Thaware
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Shuibin Ni
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Myeong Jin Ju
- Department of Ophthalmology and Visual
Sciences, University of British Columbia,
Vancouver, BC, Canada
- School of Biomedical Engineering,
University of British Columbia, Vancouver,
BC, Canada
| | - Travis Redd
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Yifan Jian
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
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12
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Gao R, Yan M, Chen M, Hayes S, Meek KM, He H, Chen X, Xu W, Yan S, Huang Y, Ding S, Wang Q, Li J, Huang J. The Impact of Different Rose Bengal Formulations on Corneal Thickness and the Efficacy of Rose Bengal/Green Light Corneal Cross-linking in the Rabbit Eye. J Refract Surg 2022; 38:450-458. [PMID: 35858194 DOI: 10.3928/1081597x-20220601-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine central corneal thickness (CCT) changes during in vivo rose bengal-green light corneal cross-linking (RG-CXL) and compare the CXL efficacy of different rose bengal formulations. METHODS After epithelium removal, the right eyes of rabbits were immersed in rose bengal solution prepared by different solvents (water, phosphate buffered saline, dextran, and hydroxypropyl methylcellulos [HPMC]) for 2 or 20 minutes, then the rose bengal distribution in the corneal stroma was analyzed by confocal fluorescence detection. During the RG-CXL process, the CCT was measured at seven time points. The left eyes served as the untreated control group. Corneal enzymatic resistance and corneal biomechanics were tested to compare the RG-CXL efficacy. RESULTS The rose bengal infiltration depths were 120 and 200 µm for the 2- and 20-minute groups, respectively. CCT increased significantly after infiltration, then decreased significantly in the first 200 seconds of irradiation and decreased slowly for the next 400 seconds. The CCT of the 20-minute groups was significantly thicker than that of the 2-minute groups (P < .0001). All RG-CXL treatments improved the corneal enzymatic resistance and corneal biomechanics, with the effects being greater in the 20-minute groups. The inclusion of 1.1% HPMC in the rose bengal formulation helped to maintain CCT during irradiation while not affecting either the infiltration of rose bengal or the efficacy of RG-CXL. CONCLUSIONS Within the range studied, RG-CXL efficacy increased with infiltration time. The incorporation of a 20-minute infiltration of 0.1% rose bengal-1.1% HPMC into the RG-CXL procedure may further improve the safety of the treatment and its prospects for clinical use. [J Refract Surg. 2022;38(7):450-458.].
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13
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Rosales-Rojas R, Zuñiga-Bustos M, Salas-Sepúlveda F, Galaz-Araya C, Zamora RA, Poblete H. Self-Organization Dynamics of Collagen-like Peptides Crosslinking Is Driven by Rose-Bengal-Mediated Electrostatic Bridges. Pharmaceutics 2022; 14:pharmaceutics14061148. [PMID: 35745721 PMCID: PMC9231032 DOI: 10.3390/pharmaceutics14061148] [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: 04/16/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022] Open
Abstract
The present work focuses on the computational study of the structural micro-organization of hydrogels based on collagen-like peptides (CLPs) in complex with Rose Bengal (RB). In previous studies, these hydrogels computationally and experimentally demonstrated that when RB was activated by green light, it could generate forms of stable crosslinked structures capable of regenerating biological tissues such as the skin and cornea. Here, we focus on the structural and atomic interactions of two collagen-like peptides (collagen-like peptide I (CLPI), and collagen-like peptide II, (CLPII)) in the presence and absence of RB, highlighting the acquired three-dimensional organization and going deep into the stabilization effect caused by the dye. Our results suggest that the dye could generate a ternary ground-state complex between collagen-like peptide fibers, specifically with positively charged amino acids (Lys in CLPI and Arg in CLPII), thus stabilizing ordered three-dimensional structures. The discoveries generated in this study provide the structural and atomic bases for the subsequent rational development of new synthetic peptides with improved characteristics for applications in the regeneration of biological tissues during photochemical tissue bonding therapies.
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Affiliation(s)
- Roberto Rosales-Rojas
- Center for Bioinformatics, Simulation and Modelling, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile; (R.R.-R.); (M.Z.-B.); (F.S.-S.); (C.G.-A.)
- Doctorado en Ciencias mención Modelado de Sistemas Químicos y Biológicos, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile
| | - Matías Zuñiga-Bustos
- Center for Bioinformatics, Simulation and Modelling, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile; (R.R.-R.); (M.Z.-B.); (F.S.-S.); (C.G.-A.)
| | - Francisca Salas-Sepúlveda
- Center for Bioinformatics, Simulation and Modelling, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile; (R.R.-R.); (M.Z.-B.); (F.S.-S.); (C.G.-A.)
| | - Constanza Galaz-Araya
- Center for Bioinformatics, Simulation and Modelling, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile; (R.R.-R.); (M.Z.-B.); (F.S.-S.); (C.G.-A.)
- Doctorado en Ciencias mención Modelado de Sistemas Químicos y Biológicos, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile
| | - Ricardo A. Zamora
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Baldiri Reixac 10-12, 08028 Barcelona, Spain
- Network Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
- Correspondence: (R.A.Z.); (H.P.)
| | - Horacio Poblete
- Center for Bioinformatics, Simulation and Modelling, Facultad de Ingeniería, Universidad de Talca, Talca 3465548, Chile; (R.R.-R.); (M.Z.-B.); (F.S.-S.); (C.G.-A.)
- Correspondence: (R.A.Z.); (H.P.)
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14
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Bronte-Ciriza D, Birkenfeld JS, de la Hoz A, Curatolo A, Germann JA, Villegas L, Varea A, Martínez-Enríquez E, Marcos S. Estimation of scleral mechanical properties from air-puff optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2021; 12:6341-6359. [PMID: 34745741 PMCID: PMC8548012 DOI: 10.1364/boe.437981] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/15/2021] [Accepted: 08/15/2021] [Indexed: 05/11/2023]
Abstract
We introduce a method to estimate the biomechanical properties of the porcine sclera in intact eye globes ex vivo, using optical coherence tomography that is coupled with an air-puff excitation source, and inverse optimization techniques based on finite element modeling. Air-puff induced tissue deformation was determined at seven different locations on the ocular globe, and the maximum apex deformation, the deformation velocity, and the arc-length during deformation were quantified. In the sclera, the experimental maximum deformation amplitude and the corresponding arc length were dependent on the location of air-puff excitation. The normalized temporal deformation profile of the sclera was distinct from that in the cornea, but similar in all tested scleral locations, suggesting that this profile is independent of variations in scleral thickness. Inverse optimization techniques showed that the estimated scleral elastic modulus ranged from 1.84 ± 0.30 MPa (equatorial inferior) to 6.04 ± 2.11 MPa (equatorial temporal). The use of scleral air-puff imaging holds promise for non-invasively investigating the structural changes in the sclera associated with myopia and glaucoma, and for monitoring potential modulation of scleral stiffness in disease or treatment.
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Affiliation(s)
- David Bronte-Ciriza
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
- CNR - IPCF, Istituto per i Processi Chimico-Fisici, Messina, Italy
- Co-first authors
| | - Judith S Birkenfeld
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
- Co-first authors
| | - Andrés de la Hoz
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Andrea Curatolo
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
- International Centre for Translational Eye Research, Warsaw, Poland
- Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
| | - James A Germann
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Lupe Villegas
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Alejandra Varea
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Eduardo Martínez-Enríquez
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Susana Marcos
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
- Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, NY 14642, USA
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15
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Multi-physics modeling and finite element formulation of corneal UV cross-linking. Biomech Model Mechanobiol 2021; 20:1561-1578. [PMID: 34009489 DOI: 10.1007/s10237-021-01463-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
The UV cross-linking technique applied to the cornea is a popular and effective therapy for eye diseases such as keratoconus and ectatic disorders. The treatment strengthens the cornea by forming new cross-links via photochemical reactions and, in turn, prevents the disease from further developing. To better understand and capture the underlying mechanisms, we develop a multi-physics model that considers the migration of the riboflavin (i.e., the photo-initializer), UV light absorption, the photochemical reaction that forms the cross-links, and biomechanical changes caused by changes to the microstructure. Our model is calibrated to a set of nanoindentation tests on UV cross-linked corneas from the literature. Additionally, we implement our multi-physics model numerically into a commercial finite element software. We also compare our simulation against a set of inflation tests from the literature. The simulation capability allows us to make quantitative predictions of a therapy's outcomes in full 3-D, based on the actual corneal geometry; it also helps medical practitioners with surgical planning.
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Saad S, Saad R, Jouve L, Kallel S, Trinh L, Goemaere I, Borderie V, Bouheraoua N. Corneal crosslinking in keratoconus management. J Fr Ophtalmol 2020; 43:1078-1095. [DOI: 10.1016/j.jfo.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/04/2023]
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