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Ruan Y, Buonfiglio F, Gericke A. Adrenoceptors in the Eye - Physiological and Pathophysiological Relevance. Handb Exp Pharmacol 2024; 285:453-505. [PMID: 38082203 DOI: 10.1007/164_2023_702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
The autonomic nervous system plays a crucial role in the innervation of the eye. Consequently, it comes as no surprise that catecholamines and their corresponding receptors have been extensively studied and characterized in numerous ocular structures, including the cornea, conjunctiva, lacrimal gland, trabecular meshwork, uvea, and retina. These investigations have unveiled substantial clinical implications, particularly in the context of treating glaucoma, a progressive neurodegenerative disorder responsible for irreversible vision loss on a global scale. The primary therapeutic approaches for glaucoma frequently involve the modulation of α1-, α2-, and β-adrenoceptors, making them pivotal targets. In this chapter, we offer a comprehensive overview of the expression, distribution, and functional roles of adrenoceptors within various components of the eye and its associated structures. Additionally, we delve into the pivotal role of adrenoceptors in the pathophysiology of glaucoma. Furthermore, we provide a concise historical perspective on adrenoceptor research, examine the distinct contributions of individual adrenoceptor subtypes to the treatment of various ocular conditions, and propose potential future avenues of exploration in this field.
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Affiliation(s)
- Yue Ruan
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Francesco Buonfiglio
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
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Hedengran A, Kolko M. The molecular aspect of anti-glaucomatous eye drops - are we harming our patients? Mol Aspects Med 2023; 93:101195. [PMID: 37459821 DOI: 10.1016/j.mam.2023.101195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 08/14/2023]
Abstract
Glaucoma is one of the leading causes of irreversible blindness. Progression is halted with a reduction in intraocular pressure (IOP), which is most often achieved with eye drops. A major challenge in the topical treatment of glaucoma patients is the many side effects and the resulting reduced adherence. Side effects may of course be due to the molecular properties of the active pharmaceutical ingredients (APIs). There are currently six different APIs available: prostaglandin analogues, β-adrenergic inhibitors, α-adrenergic agonists, carbonic anhydrase inhibitors, rho-kinase inhibitors and muscarinic 3 agonists. But the additives used in eye drops are also known to cause damage to the ocular surface and to some extent also to the deeper tissues. Said additives are considered inactive molecular components and are added to secure for instance viscosity and pH value, and to prevent contamination. There has been an increasing focus on the harmful effects of preservatives, with the most commonly used preservative benzalkonium chloride (BAK) being particularly controversial. BAK has long been recognized as a toxin that increases the risk of ocular discomfort. This can affect the adherence and ultimately result in lack of disease control. Other issues include the addition of certain buffers, such as phosphates, and varying pH values. This review will address the different molecular components of the IOP-lowering eye drops and what to be aware of when prescribing topical glaucoma treatment.
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Affiliation(s)
- Anne Hedengran
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2200, Copenhagen N, Denmark; Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark.
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2200, Copenhagen N, Denmark; Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark.
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Opazo-Toro V, Fortuna V, Jiménez W, Pazos López M, Royo MJM, Ventura-Abreu N, Brunet M, Milla E. Genotype and Phenotype Influence the Personal Response to Prostaglandin Analogues and Beta-Blockers in Spanish Glaucoma and Ocular Hypertension Patients. Int J Mol Sci 2023; 24:ijms24032093. [PMID: 36768422 PMCID: PMC9916755 DOI: 10.3390/ijms24032093] [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: 12/12/2022] [Revised: 01/10/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
Analysis of the genotype that predicts the phenotypic characteristics of a cohort of glaucoma and ocular hypertension patients, and the correlation with their personal pharmacological response to beta-blockers (BB) and prostaglandin analogues (PGA). Prospective study that included 139 eyes from 72 patients under BB and/or PGA treatment, and in some cases other types of ocular hypotensive treatments. Five single-nucleotide polymorphisms were genotyped by real-time PCR assays: prostaglandin-F2α receptor (rs3766355, rs3753380); cytochrome-P450 2D6 (rs16947, rs769258); and beta-2-adrenergic receptor (rs1042714). Other studied variables were mean deviation (MD) of visual field, previous ocular interventions, medical treatment, baseline (bIOP), and treated intraocular pressure (tIOP). From a total of 139 eyes, 71 (51.1%) were left eyes. The main diagnosis was primary open angle glaucoma (66.2%). A total of 57 (41%) eyes were under three or more medications (PGA + BB + other) and, additionally, 57 eyes (41%) had had some kind of glaucoma surgery. The mean bIOP and tIOP were 26.55 ± 8.19 and 21.01 ± 5.54 mmHg, respectively. Significant differences in tIOP were found between heterozygous (HT) (21.07 ± 0.607 mmHg) and homozygous (HM) (20.98 ± 0.639 mmHg) rs3766355 with respect to wildtype individuals (16 ± 1.08 mmHg) (p = 0.031). The MD values presented significant differences between wildtype rs3766355 (-2 ± 2.2 dB), HT (-3.87 ± 4 dB), and HM carriers (-9.37 ± 9.51 dB) (p = 0.009). Significant differences were also observed between the MD in wildtype rs3753380 (-6.1 ± 8.67 dB), HT (-9.02 ± 8.63 dB), and HM carriers (-9.51 ± 7.44 dB) (p = 0.017). Patients carrying the variant rs3766355 in HM or HT presented clinically-significantly higher tIOP than wildtype patients. Additionally, some differences in MD were found in rs3766355 and rs3753380 carriers, and the more alleles that were affected, the worse the MD value, meaning greater severity of the glaucoma. Poor response to treatment and more visual field damage may be associated with being a carrier of these mutated alleles.
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Affiliation(s)
- Valeria Opazo-Toro
- Glaucoma Unit, Instituto Oftalmologico Integral, C/María Auxiliadora 25, 08017 Barcelona, Spain
| | - Virginia Fortuna
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics Service, Biomedical Diagnostic Center, Hospital Clinic Barcelona, University of Barcelona, 08007 Barcelona, Spain
| | - Wladimiro Jiménez
- Biochemistry and Molecular Genetics Service, Center for Biomedical Diagnosis, Hospital Clinic Barcelona, 08036 Barcelona, Spain
- August Pí i Sunyer Research Institute (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Correspondence:
| | - Marta Pazos López
- Glaucoma Unit, Institut Clínic d’Oftalmologia, Hospital Clínic, 08036 Barcelona, Spain
| | | | | | - Mercè Brunet
- Biochemistry and Molecular Genetics Service, Center for Biomedical Diagnosis, Hospital Clinic Barcelona, 08036 Barcelona, Spain
- August Pí i Sunyer Research Institute (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Elena Milla
- August Pí i Sunyer Research Institute (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
- Glaucoma Unit, Institut Clínic d’Oftalmologia, Hospital Clínic, 08036 Barcelona, Spain
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Silva-Alarcon S, Valencia C, Newball L, Saldarriaga W, Castillo A. Molecular Variants in Genes related to the Response to Ocular Hypotensive Drugs in an Afro-Colombian Population. Open Ophthalmol J 2022. [DOI: 10.2174/18743641-v16-e2205250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aims:
This study aimed to conduct an exploratory analysis of the pharmacogenomic variants involved in ocular hypotensive drugs to understand the individual differential response in an Afro-descendant population.
Background:
Glaucoma is the leading cause of irreversible blindness worldwide. The pharmacologic treatment available consists of lowering intraocular pressure by administering topical drugs. In Asian and Caucasian people, pharmacogenomic variants associated with the efficacy of these treatments have been identified. However, in Afro-descendant populations, there is a profound gap in this knowledge.
Objective:
This study identified the pharmacogenomic variants related to ocular hypotensive efficacy treatment in Afro-descendant individuals from the Archipelago of San Andres and Providence, Colombia.
Methods:
An analysis of whole-exome sequencings (WES), functional annotation, and clinical significance was performed for pharmacogenomic variants reported in PharmGKB databases; in turn, an in silico available prediction analysis was carried out for the novel variants.
Results:
We identified six out of 18 non-synonymous variants with a clinical annotation in PharmGKB. Five were classified as level three evidence for the hypotensive drugs; rs1801252 and rs1801253 in the ADRB1 gene and rs1042714 in the ADRB2 gene. These pharmacogenomic variants have been involved in a lack of efficacy of topical beta-blockers and higher systolic and diastolic pressure under treatment with ophthalmic timolol drug. The rs1045642 in the ABCB1 gene was associated with greater efficacy of treatments with latanoprost drug. Also, we found the haplotypes *17 for CYP2D6 and *10 for CYP2C19; both related to reducing the enzyme activity to timolol drug metabolization. In addition, we observed 50 novel potentially actionable variants; 36 synonymous, two insertion variants that caused frameshift mutations, and 12 non-synonymous, where five were predicted to be pathogenic based on several pathogenicity predictions.
Conclusion:
Our results suggested that the pharmacogenomic variants were found to decrease the ocular hypotensive efficacy treatment in a Colombian Afro-descendant population and revealed a significant proportion of novel variants with a potential to influence drug response.
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Yoon DJ, Kaur R, Gallegos A, West K, Yang H, Schaefer S, Tchanque-Fossuo C, Dahle SE, Isseroff RR. Repurposing Ophthalmologic Timolol for Dermatologic Use: Caveats and Historical Review of Adverse Events. Am J Clin Dermatol 2021; 22:89-99. [PMID: 33237496 DOI: 10.1007/s40257-020-00567-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2020] [Indexed: 01/13/2023]
Abstract
Ophthalmic timolol solution is increasingly being repurposed as a topical therapeutic for a variety of dermatologic diseases, including pyogenic granulomas, infantile hemangiomas, and chronic wounds. There are no published guidelines or protocols for use in these indications in adults, and the dermatologic community may not be familiar with adverse events that have been extensively documented relating to its ophthalmic use. We review the evidence available relating to adverse events to topical timolol use to evaluate its safety in dermatologic applications and to alert clinicians to screening and monitoring that is needed when repurposing this drug for dermatologic use. The majority of serious adverse events associated with ophthalmic timolol were reported in the first 7 years of use, between 1978 and 1985, of which most common were cardiovascular and respiratory events, but also included 32 deaths. The available evidence suggests that ophthalmic timolol safety profiling may have been incomplete prior to widespread use. Recent clinical trials for dermatologic indications have focused on documenting efficacy and have not had rigorous monitoring for potential adverse events. Topical timolol may be safe and effective for the treatment of various dermatologic conditions in patients whose medical histories have been carefully reviewed for evidence of pre-existing cardiac or pulmonary disease and are monitored for potential adverse events. Despite the wide use of timolol in ophthalmologic practice, safe dermatologic repurposing requires recognition of the potential for facilitated systemic absorption though the skin and appreciation of its history of adverse events.
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Affiliation(s)
- Daniel J Yoon
- Department of Dermatology, University of California Davis School of Medicine, Institute for Regenerative Cures, 2921 Stockton Blvd, Ste 1630, Sacramento, CA, 95817, USA
- Dermatology Service, VA Northern California Health Care System, Mather, CA, USA
| | - Ramanjot Kaur
- Dermatology Service, VA Northern California Health Care System, Mather, CA, USA
| | - Anthony Gallegos
- Department of Dermatology, University of California Davis School of Medicine, Institute for Regenerative Cures, 2921 Stockton Blvd, Ste 1630, Sacramento, CA, 95817, USA
| | - Kaitlyn West
- Dermatology Service, VA Northern California Health Care System, Mather, CA, USA
| | - Hsinya Yang
- Department of Dermatology, University of California Davis School of Medicine, Institute for Regenerative Cures, 2921 Stockton Blvd, Ste 1630, Sacramento, CA, 95817, USA
| | - Saul Schaefer
- Department of Internal Medicine, University of California School of Medicine, Davis, CA, USA
| | | | - Sara E Dahle
- Department of Dermatology, University of California Davis School of Medicine, Institute for Regenerative Cures, 2921 Stockton Blvd, Ste 1630, Sacramento, CA, 95817, USA
- Podiatry Section, VA Northern California Health Care System, Mather, CA, USA
| | - R Rivkah Isseroff
- Department of Dermatology, University of California Davis School of Medicine, Institute for Regenerative Cures, 2921 Stockton Blvd, Ste 1630, Sacramento, CA, 95817, USA.
- Dermatology Service, VA Northern California Health Care System, Mather, CA, USA.
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Messina Baas O, Pacheco Cuellar G, Toral-López J, Lara Huerta SF, Gonzalez-Huerta LM, Urueta-Cuellar H, Rivera-Vega MR, Babayan-Mena I, Cuevas-Covarrubias SA. ADRB1andADBR2Gene Polymorphisms and the Ocular Hypotensive Response to Topical Betaxolol in Healthy Mexican Subjects. Curr Eye Res 2014; 39:1076-80. [DOI: 10.3109/02713683.2014.900807] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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In vitro and in vivo efficacy of SYL040012, a novel siRNA compound for treatment of glaucoma. Mol Ther 2013; 22:81-91. [PMID: 24025749 DOI: 10.1038/mt.2013.216] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/03/2013] [Indexed: 12/30/2022] Open
Abstract
Glaucoma is a progressive ocular syndrome characterized by degeneration of the optic nerve and irreversible visual field loss. Elevated intraocular pressure (IOP) is the main risk factor for glaucoma. Increased IOP is the result of an imbalance between synthesis and outflow of aqueous humor (AH). Blocking β2 adrenergic receptor (ADRB2) has shown to reduce IOP by decreasing production of AH at the ciliary body (CB). SYL040012 is a siRNA designed to specifically silence ADRB2 currently under development for glaucoma treatment. Here, we show that SYL040012 specifically reduces ADRB2 expression in cell cultures and eye tissues. The compound enters the eye shortly after administration in eye drops and is rapidly distributed among structures of the anterior segment of the eye. In addition, SYL040012 is actively taken up by cells of the CB but not by cells of systemic organs such as the lungs, where inhibition of ADRB2 could cause undesirable side effects. Moreover, SYL040012 reduces IOP in normotensive and hypertensive animal models and the effect appears to be long lasting and extremely well tolerated both locally and systemically.
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McCarty CA, Peissig P, Caldwell MD, Wilke RA. The Marshfield Clinic Personalized Medicine Research Project: 2008 scientific update and lessons learned in the first 6 years. Per Med 2008; 5:529-542. [PMID: 29783440 DOI: 10.2217/17410541.5.5.529] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Marshfield Clinic Personalized Medicine Research Project is the largest population-based biobank in the USA, with the ability to recontact subjects to obtain additional information to facilitate gene-environment studies. Nearly 20,000 adults have enrolled in the Personalized Medicine Research Project since 2001, after providing active written consent to access their Marshfield Clinic medical records to define phenotype and providing blood samples from which DNA, plasma and serum samples were stored. Numerous studies are underway in the area of pharmacogenetics and genetic epidemiology. In addition to the scientific discoveries being made, much has been learned regarding biobanking and the management of large amounts of data being generated. The purpose of this paper is to share the advice provided by the external Scientific Advisory Board and the scientific lessons learned along the way to build this research infrastructure and facilitate its use.
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Affiliation(s)
- Catherine A McCarty
- Center for Human Genetics, Marshfield Clinic Research Foundation, 1000 N Oak Avenue (ML1), Marshfield, WI 54449, USA.
| | - Peggy Peissig
- Biomedical Informatics Research Center, Marshfield Clinic Research Foundation, 1000 N Oak Avenue (ML1), Marshfield, WI 54449, USA
| | - Michael D Caldwell
- Department of Surgery, Marshfield Clinic, 1000 N Oak Avenue (ML1), Marshfield, WI 54449, USA
| | - Russell A Wilke
- Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee,WI, USA.,Department of Pharmacology and Toxicology, Medical College of Wisconsin, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee,WI, USA.,Human and Molecular Genetics Center, Medical College of Wisconsin, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee,WI, USA
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