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Wu J, Zhou L, Liu Y, Zhang X, Yang Y, Zhu X, Bu Q, Shan X, Yin J, Weinreb RN, Zhou Q, Pan X, Huang AS. VEGF-C and 5-Fluorouracil Improve Bleb Survival in a Rabbit Glaucoma Surgery Trabeculectomy Model. Invest Ophthalmol Vis Sci 2024; 65:32. [PMID: 38771570 PMCID: PMC11114614 DOI: 10.1167/iovs.65.5.32] [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: 02/02/2024] [Accepted: 04/10/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose To evaluate VEGF-C-induced lymphoproliferation in conjunction with 5-fluorouracil (5-FU) antimetabolite treatment in a rabbit glaucoma filtration surgery (GFS) model. Methods Thirty-two rabbits underwent GFS and were assigned to four groups (n = 8 each) defined by subconjunctival drug treatment: (a) VEGF-C combined with 5-FU, (b) 5-FU, (c) VEGF-C, (d) and control. Bleb survival, bleb measurements, and IOP were evaluated over 30 days. At the end, histology and anterior segment OCT were performed on some eyes. mRNA was isolated from the remaining eyes for RT-PCR evaluation of vessel-specific markers (lymphatics, podoplanin and LYVE-1; and blood vessels, CD31). Results Qualitatively and quantitatively, VEGF-C combined with 5-FU resulted in blebs which were posteriorly longer and wider than the other conditions: vs. 5-FU (P = 0.043 for longer, P = 0.046 for wider), vs. VEGF-C (P < 0.001, P < 0.001) and vs. control (P < 0.001, P < 0.001). After 30 days, the VEGF-C combined with 5-FU condition resulted in longer bleb survival compared with 5-FU (P = 0.025), VEGF-C (P < 0.001), and control (P < 0.001). Only the VEGF-C combined with 5-FU condition showed a negative correlation between IOP and time that was statistically significant (r = -0.533; P = 0.034). Anterior segment OCT and histology demonstrated larger blebs for the VEGF-C combined with 5-FU condition. Only conditions including VEGF-C led to increased expression of lymphatic markers (LYVE-1, P < 0.001-0.008 and podoplanin, P = 0.002-0.011). Expression of CD31 was not different between the groups (P = 0.978). Conclusions Adding VEGF-C lymphoproliferation to standard antimetabolite treatment improved rabbit GFS success and may suggest a future strategy to improve human GFSs.
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Affiliation(s)
- Jingyi Wu
- Shandong First Medical University, Jinan, Shandong Province, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Longfang Zhou
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Yameng Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Xiaowei Zhang
- Hamilton Glaucoma Center, The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, United States
| | - Yuanhang Yang
- Shandong First Medical University, Jinan, Shandong Province, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Xinyuan Zhu
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Qianwen Bu
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
| | - Xinmiao Shan
- Shandong First Medical University, Jinan, Shandong Province, China
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Jia Yin
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, United States
| | - Qingjun Zhou
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Xiaojing Pan
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong Province, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong Province, China
| | - Alex S. Huang
- Hamilton Glaucoma Center, The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, United States
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Wei H, Wang J, Wang R, Wang Y, Wang X, Feng Z. Effects of atorvastatin on the function of Tenon's capsule fibroblasts in human eyes. Int Ophthalmol 2023; 43:3707-3715. [PMID: 37422546 DOI: 10.1007/s10792-023-02780-5] [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: 09/18/2022] [Accepted: 06/22/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE This study aimed to explore the role of atorvastatin (ATO) in the prevention and treatment of the scarring of filtration channels after glaucoma surgery. METHODS Human Tenon's capsule fibroblasts (HTFs) were co-cultured with various concentrations of ATO. First, Cell Counting Kit-8 assay was performed to evaluate the effects of various concentrations of ATO on the viability of HTFs. Then, after the ATO stimulated the HTFs for 24 h, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay was performed to evaluate the apoptosis of HTFs. Transwell assay was also performed to evaluate the migration of HTFs. Moreover, enzyme-linked immunosorbent assay (ELISA) was performed to detect the protein expression levels of transforming growth factor-β1 (TGF-β1) and TGF-β2 in the cell culture supernatant of HTFs. Western blot was carried out to detect the protein expression levels of smooth muscle actin (SMA), p38, Smad3, fibronectin, collagen I and collagen III in different groups. RESULTS The results revealed that ATO could inhibit the proliferation and migration of HTFs. Based on the TUNEL assay, 100 μM and 150 μM ATO could induce cell apoptosis. The ELISA results indicated that ATO could down-regulate the expression level of TGF-β2, and western blot analysis revealed that the protein expression levels of SMA, p38, Smad3, fibronectin, collagen I and collagen III in the TGF-β2 group were all up-regulated compared with the control group, whereas the addition of ATO could reverse this up-regulation. CONCLUSIONS ATO could inhibit the proliferation and migration of HTFs and induce their apoptosis. It was preliminary proven that ATO could inhibit the signaling pathway induced by TGF-β. It is suggested that ATO could be a basis for the treatment of the scarring of filtration channels after glaucoma surgery.
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Affiliation(s)
- Haiying Wei
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Jian Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Ruiqi Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Yeqing Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Xiaodan Wang
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Zhuolei Feng
- Eye Hospital, The First Affiliated Hospital of Harbin Medical University, Key Laboratory of Basic and Clinical Research of Heilongjiang Province, No. 23, Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China.
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Ruiz-Lozano RE, Azar NS, Mousa HM, Quiroga-Garza ME, Komai S, Wheelock-Gutierrez L, Cartes C, Perez VL. Ocular surface disease: a known yet overlooked side effect of topical glaucoma therapy. FRONTIERS IN TOXICOLOGY 2023; 5:1067942. [PMID: 37547228 PMCID: PMC10403269 DOI: 10.3389/ftox.2023.1067942] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 07/14/2023] [Indexed: 08/08/2023] Open
Abstract
Ocular surface disease (OSD), a disorder affecting the lacrimal and meibomian glands and the corneal and conjunctival epithelium, is a well-known complication of topical glaucoma therapy. OSD can present as a new or pre-existing condition that virtually any anti-glaucoma formulation can exacerbate. As such, both glaucoma and OSD frequently coexist. Typical OSD symptoms include ocular discomfort, redness, burning, and dryness, whereas signs include periorbital and eyelid skin pigmentation, conjunctival scarring, and superficial punctate keratitis. Pressure-lowering eyedrops can cause toxic, allergic, and inflammatory reactions on the ocular surface. The latter can result from either preservatives or direct toxicity from the active molecule. Although usually mild, OSD can cause significant symptoms that lead to poor quality of life, decreased compliance to therapy, glaucoma progression, and worse visual outcomes. Given the chronic nature of glaucoma, lack of curative therapy, and subsequent lifelong treatment, addressing OSD is necessary. This manuscript aims to provide an up-to-date overview of OSD's signs, symptoms, and pathogenic mechanisms from glaucoma therapy toxicity.
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Affiliation(s)
- Raul E. Ruiz-Lozano
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de La Salud, Monterrey, Mexico
| | - Nadim S. Azar
- Department of Ophthalmology, Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, United States
| | - Hazem M. Mousa
- Department of Ophthalmology, Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, United States
| | - Manuel E. Quiroga-Garza
- Department of Ophthalmology, Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, United States
| | - Seitaro Komai
- Department of Ophthalmology, Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, United States
| | | | - Cristian Cartes
- Unidad Oftalmología, Departamento de Especialidades, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Victor L. Perez
- Department of Ophthalmology, Foster Center for Ocular Immunology at Duke Eye Center, Duke University School of Medicine, Durham, NC, United States
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Singh S, Trakos N, Ali MJ. Effect of Topical 5-Fluorouracil on Lacrimal Drainage System: Histopathological Evidence From Animal Experiments and Potential Clinical Implications. Ophthalmic Plast Reconstr Surg 2023; 39:288-292. [PMID: 36356188 DOI: 10.1097/iop.0000000000002289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The purpose of this study is to investigate the histopathological changes in the lacrimal drainage system of rabbits following the application of 1% topical 5-fluorouracil (5-FU) for 4 weeks. METHODS Ten eyes of 10 healthy New Zealand white rabbits were subjected to topical instillation of 1% (10 mg/mL) 5-FU, 1 drop 4 times a day for 4 weeks. Rabbits underwent a detailed ocular examination including eyelids, ocular surface, punctal, peri-punctal changes, and nasolacrimal duct patency at baseline and after 4 weeks of 5-FU. The rabbits were then sacrificed, and the eyelid, conjunctiva, lacrimal gland, and the entire lacrimal drainage system were retrieved for histopathological analysis as per standard protocols. RESULTS Clinically demonstrable peripunctal changes and canalicular stenosis were noted in 6 (60%, 6/10) rabbits. Two of these (20%, 2/10) had additional complete regurgitation of clear fluid, indicating a nasolacrimal duct obstruction. The remaining 4 (40%, 4/10) clinically did not demonstrate lacrimal drainage changes and were patent on irrigation. The conjunctiva showed focal loss of goblet cells in several areas. Significant changes were noted in the canalicular, lacrimal sac, and the nasolacrimal duct tissues in the form of epithelial hyperplasia, subepithelial inflammation, edema, dilated and congested vessels, and fibrosis. The lacrimal gland, eyelid tissue (excluding tarsal conjunctiva), and cornea showed no significant histopathological changes. CONCLUSIONS Clinical and histopathological changes were noted in the lacrimal drainage system of rabbits subjected to topical 5-FU application. These findings can have potential clinical implications for patients receiving 5-FU therapy.
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Affiliation(s)
- Swati Singh
- Ophthalmic Plastics Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India
- Institute of Clinical and Functional Anatomy, Friedrich-Alexander University, Erlangen, Germany
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | | | - Mohammad Javed Ali
- Institute of Clinical and Functional Anatomy, Friedrich-Alexander University, Erlangen, Germany
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
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Mukherjee P, Roy S, Ghosh D, Nandi SK. Role of animal models in biomedical research: a review. Lab Anim Res 2022; 38:18. [PMID: 35778730 PMCID: PMC9247923 DOI: 10.1186/s42826-022-00128-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
The animal model deals with the species other than the human, as it can imitate the disease progression, its’ diagnosis as well as a treatment similar to human. Discovery of a drug and/or component, equipment, their toxicological studies, dose, side effects are in vivo studied for future use in humans considering its’ ethical issues. Here lies the importance of the animal model for its enormous use in biomedical research. Animal models have many facets that mimic various disease conditions in humans like systemic autoimmune diseases, rheumatoid arthritis, epilepsy, Alzheimer’s disease, cardiovascular diseases, Atherosclerosis, diabetes, etc., and many more. Besides, the model has tremendous importance in drug development, development of medical devices, tissue engineering, wound healing, and bone and cartilage regeneration studies, as a model in vascular surgeries as well as the model for vertebral disc regeneration surgery. Though, all the models have some advantages as well as challenges, but, present review has emphasized the importance of various small and large animal models in pharmaceutical drug development, transgenic animal models, models for medical device developments, studies for various human diseases, bone and cartilage regeneration model, diabetic and burn wound model as well as surgical models like vascular surgeries and surgeries for intervertebral disc degeneration considering all the ethical issues of that specific animal model. Despite, the process of using the animal model has facilitated researchers to carry out the researches that would have been impossible to accomplish in human considering the ethical prohibitions.
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Affiliation(s)
- P Mukherjee
- Department of Veterinary Clinical Complex, West Bengal University of Animal and Fishery Sciences, Mohanpur, Nadia, India
| | - S Roy
- Department of Veterinary Clinical Complex, West Bengal University of Animal and Fishery Sciences, Mohanpur, Nadia, India
| | - D Ghosh
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - S K Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India.
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Wolters JEJ, van Mechelen RJS, Al Majidi R, Pinchuk L, Webers CAB, Beckers HJM, Gorgels TGMF. History, presence, and future of mitomycin C in glaucoma filtration surgery. Curr Opin Ophthalmol 2021; 32:148-159. [PMID: 33315724 DOI: 10.1097/icu.0000000000000729] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Mitomycin C (MMC) is an alkylating agent with extraordinary ability to crosslink DNA, preventing DNA synthesis. By this virtue, MMC is an important antitumor drug. In addition, MMC has become the gold standard medication for glaucoma filtration surgery (GFS). This eye surgery creates a passage for drainage of aqueous humor (AqH) out of the eye into the sub-Tenon's space with the aim of lowering the intraocular pressure. A major cause of failure of this operation is fibrosis and scarring in the sub-Tenon's space, which will restrict AqH outflow. Intraoperative application of MMC during GFS has increased GFS success rate, presumably mainly by reducing fibrosis after GFS. However, still 10% of glaucoma surgeries fail within the first year. RECENT FINDINGS In this review, we evaluate risks and benefits of MMC as an adjuvant for GFS. In addition, we discuss possible improvements of its use by adjusting dose and method of administration. SUMMARY One way of improving GFS outcome is to prolong MMC delivery by using a drug delivery system.
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Affiliation(s)
- Jarno E J Wolters
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Ralph J S van Mechelen
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rana Al Majidi
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Leonard Pinchuk
- InnFocus, Inc., a Santen Company
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
| | - Henny J M Beckers
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
| | - Theo G M F Gorgels
- University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht
- Chemelot Institute for Science and Technology (InSciTe), Geleen
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Chong RS, Crowston JG, Wong TT. Experimental models of glaucoma filtration surgery. Acta Ophthalmol 2021; 99:9-15. [PMID: 32715621 DOI: 10.1111/aos.14485] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/09/2020] [Indexed: 12/15/2022]
Abstract
Glaucoma filtration surgery plays an important role in achieving intraocular pressure (IOP) reduction in patients who have high IOP despite maximum medical therapy. Preclinical experimental models of glaucoma filtration surgery contribute a great deal to our knowledge of the wound healing processes that predispose to scarring and may lead to poor outcomes. However, this research needs to be interpreted in the light of the specific study design, animal model and methods used. We review the existing literature addressing various models of experimental glaucoma filtration surgery, discuss the considerations in assessing these models and describe future steps in evaluating potential therapeutics and bleb characteristics that could impact translational research in this field.
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Affiliation(s)
- Rachel S Chong
- Singapore National Eye Centre Singapore Singapore
- Singapore Eye Research Institute Singapore Singapore
- Duke‐NUS Medical School Singapore Singapore
- Genome Institute of Singapore Agency for Science Technology and Research Singapore Singapore
| | - Jonathan G Crowston
- Singapore National Eye Centre Singapore Singapore
- Singapore Eye Research Institute Singapore Singapore
- Duke‐NUS Medical School Singapore Singapore
| | - Tina T Wong
- Singapore National Eye Centre Singapore Singapore
- Singapore Eye Research Institute Singapore Singapore
- Duke‐NUS Medical School Singapore Singapore
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Wu M, Wang S, Wang Y, Zhang F, Shao T. Targeted delivery of mitomycin C-loaded and LDL-conjugated mesoporous silica nanoparticles for inhibiting the proliferation of pterygium subconjunctival fibroblasts. Exp Eye Res 2020; 197:108124. [PMID: 32598971 DOI: 10.1016/j.exer.2020.108124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/07/2020] [Accepted: 06/17/2020] [Indexed: 11/26/2022]
Abstract
Pterygium is a degenerative disease that characterized by excessive fibrovascular proliferation. To reduce the recurrence rate, surgery is the main strategy, in combination with adjacent procedures or adjunctive therapy. One of the most common adjunctive agents, mitomycin C (MMC), is known as an alkylating agent that inhibits fibroblast proliferation but is limitedly applied in pterygium due to various complications. A previous study demonstrated that activated pterygium subconjunctival fibroblasts overexpressed low-density lipoprotein (LDL) receptors. In this study, we designed and synthesized MMC-loaded mesoporous silica nanoparticles conjugated with LDL (MMC@MSNs-LDL) to deliver MMC into activated pterygium fibroblasts in a targeted manner. The MMC loading efficiency was approximately 6%. The cell viability test (CCK-8 assay) revealed no cytotoxicity for the empty carrier MSNs at a concentration of ≤1 mg/ml after administration for 48 h in subconjunctival fibroblasts. Primary pterygium and normal human subconjunctival fibroblasts with or without stimulation by vascular endothelial growth factor (VEGF) were treated as follows: 1) 10 μg/ml MMC@MSNs-LDL for 24 h (MMC concentration: 0.6 μg/ml); 2) 0.2 mg/ml MMC for 5 min then cultured for 24 h after MMC removal; and 3) normal culture without any drug treatment. At 24 h, the anti-proliferative effect of MMC@MSNs-LDL in activated pterygium fibroblasts was similar to that of MMC (cell viability: 46.2 ± 5.5% vs 40.5 ± 1.1%, respectively, P = 0.349). Furthermore, the cytotoxicity of MMC@MSNs-LDL to normal fibroblasts with or without VEGF stimulation was significantly lower than that of traditional MMC (cell viability: 75.6 ± 4.4% vs 36.0 ± 1.5%, respectively, P < 0.001; 84.7 ± 5.5% vs 35.7 ± 1.3%, P < 0.001). The binding of fluorescently labeled MMC@MSNs-LDL in fibroblasts was assessed using confocal fluorescence microscopy. The uptake of targeted nanoparticles in fibroblasts was time dependent and saturated at 6 h. VEGF-activated pterygium fibroblasts showed more uptake of MMC@MSNs-LDL than normal fibroblasts with or without VEGF activation (both P < 0.001). Our data strongly suggest that MMC@MSNs-LDL had an effective antiproliferative role in activated pterygium fibroblasts, with reduced toxicity to normal fibroblasts compared to traditional application of MMC. LDL-mediated drug delivery might have great potential in the management of pterygium recurrence.
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Affiliation(s)
- Mengliang Wu
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, Shanghai, 200031, PR China
| | - Shangfeng Wang
- Department of Chemistry, State Key Laboratory of Molecular Engineering of Polymers, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials and iChem, Fudan University, Shanghai, 200433, PR China
| | - Yan Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, Shanghai, 200031, PR China
| | - Fan Zhang
- Department of Chemistry, State Key Laboratory of Molecular Engineering of Polymers, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials and iChem, Fudan University, Shanghai, 200433, PR China.
| | - Tingting Shao
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, School of Shanghai Medicine, Fudan University, Shanghai, 200031, PR China.
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Fischer NA, Kahook MY, Abdullah S, Porteous E, Ammar DA, Patnaik JL, SooHoo JR. Effect of Novel Design Modifications on Fibrotic Encapsulation: An In Vivo Glaucoma Drainage Device Study in a Rabbit Model. Ophthalmol Ther 2020; 9:279-291. [PMID: 32152939 PMCID: PMC7196114 DOI: 10.1007/s40123-020-00242-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To quantify the effects of modified Ahmed glaucoma valves® (AGV) with anti-fibrotic plate coatings or a plate surface micro-pattern on outflow resistance and tissue response. Methods Twelve New Zealand rabbits were divided into four groups: commercially available AGV implants (n = 3), AGV with hydrophilic coating (n = 3), AGV with heparin coating (n = 3), and AGV with a plate surface micro-pattern (n = 3). After 6 weeks, the anterior chamber silicone tube was cannulated in situ and perfused with 2.5 μL/min of saline. The pressures were recorded with a perfusion system to measure outflow resistance. The rabbits were then euthanized followed by enucleation of all eyes for bleb histological analyses. Results Hydrostatic pressures were significantly lower in AGVs with the hydrophilic plate coating (mean difference −9.6 mm Hg; p < 0.001), heparin-coated plates (mean difference −4.4 mm Hg; p < 0.001), and micro-patterned plates (mean difference −18.6 mm Hg, p < 0.001), indicating lower outflow resistance compared to control AGV models. Fibrotic encapsulation was lower in hydrophilic plate coating (84.2 μm; mean difference −6.2 μm, p = 0.425), micro-patterned surface (63.7 μm; mean difference −26.7 μm, p = 0.003), and heparin plate coating (49.3 μm; mean difference −41.1 μm, p = 0.006) when compared to control AGV models. Conclusions Modified AGVs with plate coatings and AGVs with micro-patterned plates both appear to reduce postoperative fibrotic encapsulation and aqueous outflow resistance by altering the tissue response to implanted materials. Further studies are needed to characterize the safety and role of plate surface modifications on glaucoma drainage devices.
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Affiliation(s)
- Nathan A Fischer
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Malik Y Kahook
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - David A Ammar
- Lions Eye Institute for Transplant and Research, Tampa, FL, USA
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jeffrey R SooHoo
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
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Yadav KS, Sharma S. Implantable drainage devices in glaucoma: Quo vadis? Eur J Pharm Sci 2019; 133:1-7. [DOI: 10.1016/j.ejps.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/28/2019] [Accepted: 03/10/2019] [Indexed: 10/27/2022]
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Schwerk B, Harder L, Windhövel C, Hewicker-Trautwein M, Wagner A, Bach JP, Voigt LC, Hinze U, Chichkov B, Haferkamp H, Lubatschowski H, Nikolic S, Nolte I. Comparison of two prototypes of a magnetically adjustable glaucoma implant in rabbits. PLoS One 2019; 14:e0215316. [PMID: 30973952 PMCID: PMC6459522 DOI: 10.1371/journal.pone.0215316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/30/2019] [Indexed: 01/03/2023] Open
Abstract
Glaucoma drainage devices are used in surgical glaucoma therapy. Success of controlling the intraocular pressure is limited due to fibrous implant encapsulation and fibrin coating on the implant which lead to drainage obstructions. An innovative implant with a magnetically adjustable valve was developed. The valve opening of the implant should eliminate inflammatory products from the outflow area and affect fibrous tissue formation to achieve a sufficient long-term aqueous humour outflow. Lifting of this valve should disturb cell adhesion by exerting mechanical forces. Before testing this hypothesis, the flow characteristics of glaucoma drainage devices, especially the outflow resistance by regular IOP, should be considered in a pilot study, as they are important in preventing too low postoperative intraocular pressure known as ocular hypotony. Therefore, two prototypes of the innovative implant differing in their valve area design were examined regarding their flow characteristics in a limited animal experiment lasting two weeks. Ten healthy New Zealand White rabbits were divided into two groups (A & B) with different implanted prototypes. Daily, tonometry and direct ophthalmoscopy were performed to assess the intraocular pressure and the inflammatory reaction of the eye. After two weeks, the rabbits were euthanised to evaluate the initially histological inflammatory reaction to the implant. In group A, one case of hypotony emerged. When considering the entire observation period, a highly statistically significant difference between the intraocular pressure in the operated eye and that in the control eye was detected in group A (p < 0.0001) in contrast to group B (p = 0.0063). The postoperative inflammatory signs decreased within two weeks. Histologically, a typical but low level foreign body reaction with macrophages and lymphocytes as well as mild to moderate fibrosis was seen after the short experimental period. Based on our tonometric results, prototype B seems to be the system of choice for further research assessing its long-term function and biocompatibility.
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Affiliation(s)
- Birthe Schwerk
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- * E-mail: (IN); (BS)
| | - Lisa Harder
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Claudia Windhövel
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | | | - Anna Wagner
- Institute for Pathology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Jan-Peter Bach
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Lena Carolin Voigt
- Clinic for Small Mammals, Reptiles and Birds, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Ulf Hinze
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University Hannover, Hannover, Germany
| | - Boris Chichkov
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University Hannover, Hannover, Germany
| | - Heinz Haferkamp
- Gottfried Wilhelm Leibniz University Hannover, Hannover, Germany
| | | | | | - Ingo Nolte
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- * E-mail: (IN); (BS)
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Dong A, Han L, Shao Z, Fan P, Zhou X, Yuan H. Glaucoma Drainage Device Coated with Mitomycin C Loaded Opal Shale Microparticles to Inhibit Bleb Fibrosis. ACS APPLIED MATERIALS & INTERFACES 2019; 11:10244-10253. [PMID: 30689341 DOI: 10.1021/acsami.8b18551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Excessive fibrosis is the topmost factor for the defeat of surgical glaucoma drainage device (GDD) implantation. Adjuvant drug approaches are promising to help reduce the scar formation and excessive fibrosis. Opal shale (OS), as a natural state and noncrystalline silica substance with poriferous nature and strong adsorbability, is highly likely to undertake drug loading and delivery. Here, we employed OS microparticles (MPs) by ultrasound and centrifugation and presented an innovative and improved GDD coated with OS MPs, which were loaded with mitomycin C (MMC). MMC-loaded OS MPs were physically absorbed on the Ahmed glaucoma valve surface through OS' adsorbability. About 5.51 μg of MMC was loaded on the modified Ahmed glaucoma valve and can be released for 18 days in vitro. MMC-loaded OS MPs inhibited fibroblast proliferation and showed low toxicity to primary Tenon's fibroblasts. The ameliorated drainage device was well tolerated and effective in reducing the fibrous reaction in vivo. Hence, our study constructed an improved Ahmed glaucoma valve using OS MPs without disturbing aqueous humor drainage pattern over the valve surface. The modified Ahmed glaucoma valve successfully alleviated scar tissue formation after GDD implantation surgery.
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Affiliation(s)
- Aimeng Dong
- Department of Ophthalmology , The Second Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China
- The Key Laboratory of Myocardial Ischemia , Harbin Medical University, Ministry of Education , Harbin , Heilongjiang Province 150081 , P. R. China
| | - Liang Han
- Department of Pharmaceutics, College of Pharmaceutical Sciences , Soochow University , Suzhou 215123 , P. R. China
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and College of Pharmaceutical Sciences , Soochow University , Suzhou 215123 , P. R. China
| | - Zhengbo Shao
- Department of Ophthalmology , The Second Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China
| | - Pan Fan
- Department of Ophthalmology , The Second Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China
| | - Xinrong Zhou
- Department of Ophthalmology , The Second Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China
| | - Huiping Yuan
- Department of Ophthalmology , The Second Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang 150081 , P. R. China
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13
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Szabó D, Kovács D, Endrész V, Igaz N, Jenovai K, Spengler G, Tiszlavicz L, Molnár J, Burián K, Kiricsi M, Rovó L. Antifibrotic effect of mitomycin-C on human vocal cord fibroblasts. Laryngoscope 2019; 129:E255-E262. [PMID: 30618152 DOI: 10.1002/lary.27657] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/05/2018] [Accepted: 10/10/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Acquired laryngotracheal stenosis is a potentially life-threatening situation and a very difficult and challenging problem in laryngology. Therefore, new trends and innovative approaches based on antifibrotic drugs and minimally invasive regimens are being developed to attenuate laryngotracheal fibrosis and scarring. The purpose of this study was to examine the efficacy of mitomycin-C (MMC) to reverse the transforming growth factor (TGF)-β-induced differentiation of MRC-5 fibroblast and human primary vocal cord fibroblasts to reveal the possible applicability of MMC to laryngotracheal fibrotic conditions. METHODS Human primary fibroblast cells were isolated from vocal cord specimens of patients undergoing total laryngectomy. The established primary vocal cord fibroblast cell cultures as well as the MRC-5 human fibroblast cells were treated with 5 ng/mL TGF-β alone and then with 0.5 µg/mL MMC for 24 hours. Differentiation of fibroblasts was characterized by α-smooth muscle actin (α-SMA) immunhistochemistry, Western blot analysis, and real-time polymerase chain reaction. Cell motility was assessed by wound-healing assay. RESULTS Elevated α-SMA mRNA and protein expression as well as increased cell motility were observed upon TGF-β exposures. However, after MMC treatments the TGF-β-induced fibroblasts exhibited a significant decrease in α-SMA expression and wound-healing activity. Therefore, TGF-β-stimulated fibroblast-myofibroblast transformation was reversed at least in part by MMC treatment. Histopathological examinations of tissue specimens of a laryngotracheal stenosis patient supported these findings. CONCLUSION Antifibrotic effects of MMC were demonstrated on the human MRC-5 cell line and on primary vocal cord fibroblast cultures. These results verify that MMC can be used with success to reverse upper airway stenosis by reverting the myofibroblast phenotype. LEVEL OF EVIDENCE NA Laryngoscope, 129:E255-E262, 2019.
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Affiliation(s)
- Diána Szabó
- Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Szeged, Hungary
| | - Dávid Kovács
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Valéria Endrész
- Department of Medical Microbiology and Immunobiology, Szeged, Hungary
| | - Nóra Igaz
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Kitti Jenovai
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | | | | | - József Molnár
- Department of Medical Microbiology and Immunobiology, Szeged, Hungary
| | - Katalin Burián
- Department of Medical Microbiology and Immunobiology, Szeged, Hungary
| | - Mónika Kiricsi
- Department of Biochemistry and Molecular Biology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - László Rovó
- Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Szeged, Hungary
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14
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Banerjee M, Saraswatula S, Willows LG, Woods H, Brettmann B. Pharmaceutical crystallization in surface-modified nanocellulose organogels. J Mater Chem B 2018; 6:7317-7328. [PMID: 32254641 DOI: 10.1039/c8tb01554f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A significant research focus in the pharmaceutical industry is on methods to improve drug uptake into the body by increased dissolution of poorly water soluble active pharmaceutical ingredients (APIs) or sustained drug release behavior, which results in higher overall uptake. Production of higher energy, higher solubility polymorphs is one approach to address this problem. Here we utilize natural materials, cellulose nanocrystals (CNCs), that have a high surface area covered with readily-modified hydroxyl groups to form organogels that promote API crystallization into polymorphs that differ from the as-received materials. We form the gels by oxidizing the CNCs and mixing them with an amine-containing surfactant, octadecylamine (ODA) in dimethylsulfoxide (DMSO) and we optimize the composition and preparation conditions for these gels. The APIs, sulfamethoxazole, sulfapyridine, and sulfamerazine, are added to the mixture prior to the gelation step and are expected to localize in the solvophobic regions of the physical gel and crystallize. We found that sulfamethoxazle recovered from the gels is in the amorphous state, while sulfapyridine crystallizes into a mixture of forms I, III and IV, and sulfamerazine crystallizes into forms I and II, which are different from the as-received materials. This system shows promise for rational design of nanocellulose organogel supports for heterogeneous crystallization of pharmaceutical materials with desired polymorphs.
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Affiliation(s)
- Manali Banerjee
- School of Materials Science and Engineering, Georgia Institute of Technology, Georgia.
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15
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Bao N, Jiang ZX, Coh P, Tao LM. Long-term outcomes of uveitic glaucoma treated with Ahmed valve implant in a series of Chinese patients. Int J Ophthalmol 2018; 11:629-634. [PMID: 29675382 PMCID: PMC5902368 DOI: 10.18240/ijo.2018.04.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/29/2018] [Indexed: 12/14/2022] Open
Abstract
AIM To report long-term outcomes of secondary glaucoma due to uveitis treated with Ahmed glaucoma valve (AGV) implantation in a series of Chinese patients. METHODS The retrospective study included 67 eyes from 56 patients with uveitic glaucoma who underwent AGV implantation. Success of the treatment was defined as patients achieving intraocular pressure (IOP) levels between 6 and 21 mm Hg with or without additional anti-glaucoma medications and/or a minimum of 20% reduction from baseline IOP. The main outcome measurements included IOP, the number of glaucoma medications at 1, 3, 6, 12, 24, 36, 48 and 60mo after surgery, surgical complications, final best-corrected vision acuity (BCVA), visual field (VF) and retinal nerve fiber layer (RNFL). RESULTS The mean follow-up was 53.3±8.5 (range 48 to 60)mo. The cumulative probability of success rate was 98.5%, 95.5%, 89.6%, 83.6%, 76.1%, 70.1%, 65.7% and 61.2% at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively. IOP was reduced from a baseline of 30.8±6.8 to 9.9±4.1, 10.1±4.2, 10.9±3.7, 12.9±4.6, 13.8±3.9, 13.2±4.6, 12.3±3.5 and 13.1±3.7 mm Hg at 1, 3, 6, 12, 24, 36, 48 and 60mo, respectively (P<0.01). The number of postoperative glaucoma medications was significantly decreased compared with baseline at all time points during the study period (P<0.05). There was no significant difference between preoperative and postoperative BCVA. Remarkable surgical complications were not found after surgery. The VF and RNFL of the patients were stable after the surgery. CONCLUSION AGV implantation is safe and effect in terms of reducing IOP, decreasing the number of glaucoma medications, and preserving vision for patients with uveitic glaucoma.
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Affiliation(s)
- Ning Bao
- Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Paul Coh
- Department of Ophthalmology, University of California, San Francisco 94143-0730, California, USA
| | - Li-Ming Tao
- Department of Ophthalmology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
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16
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Calejo MT, Ilmarinen T, Skottman H, Kellomäki M. Breath figures in tissue engineering and drug delivery: State-of-the-art and future perspectives. Acta Biomater 2018; 66:44-66. [PMID: 29183847 DOI: 10.1016/j.actbio.2017.11.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/09/2017] [Accepted: 11/22/2017] [Indexed: 12/11/2022]
Abstract
The breath figure (BF) method is an easy, low-cost method to prepare films with a highly organized honeycomb-like porous surface. The particular surface topography and porous nature of these materials makes them valuable substrates for studying the complex effects of topography on cell fate, and to produce biomimetic materials with high performance in tissue engineering. Numerous researchers over the last two decades have studied the effects of the honeycomb topography on a variety of primary and immortalized cell lines, and drew important conclusions that can be translated to the construction of optimal biomaterials for cell culture. The literature also encouragingly shows the potential of honeycomb films to induce differentiation of stem cells down a specific lineage without the need for biochemical stimuli. Here, we review the main studies where BF honeycomb films are used as substrates for tissue engineering applications. Furthermore, we highlight the numerous advantages of the porous nature of the films, such as the enhanced, spatially controlled adsorption of proteins, the topographical cues influencing cellular behavior, and the enhanced permeability which is essential both in vitro and in vivo. Finally, this review highlights the elegant use of honeycomb films as drug-eluting biomaterials or as reservoirs for distinct drug delivery systems. STATEMENT OF SIGNIFICANCE Combining biocompatible surfaces and 3D nano/microscale topographies, such as pores or grooves, is an effective strategy for manufacturing tissue engineering scaffolds. The breath figure (BF) method is an easy technique to prepare cell culture substrates with an organized, honeycomb-like porous surface. These surface features make these scaffolds valuable for studying how the cells interact with the biomaterials. Their unique surface topography can also resemble the natural environment of the tissues in the human body. For that reason, numerous studies, using different cell types, have shown that honeycomb films can constitute high performance substrates for cell culture. Here, we review those studies, we highlight the advantages of honeycomb films in tissue engineering and we discuss their potential as unique drug-eluting systems.
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Affiliation(s)
- Maria Teresa Calejo
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland.
| | - Tanja Ilmarinen
- BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Heli Skottman
- BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Minna Kellomäki
- BioMediTech Institute and Faculty of Biomedical Sciences and Engineering, Tampere University of Technology, Tampere, Finland; BioMediTech Institute and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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17
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Bikbov MM, Khusnitdinov II. [Ahmed valve in glaucoma surgery]. Vestn Oftalmol 2018; 133:126-130. [PMID: 29319679 DOI: 10.17116/oftalma20171336126-130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is a review on Ahmed valve application in glaucoma surgery. It contains, in particular, data on the Ahmed valve efficiency, results of experimental and histological studies of filtering bleb encapsulation, examines the use of antimetabolites and anti-VEGF agents, and discusses implantation techniques. The current appraisal of antimetabolites delivery systems integrated into the Ahmed valve is presented. Various complications encountered in practice and preventive measures are also covered.
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Affiliation(s)
- M M Bikbov
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russian Federation, 450008
| | - I I Khusnitdinov
- Ufa Eye Research Institute, Academy of Sciences of the Republic of Bashkortostan, 90 Pushkin St., Ufa, Russian Federation, 450008
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18
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Park KS, Kim KN, Lee SB, Kim JY, Kim CS. Comparison of Effects and Complications between Conventional Trabeculectomy and Trabeculectomy with a Collagen Matrix Insertion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.1.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kee Sup Park
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Kyoung Nam Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung Bok Lee
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jung Yeul Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Chang-sik Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea
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19
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Leelakanok N, Geary S, Salem A. Fabrication and Use of Poly(d,l-lactide-co-glycolide)-Based Formulations Designed for Modified Release of 5-Fluorouracil. J Pharm Sci 2017; 107:513-528. [PMID: 29045885 DOI: 10.1016/j.xphs.2017.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 12/14/2022]
Abstract
5-fluorouracil (5-FU) is a chemotherapeutic agent that has been used for the treatment of a variety of malignancies since its initial introduction to the clinic in 1957. Owing to its short biological half-life, multiple dosings are generally required to maintain effective 5-FU plasma concentrations throughout the therapeutic period. Clinical studies have shown that continuous 5-FU administration is generally superior to bolus injection as exhibited by lower toxicities and increased therapeutic efficacy. Optimal therapeutic efficacy, however, is often compromised by the limiting therapeutic index. Whilst oral formulations are also used, these suffer from the drawbacks of variable bioavailability and first-pass metabolism. As a result, sustained release formulations of 5-FU have been investigated in an effort to mimic the kinetics of continuous infusion particularly for situations where local delivery is considered appropriate. The biocompatible, biodegradable, and highly tunable synthetic polymer, poly(d,l-lactide-co-glycolide) (PLGA), is widely used as a vector for sustained drug delivery, however, issues such as insufficient loading and inappropriate burst release kinetics have dogged progress into the clinic for small hydrophilic drugs such as 5-FU. This review provides introductory information about the mechanism of action, pharmacokinetic and physicochemical properties, and clinical use of 5-FU that have contributed to the development of PLGA-based 5-FU release platforms. In addition, this review provides information on fabrication methods used for a range of 5-FU-loaded PLGA formulations and discusses factors affecting the release kinetics of 5-FU as well as the in vitro and in vivo antitumor or antiproliferative efficacy of these platforms.
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Affiliation(s)
- Nattawut Leelakanok
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242
| | - Sean Geary
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242
| | - Aliasger Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, Iowa City, Iowa 52242.
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Szigiato AA, Podbielski DW, Ahmed IIK. Sustained drug delivery for the management of glaucoma. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1280393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Dominik W. Podbielski
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Iqbal Ike K. Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
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21
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A role for antimetabolites in glaucoma tube surgery: current evidence and future directions. Curr Opin Ophthalmol 2016; 27:164-9. [PMID: 26720778 DOI: 10.1097/icu.0000000000000244] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Glaucoma is the leading cause of irreversible blindness worldwide. The main treatment modality for glaucoma is the reduction and control of the intraocular pressure (IOP). Glaucoma filtration surgery, including trabeculectomy and/or implantation of a glaucoma drainage device (GDD), is warranted if IOP remains medically uncontrolled. However, postoperative scarring remains a critical determinant of long-term bleb survival and IOP control after drainage surgery. Antimetabolites, such as mitomycin C and 5-fluorouracil, have been used for many years to increase survival time of filtration surgeries by preventing bleb fibrosis and scarring. The aim of this study is to provide an overview of: the current usage of these antimetabolites in GDD, the recent advancements of these antimetabolites in combination with other technologies, and the role of future antimetabolites. RECENT FINDINGS Mitomycin C and 5-fluorouracil have been used in GDD and trabeculectomy to prevent the exaggerated cellular reaction that leads to fibrosis. The adjunctive administration of these drugs intraoperatively and postoperatively has resulted in a lower rate of the hypertensive phase, and possibly a better long-term success rate in Ahmed valve surgeries. However, the application of these antimetabolites and their multiple-dosing applications are associated with nonspecific cytotoxicity and potentially severe complications such as bleb leak and conjunctival erosion over the tube. Recent studies are thus focusing on different medications, targeting new molecular pathways, and designing new delivery vehicles to minimize current antimetabolites side-effects and increase their efficacy. Promising results of these studies have led to development of new collaborative medications and advanced drug delivery systems for better modulation of GDD surgeries' predictable outcomes. SUMMARY The development of small molecule therapeutics, combination therapies, and innovative drug vehicles to prevent postsurgical fibrosis and achieve better surgical outcome in glaucoma filtration surgeries is promising.
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Cejkova J, Cejka C, Trosan P, Zajicova A, Sykova E, Holan V. Treatment of alkali-injured cornea by cyclosporine A-loaded electrospun nanofibers – An alternative mode of therapy. Exp Eye Res 2016; 147:128-137. [DOI: 10.1016/j.exer.2016.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/14/2016] [Accepted: 04/19/2016] [Indexed: 11/29/2022]
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23
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Qi S, Craig D. Recent developments in micro- and nanofabrication techniques for the preparation of amorphous pharmaceutical dosage forms. Adv Drug Deliv Rev 2016; 100:67-84. [PMID: 26776230 DOI: 10.1016/j.addr.2016.01.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/03/2016] [Indexed: 12/27/2022]
Abstract
Nano- and microfabrication techniques have been widely explored in the textile, polymer and biomedical arenas, although more recently these systems have attracted considerable interest as drug delivery vehicles with concomitant considerations of physical characterization, scalability, stability and drug release. In this review, the current thinking with regards to the manufacture of solid amorphous pharmaceutical materials using electrohydrodynamic and gyration-based approaches, melt-spinning approaches, thermal moulding, inkjet printing and 3D printing will be examined in the context of their potential and actual viability as dosage forms. A series of practical examples will be discussed as to how these approaches have been used as means of producing drug delivery systems for a range of delivery systems and treatments.
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Affiliation(s)
- Sheng Qi
- School of Pharmacy, University of East Anglia, Norwich, Norfolk, NR4 7TJ, UK
| | - Duncan Craig
- UCL School of Pharmacy, 29-39 Brunswick Square, London, WC1N 1AX, UK
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Bikbov MM, Khusnitdinov II. The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery. J Curr Glaucoma Pract 2016; 9:86-91. [PMID: 26997843 PMCID: PMC4779947 DOI: 10.5005/jp-journals-10008-1191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/17/2015] [Indexed: 11/23/2022] Open
Abstract
The treatment of refractory glaucoma (RG) is challenging. The commonly adopted strategy in RG treatment is a glaucoma drainage device (GDD) implantation, which despite its radical nature may not always provide the desired intraocular pressure (IOP) levels for a long term. This review is based on the scientific literature on Ahmed glaucoma valve (AGV) implantation for refractory glaucoma. The technique of AGV implantation is described and data for both the types, FP7 and FP8 performance are presented. The outcome with adjunct antimetabolite and anti-VEGF drugs are also highlighted. An insight is given about experimental and histological examinations of the filtering bleb encapsulation. The article also describes various complications and measures to prevent them. How to cite this article: Bikbov MM, Khusnitdinov II. The Results of the Use of Ahmed Valve in Refractory Glaucoma Surgery. J Curr Glaucoma Pract 2015;9(3):86-91.
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Arora JS, Cremaldi JC, Holleran MK, Ponnusamy T, He J, Pesika NS, John VT. Hydrogel Inverse Replicas of Breath Figures Exhibit Superoleophobicity Due to Patterned Surface Roughness. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2016; 32:1009-1017. [PMID: 26752016 DOI: 10.1021/acs.langmuir.5b03870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The wetting behavior of a surface depends on both its surface chemistry and the characteristics of surface morphology and topography. Adding structure to a flat hydrophobic or oleophobic surface increases the effective contact angle and thus the hydrophobicity or oleophobicity of the surface, as exemplified by the lotus leaf analogy. We describe a simple strategy to introduce micropatterned roughness on surfaces of soft materials, utilizing the template of hexagonally packed pores of breath figures as molds. The generated inverse replicas represent micron scale patterned beadlike protrusions on hydrogel surfaces. This added roughness imparts superoleophobic properties (contact angle of the order of 150° and greater) to an inherently oleophobic flat hydrogel surface, when submerged. The introduced pattern on the hydrogel surface changes morphology as it swells in water to resemble morphologies remarkably analogous to the compound eye. Analysis of the wetting behavior using the Cassie-Baxter approximation leads to estimation of the contact angle in the superoleophobic regime and in agreement with the experimental value.
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Affiliation(s)
- Jaspreet Singh Arora
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
| | - Joseph C Cremaldi
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
| | - Mary Kathleen Holleran
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
| | - Thiruselvam Ponnusamy
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
| | - Jibao He
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
| | - Noshir S Pesika
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
- Vector Borne Infectious Diseases Research Center, Tulane University , New Orleans, Louisiana 70112, United States
| | - Vijay T John
- Department of Chemical and Biomolecular Engineering, Tulane University , New Orleans, Louisiana 70118, United States
- Vector Borne Infectious Diseases Research Center, Tulane University , New Orleans, Louisiana 70112, United States
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