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Ji HB, Hong JY, Kim CR, Min CH, Han JH, Kim MJ, Kim SN, Lee C, Choy YB. Microchannel-embedded implantable device with fibrosis suppression for prolonged controlled drug delivery. Drug Deliv 2022; 29:489-498. [PMID: 35147052 PMCID: PMC8843219 DOI: 10.1080/10717544.2022.2032873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
For the prolonged, controlled delivery of systemic drugs, we propose an implantable drug-delivery chip (DDC) embedded with pairs of a microchannel and drug-reservoir serving as a drug diffusion barrier and depot, respectively. We pursued a DDC for dual drugs: a main-purpose drug, diclofenac (DF), for systemic exposure, and an antifibrotic drug, tranilast (TR), for local delivery. Thus, the problematic fibrotic tissue formation around the implanted device could be diminished, thereby less hindrance in systemic exposure of DF released from the DDC. First, we separately prepared DDCs for DF or TR delivery, and sought to find a proper microchannel length for a rapid onset and sustained pattern of drug release, as well as the required drug dose. Then, two distinct DDCs for DF and TR delivery, respectively, were assembled to produce a Dual_DDC for the concurrent delivery of DF and TR. When the Dual_DDC was implanted in living rats, the DF concentration in blood plasma did not drop significantly in the later periods after implantation relative to that in the early periods before fibrotic tissue formation. When the Dual_DDC was implanted without TR, there was a significant decrease in the blood plasma DF concentration as the time elapsed after implantation. Biopsied tissues around the Dual_DDC exhibited a significant decrease in the fibrotic capsule thickness and collagen density relative to the Dual_DDC without TR, owing to the effect of the local, sustained release of the TR.
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Affiliation(s)
- Han Bi Ji
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Jae Young Hong
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Cho Rim Kim
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Chang Hee Min
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Jae Hoon Han
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Min Ji Kim
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea
| | - Se-Na Kim
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Cheol Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Bin Choy
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, Republic of Korea.,Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea
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Samaeili A, Rahmani S, Hassanpour K, Meshksar A, Ansari I, Afsar-Aski S, Einollahi B, Pakravan M. A new glaucoma drainage implant with the use of Polytetrafluoroethylene (PTFE). A pilot study. Rom J Ophthalmol 2021; 65:150-156. [PMID: 34179580 PMCID: PMC8207869 DOI: 10.22336/rjo.2021.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: To investigate the implantation of Polytetrafluoroethylene (PTFE) as a glaucoma drainage device. Methods: This study has been done in two steps. First, the constructed implants have been used in 4 rabbits and the histopathologic response was evaluated. In the second step, the implants were used in the 6 eyes of 6 patients with end-stage glaucoma with uncontrolled IOP and poor visual acuity. The tube was made of two-layer of PTFE membrane measuring 8 * 6 mm with a thickness of 1.8 mm and a silicone tube. The rabbits and the human eyes underwent surgical implantation of the tube in the anterior chamber. The histopathologic evaluation was done using H&E staining. Visual acuity, intraocular pressure and the number of glaucoma medications were assessed before and after the surgery. Results: In the histopathologic evaluation, subconjunctival polarizing fibers of a synthetic mesh infiltrated by fibrovascular septa was seen. A granulomatous inflammatory reaction composed of histiocytes, lymphocytes, and multinucleated giant cells were seen around and between the synthetic bundles. The average age of patients was 63 ± 5.5 years. The mean IOP reached from 36.6 ± 5.7 mmHg at baseline to 16.2 ± 8.9 mmHg at the final follow-up. Patients were followed for an average of 6.6 ± 4.5 months. One patient found hypotony refractory to medical and surgical treatment, which led to implant removal. One patient had uncontrolled IOP and finally led to phthisis bulbi following slow CPC. The remaining four eyes did well during the follow-up. Conclusion: The use of PTFE as a new polymer in tube shunt construction was reported. Larger studies, modification of the PTFE membranes like changing the porosity amount, and size of PTFE membranes might result in different conclusions.
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Affiliation(s)
- Azadeh Samaeili
- Department of Ophthalmology, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Rahmani
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kiana Hassanpour
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aidin Meshksar
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Poostchi Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Ansari
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sasha Afsar-Aski
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahram Einollahi
- Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Pakravan
- Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ahmed implant coated with poly(2-methacryloyloxyethyl phosphorylcholine) inhibits foreign body reactions in rabbit eyes. PLoS One 2021; 16:e0252467. [PMID: 34048489 PMCID: PMC8162657 DOI: 10.1371/journal.pone.0252467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/16/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Wound healing after Ahmed glaucoma valve (AGV) implantation often entails fibrosis as a foreign body reaction to the silicone plate. Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) forms an antifouling surface that inhibits fibrosis during wound healing. In this study, we aimed to compare the effects of the implantation of AGV coated with PMPC (wPMPC) versus AGV without PMPC (woPMPC) in rabbits. Methods Six New Zealand White rabbit does underwent AGV implantation in both eyes. For each rabbit, one eye was randomly selected for implantation of AGV wPMPC and a conventional AGV (woPMPC) was implanted in the contralateral eye. Gross conjunctival vascularity was compared between the two groups at the first, second, and fourth weeks after surgery. The eyes were enucleated in four weeks and subjected to staining with hematoxylin and eosin and Masson’s trichrome stain. The fibrosis and inflammation status among the eye samples were compared by measuring the thickness of the fibrotic walls and counting the number of chronic inflammatory cells around the AGV. Counting of inflammatory cells and measuring fibrotic wall thickness were done in a blinded method to eliminate observer bias. Statistical analysis was performed using the Mann-Whitney U test. Results Gross and histological examinations revealed no toxic effects of PMPC. There were no apparent differences in overall conjunctival vascularity between the two groups at weeks 1, 2, and 4 after surgery. The average inflammatory cell counts were 14.3 ± 5.8 per slide and 27.3 ± 8.6 per slide in the wPMPC and woPMPC groups, respectively (p = 0.037). The average thicknesses of the fibrotic wall were 57.9 ± 11.3 μm and 81.5 ± 21.3 μm in the wPMPC and woPMPC groups, respectively (p = 0.025). Conclusion Compared to the woPMPC group, the number of inflammatory cells and fibrosis were significantly decreased in the wPMPC group.
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