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Cui W, Chen S, Hu T, Zhou T, Qiu C, Jiang L, Cheng X, Ji J, Yao K, Han H. Nanoceria-Mediated Cyclosporin A Delivery for Dry Eye Disease Management through Modulating Immune-Epithelial Crosstalk. ACS NANO 2024; 18:11084-11102. [PMID: 38632691 DOI: 10.1021/acsnano.3c11514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Dry eye disease (DED) affects a substantial worldwide population with increasing frequency. Current single-targeting DED management is severely hindered by the existence of an oxidative stress-inflammation vicious cycle and complicated intercellular crosstalk within the ocular microenvironment. Here, a nanozyme-based eye drop, namely nanoceria loading cyclosporin A (Cs@P/CeO2), is developed, which possesses long-term antioxidative and anti-inflammatory capacities due to its regenerative antioxidative activity and sustained release of cyclosporin A (CsA). In vitro studies showed that the dual-functional Cs@P/CeO2 not only inhibits cellular reactive oxygen species production, sequentially maintaining mitochondrial integrity, but also downregulates inflammatory processes and repolarizes macrophages. Moreover, using flow cytometric and single-cell sequencing data, the in vivo therapeutic effect of Cs@P/CeO2 was systemically demonstrated, which rebalances the immune-epithelial communication in the corneal microenvironment with less inflammatory macrophage polarization, restrained oxidative stress, and enhanced epithelium regeneration. Collectively, our data proved that the antioxidative and anti-inflammatory Cs@P/CeO2 may provide therapeutic insights into DED management.
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Affiliation(s)
- Wenyu Cui
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
| | - Sheng Chen
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, P. R. China
| | - Tianyi Hu
- Institute of Immunology, Zhejiang University School of Medicine, Hangzhou 310058, P. R. China
| | - Tinglian Zhou
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
| | - Chen Qiu
- MOE Laboratory of Biosystems Homeostasis & Protection and iCell Biotechnology Regenerative Biomedicine Laboratory of College of Life Sciences, Zhejiang University, Hangzhou 310058, P. R. China
| | - Luyang Jiang
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
| | - Xiaoyu Cheng
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
| | - Jian Ji
- MOE Key Laboratory of Macromolecule Synthesis and Functionalization of Ministry of Education, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou 310058, P. R. China
| | - Ke Yao
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
| | - Haijie Han
- Eye Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou 310009, P. R. China
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Locatelli EVT, Acuna KA, Betz J, Tovar AA, Galor A. Comparison of Subjective Responses to Cyclosporine 0.05% Versus Lifitegrast 5.0% in Individuals With Dry Eye Disease. Cornea 2024; 43:88-94. [PMID: 36853599 DOI: 10.1097/ico.0000000000003266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE The aim of the study was to examine subjective responses to cyclosporine A (CsA) 0.05% versus lifitegrast 5% in individuals with dry eye disease. METHODS This study was a retrospective review of individuals with clinically diagnosed dry eye disease treated with both CsA 0.05% and lifitegrast 5% over the course of their disease. Information collected included demographics, comorbidities, and dry eye disease signs. Treatment preferences were noted as mild or strong for a particular medication, no preference, or unable to tolerate either medication. The primary outcome measure was patient-reported medication preference. The secondary outcome measure was an examination of individual and eye factors that related to medication preference. RESULTS Sixty-four individuals (mean age 66.73 ± 13.17 years; 82.8% male, 71.9% White, 29.7% Hispanic) used both CsA and lifitegrast over the course of their disease. Of those, 33 preferred CsA (12.5% mildly and 39.1% strongly), 14 preferred lifitegrast (3.1% mildly and 18.8% strongly), 12 had no preference (18.8%), and 5 could not tolerate either medication (7.8%) due to side effects. No demographic characteristics, comorbidities, or ocular surface findings correlated with medication preference. CONCLUSIONS In individuals who used both CsA 0.05% and lifitegrast 5% over the course of their disease, a higher frequency of individuals preferred CsA. No clinical factors correlated with medication preference.
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Affiliation(s)
- Elyana Vittoria Tessa Locatelli
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL
- Research Services, Miami Veterans Affairs Medical Center, Miami, FL; and
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
| | - Kelly Ann Acuna
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL
- Research Services, Miami Veterans Affairs Medical Center, Miami, FL; and
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
| | - Jason Betz
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL
- Research Services, Miami Veterans Affairs Medical Center, Miami, FL; and
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
| | | | - Anat Galor
- Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL
- Research Services, Miami Veterans Affairs Medical Center, Miami, FL; and
- Bascom Palmer Eye Institute, University of Miami, Miami, FL
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L Bello M, Mendes GEM, Silva ACR, Faria RX. Virtual screening indicates potential inhibitors of the P2X7 receptor. Comput Biol Med 2023; 164:107299. [PMID: 37552915 DOI: 10.1016/j.compbiomed.2023.107299] [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: 03/22/2023] [Revised: 07/11/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
Anti-inflammatory agents can be synthetic or natural compounds and are often used to attenuate different levels of inflammation. Inflammatory diseases, due to the involvement of multiple systems, are becoming difficult to treat, involve long durations of therapy where applicable, have a high cost of management and have a deleterious impact on public health. The search for natural and synthetic compounds with anti-inflammatory activity is an important strategy in drug design. Bioactive synthetic drugs may be repurposed for other pharmacological applications, and natural product chemical structures offer unlimited opportunities for new drug discoveries due to the unparalleled availability of chemical diversity. Virtual screening of 2774 molecules on the mouse P2X7 protein showed that potential ligands are composed of five flavonoids (narirutin, diosmin, complanatuside, hesperidin, and oroxin B) and other drugs such as velpatasvir, itacitinib and lifitegrast. In vitro studies in mouse cells confirmed the inhibitory activity of the indicated ligands on the P2X7 receptor by applying virtual screening. The behavior of protein bonded to the ligands was verified by analysis of the molecular dynamic simulation trajectories for four of the most potent inhibitor compounds, indicating that the ligands velpatasvir, itacitinib, lithospermic acid and narirutin remained in the binding site indicated by molecular docking.
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Affiliation(s)
- Murilo L Bello
- Pharmaceutical Planning and Computer Simulation Laboratory, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guilherme Eduardo M Mendes
- Pharmaceutical Planning and Computer Simulation Laboratory, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil; Postgraduate Program in Sciences and Biotechnology, Instituto de Biologia, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Ana Cláudia R Silva
- Laboratory for Environmental Health Assessment and Promotion, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Robson X Faria
- Laboratory for Environmental Health Assessment and Promotion, Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.
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Coco G, Ambrosini G, Poletti S, Meliante LA, Taloni A, Scorcia V, Giannaccare G. Recent advances in drug treatments for dry eye disease. Expert Opin Pharmacother 2023; 24:2059-2079. [PMID: 37804227 DOI: 10.1080/14656566.2023.2269090] [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: 07/04/2023] [Accepted: 10/06/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION Dry eye disease (DED) is a common ocular condition with a significant impact on patients' quality of life. Conventional treatments include behavioral changes, tear substitutes, and anti-inflammatory agents; however, recent advances in the understanding of DED pathogenesis have opened the way to the development of novel treatment strategies able to target several pathways involved in the onset and persistence of DED. AREAS COVERED Literature search was conducted on PubMed and Scopus around the term 'dry eye disease' and others involving its pathophysiology and therapeutic strategy. The primary focus was on recent drugs approved by FDA or under investigation in phase 3 clinical trials. Google and ClinicalTrials.gov were used for obtaining information about the status of FDA approval and ongoing clinical trials. EXPERT OPINION Due to its multifaced pathogenesis, DED management is often challenging, and patients' needs are frequently unmet. Recently, several novel treatments have been either FDA-approved or studied in late-phase trials. These novel drugs target-specific biological components of the ocular surface and reduce inflammation and ocular pain. Additionally, new drug delivery systems allow for increased bioavailability, improve effective dosing, and minimize ocular side effects. These advances in drug therapies show real promise for better management of DED patients.
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Affiliation(s)
- Giulia Coco
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ambrosini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Poletti
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Laura Antonia Meliante
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Taloni
- Department of Ophthalmology, University of Magna Græcia, Catanzaro, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University of Magna Græcia, Catanzaro, Italy
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Kitao M, Hayashi R, Nomi K, Kobayashi R, Katayama T, Takayanagi H, Oguchi A, Murakawa Y, Nishida K. Identification of BST2 as a conjunctival epithelial stem/progenitor cell marker. iScience 2023; 26:107016. [PMID: 37389178 PMCID: PMC10300367 DOI: 10.1016/j.isci.2023.107016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
The conjunctival epithelium consists of conjunctival epithelial cells and goblet cells derived from conjunctival epithelial stem/progenitor cells. However, the source of these cells is not well known because no specific markers for conjunctival epithelial stem/progenitor cells have been discovered. Therefore, to identify conjunctival epithelial stem/progenitor cell markers, we performed single-cell RNA sequencing of a conjunctival epithelial cell population derived from human-induced pluripotent stem cells (hiPSCs). The following conjunctival epithelial markers were identified: BST2, SLC2A3, AGR2, TMEM54, OLR1, and TRIM29. Notably, BST2 was strongly positive in the basal conjunctival epithelium, which is thought to be rich in stem/progenitor cells. Moreover, BST2 was able to sort conjunctival epithelial stem/progenitor cells from hiPSC-derived ocular surface epithelial cell populations. BST2-positive cells were highly proliferative and capable of successfully generating conjunctival epithelial sheets containing goblet cells. In conclusion, BST2 has been identified as a specific marker of conjunctival epithelial stem/progenitor cells.
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Affiliation(s)
- Masahiro Kitao
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Ryuhei Hayashi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
- Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka 565-0871, Japan
| | - Kimihito Nomi
- Business Strategy Office, ROHTO Pharmaceutical, Osaka, Osaka 544-0012, Japan
| | - Reiko Kobayashi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tomohiko Katayama
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Hiroshi Takayanagi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
- Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Akiko Oguchi
- RIKEN-IFOM Joint Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Yasuhiro Murakawa
- RIKEN-IFOM Joint Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Kyoto 606-8501, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka 565-0871, Japan
- Premium Research Institute for Human Metaverse Medicine (WPI-PRIMe), Osaka University, Suita, Osaka 565-0871, Japan
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Reyes N, Huang JJ, Choudhury A, Pondelis N, Locatelli EV, Felix ER, Pattany PM, Galor A, Moulton EA. Botulinum toxin A decreases neural activity in pain-related brain regions in individuals with chronic ocular pain and photophobia. Front Neurosci 2023; 17:1202341. [PMID: 37404468 PMCID: PMC10315909 DOI: 10.3389/fnins.2023.1202341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction To examine the effect of botulinum toxin A (BoNT-A) on neural mechanisms underlying pain and photophobia using functional magnetic resonance imaging (fMRI) in individuals with chronic ocular pain. Methods Twelve subjects with chronic ocular pain and light sensitivity were recruited from the Miami Veterans Affairs eye clinic. Inclusion criteria were: (1) chronic ocular pain; (2) presence of ocular pain over 1 week recall; and (3) presence of photophobia. All individuals underwent an ocular surface examination to capture tear parameters before and 4-6 weeks after BoNT-A injections. Using an event-related fMRI design, subjects were presented with light stimuli during two fMRI scans, once before and 4-6 weeks after BoNT-A injection. Light evoked unpleasantness ratings were reported by subjects after each scan. Whole brain blood oxygen level dependent (BOLD) responses to light stimuli were analyzed. Results At baseline, all subjects reported unpleasantness with light stimulation (average: 70.8 ± 32.0). Four to six weeks after BoNT-A injection, unpleasantness scores decreased (48.1 ± 33.6), but the change was not significant. On an individual level, 50% of subjects had decreased unpleasantness ratings in response to light stimulation compared to baseline ("responders," n = 6), while 50% had equivalent (n = 3) or increased (n = 3) unpleasantness ("non-responders"). At baseline, several differences were noted between responders and non-responders; responders had higher baseline unpleasantness ratings to light, higher symptoms of depression, and more frequent use of antidepressants and anxiolytics, compared to non-responders. Group analysis at baseline displayed light-evoked BOLD responses in bilateral primary somatosensory (S1), bilateral secondary somatosensory (S2), bilateral anterior insula, paracingulate gyrus, midcingulate cortex (MCC), bilateral frontal pole, bilateral cerebellar hemispheric lobule VI, vermis, bilateral cerebellar crus I and II, and visual cortices. BoNT-A injections significantly decreased light evoked BOLD responses in bilateral S1, S2 cortices, cerebellar hemispheric lobule VI, cerebellar crus I, and left cerebellar crus II. BoNT-A responders displayed activation of the spinal trigeminal nucleus at baseline where non-responders did not. Discussion BoNT-A injections modulate light-evoked activation of pain-related brain systems and photophobia symptoms in some individuals with chronic ocular pain. These effects are associated with decreased activation in areas responsible for processing the sensory-discriminative, affective, dimensions, and motor responses to pain.
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Affiliation(s)
- Nicholas Reyes
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Jaxon J. Huang
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Anjalee Choudhury
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Nicholas Pondelis
- Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Elyana V. Locatelli
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Elizabeth R. Felix
- Research Service, Miami Veterans Administration Medical Center, Miami, FL, United States
- Physical Medicine and Rehabilitation, University of Miami, Miami, FL, United States
| | - Pradip M. Pattany
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Anat Galor
- Surgical Services, Miami Veterans Administration Medical Center, Miami, FL, United States
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States
| | - Eric A. Moulton
- Brain and Eye Pain Imaging Lab, Pain and Affective Neuroscience Center, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- Department of Ophthalmology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
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Mangwani-Mordani S, Goodman CF, Galor A. Novel Treatments for Chronic Ocular Surface Pain. Cornea 2023; 42:261-271. [PMID: 36729473 PMCID: PMC9918665 DOI: 10.1097/ico.0000000000003193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/28/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Several etiologies can contribute to ocular surface pain including nociceptive, peripheral neuropathic, and central neuropathic mechanisms. Clinical clues can help identify contributors to ocular surface pain in a patient. In individuals whose pain persists despite targeting nociceptive contributors, neuropathic mechanisms should be considered and addressed using oral, topical, and/or adjuvant agents.
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Affiliation(s)
- Simran Mangwani-Mordani
- Surgical Services, Miami Veterans Affairs Medical Center, 1201 NW 17 Street, Miami, FL, 33125, USA
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, 900 NW 17 Street, Miami, FL 33136, USA
| | - Courtney F. Goodman
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, 900 NW 17 Street, Miami, FL 33136, USA
| | - Anat Galor
- Surgical Services, Miami Veterans Affairs Medical Center, 1201 NW 17 Street, Miami, FL, 33125, USA
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, 900 NW 17 Street, Miami, FL 33136, USA
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Lindgren ES, Cil O, Verkman AS, Pasricha ND. Ocular Surface Ion Transport and Dry Eye Disease. CURRENT OPHTHALMOLOGY REPORTS 2022; 10:188-197. [PMID: 38213468 PMCID: PMC10783585 DOI: 10.1007/s40135-022-00295-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 10/24/2022]
Abstract
Purpose of Review To review the role of ocular surface epithelial (corneal and conjunctival) ion transporters in the pathogenesis and treatment of dry eye disease (DED). Recent Findings Currently, anti-inflammatory agents are the mainstay of DED treatment, though there are several agents in development that target ion transport proteins on the ocular surface, acting by pro-secretory or anti-absorptive mechanisms to increase the tear fluid Film volume. Activation or inhibition of selected ion transporters can alter tear fluid osmolality, driving water transport onto the ocular surface via osmosis. Several ion transporters have been proposed as potential therapeutic targets for DED, including the cystic fibrosis transmembrane conductance regulator (CFTR), calcium-activated chloride channels (CaCCs), and the epithelial sodium channel (ENaC). Summary Ocular surface epithelial cell ion transporters are promising targets for pro-secretory and anti-absorptive therapies of DED.
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Affiliation(s)
- Ethan S. Lindgren
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Onur Cil
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Alan S. Verkman
- Departments of Medicine and Physiology, University of California San Francisco, San Francisco, CA, USA
| | - Neel D. Pasricha
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Francis I. Proctor Foundation, University of California San Francisco, San Francisco, CA, USA
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Wang X, Hui Q, Jin Z, Rao F, Jin L, Yu B, Banda J, Li X. Roles of growth factors in eye development and ophthalmic diseases. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:613-625. [PMID: 36581579 PMCID: PMC10264994 DOI: 10.3724/zdxbyxb-2022-0603] [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: 03/01/2022] [Accepted: 07/30/2022] [Indexed: 12/02/2022]
Abstract
Growth factors are active substances secreted by a variety of cells, which act as messengers to regulate cell migration, proliferation and differentiation. Many growth factors are involved in the eye development or the pathophysiological processes of eye diseases. Growth factors such as vascular endothelial growth factor and basic fibroblast growth factor mediate the occurrence and development of diabetic retinopathy, choroidal neovascularization, cataract, diabetic macular edema, and other retinal diseases. On the other hand, growth factors like nerve growth factor, ciliary neurotrophic factor, glial cell line-derived neurotrophic factor, pigment epithelial-derived factor and granulocyte colony-stimulating factor are known to promote optic nerve injury repair. Growth factors are also related to the pathogenesis of myopia. Fibroblast growth factor, transforming growth factor-β, and insulin-like growth factor regulate scleral thickness and influence the occurrence and development of myopia. This article reviews growth factors involved in ocular development and ocular pathophysiology, discusses the relationship between growth factors and ocular diseases, to provide reference for the application of growth factors in ophthalmology.
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Venkateswaran N, Luna RD, Gupta PK. Ocular surface optimization before cataract surgery. Saudi J Ophthalmol 2022; 36:142-148. [PMID: 36211316 PMCID: PMC9535908 DOI: 10.4103/sjopt.sjopt_190_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/27/2021] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
The evolution of refractive cataract surgery has increased patient expectations for visual outcomes following cataract surgery. Precise biometry and keratometry are critical for accurate intraocular lens (IOL) selection and favorable surgical outcomes. In patients with the ocular surface disease and corneal pathologies, preoperative measurements can often be erroneous, leading to postoperative refractive surprises and dissatisfied patients. Conditions such as dry eye disease, epithelial basement membrane dystrophy, Salzmann's nodular dystrophy, and pterygia need to be addressed thoroughly before performing cataract surgery to optimize the ocular surface, obtain high-quality preoperative measurements, and ultimately determine the appropriate IOLs. In this review, the various ocular surface pathologies affecting cataract surgery outcomes and options for treatment are discussed and the importance of optimization of the ocular surface before cataract surgery is reviewed.
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Affiliation(s)
- Nandini Venkateswaran
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Regina D. Luna
- Duke Eye Center, Duke University, Durham, North Carolina, USA
| | - Preeya K. Gupta
- Triangle Eye Consultants, Durham, North Carolina, USA,Address for correspondence: Dr. Preeya K. Gupta, 2075 Renaissance Park Place, Cary, North Carolina 27713, USA. E-mail:
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Choudhry HS, Hosseini S, Choudhry HS, Fatahzadeh M, Khianey R, Dastjerdi MH. Updates in diagnostics, treatments, and correlations between oral and ocular manifestations of Sjogren's syndrome. Ocul Surf 2022; 26:75-87. [PMID: 35961534 DOI: 10.1016/j.jtos.2022.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 07/03/2022] [Accepted: 08/03/2022] [Indexed: 02/07/2023]
Abstract
Sjogren's syndrome (SS) is characterized as an autoimmune disorder targeting secretory glands, including the lacrimal and salivary glands, causing dry eye and dry mouth predominantly in women over the age of 40. In this review, we summarize recent advancements in SS diagnostics, treatments, and our understanding of correlations between oral and ocular manifestations of SS. Google Scholar and PubMed databases were utilized to search peer-reviewed papers since 2016 on SS diagnosis, treatment, and correlations between oral and ocular manifestations. For diagnostics, we discuss the updated SS classification criteria by the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR), new biomarkers, and compare studies of current diagnostic methods with alternative technologies. For treatments, we discuss topical, systemic, and surgical treatment developments in the management of oral and ocular symptoms of SS as there is still no cure for the disorder. Finally, we report studies that directly suggest correlations between the ocular surface disease and oral disease in SS, as well as shared abnormalities in the microbiome and cytokine expression that may be correlated. We conclude by stating limitations to our review as well as paths moving forward. Elucidating correlations between oral and ocular manifestations may be the key to furthering our understanding of SS pathogenesis as well as defining new standards for diagnosis and treatment.
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Affiliation(s)
- Hassaam S Choudhry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
| | - Shayan Hosseini
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
| | - Hannaan S Choudhry
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
| | - Mahnaz Fatahzadeh
- Department of Diagnostic Science, Division of Oral Medicine, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ, 07103, USA
| | - Reena Khianey
- Department of Medicine, Rheumatology, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA
| | - Mohammad H Dastjerdi
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, 90 Bergen Street, Newark, NJ, 07103, USA.
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Chaudhari P, Birangal S, Mavlankar N, Pal A, Mallela LS, Roy S, Kodoth AK, Ghate V, Nampoorthiri M, Lewis SA. Oil-free eye drops containing Cyclosporine A/cyclodextrin/PVA supramolecular complex as a treatment modality for dry eye disease. Carbohydr Polym 2022; 297:120007. [DOI: 10.1016/j.carbpol.2022.120007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 11/02/2022]
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13
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Krstić L, Jarho P, Ruponen M, Urtti A, González-García MJ, Diebold Y. Improved ocular delivery of quercetin and resveratrol: A comparative study between binary and ternary cyclodextrin complexes. Int J Pharm 2022; 624:122028. [PMID: 35853567 DOI: 10.1016/j.ijpharm.2022.122028] [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: 03/31/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022]
Abstract
The number of patients affected by Dry Eye Disease (DED) had notably increased worldwide, addressing the need of novel therapeutic approaches. Polyphenols, quercetin (QUE) and resveratrol (RSV) show necessary antioxidant and anti-inflammatory properties to manage DED, but their application as topical eyedrops is restricted by low aqueous solubility and low chemical stability. Cyclodextrins (CD) are widely used to improve physicochemical characteristics of drugs. Consequently, the aim of this study was to make a comparison between binary complexes with quercetin, resveratrol and cyclodextrins and tertiary complexes adding hyaluronic acid (HA). Both complexes were able to enhance solubility and stability of QUE and RSV. AFM imaging and DLS measurements disclose the formation of spherical nanoaggregates within tertiary complexes of both QUE and RSV with mean diameters of 103 and 82 nm. Neither complex demonstrated cytotoxic effect in in vitro studies in corneal (HCE) and conjunctival (IM-ConjEpi) cell lines. In HCE cells, complexes containing QUE or RSV at their highest concentrations were able to scavenge more than 95 % of the ROS that were produced intracellularly (p < 0.005). Similar response was observed with IM-ConjEpi cells. The antioxidant effect was maintained in the complexes with HA. This confirmed their potential as viable topical treatment for DED.
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Affiliation(s)
- Luna Krstić
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain
| | - Pekka Jarho
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland
| | - Marika Ruponen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland
| | - Arto Urtti
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland; Drug Research Program, Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, 00014 Helsinki, Finland
| | - María J González-García
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Yolanda Diebold
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
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14
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Tovar A, Gomez A, Serrano A, Blanco MP, Galor A, Swaminathan SS, de Rivero Vaccari JP, Sabater AL. Role of Caspase-1 as a Biomarker of Ocular Surface Damage. Am J Ophthalmol 2022; 239:74-83. [PMID: 35151638 DOI: 10.1016/j.ajo.2022.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the potential of caspase-1 as a biomarker for ocular surface damage. DESIGN Cross-sectional study. METHODS A total of 113 tear samples (64 subjects) were analyzed. Sixty-one samples were from individuals with dry eye disease (DED), defined as Ocular Surface Disease Index (OSDI) ≥13 and/or corneal staining (CS) ≥3; 32 were from individuals who used glaucoma medication, irrespective of DED metrics; and 20 were from controls (CS <3 and OSDI <13). All individuals completed a medical history form and underwent an ocular surface assessment. Protein levels of caspase-1 were determined by enzyme-linked immunosorbent assay off Schirmer's strips. The primary analysis compared caspase-1 levels in individuals with signs of ocular surface damage (CS ≥3) in both case groups and controls. Secondary correlational analyses were conducted to examine relationships between caspase-1 levels and ocular signs and symptoms. Finally, area under the curve (AUC) analyses were performed to examine relationships between inflammatory markers and CS. RESULTS The mean age of the population was 58±18 years; 70% were female. Tear samples from individuals with ocular surface damage presented higher caspase-1 levels than the control group. Caspase-1 levels showed a moderate positive correlation with CS (Spearman r = 0.31; P = .001) and eye redness (Spearman r = 0.39; P = .004), and a negative correlation with Schirmer's (Spearman r = -0.46; P < .001) and tear break-up time (Spearman r = -0.33; P = .0006). Caspase-1 showed higher sensitivity and AUC for detecting ocular surface damage than InflammaDry, and its expression was not affected by anti-inflammatory agents. CONCLUSION Caspase-1 levels were higher in the tears of individuals with ocular surface damage, suggesting its potential to be used as a biomarker and/or therapeutic target.
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Affiliation(s)
- Arianna Tovar
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Angela Gomez
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Andres Serrano
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Maricarmen Perez Blanco
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Anat Galor
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Swarup S Swaminathan
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S)
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA (J.P.R.V)
| | - Alfonso L Sabater
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA (A.T, A.G, A.S, M.P.B, S.S.S, A.L.S).
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15
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Design, synthesis, and LFA-1/ICAM-1 antagonist activity evaluation of Lifitegrast analogues. Med Chem Res 2022; 31:555-579. [PMID: 35194364 PMCID: PMC8853157 DOI: 10.1007/s00044-022-02851-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/18/2022] [Indexed: 10/28/2022]
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16
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Hirabayashi T, Shibato J, Kimura A, Yamashita M, Takenoya F, Shioda S. Potential Therapeutic Role of Pituitary Adenylate Cyclase-Activating Polypeptide for Dry Eye Disease. Int J Mol Sci 2022; 23:664. [PMID: 35054857 PMCID: PMC8775530 DOI: 10.3390/ijms23020664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 12/27/2022] Open
Abstract
Dry eye disease (DED) is caused by a reduction in the volume or quality of tears. The prevalence of DED is estimated to be 100 million in the developed world. As aging is a risk factor for DED, the prevalence of DED is expected to grow at a rapid pace in aging populations, thus creating an increased need for new therapies. This review summarizes DED medications currently in clinical use. Most current medications for DED focus on stimulating tear secretion, mucin secretion, or suppressing inflammation, rather than simply replenishing the ocular surface with moisture to improve symptoms. We recently reported that the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide) induces tear secretion and suppresses corneal injury caused by a reduction in tears. Moreover, it has been reported that a PACAP in water and a 0.9% saline solution at +4 °C showed high stability and achieved 80-90% effectiveness after 2 weeks of treatment. These results reveal PACAP as a candidate DED medication. Further research on the clinical applications of PACAP in DED is necessary.
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Affiliation(s)
- Takahiro Hirabayashi
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Junko Shibato
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Ai Kimura
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Michio Yamashita
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Fumiko Takenoya
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Seiji Shioda
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
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Gadziński P, Froelich A, Wojtyłko M, Białek A, Krysztofiak J, Osmałek T. Microneedle-based ocular drug delivery systems - recent advances and challenges. BEILSTEIN JOURNAL OF NANOTECHNOLOGY 2022; 13:1167-1184. [PMID: 36348935 PMCID: PMC9623140 DOI: 10.3762/bjnano.13.98] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 09/28/2022] [Indexed: 05/09/2023]
Abstract
Eye diseases and injuries constitute a significant clinical problem worldwide. Safe and effective delivery of drugs to the eye is challenging mostly due to the presence of ocular barriers and clearance mechanisms. In everyday practice, the traditional eye drops, gels and ointments are most often used. Unfortunately, they are usually not well tolerated by patients due to the need for frequent use as well as the discomfort during application. Therefore, novel drug delivery systems with improved biopharmaceutical properties are a subject of ongoing scientific investigations. Due to the developments in microtechnology, in recent years, there has been a remarkable advance in the development of microneedle-based systems as an alternative, non-invasive form for administering drugs to the eye. This review summarizes the latest achievements in the field of obtaining microneedle ocular patches. In the manuscript, the most important manufacturing technologies, microneedle classification, and the research studies related to ophthalmic application of microneedles are presented. Finally, the most important advantages and drawbacks, as well as potential challenges related to the unique anatomy and physiology of the eye are summarized and discussed.
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Affiliation(s)
- Piotr Gadziński
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences
| | - Anna Froelich
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences
| | - Monika Wojtyłko
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences
| | - Antoni Białek
- Student Research Group of Pharmaceutical Technology, Poznan University of Medical Sciences
| | - Julia Krysztofiak
- Student Research Group of Pharmaceutical Technology, Poznan University of Medical Sciences
| | - Tomasz Osmałek
- Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences
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18
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Huang W, Huang L, Li W, Saglam MS, Tourmouzis K, Goldstein SM, Master A, Honkanen R, Rigas B. Once-Daily Topical Phosphosulindac Is Efficacious in the Treatment of Dry Eye Disease: Studies in Rabbit Models of Its Main Clinical Subtypes. J Ocul Pharmacol Ther 2021; 38:102-113. [PMID: 34964663 PMCID: PMC8817715 DOI: 10.1089/jop.2021.0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: Dry eye disease (DED) is classified as aqueous deficient, evaporative, or mixed. We investigated the therapeutic effect of the novel anti-inflammatory drug phosphosulindac (PS) in rabbit models of DED encompassing its pathogenesis, and its transition to chronicity. Methods: We treated three rabbit models of DED with PS (hydrogel formulation) or vehicle topically applied 1 × /day. We induced aqueous-deficient DED (acute and chronic) by injecting Concanavalin A into lacrimal glands; evaporative DED by injecting into the upper eyelid inactivated Mycobacterium tuberculosis in complete Freund's adjuvant; and mixed DED through desiccative stress, induced by holding open the eye for 3 h. We determined corneal sensitivity, tear break-up time (TBUT), Schirmer's tear test (STT), tear osmolality, and fluorescein staining of the ocular surface. Results: PS reversed all abnormal DED parameters. In acute DED, PS dose dependently normalized corneal sensitivity and tear osmolality; and improved TBUT, STT, and fluorescein staining. PS normalized corneal sensitivity and improved all other parameters in chronic aqueous-deficient DED. In evaporative DED, PS normalized corneal sensitivity and improved TBUT and fluorescein staining (osmolality and STT were not significantly changed in this model). In the desiccative stress model, PS improved TBUT and fluorescein staining but had no effect on STT or tear osmolality. Conclusions: PS rapidly reversed almost all DED parameters in its three subtypes. The normalization of the suppressed corneal sensitivity suggests the possibility of marked symptomatic relief by PS. The hydrogel formulation allows once-daily dosing. PS merits further development as a potential treatment for DED.
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Affiliation(s)
- Wei Huang
- Department of Ophthalmology and Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.,Department of Ophthalmology, 2nd Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liqun Huang
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wenyi Li
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - M Sait Saglam
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | | | | | - Adam Master
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Robert Honkanen
- Department of Ophthalmology and Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Basil Rigas
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
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19
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Xu W, Gong X, Odilov A, Hu T, Jiang X, Zhu F, Guo S, Jiang D, Wu M, Shen J. Scalable Process for Making 5,7-Dichlorotetrahydroisoquinoline-6-carboxylic Acid Using Methylene as the Protecting Group. Org Process Res Dev 2021. [DOI: 10.1021/acs.oprd.1c00229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Wanbin Xu
- CAS Key Laboratory for Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, People’s Republic of China
- University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, People’s Republic of China
| | - Xudong Gong
- Topharman Shanghai Co., Ltd., Building 1, 388 Jialilue Road, Zhangjiang Hitech Park, Shanghai 201203, People’s Republic of China
| | - Abdullajon Odilov
- CAS Key Laboratory for Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, People’s Republic of China
- University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, People’s Republic of China
| | - Tianwen Hu
- University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, People’s Republic of China
| | - Xiangrui Jiang
- CAS Key Laboratory for Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, People’s Republic of China
| | - Fuqiang Zhu
- Topharman Shanghai Co., Ltd., Building 1, 388 Jialilue Road, Zhangjiang Hitech Park, Shanghai 201203, People’s Republic of China
| | - Shuang Guo
- Topharman Shanghai Co., Ltd., Building 1, 388 Jialilue Road, Zhangjiang Hitech Park, Shanghai 201203, People’s Republic of China
| | - Dehui Jiang
- Topharman Shanghai Co., Ltd., Building 1, 388 Jialilue Road, Zhangjiang Hitech Park, Shanghai 201203, People’s Republic of China
| | - Mingjun Wu
- Topharman Shanghai Co., Ltd., Building 1, 388 Jialilue Road, Zhangjiang Hitech Park, Shanghai 201203, People’s Republic of China
| | - Jingshan Shen
- CAS Key Laboratory for Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, People’s Republic of China
- University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, People’s Republic of China
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20
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McMullin D, Clark D, Cavanagh B, Karpecki P, Brady TC. A Post-Acute Ocular Tolerability Comparison of Topical Reproxalap 0.25% and Lifitegrast 5% in Patients with Dry Eye Disease. Clin Ophthalmol 2021; 15:3889-3900. [PMID: 34588761 PMCID: PMC8473572 DOI: 10.2147/opth.s327691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the subjective eye drop experience of patients with dry eye disease (DED) over approximately 1 hour after a single dose of two formulations of reproxalap versus lifitegrast. Methods Two formulations of topical ocular reproxalap 0.25% were evaluated versus lifitegrast ophthalmic solution 5% in patients with DED in a single-center, double-masked, active-comparator, single-dose crossover clinical trial. Nineteen patients had test article topically administered to both eyes. Treatments were administered 2 to 4 days apart. Comfort assessments, including ocular discomfort, blurry vision, and dysgeusia assessments; ocular descriptive assessments; quality of life assessments; and overall experience questions were completed after each treatment over one hour, beginning at 90 seconds. Results Both reproxalap formulations scored better in ocular discomfort score (ODS), blurry vision, and dysgeusia assessments than lifitegrast at each timepoint and cumulatively over all time points after instillation. There were lower rates of negative responses for both reproxalap formulations compared to lifitegrast across ocular discomfort, blurry vision, and dysgeusia assessments, and the durations of negative responses were shorter with reproxalap than with lifitegrast. The reproxalap groups experienced fewer quality of life impacts. No significant safety findings were observed following reproxalap or lifitegrast administration. Conclusion The reproxalap eye drop experience over 1 hour after instillation was superior to that of lifitegrast. There were no statistically significant differences between reproxalap groups for ODS, blurry vision, or dysgeusia. The improved performance of reproxalap with regard to the most commonly reported side effects of lifitegrast (ie, ocular discomfort, blurry vision, and dysgeusia) may result in greater patient adherence and lower discontinuation rates.
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Affiliation(s)
| | - David Clark
- Aldeyra Therapeutics, Inc, Lexington, MA, USA
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21
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Chen TY, Tseng CL, Lin CA, Lin HY, Venkatesan P, Lai PS. Effects of Eye Drops Containing Hyaluronic Acid-Nimesulide Conjugates in a Benzalkonium Chloride-Induced Experimental Dry Eye Rabbit Model. Pharmaceutics 2021; 13:1366. [PMID: 34575442 PMCID: PMC8469214 DOI: 10.3390/pharmaceutics13091366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 12/22/2022] Open
Abstract
Dry eye syndrome (DES) is a common ocular disease worldwide. Currently, anti-inflammatory agents and immunosuppressive drugs, such as cyclosporine A, have been widely used to treat this chronic condition. However, the multifactorial etiology of DES, poor tolerance, low bioavailability, and prolonged treatment to response time have limited their usage. In this study, nimesulide, a cyclooxygenase (COX)-2 selective inhibitor, was conjugated with hyaluronic acid (HA), and the HA-nimesulide conjugates were expected to increase the solubility and biocompatibility for alleviating the DES in the benzalkonium chloride (BAC)-induced goblet cell-loss dry eye model. The therapeutic efficacy of HA-nimesulide was assessed using fluorescein staining, goblet cell density by conjunctival impression cytology, and histology and immunohistochemistry of corneal tissues. Compared to commercial artificial tears and Restasis®, the HA-nimesulide conjugates could promote goblet cell recovery and enhance the regeneration of the corneal epithelium. Importantly, immunofluorescent staining studies demonstrated that the HA-nimesulide conjugates could decrease the number of infiltrating CD11b-positive cells after two weeks of topical application. In the anti-inflammatory test, the HA-nimesulide conjugates could inhibit the production of pro-inflammatory cytokines and prostaglandin E2 (PGE2) in the lipopolysaccharide (LPS)-stimulated Raw 264.7 cell model. In conclusion, we demonstrated that HA-nimesulide conjugates had anti-inflammatory activity, and promoted goblet cell recovery and corneal epithelium regeneration when used as topical eye drops; accordingly, the HA-nimesulide conjugates could potentially be effective for the treatment of DES.
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Affiliation(s)
- Tzu-Yang Chen
- Department of Chemistry, National Chung Hsing University, Taichung 40227, Taiwan; (T.-Y.C.); (P.V.)
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan;
| | - Chih-An Lin
- Ph.D. Program of Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung 40227, Taiwan;
| | - Hua-Yang Lin
- Preclinical Development Research Department, Holy Stone Healthcare Co., Ltd., Taipei 11493, Taiwan;
| | - Parthiban Venkatesan
- Department of Chemistry, National Chung Hsing University, Taichung 40227, Taiwan; (T.-Y.C.); (P.V.)
| | - Ping-Shan Lai
- Department of Chemistry, National Chung Hsing University, Taichung 40227, Taiwan; (T.-Y.C.); (P.V.)
- Ph.D. Program of Tissue Engineering and Regenerative Medicine, National Chung Hsing University, Taichung 40227, Taiwan;
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22
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Master A, Kontzias A, Huang L, Huang W, Tsioulias A, Zarabi S, Wolek M, Wollocko BM, Honkanen R, Rigas B. The transcriptome of rabbit conjunctiva in dry eye disease: Large-scale changes and similarity to the human dry eye. PLoS One 2021; 16:e0254036. [PMID: 34324523 PMCID: PMC8321226 DOI: 10.1371/journal.pone.0254036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/17/2021] [Indexed: 01/31/2023] Open
Abstract
The pathophysiology of dry eye disease (DED) remains largely unknown, accounting in part for the lack of successful treatments. We explored the pathophysiology of DED using a rabbit model of chronic DED induced with 3 weekly injections of Concanavalin A into the periorbital lacrimal glands. The transcriptome of full-thickness's conjunctival tissue from rabbits with DED and from normal controls was determined using microarrays and, as needed, confirmatory real-time polymerase chain reactions. Results were subjected to bioinformatic analysis. DED induced large-scale changes in gene transcription involving 5,184 genes (22% of the total). Differentially expressed genes could be segregated into: functional modules and clusters; altered pathways; functionally linked genes; and groups of individual genes of known or suspected pathophysiological relevance to DED. A common feature of these subgroups is the breadth and magnitude of the changes that encompass ocular immunology and essentially all aspects of cell biology. Prominent changes concerned innate and adaptive immune responses; ocular surface inflammation; at least 25 significantly altered signaling pathways; a large number of chemokines; cell cycle; and apoptosis. Comparison of our findings to the limited extant transcriptomic data from DED patients associated with either Sjogren's syndrome or non-Sjogren's etiologies revealed a significant correlation between human and rabbit DED transcriptomes. Our data, establishing the large-scale transcriptomic changes of DED and their potential similarity to the human, underscore the enormous complexity of DED; establish a robust animal model of DED; will help expand our understanding of its pathophysiology; and could guide the development of successful therapeutic strategies.
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Affiliation(s)
- Adam Master
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Apostolos Kontzias
- Department of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Liqun Huang
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Medicon Pharmaceuticals, Inc., Setauket, New York, United States of America
| | - Wei Huang
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York, United States of America
| | - Anna Tsioulias
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Samaneh Zarabi
- Department of Pathology, Stony Brook University, Stony Brook, New York, United States of America
| | - Michael Wolek
- Renaissance Medical School, Stony Brook University, Stony Brook, New York, United States of America
| | - Brian M. Wollocko
- Renaissance Medical School, Stony Brook University, Stony Brook, New York, United States of America
| | - Robert Honkanen
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York, United States of America
| | - Basil Rigas
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, United States of America
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Binyousef FH, Alruwaili SA, Altammami AF, Alharbi AA, Alrakaf FA, Almazrou AA. Impact of Dry Eye Disease on Work Productivity Among Saudi Workers in Saudi Arabia. Clin Ophthalmol 2021; 15:2675-2681. [PMID: 34211260 PMCID: PMC8239165 DOI: 10.2147/opth.s313158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of dry eye disease (DED) on work productivity in Saudi Arabia and investigate its effect on daily activities. Patients and Methods We conducted a cross-sectional study on male and female Saudi workers age 20 years or older. The data were collected via self-administered questionnaires distributed electronically through social media. We used the Ocular Surface Disease Index questionnaire to diagnose DED patients and assess their DED severity as mild, moderate, and severe. Results A total of 463 respondents qualified for the study. All patients in the DED groups reported a loss of work productivity. Most patients in the severe DED group (59%) reported difficulty focusing on work due to DED, whereas 17.1% of patients with mild DED and 22.7% with moderate DED reported the same. These findings indicate significantly worsening productivity as DED progresses in severity (p<0.05). Participants with severe DED reported significantly more affected work hours weekly (35.8%) than participants with moderate (6.1%) and mild DED (7.1%). Conclusion DED has a significant impact on work productivity, with the most pronounced effect among office workers. It is essential to screen office workers for DED and enhance the awareness of its effect on work productivity among the workforce and healthcare providers.
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Affiliation(s)
- Faris H Binyousef
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Shahad A Alruwaili
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulaziz F Altammami
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Ahmed A Alharbi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Feras A Alrakaf
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrhman A Almazrou
- Ophthalmology Department, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Huang W, Wen Z, Saglam MS, Huang L, Honkanen RA, Rigas B. Phospho-Sulindac (OXT-328) Inhibits Dry Eye Disease in Rabbits: A Dose-, Formulation- and Structure-Dependent Effect. J Ocul Pharmacol Ther 2021; 37:321-330. [PMID: 34152861 DOI: 10.1089/jop.2019.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: Inflammation of the ocular surface is central to dry eye disease (DED). The anti-inflammatory agent phospho-sulindac (PS) at a high dose was efficacious against DED in a rabbit model. We assessed the dose, formulation and structure dependence of PS's effect. Methods: In rabbits with concanavalin A-induced DED we evaluated a range of PS concentrations (0.05%-1.6%) and dosing frequencies, assessed the duration of its effect with PS in 2 solution formulations and one emulsion formulation, and compared the efficacy of PS to that of sulindac, and of the structurally similar phospho-ibuprofen amide. We determined tear breakup time (TBUT) (tear stability), Schirmer's tear test (tear production), and by esthesiometry corneal sensitivity (symptoms). We also determined the biodistribution in the eye of topically applied PS. Results: PS in a solution formulation, given as eye drops q.i.d. was efficacious starting at a dose of 0.1%. The effect was apparent after 2 days of treatment and lasted at least 8 days after the last dose. Both signs (evidenced by TBUT and Schirmer's test) and symptoms (measured by corneal sensitivity) improved significantly. The best formulation was the solution formulation; a cyclodextrin-based formulation was also successful but the emulsion formulation was not. PS and its metabolites were essentially restricted to the anterior chamber of the eye. Sulindac and phospho-ibuprofen amide had no efficacy on DED. Conclusions: PS is efficacious against DED. Its effect, encompassing signs, and symptoms, are dose, formulation, and structure dependent. PS has therapeutic promise and merits further development.
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Affiliation(s)
- Wei Huang
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York, USA.,Department of Medicine, Stony Brook University, Stony Brook, New York, USA.,Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziyi Wen
- Department of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Muhammet S Saglam
- Department of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Liqun Huang
- Department of Medicine, Stony Brook University, Stony Brook, New York, USA.,Medicon Pharmaceuticals, Setauket, New York, USA
| | - Robert A Honkanen
- Department of Ophthalmology, Stony Brook University, Stony Brook, New York, USA
| | - Basil Rigas
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
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Clark D, Tauber J, Sheppard J, Brady TC. Early Onset and Broad Activity of Reproxalap in a Randomized, Double-Masked, Vehicle-Controlled Phase 2b Trial in Dry Eye Disease. Am J Ophthalmol 2021; 226:22-31. [PMID: 33529588 DOI: 10.1016/j.ajo.2021.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess the activity of reproxalap, a novel reactive aldehyde species (RASP) inhibitor, relative to vehicle in patients with dry eye disease (DED) DESIGN: Randomized, double-masked, vehicle-controlled Phase 2b trial METHODS: Three hundred patients with DED were randomly assigned 1:1:1 at multiple US sites to receive 0.1% topical ocular reproxalap, 0.25% topical ocular reproxalap, or vehicle. Eyes were treated bilaterally 4 times daily for 12 weeks. Standard signs and symptoms of DED were assessed at baseline and at Weeks 2, 4, 8, and 12. RESULTS A dose response was observed for signs and symptoms of DED. Relative to vehicle over 12 weeks of therapy, the largest symptomatic improvement was observed in ocular dryness (0.25%, P = .047), and the largest objective sign improvement was observed in nasal region fluorescein staining (0.25%, P = .030). A greater proportion of patients receiving 0.25% reproxalap vs. vehicle reported dryness scores of 0 (P = .012). Improvements in combined DED symptoms were evident by the first post-baseline visit (Week 2, 0.25%, P < .0001) in patients with baseline scores greater than or equal to median values. No significant changes in safety measures were observed. CONCLUSION The novel RASP inhibitor reproxalap demonstrated rapid, broad, and clinically relevant symptomatic control, in conjunction with statistically significant improvement over vehicle in signs of DED as demonstrated by fluorescein staining, in DED patients over 12 weeks of therapy. The results represent the first vehicle-controlled evidence for the therapeutic potential of RASP inhibition to mitigate the signs and symptoms of dry eye disease.
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Affiliation(s)
- David Clark
- From Aldeyra Therapeutics (D.C., T.C.B.), Lexington, Massachusetts
| | | | - John Sheppard
- Virginia Eye Consultants (J.S.), Norfolk, Virginia, USA
| | - Todd C Brady
- From Aldeyra Therapeutics (D.C., T.C.B.), Lexington, Massachusetts.
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26
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Scalinci SZ, Pacella E, Battagliola ET. Prolonged face mask use might worsen dry eye symptoms. Indian J Ophthalmol 2021; 69:1508-1510. [PMID: 34011730 PMCID: PMC8302327 DOI: 10.4103/ijo.ijo_2641_20] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: The aim of this study was to explore whether prolonged and consistent face mask use might be associated with worsening of dry eye symptoms in patients with dry eye disease (DED). Methods: Subjects with a previous diagnosis of DED. Their OSDI scores were compared with those recorded in Fall 2019 using the Wilcoxon paired test. Participants were stratified by face mask use: heavy (Group A) or standard (Group B) face mask users. Heavy use was defined as wearing any type of face mask for at least 6 hours a day, at least 5 days per week in the last 2 months. Results: 67 subjects (mean age: 45.27 ± 10.06 SD years, 40% males and 60% females). Median OSDI score in Fall 2019: 18.75. Median OSDI in Spring 2020: 20.83. The Hodges-Lehmann median difference was 2.09 (95% CI [1.05, 4.17]) (P < 0.0001). The population was then stratified into heavy and standard face mask users: Group A included heavy users (31 subjects; mean age: 42.81 ± 10.48 SD years; 35% males and 65% females), Group B included standard users (36 subjects; mean age: 47.39 ± 9.31 SD years; 44% males and 56% females). The Hodges-Lehmann median difference was 5.21 (95% CI [3.13, 7.29]) in Group A (P < 0.0001), and 1.04 (95% [0, 2.08]) in Group B (P = 0.0177). Conclusion: Prolonged and consistent face mask use is associated with an increase in OSDI scores. Whether face mask use is responsible for the worsening of symptoms of DED remains to be elucidated.
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Affiliation(s)
| | - Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Nomi K, Hayashi R, Ishikawa Y, Kobayashi Y, Katayama T, Quantock AJ, Nishida K. Generation of functional conjunctival epithelium, including goblet cells, from human iPSCs. Cell Rep 2021; 34:108715. [PMID: 33535050 DOI: 10.1016/j.celrep.2021.108715] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/23/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022] Open
Abstract
The conjunctival epithelium, which covers the sclera (the white of the eye) and lines the inside of the eyelids, is essential for mucin secretion and the establishment of a healthy tear film. Here, we describe human conjunctival development in a self-formed ectodermal autonomous multi-zone (SEAM) of cells that were derived from human-induced pluripotent stem cells (hiPSCs) and mimic whole-eye development. Our data indicate that epidermal growth factor (EGF) drives the generation of cells with a conjunctival epithelial lineage. We also show that individual conjunctival cells can be sorted and reconstituted by cultivation into a functional conjunctival epithelium that includes mucin-producing goblet cells. Keratinocyte growth factor (KGF), moreover, is necessary for the maturation of hiPSC-derived conjunctival epithelium-particularly the goblet cells-indicating key complementary roles of EGF and KGF in directing the differentiation and maturation, respectively, of the human conjunctival epithelium.
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Affiliation(s)
- Kimihito Nomi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Ryuhei Hayashi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Yuki Ishikawa
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Yuki Kobayashi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tomohiko Katayama
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Department of Stem Cells and Applied Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Andrew J Quantock
- Structural Biophysics Group, School of Optometry and Vision Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF24 4HQ, Wales, UK
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka 565-0871, Japan.
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Krstić L, González-García MJ, Diebold Y. Ocular Delivery of Polyphenols: Meeting the Unmet Needs. Molecules 2021; 26:molecules26020370. [PMID: 33445725 PMCID: PMC7828190 DOI: 10.3390/molecules26020370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
Nature has become one of the main sources of exploration for researchers that search for new potential molecules to be used in therapy. Polyphenols are emerging as a class of compounds that have attracted the attention of pharmaceutical and biomedical scientists. Thanks to their structural peculiarities, polyphenolic compounds are characterized as good scavengers of free radical species. This, among other medicinal effects, permits them to interfere with different molecular pathways that are involved in the inflammatory process. Unfortunately, many compounds of this class possess low solubility in aqueous solvents and low stability. Ocular pathologies are spread worldwide. It is estimated that every individual at least once in their lifetime experiences some kind of eye disorder. Oxidative stress or inflammatory processes are the basic etiological mechanisms of many ocular pathologies. A variety of polyphenolic compounds have been proved to be efficient in suppressing some of the indicators of these pathologies in in vitro and in vivo models. Further application of polyphenolic compounds in ocular therapy lacks an adequate formulation approach. Therefore, more emphasis should be put in advanced delivery strategies that will overcome the limits of the delivery site as well as the ones related to the polyphenols in use. This review analyzes different drug delivery strategies that are employed for the formulation of polyphenolic compounds when used to treat ocular pathologies related to oxidative stress and inflammation.
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Affiliation(s)
- Luna Krstić
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
| | - María J. González-García
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Yolanda Diebold
- Insituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, 47011 Valladolid, Spain; (L.K.); (M.J.G.-G.)
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-883423274
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Starr CE, Gupta PK, Farid M, Beckman KA, Chan CC, Yeu E, Gomes JAP, Ayers BD, Berdahl JP, Holland EJ, Kim T, Mah FS. An algorithm for the preoperative diagnosis and treatment of ocular surface disorders. J Cataract Refract Surg 2020; 45:669-684. [PMID: 31030780 DOI: 10.1016/j.jcrs.2019.03.023] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022]
Abstract
Any ocular surface disease (OSD), but most commonly, dry-eye disease (DED), can reduce visual quality and quantity and adversely affect refractive measurements before keratorefractive and phacorefractive surgeries. In addition, ocular surgery can exacerbate or induce OSD, leading to worsened vision, increased symptoms, and overall dissatisfaction postoperatively. Although most respondents of the recent annual American Society of Cataract and Refractive Surgery (ASCRS) Clinical Survey recognized the importance of DED on surgical outcomes, many were unaware of the current guidelines and most were not using modern diagnostic tests and advanced treatments. To address these educational gaps, the ASCRS Cornea Clinical Committee developed a new consensus-based practical diagnostic OSD algorithm to aid surgeons in efficiently diagnosing and treating visually significant OSD before any form of refractive surgery is performed. By treating OSD preoperatively, postoperative visual outcomes and patient satisfaction can be significantly improved.
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Affiliation(s)
- Christopher E Starr
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA.
| | | | - Marjan Farid
- Gavin Herbert Eye Institute, University of California, Irvine, California, USA
| | - Kenneth A Beckman
- Department of Ophthalmology, The Ohio State University and Comprehensive EyeCare of Central Ohio, Westerville, Ohio, USA
| | - Clara C Chan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada
| | - Elizabeth Yeu
- Eastern Virginia Medical School, Virginia Eye Consultants, Norfolk, Virginia, USA
| | - José A P Gomes
- Paulista Medical School, Federal University of São Paulo, Brazil
| | | | | | | | - Terry Kim
- Duke University Eye Center, Durham, North Carolina, USA
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Epitropoulos AT, Therattil A, Periman LM, Rosenberg ED. Improving Tolerance and Compliance with Topical Immunomodulators Using Micro-Emulsion Lipid Layer Artificial Tears. Clin Ophthalmol 2020; 14:1921-1929. [PMID: 32753836 PMCID: PMC7352371 DOI: 10.2147/opth.s258983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/11/2020] [Indexed: 01/07/2023] Open
Abstract
Purpose To investigate the efficacy of a micro-emulsion (ME) lipid layer artificial tear in improving tolerance of immunomodulator eye drops for the treatment of dry eye disease. Patients and Methods A total of 33 patients with previously diagnosed dry eye disease were given the micro-emulsion lipid layer artificial tear in conjunction with either lifitegrast or cyclosporine. Patients were queried on their tolerance of the regimen by reporting VAS scores before starting the adjunctive eye drop, immediately after starting, and 2–3 weeks later. Tolerance was statistically compared over time and with respect to previous medication compliance, timing of the adjunctive eye drop, age, gender, and ethnicity. Results Across all patients, the VAS pre-treatment score (6.8 ± 0.6) was significantly higher than both the VAS 1-day post ME lipid tear instillation time point (3.0 ± 0.7) (post hoc Bonferroni, p < 0.001) and the VAS 2–3-week post instillation time point (1.7 ± 0.7) (post hoc Bonferroni, p < 0.001), with the mean VAS score improving over time (post hoc Bonferroni, p < 0.028). Average VAS scores did not vary with respect to specific medical therapy or the timing of instillation of this artificial tear. Both the “at-risk” and “conversion” groups independently had significant improvements at both 1-day and 2–3-week time points compared to baseline. Conclusion The micro-emulsion lipid layer artificial tear was effective as an adjunctive eye drop to improve tolerance of lifitegrast and cyclosporine for patients with dry eye disease who were at risk of failing or had previously failed immunomodulatory therapy.
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Affiliation(s)
- Alice T Epitropoulos
- Ophthalmic Surgeons & Consultants of Ohio, The Eye Center of Columbus, Department of Ophthalmology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | | | - Eric D Rosenberg
- Weill-Cornell Medical College, Department of Ophthalmology, New York, NY, USA
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Wu H, Lin L, Du X, Zhang L, Yin X, Dong X, Hao X, Xie L, Qu C, Ni J. Study on the potential effective ingredients of Xiaosheng prescription for dry eye disease. Biomed Pharmacother 2020; 127:110051. [DOI: 10.1016/j.biopha.2020.110051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 11/27/2022] Open
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Periman LM, Perez VL, Saban DR, Lin MC, Neri P. The Immunological Basis of Dry Eye Disease and Current Topical Treatment Options. J Ocul Pharmacol Ther 2020; 36:137-146. [PMID: 32175799 PMCID: PMC7175622 DOI: 10.1089/jop.2019.0060] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/29/2019] [Indexed: 12/13/2022] Open
Abstract
Homeostasis of the lacrimal functional unit is needed to ensure a well-regulated ocular immune response comprising innate and adaptive phases. When the ocular immune system is excessively stimulated and/or immunoregulatory mechanisms are disrupted, the balance between innate and adaptive phases is dysregulated and chronic ocular surface inflammation can result, leading to chronic dry eye disease (DED). According to the Tear Film and Ocular Surface Society Dry Eye Workshop II definition, DED is a multifactorial disorder of the ocular surface characterized by impairment and loss of tear homeostasis (hyperosmolarity), ocular discomfort or pain, and neurosensory abnormalities. Dysregulated ocular immune responses result in ocular surface damage, which is a further contributing factor to DED pathology. Several therapeutics are available to break the vicious circle of DED and prevent chronic disease and progression, including immunosuppressive agents (steroids) and immunomodulators (cyclosporine and lifitegrast). Given the chronic inflammatory nature of DED, each of these agents is commonly used in clinical practice. In this study, we review the immunopathology of DED and the molecular and cellular actions of current topical DED therapeutics to inform clinical decision making.
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Affiliation(s)
| | - Victor L. Perez
- Duke Eye Center, Duke University School of Medicine, Durham, North Carolina
| | - Daniel R. Saban
- Duke Eye Center, Duke University School of Medicine, Durham, North Carolina
| | - Meng C. Lin
- School of Optometry, Clinical Research Center, University of California, Berkeley, California
| | - Piergiorgio Neri
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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Zayan K, Aggarwal S, Felix E, Levitt R, Sarantopoulos K, Galor A. Transcutaneous Electrical Nerve Stimulation for the Long-Term Treatment of Ocular Pain. Neuromodulation 2020; 23:871-877. [PMID: 32196838 DOI: 10.1111/ner.13146] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/13/2020] [Accepted: 02/24/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Ocular pain is a debilitating condition that is challenging to treat as therapies that target the ocular surface are often ineffective. We previously reported a short-term reduction in ocular pain after one periocular transcutaneous electrical nerve stimulation (TENS) session. The current study aims to elucidate the long-term effect of TENS on ocular pain. MATERIALS AND METHODS Fourteen individuals with eye pain were identified as candidates for a TENS device (RS Medical, Vancouver) for home use after a successful trial in clinic between February 2018 and July 2019 at the Miami Veterans Administration Hospital or University of Miami. Ten of the 14 patients were included in this retrospective review, based on the inclusion of receiving and using the device for a minimum of three months. The median age of the ten patients was 47.5 years, range 32-73 years, and eight were male. The main outcome measures were 1) frequency of long-term integration of TENS into ocular pain management and 2) patient reported ocular pain intensity (0-10) pre- vs. post-treatment. RESULTS Patients reported an initial median use of the device 14.0 times per week and over time reducing the frequency to 3.0 times per week. All reported that the TENS unit was successfully incorporated into their ocular pain management routine for at least three months (median duration of use 6.5 months, range 3-14 months). Nine of ten patients reported subjective pain reduction with use of the TENS device at home. Overall, pain intensity decreased by approximately 27.4% (mean rank = 5.6, Z = -2.1, p = 0.02) post- vs. pre-treatment. No adverse events associated with TENS were reported in any patient. CONCLUSION Our preliminary data suggest that TENS can be integrated into the long-term management of ocular pain with improvements in overall pain intensity.
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Affiliation(s)
- Kristen Zayan
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Shruti Aggarwal
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Elizabeth Felix
- Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Roy Levitt
- Department of Anesthesia, University of Miami, Miller School of Medicine, Miami, FL, USA
| | | | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL, USA
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Askari G, Rafie N, Miraghajani M, Heidari Z, Arab A. Association between vitamin D and dry eye disease: A systematic review and meta-analysis of observational studies. Cont Lens Anterior Eye 2020; 43:418-425. [PMID: 32169320 DOI: 10.1016/j.clae.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE A number of studies have examined the association between vitamin D and dry eye disease in different populations, but findings are inconclusive. Herein, available observational studies were systematically reviewed to elucidate the overall relationship between vitamin D and dry eye disease among adult population. METHODS PubMed, Scopus, Google scholar and ISI web of science databases were searched until January 2020 for studies assessing the association between vitamin D and dry eye disease. The Newcastle-Ottawa Quality Assessment Scale was used to examine the quality of each study. RESULTS A total of 14 studies out of 252 met the inclusion criteria and were included in this systematic review and meta-analysis. Serum 25(OH) D3 was lower in dry eye disease subjects compared to healthy ones (WMD -5.93; 95 % CI, -7.47 to -4.40; P < 0.001) with evidence of significant heterogeneity (I2 = 94.6 % p < 0.001). Also, in final analysis, vitamin D correlated significantly with ocular surface disease index (Fisher's Z: -0.26; 95 % CI, -0.48 to -0.04; P = 0.018), with significant heterogeneity between studies (I2 = 59.3 %, P = 0.043). CONCLUSION It was found that serum vitamin D had a significantly lower level in dry eye disease patients, and correlated with ocular surface disease index but no other dry eye disease parameter. The findings add to the existing literature supporting the concept that nutrition especially vitamin D plays an important role in human eye health. Prospective studies are needed to confirm this relationship.
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Affiliation(s)
- Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nahid Rafie
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Maryam Miraghajani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; The Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Wishna A, Hurtig A, Templeton K. Eye Conditions in Women. GENDER AND THE GENOME 2020. [DOI: 10.1177/2470289720907105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Changes in vision can have significant impact on health and quality of life. Differences between women and men have been identified in the incidence of several eye conditions. Some of these differences are a result of the greater longevity of women. However, the eye, like other organs, is susceptible to the impacts of inflammation and sex steroids. Conditions, such as thyroid eye disease, optic neuritis, and dry eye disease are related to autoimmune or inflammatory conditions and are, thus, more common among women. Idiopathic intracranial hypertension occurs disproportionately in women of childbearing age; the etiology of this condition appears to be related to both inflammatory and sex hormone fluctuations.
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Affiliation(s)
- Anne Wishna
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Amanda Hurtig
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Kim Templeton
- University of Kansas Medical Center, Kansas City, KS, USA
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Choi SW, Cha BG, Kim J. Therapeutic Contact Lens for Scavenging Excessive Reactive Oxygen Species on the Ocular Surface. ACS NANO 2020; 14:2483-2496. [PMID: 31935066 DOI: 10.1021/acsnano.9b10145] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Excessive reactive oxygen species (ROS) play a significant role in the pathogenesis of many eye diseases. Controlling oxidative stress by reducing the amount of ROS is a potential therapeutic strategy for the prevention and treatment of eye diseases, particularly ocular surface diseases. Ceria nanoparticles (CeNPs) have been investigated owing to their efficient ROS-scavenging properties. To overcome the disadvantages of eyedrop administration due to rapid elimination on the surface of the eye and to retain the intrinsic properties of contact lenses, we developed an ROS-scavenging water-soluble CeNP-embedded contact lens (CeNP-CL) for the prevention of ocular surface diseases. The intrinsic ROS-scavenging property of the CeNPs, which mimicked the activities of superoxide dismutase and catalase, was incorporated into polyhydroxyethyl methacrylate-based contact lenses. The CeNP-CL exhibited high transparency and physical properties comparable to those of a commercial contact lens, along with excellent extracellular ROS-scavenging properties. The viabilities of human conjunctival epithelial cells and human meibomian gland epithelial cells were significantly enhanced in the presence of CeNP-CLs, even in media with high H2O2 contents (100 and 500 μM). Additionally, the wearing of CeNP-CLs on the eyes had a protective effect in a mouse model when 3% H2O2 eyedrops were administered. These results indicate the salvaging effect of the CeNP-CL in a high-ROS environment on the ocular surface, which may be helpful for the treatment of ocular surface diseases.
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Affiliation(s)
- Seung Woo Choi
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST) , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
| | - Bong Geun Cha
- School of Chemical Engineering , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
| | - Jaeyun Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST) , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
- School of Chemical Engineering , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
- Biomedical Institute for Convergence at SKKU (BICS) , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
- Institute of Quantum Biophysics (IQB) , Sungkyunkwan University (SKKU) , Suwon 16419 , Republic of Korea
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Chhabra S, Jerkins JH, Conto JE, Zellner K, Shah NN, Hari PN, Hamadani M. Lifitegrast ophthalmic solution for treatment of ocular chronic graft-versus-host disease. Leuk Lymphoma 2019; 61:869-874. [PMID: 31762357 DOI: 10.1080/10428194.2019.1695049] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ocular chronic graft-versus-host disease (oGVHD) is a relatively common complication that occurs following allogeneic hematopoietic cell transplantation. Keratoconjunctivitis sicca (KCS) is the most common manifestation of oGVHD. Lifitegrast is a lymphocyte function-associated antigen-1 antagonist approved to reduce inflammation and symptoms in patients with dry eye disease. We evaluated the efficacy and safety of lifitegrast (5% ophthalmic solution) in patients with ocular GVHD in a single-institution retrospective cohort study of eighteen allogeneic transplant recipients who received topical lifitegrast for oGVHD treatment. The outcome of interest was improvement in oGVHD severity score by National Institutes of Health (NIH) criteria. Lifitegrast was well-tolerated and no serious adverse events were observed. Lifitegrast significantly improved NIH severity scores in 8 (44%) patients. The findings of this study suggest lifitegrast is safe, well-tolerated and is an effective option for oGVHD manifesting as KCS. Prospective evaluation is warranted to confirm efficacy of lifitegrast in this population.HighlightsIn this single-institution retrospective cohort study of eighteen patients who received allogeneic transplant between 2013 and 2018, and received topical lifitegrast for treatment of ocular GVHD, the results demonstrate that lifitegrast eye drops were well-tolerated and led to improvement in symptoms of KCS in 8 (44%) patients.Lifitegrast has the potential to fulfill an unmet need in allogeneic transplant patients with ocular GVHD. Further prospective study is warranted for confirmation.
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Affiliation(s)
- Saurabh Chhabra
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - James H Jerkins
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John E Conto
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katie Zellner
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Nirav N Shah
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Parameswaran N Hari
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mehdi Hamadani
- Division of Hematology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Lee TG, Hyun SW, Jo K, Park B, Lee IS, Song SJ, Kim CS. Achyranthis radix Extract Improves Urban Particulate Matter-Induced Dry Eye Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183229. [PMID: 31487776 PMCID: PMC6765805 DOI: 10.3390/ijerph16183229] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/23/2019] [Accepted: 09/02/2019] [Indexed: 02/06/2023]
Abstract
Dry eye disease (DED) is a multifactorial inflammatory disease that severely impairs patients' quality of life. Particulate matter comprises a harmful mixture of particles less than 10 μm in size, which on contact with the eye, causes inflammation in the cornea/conjunctival epithelium, threatening eye health and triggering the onset of DED. Achyranthis radix is an ingredient of traditional medicine generally used for treating osteoporosis, trauma, and thrombosis in Asian countries. However, the effect of Achyranthis radix on eye health has not been elucidated. In this study, we evaluate the protective effect of Achyranthis radix hot water extract (ARE) in a rat model of urban particulate matter (UPM)-induced DED. UPM with or without ARE were topically administered on both eyes thrice daily for 10 days. ARE induced tear secretion and improved corneal irregularity. Additionally, ARE treatment protected the corneal epithelial cells from UPM-induced apoptosis. It also restored rMuc4 expression in the cornea and increased goblet cell density in the conjunctiva. These results are suggestive of the potential of ARE as a topical therapeutic agent for treating DED.
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Affiliation(s)
- Tae Gu Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Soo-Wang Hyun
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Kyuhyung Jo
- Non-clinical Research Collaboration Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Bongkyun Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Ik Soo Lee
- Non-clinical Research Collaboration Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Su Jeong Song
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
| | - Chan-Sik Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea.
- Korean Convergence Medicine, University of Science Technology (UST), Daejeon 34054, Korea.
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Abstract
Introduction Dry Eye (DE) is a multifactorial condition with a variable clinical presentation. This highly prevalent disease has multiple symptoms and signs that often do not correlate with one another. As such, the diagnosis of DE can be challenging to make, and a systematic approach must be taken. Areas covered We review the different methods commonly utilized to evaluate a patient complaining of DE symptoms. Included in this review are clinical examination techniques, point of care tests, and imaging techniques. Expert opinion DE is an umbrella term that encompasses different etiologies and pathophysiological mechanisms. The current definition recognizes tear instability, high osmolarity, inflammation, and neuro-sensory dysfunction as causative entities. The approach to DE begins with a systematic assessment of symptoms and signs, evaluating for both nociceptive and neuropathic sources of symptoms. Future research is needed to develop tests that assess neurosensory status in DE and couple point of care tests with therapeutic algorithms.
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Affiliation(s)
- Amy Kloosterboer
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | | | - Anat Galor
- Miami Veterans Administration Medical Center, Miami, Florida, USA.,Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
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Miller FC, Coburn PS, Huzzatul MM, LaGrow AL, Livingston E, Callegan MC. Targets of immunomodulation in bacterial endophthalmitis. Prog Retin Eye Res 2019; 73:100763. [PMID: 31150824 DOI: 10.1016/j.preteyeres.2019.05.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 12/11/2022]
Abstract
Bacterial infection of the posterior segment of the eye (endophthalmitis) leads to a robust host response that often results in irreversible damage to the layers of the retina, significant vision loss, and in some patients, enucleation of the globe. While a great deal of effort has gone into understanding the role of bacterial virulence factors in disease initiation and propagation, it is becoming increasingly clear that the host response to infection plays a major role in causing the damage associated with endophthalmitis. Researchers have identified the host receptors which detect infecting organisms and initiate the cascade of events that result in inflammation. This inflammation may damage nonregenerative tissues of the eye while attempting to clear the infection. Both Gram-positive and Gram-negative bacteria can cause endophthalmitis. These organisms initiate an immune response by activating toll-like receptor (TLR) pathways. Once an inflammatory response is initiated, the expression of immunomodulators, such as proinflammatory chemokines and cytokines, affect the recruitment of PMNs and other inflammatory cells into the eye. We and others have reported that knockout mice that do not express specific inflammatory pathways and molecules have an attenuated response to infection and retain significant retinal function. These findings suggest that host immune mediators are important components of the response to infections in the posterior segment of the eye, and the timing and level of their production may be related to the severity of the damage and the ultimate visual outcome. If that is the case, a better understanding of the complex and often redundant role of these pathways and inflammatory mediators may identify host molecules as potential anti-inflammatory therapeutic targets. This review highlights potential anti-inflammatory targets during acute inflammation in endophthalmitis, compares and contrasts those with findings in other models of ocular inflammation, and translates current immunomodulatory strategies for other types of infection and inflammation to this blinding disease. Given the poor visual outcomes seen in patients treated with antibiotics alone or in combination with corticosteroids, immunomodulation in addition to antibiotic therapy might be more effective in preserving vision than current regimens.
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Affiliation(s)
- Frederick C Miller
- Department of Family and Preventive Medicine, USA; Department of Cell Biology, USA
| | | | | | | | | | - Michelle C Callegan
- Department of Ophthalmology, USA; Department of Microbiology and Immunology, USA; Oklahoma Center for Neuroscience, USA; University of Oklahoma Health Sciences Center, Dean McGee Eye Institute, Oklahoma City, OK, USA.
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Galor A. Painful Dry Eye Symptoms: A Nerve Problem or a Tear Problem? Ophthalmology 2019; 126:648-651. [PMID: 31005185 DOI: 10.1016/j.ophtha.2019.01.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/25/2019] [Accepted: 01/30/2019] [Indexed: 12/15/2022] Open
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Vivino FB, Bunya VY, Massaro-Giordano G, Johr CR, Giattino SL, Schorpion A, Shafer B, Peck A, Sivils K, Rasmussen A, Chiorini JA, He J, Ambrus JL. Sjogren's syndrome: An update on disease pathogenesis, clinical manifestations and treatment. Clin Immunol 2019; 203:81-121. [PMID: 31022578 DOI: 10.1016/j.clim.2019.04.009] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Frederick B Vivino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Vatinee Y Bunya
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Giacomina Massaro-Giordano
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Chadwick R Johr
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Stephanie L Giattino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Annemarie Schorpion
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Brian Shafer
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Ammon Peck
- Department of Infectious Diseases and Immunology, University of Florida College of Veterinary Medicine, PO Box 100125, Gainesville, FL 32610, USA.
| | - Kathy Sivils
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - Astrid Rasmussen
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - John A Chiorini
- NIH, Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, Building 10, Room 1n113, 10 Center DR Msc 1190, Bethesda, MD 20892-1190, USA.
| | - Jing He
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Julian L Ambrus
- Division of Allergy, Immunology and Rheumatology, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA.
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Abstract
PURPOSE OF REVIEW The prevalence and burden of dry eye disease continues to grow at a rapid pace, creating an increased need for new therapies. In a sector once limited to only a handful of treatments, clinicians now have multiple options available for patients who fail traditional therapies. This review summarizes the various treatment options available to clinicians treating complex dry eye disease patients. RECENT FINDINGS As we better understand the multifactorial mechanisms leading to dry eye disease, treatments increasingly focus on the amelioration of the underlying deficiencies and inflammation, rather than on transient symptomatic relief alone. Most topical medications seek to replace deficient growth factors and/or decrease inflammation on the ocular surface. The majority of new devices and procedures seek to treat meibomian gland dysfunction, with one new device stimulating tear production through utilizing the nasolacrimal reflex pathway. SUMMARY Clinicians have more options at their disposal in the treatment of dry eye disease than ever before, including topical medications and devices.
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Menopause and Dry Eye Syndrome. Nurs Womens Health 2018; 23:71-78. [PMID: 30594503 DOI: 10.1016/j.nwh.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/12/2018] [Accepted: 11/01/2018] [Indexed: 01/05/2023]
Abstract
Dry eye syndrome is a common ophthalmic complaint. Women, especially menopausal women with comorbidities, are at greater risk for developing dry eye syndrome and subsequent negative effects on their overall eye health. In this article, I review the anatomy and physiology of the ocular surface of the eye, pathophysiology of dry eyes and its complications, risk factors for menopausal women, and assessment tools that nurses can use. Implications for nursing practice are discussed, and a case example illustrates clinical points.
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