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Medic N, Boldin I, Berisha B, Matijak-Kronschachner B, Aminfar H, Schwantzer G, Müller-Lierheim WGK, van Setten GB, Horwath-Winter J. Application frequency - key indicator for the efficiency of severe dry eye disease treatment - evidence for the importance of molecular weight of hyaluronan in lubricating agents. Acta Ophthalmol 2024; 102:e663-e671. [PMID: 38131131 DOI: 10.1111/aos.16609] [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: 05/01/2023] [Revised: 11/09/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Lubricant eye drops are the main therapeutic resource for dry eye disease (DED), with each drop representing the equivalent of ocular surface disease treatment. Thus, any reduction in the frequency of eye drop application reflects a degree of therapeutic success. Considering also the socioeconomic burden of DED, we investigated eye drop application frequency (DF) as a parameter to potentially track the success of therapy in severe DED. Hyaluronan (HA)-containing eye drops have become the first choice for tear substitution in many countries, and recent data indicate that the average molecular weight (Mw) of HA determines the therapeutic efficacy of such eye drops. This post-hoc subgroup analysis of a previously published multicentre prospective randomized open-label study, HYLAN M, is set out to compare the effects of very high Mw HA (hylan A) eye drops to comparator eye drops, containing lower Mw HA (control). METHODS Patients with severe DED (n = 47), recruited as part of the larger HYLAN M prospective, multicentre, open-label study, were randomized into two groups: hylan A and control group. In the hylan A group, 24 patients replaced their HA-containing eye drops with eye drops containing 0.15% hylan A, whereas the 23 control patients continued to use comparator HA eye drops. The DF was recorded daily by all participants over 8 weeks, and other subjective and objective parameters of DED were assessed at the time of inclusion (baseline), as well as at week 4 and 8. RESULTS There was a significant decrease in DF in the hylan A users between the baseline and week 4 (p = 0.004), remaining stable until week 8. Indeed, in contrast to the baseline, the hylan A group had a significantly lower DF than the control group at weeks 4 (p = 0.018) and 8 (p = 0.008). Likewise, the ocular surface disease index (OSDI) improved significantly between the time of inclusion and week 4 (p < 0.001) in hylan A users, remaining stable until week 8. The OSDI was similar in both groups at the baseline but it was significantly lower in the hylan A group than in the control group at week 4 (p = 0.002), remaining lower at week 8. Such a decrease in the DF and OSDI was not witnessed in the control group at any time point. The objective parameters assessed did not differ significantly within or between the two groups. CONCLUSION When treating severe DED, the DF can be significantly reduced by using very high Mw HA (3 MDa) lubricant eye drops, which better alleviate DED symptoms and decrease the OSDI scores. These drops not only provide an attractive and comfortable alternative for patients with severe DED but also offer the possibility of reducing the disease's socioeconomic burden, both for affected individuals and society as a whole.
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Affiliation(s)
- Nika Medic
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Ingrid Boldin
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Bujar Berisha
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Haleh Aminfar
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | - Gerold Schwantzer
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | | | - Gysbert-Botho van Setten
- Department of Clinical Neuroscience, St. Eriks Eye Hospital, Karolinska Institutet, Stockholm, Sweden
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Higa K, Kimoto R, Kojima T, Dogru M, Müller-Lierheim WGK, Shimazaki J. Therapeutic Aqueous Humor Concentrations of Latanoprost Attained in Rats by Administration in a Very-High-Molecular-Weight Hyaluronic Acid Eye Drop. Pharmaceutics 2024; 16:523. [PMID: 38675184 PMCID: PMC11053993 DOI: 10.3390/pharmaceutics16040523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/25/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The temporal change in concentration of a novel medicine, Latanoprost (LP), was evaluated in the aqueous humor of rats (6-8-week-old Jcl:Wister rats) when delivered in a very-high-molecular-weight hyaluronic acid (vHiHA) eye drop. Animals were randomly assigned to three treatment groups (LP + vHiHA (LPvHiHA), commercial LP (cLP), and diluted LP (dLP)) and after instilling the eye drops, the aqueous humor (AH) was collected at 0.5, 1, 2, 4, and 6 h to measure the LP concentration using an enzyme-linked immunosorbent assay (ELISA). Although the LP concentration in the LPvHiHA eye drop formulation was 3.57 times lower than in the commercial eye drops used (cLP), the LP concentration in the AH following LPvHiHA administration reached a value close to that of cLP. The cLP was diluted to the same concentration of LP as in the LPvHiHA eye drops for the dLP group, but the LP concentration in the AH of these animals was lower than that of the LPvHiHA rats at all time points. The higher LP concentration in the AH of the LPvHiHA rats suggests that vHiHA may aid the transport of LP across the ocular surface epithelium.
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Affiliation(s)
- Kazunari Higa
- Cornea Center Eye Bank, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa 272-8513, Japan; (R.K.); (J.S.)
| | - Reona Kimoto
- Cornea Center Eye Bank, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa 272-8513, Japan; (R.K.); (J.S.)
| | - Takashi Kojima
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Tokyo 160-8582, Japan; (T.K.); (M.D.)
| | - Murat Dogru
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Tokyo 160-8582, Japan; (T.K.); (M.D.)
| | | | - Jun Shimazaki
- Cornea Center Eye Bank, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa 272-8513, Japan; (R.K.); (J.S.)
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa 272-8513, Japan
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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [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: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Chen J, Gong Y, Sun X, Chen N, Zhao Z, Zhang W, Zheng Y. Prostaglandin E2 may clinically alleviate dry eye disease by inducing Th17 cell differentiation. Chem Biol Drug Des 2024; 103:e14477. [PMID: 38361150 DOI: 10.1111/cbdd.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/17/2024]
Abstract
Dry eye (DE) is a multifactorial ocular surface disease characterised by an imbalance in tear homeostasis. The pathogenesis of DE is complex and related to environmental, immunological (e.g., T helper 17 cells) and other factors. However, the DE disease pathogenesis remains unclear, thereby affecting its clinical treatment. This study aimed to explore the mechanism through which prostaglandin E2 (PGE2) affects DE inflammation by regulating Th17. The DE mouse model was established through subcutaneous injection of scopolamine hydrobromide. The tear secretion test and break-up time (BUT) method were used to detect tear secretion and tear film BUT, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of PGE2, interleukin (IL)-17, IL-6 and tumour necrosis factor (TNF-α) in tear fluid and those of PGE2 and IL-17 in the serum. RT-qPCR and western blotting were used to test the mRNA and protein expression levels of IL-17 and retinoid-related orphan receptor-γt (RORγt). PGE2 was highly expressed in the DE mouse model. The mRNA and protein levels of IL-17 and the key Th17 transcription factor RORγt were increased in tissues of the DE mice. Moreover, PGE2 promoted tear secretion, reduced the BUT, increased the IL-17 concentration in tears and increased the Th17 cell proportion in DE, whereas the PGE2 receptor inhibitor AH6809 reversed the effects of PGE2 on tear secretion, BUT, and the Th17 cell proportion in draining lymph node (DLN) cells. Taken together, the study findings indicate that PGE2 could induce DE-related symptoms by promoting Th17 differentiation.
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Affiliation(s)
- Jingyao Chen
- Department of Ophthalmology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
- Ophthalmology Department of Kunming First People's Hospital, Kunming, China
| | - Yu Gong
- Kunming Medical University, Kunming, China
| | - Xiaoyu Sun
- Kunming Medical University, Kunming, China
| | - Nuo Chen
- Kunming Medical University, Kunming, China
| | - Zijun Zhao
- Department of Ophthalmology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Weijia Zhang
- Department of Ophthalmology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Yixin Zheng
- Department of Ophthalmology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, China
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Kim TH, Heo SY, Chandika P, Kim YM, Kim HW, Kang HW, Je JY, Qian ZJ, Kim N, Jung WK. A literature review of bioactive substances for the treatment of periodontitis: In vitro, in vivo and clinical studies. Heliyon 2024; 10:e24216. [PMID: 38293511 PMCID: PMC10826675 DOI: 10.1016/j.heliyon.2024.e24216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/16/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Periodontitis is a common chronic inflammatory disease of the supporting tissues of the tooth that involves a complex interaction of microorganisms and various cell lines around the infected site. To prevent and treat this disease, several options are available, such as scaling, root planning, antibiotic treatment, and dental surgeries, depending on the stage of the disease. However, these treatments can have various side effects, including additional inflammatory responses, chronic wounds, and the need for secondary surgery. Consequently, numerous studies have focused on developing new therapeutic agents for more effective periodontitis treatment. This review explores the latest trends in bioactive substances with therapeutic effects for periodontitis using various search engines. Therefore, this study aimed to suggest effective directions for therapeutic approaches. Additionally, we provide a summary of the current applications and underlying mechanisms of bioactive substances, which can serve as a reference for the development of periodontitis treatments.
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Affiliation(s)
- Tae-Hee Kim
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
| | - Seong-Yeong Heo
- Jeju Marine Research Center, Korea Institute of Ocean Science & Technology (KIOST), Jeju, 63349, Republic of Korea
| | - Pathum Chandika
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
| | - Young-Mog Kim
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
- Department of Food Science and Technology, Pukyong National University, Busan, 48513, Republic of Korea
| | - Hyun-Woo Kim
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
- Department of Marine Biology, Pukyong National University, Busan, 48513, Republic of Korea
| | - Hyun Wook Kang
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
- Major of Biomedical Engineering, Division of Smart Healthcare, College of Information Technology and Convergence and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan, 48513, Republic of Korea
| | - Jae-Young Je
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Major of Human Bioconvergence, School of Smart Healthcare, Pukyong National University, Busan, 48513, Republic of Korea
| | - Zhong-Ji Qian
- College of Food Science and Technology, School of Chemistry and Environment, Guangdong Ocean University, Zhanjiang, 524088, China
- Shenzhen Institute of Guangdong Ocean University, Guangdong Ocean University, Shenzhen, 518108, China
- Southern Marine Science and Engineering Guangdong Laboratory, Zhanjiang, 524025, China
| | - Namwon Kim
- Ingram School of Engineering, Texas State University, San Marcos, TX, 78666, USA
- Materials Science, Engineering, and Commercialization (MSEC), Texas State University, San Marcos, TX, 78666, USA
| | - Won-Kyo Jung
- Research Center for Marine Integrated Bionics Technology, Pukyong National University, Busan, 48513, Republic of Korea
- Marine Integrated Biomedical Technology Center, The National Key Research Institutes in Universities, Pukyong National University, Busan, 48513, Republic of Korea
- Major of Biomedical Engineering, Division of Smart Healthcare, College of Information Technology and Convergence and New-senior Healthcare Innovation Center (BK21 Plus), Pukyong National University, Busan, 48513, Republic of Korea
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Gard C, Cassagnes C, Muller S, Navarro C, Jahier B. Evaluation of a preservative-free, cross-linked sodium hyaluronate-based solution, Lacri + ®, in dogs with dry eye: a pilot trial. Ir Vet J 2023; 76:30. [PMID: 37798810 PMCID: PMC10557273 DOI: 10.1186/s13620-023-00259-4] [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] [Received: 11/28/2022] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The purpose of this pilot trial was to evaluate the efficacy and benefits of a preservative-free cross-linked sodium hyaluronate solution (Lacri +®, MP Labo, France) in 19 privately-owned dogs with dry eye. The animals were administered 2 drops of the tested product in each affected eye, twice a day (BID) for 30 days. Improvement in the global ocular clinical score (sum of the individual scores for conjunctivitis, ocular discharge, eye irritation, and corneal opacity/pigmentation/vascularization, each rated from 0 to 3) was defined as the primary outcome. Besides an improvement in each individual ocular score, tear film quality (Tear Break Up Time, TBUT), dogs' and owners' quality of life (QoL), as well as an increase in tear production (Schirmer Tear Test-1, STT1), were considered secondary outcomes. These criteria were assessed on D0, D0 + 15 days, and D0 + 30 days. Finally, a qualitative evaluation of clinical improvement was requested from the owners on D0 + 2, + 15 & + 30 days and from the investigators during the follow-up. RESULTS The global clinical ocular score as well as the individual conjunctival and irritation scores improved significantly (p < 0.0001) during the pilot trial. The average reduction of the global score reached 30% on D0 + 15 days and 55% on D0 + 30 days compared to D0. Ocular discharge was significantly lower (p = 0.0002) on D0 + 30 days compared to baseline; however corneal opacity did not show any significant changes from D0 to the end of the follow-up period. The quantitative tear production was increased at D + 30 (p < 0.0001), with a significant improvement as soon as 2 weeks in, with around 30% and 60% of dogs presenting an STT1 value above 10 on D0 + 15 days and on D0 + 30 days, respectively. The QoL score was significantly improved compared to D0 at all time points (p < 0.0001). After 2 days of treatment, 39% of the owners rated the efficacy as "good". The efficacy of the tested product was considered "Good" or "Very Good" by the investigators in 78% and 93% of the cases, on D0 + 15 days and D0 + 30 days, respectively. The tolerance of this preservative-free formulation was good, with only rare and transient minor local reactions, realated to administration rather than the product itself.
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Affiliation(s)
- Carole Gard
- MP Labo, 45 Boulevard Marcel Pagnol, 06130, Grasse, France
| | - Charles Cassagnes
- Clinique VetRiviera, 448 Boulevard du Mercantour, 06200, Nice, France
| | - Sarah Muller
- MP Labo, 45 Boulevard Marcel Pagnol, 06130, Grasse, France
| | | | - Bruno Jahier
- MP Labo, 45 Boulevard Marcel Pagnol, 06130, Grasse, France
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Ruan H, Aulova A, Ghai V, Pandit S, Lovmar M, Mijakovic I, Kádár R. Polysaccharide-based antibacterial coating technologies. Acta Biomater 2023; 168:42-77. [PMID: 37481193 DOI: 10.1016/j.actbio.2023.07.023] [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: 03/28/2023] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023]
Abstract
To tackle antimicrobial resistance, a global threat identified by the United Nations, is a common cause of healthcare-associated infections (HAI) and is responsible for significant costs on healthcare systems, a substantial amount of research has been devoted to developing polysaccharide-based strategies that prevent bacterial attachment and biofilm formation on surfaces. Polysaccharides are essential building blocks for life and an abundant renewable resource that have attracted much attention due to their intrinsic remarkable biological potential antibacterial activities. If converted into efficient antibacterial coatings that could be applied to a broad range of surfaces and applications, polysaccharide-based coatings could have a significant potential global impact. However, the ultimate success of polysaccharide-based antibacterial materials will be determined by their potential for use in manufacturing processes that are scalable, versatile, and affordable. Therefore, in this review we focus on recent advances in polysaccharide-based antibacterial coatings from the perspective of fabrication methods. We first provide an overview of strategies for designing polysaccharide-based antimicrobial formulations and methods to assess the antibacterial properties of coatings. Recent advances on manufacturing polysaccharide-based coatings using some of the most common polysaccharides and fabrication methods are then detailed, followed by a critical comparative overview of associated challenges and opportunities for future developments. STATEMENT OF SIGNIFICANCE: Our review presents a timely perspective by being the first review in the field to focus on advances on polysaccharide-based antibacterial coatings from the perspective of fabrication methods along with an overview of strategies for designing polysaccharide-based antimicrobial formulations, methods to assess the antibacterial properties of coatings as well as a critical comparative overview of associated challenges and opportunities for future developments. Meanwhile this work is specifically targeted at an audience focused on featuring critical information and guidelines for developing polysaccharide-based coatings. Including such a complementary work in the journal could lead to further developments on polysaccharide antibacterial applications.
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Affiliation(s)
- Hengzhi Ruan
- Department of Industrial and Materials Science, Chalmers University of Technology, 412 96 Göteborg, Sweden
| | - Alexandra Aulova
- Department of Industrial and Materials Science, Chalmers University of Technology, 412 96 Göteborg, Sweden
| | - Viney Ghai
- Department of Industrial and Materials Science, Chalmers University of Technology, 412 96 Göteborg, Sweden
| | - Santosh Pandit
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden
| | - Martin Lovmar
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; Wellspect Healthcare AB, 431 21 Mölndal, Sweden
| | - Ivan Mijakovic
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 96 Göteborg, Sweden; The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, 2800 Kongens Lyngby, Denmark.
| | - Roland Kádár
- Department of Industrial and Materials Science, Chalmers University of Technology, 412 96 Göteborg, Sweden; Wallenberg Wood Science Centre (WWSC), Chalmers University of Technology, 412 96 Göteborg, Sweden.
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Guarise C, Acquasaliente L, Pasut G, Pavan M, Soato M, Garofolin G, Beninatto R, Giacomel E, Sartori E, Galesso D. The role of high molecular weight hyaluronic acid in mucoadhesion on an ocular surface model. J Mech Behav Biomed Mater 2023; 143:105908. [PMID: 37209594 DOI: 10.1016/j.jmbbm.2023.105908] [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: 03/24/2023] [Revised: 05/08/2023] [Accepted: 05/14/2023] [Indexed: 05/22/2023]
Abstract
Hyaluronic acid (HA) is frequently formulated in eye drops to improve the stability of the tear film by hydration and lubrication. Mucoadhesion is related to the ocular residence time and therefore to the effectiveness of the eye drops. The ocular residence time of the HA formulation is correlated with the ability of HA to create specific strong interactions in the ocular surface with the mucus layer, mainly composed of a mixture of secreted mucins (MUC; gel forming MUC5AC and MUC2) and shed membrane-bound soluble mucins (MUC1, MUC4, and MUC16). Dry eye disease (DED) is a multifactorial pathology of the preocular tear film with possible damage to the ocular surface classified in two types: (1) aqueous-deficient dry eye and (2) evaporative dry eye, caused by a decrease in goblet cell density that reduces MUC expression and/or by meibomian gland dysfunction, that results in a drop in the lipidic fraction of the tear film. In this work, the binding affinity between HA and MUC2 has been evaluated with three complementary approaches because the secreted MUCs play a pivotal role in the viscoelastic properties of the tear film: 1. Rheological analysis, measuring the mucoadhesive index and the complex viscosity in relation to MM (Molecular Mass) and concentration; 2. Fluorescence analysis, using a fluorescent hydrophobic probe, to investigate the conformational change of MUC2 during the interaction with the HA polymer; 3. Surface plasmon resonance analysis, used to measure the affinity between MUC2 (immobilized on the surface of a sensor chip) and the HA polymers that flowed on it at the molecular level. For all these tests, the mucoadhesive performance of the natural HA linearly increases with the MM, whereas cross-linked HA and other emollient and gelling agents (formulated in artificial tears) do not show the same mucoadhesive properties (with the exception of xanthan gum). The mucoadhesive performance of high MM HA has also been confirmed in conditions that simulate the pathological condition of the tear film during DED by decreasing the MUC2 or oleic acid concentration. Physico-chemical analysis of a series of marketed artificial tears confirms the linear correlation between the MM of the HA used in the products and the mucoadhesive index measured on the ocular surface model.
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Affiliation(s)
- Cristian Guarise
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy.
| | - Laura Acquasaliente
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Gianfranco Pasut
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Italy
| | - Mauro Pavan
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Matteo Soato
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Giacomo Garofolin
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Riccardo Beninatto
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Elena Giacomel
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Eleonora Sartori
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
| | - Devis Galesso
- Fidia Farmaceutici S.p.A., via Ponte della Fabbrica 3/A, 35031, Abano Terme, PD, Italy
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Banerjee R, Kumar KJ, Kennedy JF. Structure and drug delivery relationship of acidic polysaccharides: A review. Int J Biol Macromol 2023:125092. [PMID: 37247706 DOI: 10.1016/j.ijbiomac.2023.125092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
Scientists from across the world are being inspired by recent development in polysaccharides and their use in medical administration. Due to their extraordinary physical, chemical, and biological characteristics, polysaccharides are excellent materials for use in medicine. Acidic polysaccharides, which include Pectin, Xanthan gum, Carrageenan, Alginate, and Glycosaminoglycan, are natural polymers with carboxyl groups that are being researched for their potential as drug delivery systems. Most publications do not discuss how the different polysaccharides interact structurally in terms of drug delivery, which limits the scope of their use. The purpose of this review is to inform readers about the structural activity correlations between acidic polysaccharides, their different modification process and effects of combination of various acidic polysaccharides which have been used in drug delivery systems and expanding their potential applications, and bringing new perspectives to the fore.
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Affiliation(s)
- Riya Banerjee
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India
| | - K Jayaram Kumar
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835215, Jharkhand, India.
| | - John F Kennedy
- Chembiotech Laboratories, Institute of Research and Development, Tenbury Wells, WR15 8FF, UK
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10
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Priani D, Muhiddin HS, Sirajuddin J, Eka HB, Bahar B, Bukhari A. Effectiveness of Topical Cyclosporin-A 0.1% Compared to Combined Topical Cyclosporin-A 0.1% with Topical Sodium Hyaluronate on Interleukin-6 Levels in the Tears of Patients with Dry Eye Disease. Vision (Basel) 2023; 7:vision7020031. [PMID: 37092464 PMCID: PMC10123752 DOI: 10.3390/vision7020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction: Pro-inflammatory cytokines are important contributors to dry eye disease (DED). The cytokine interleukin (IL)-6 has become a therapeutic target in several DED drug studies. This randomized controlled trial aimed to determine the effectiveness of topical cyclosporin-A 0.1% compared to the combination of topical cyclosporin-A 0.1% and sodium hyaluronate in reducing tear IL-6 levels in DED patients. Methods: The participants were 20 patients, each with two eyes, who had moderate-to-severe DED. Before and after treatment, the clinical degree of DED was examined in each group, using ocular surface disease index (OSDI) scores, tear break-up time (TBUT), fluorescent tests, and Schirmer I tests. In addition, tear samples were taken to examine IL-6 levels through the ELISA method. The results were analyzed using the t-test, Wilcoxon test, and Mann–Whitney test. The correlation between tear IL-6 levels and the severity of DED was analyzed using the Spearman correlation test. Results: The study showed a significantly lower tear IL-6 level, OSDI score, and degree of ocular staining after either topical cyclosporin-A 0.1% or a combination of topical cyclosporin-A 0.1% and sodium hyaluronate (all values p < 0.05). Conclusions: The combination therapy was superior in reducing tear IL-6 levels. In addition, a correlation existed between tear IL-6 levels and the severity of DED based on the TBUT, although it was weak and not statistically significant.
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Affiliation(s)
- Desti Priani
- Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
| | - Habibah S. Muhiddin
- Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
| | - Junaedi Sirajuddin
- Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
| | - Hasnah B. Eka
- Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
- Hasanuddin University Hospital, Makassar 90245, Indonesia
| | - Burhanuddin Bahar
- Department of Public Health Medicine, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
| | - Agussalim Bukhari
- Department of Clinical Nutrition, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
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11
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Weng J, Fink MK, Sharma A. A Critical Appraisal of the Physicochemical Properties and Biological Effects of Artificial Tear Ingredients and Formulations. Int J Mol Sci 2023; 24:ijms24032758. [PMID: 36769079 PMCID: PMC9917348 DOI: 10.3390/ijms24032758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Dry eye disease is among the most prevalent diseases affecting the ocular surface. Artificial tears remain the cornerstone therapy for its management. There are currently a wide variety of marketed artificial tears available to choose from. These artificial tears differ significantly in their composition and formulation. This article reviews the physicochemical and biological properties of artificial tear components and how these characteristics determine their use and efficacy in the management of dry eye. Furthermore, this article also discusses the various formulations of artificial tears such as macro and nanoemulsion and the type of preservatives present in them.
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Affiliation(s)
- Judy Weng
- Chapman University School of Pharmacy, Chapman University, Irvine, CA 92618, USA
| | - Michael K. Fink
- Department of Pathology, University of Colorado Anschutz Medical Campus, Denver, CO 80045, USA
| | - Ajay Sharma
- Chapman University School of Pharmacy, Chapman University, Irvine, CA 92618, USA
- Correspondence: ; Tel.: +1-714-516-5498
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12
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Semp DA, Beeson D, Sheppard AL, Dutta D, Wolffsohn JS. Artificial Tears: A Systematic Review. CLINICAL OPTOMETRY 2023; 15:9-27. [PMID: 36647552 PMCID: PMC9840372 DOI: 10.2147/opto.s350185] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Artificial tears are the mainstay of dry eye disease management, but also have a role in corneal abrasion and wound healing, pain and inflammation management, conjunctivitis, keratitis, contact lens rewetting and removal, and foreign body removal. A systematic review of randomized controlled trials (PROSPERO registration CRD42022369619) comparing the efficacy of artificial tears in patients with dry eye to inform prescribing choices using Web of Science, PubMed and Medline databases identified 64 relevant articles. There is good evidence that artificial tears improve symptoms of dry eye disease within a month of regular use, applied about four times a day, but signs generally take several months to improve. Not all patients with dry eye disease benefit from artificial tears, so if there is no benefit over a month, alternative management should be considered. Combination formulations are more effective than single active ingredient artificial tears. Artificial tears containing polyethylene glycol are more effective than those containing carboxymethylcellulose/carmellose sodium and hydroxypropyl methylcellulose. Those classified as having evaporative dry eye disease, benefit from artificial tears with liposomes, especially of higher concentration. The data available is limited by the definition of dry eye disease applied in published studies being variable, as well as the disease severity examined and compliance with artificial tears being rarely quantified.
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Affiliation(s)
- David A Semp
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Danielle Beeson
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Amy L Sheppard
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Debarun Dutta
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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13
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The Effect of High Molecular Weight Hyaluronic Acid and Latanoprost Eyedrops on Tear Functions and Ocular Surface Status in C57/BL6 Mice. J Clin Med 2023; 12:jcm12020544. [PMID: 36675473 PMCID: PMC9861300 DOI: 10.3390/jcm12020544] [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: 10/19/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
Anti-glaucoma eye drop treatment often induces ocular surface problems, including dry eyes, and may be associated with poor medication compliance. This study aimed to investigate the effects of a novel high molecular weight hyaluronic acid and Latanoprost eye drop on intraocular pressure, as well as the tear function and ocular surface alterations in wild type mice, comparing the results with the mice receiving commercially available Latanoprost eye drops and mice receiving no treatment. The mice were divided into three groups: Group I, control group (no treatment group); Group II, commercial Latanoprost eye drop (LP); and Group III, Comfort Shield (CS) + Latanoprost (LP) eye drop (CS + LP). The CS + LP eye drop group had an IOP lowering effect comparable to the commercial LP eye drop group. The mice receiving LP eye drops had significantly worse corneal staining scores, lesser goblet cell density(GCD), higher numbers of CD45+ staining cells, significantly higher tear film concentrations of IL-6 and IL1-b, and a significantly lower expression of corneal ZO-1 mRNA compared with the mice receiving CS + LP 7 days after eye drop instillations (p < 0.05). In conclusion, the new CS + LP formulation appeared to induce less inflammation, less corneal vital staining, and a better barrier status with an IOP lowering effect comparable to the commercial LP eye drops.
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14
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Burgalassi S, Fragai M, Francesconi O, Cerofolini L, Monti D, Leone G, Lamponi S, Greco G, Magnani A, Nativi C. Functionalized Hyaluronic Acid for “ In Situ” Matrix Metalloproteinase Inhibition: A Bioactive Material to Treat the Dry Eye Sydrome. ACS Macro Lett 2022; 11:1190-1194. [PMID: 36103254 PMCID: PMC9583614 DOI: 10.1021/acsmacrolett.2c00455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
Hyaluronic acid (HA)
is a naturally occurring polysaccharide
with
many molecular functions, including maintaining the structure and
physiology of the tissues, tissue remodeling, and inflammation. HA
is found naturally in physiological tear fluid, possesses excellent
mucus-layer-adhesive properties, and is successfully employed in the
treatment of dry eye syndrome (DES). However, HA has as major drawback:
its rapid in vivo degradation by hyaluronidase. We
report on a unique material, namely, HA-3, obtained by
the functionalization of HA with the metalloproteinase inhibitor 3 (MMPI). This material is characterized by an increased resistance
to hyaluronidase degradation, associated with MMP inhibition properties.
The ability of HA-3 to prevent dehydration of human corneal
epithelial cells in vitro and in vivo may accelerate the development of more efficient DES treatment and
broaden the application of HA in human diseases.
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Affiliation(s)
- Susi Burgalassi
- Department of Pharmacy, University of Pisa, via Bonanno 6, 56126 Pisa, Italy
| | - Marco Fragai
- Department of Chemistry (DICUS), University of Florence, Sesto Fiorentino 50019, Italy
- CeRM, via Sacconi 6, Sesto Fiorentino 50019, Italy
| | - Oscar Francesconi
- Department of Chemistry (DICUS), University of Florence, Sesto Fiorentino 50019, Italy
| | - Linda Cerofolini
- CIRMMP, University of Florence, via Sacconi, 6 Sesto Fiorentino 50019, Italy
| | - Daniela Monti
- Department of Pharmacy, University of Pisa, via Bonanno 6, 56126 Pisa, Italy
| | - Gemma Leone
- Department of Biotechnology, Chemistry and Pharmacy, via A. Moro, 2 53100 Siena, Italy
| | - Stefania Lamponi
- Department of Biotechnology, Chemistry and Pharmacy, via A. Moro, 2 53100 Siena, Italy
| | - Giuseppe Greco
- Rugani Hospital, SR222 Chiantigiana, 53035 Colombaio (Siena), Italy
| | - Agnese Magnani
- Department of Biotechnology, Chemistry and Pharmacy, via A. Moro, 2 53100 Siena, Italy
- INSTM, via G. Giusti,
9, 50121 Firenze, Italy
| | - Cristina Nativi
- Department of Chemistry (DICUS), University of Florence, Sesto Fiorentino 50019, Italy
- INSTM, via G. Giusti,
9, 50121 Firenze, Italy
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15
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Buckley C, Murphy EJ, Montgomery TR, Major I. Hyaluronic Acid: A Review of the Drug Delivery Capabilities of This Naturally Occurring Polysaccharide. Polymers (Basel) 2022; 14:polym14173442. [PMID: 36080515 PMCID: PMC9460006 DOI: 10.3390/polym14173442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
The inclusion of physiologically active molecules into a naturally occurring polymer matrix can improve the degradation, absorption, and release profile of the drug, thus boosting the therapeutic impact and potentially even reducing the frequency of administration. The human body produces significant amounts of polysaccharide hyaluronic acid, which boasts exceptional biocompatibility, biodegradability, and one-of-a-kind physicochemical features. In this review, we will examine the clinical trials currently utilizing hyaluronic acid and address the bright future of this versatile polymer, as well as summarize the numerous applications of hyaluronic acid in drug delivery and immunomodulation.
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Affiliation(s)
- Ciara Buckley
- PRISM Research Institute, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Biosciences Research Institute, Technological University of the Shannon, V94 EC5T Limerick, Ireland
| | - Emma J. Murphy
- PRISM Research Institute, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- LIFE Research Institute, Technological University of the Shannon, V94 EC5T Limerick, Ireland
| | - Therese R. Montgomery
- School of Science and Computing, Atlantic Technological University, H91 T8NW Galway, Ireland
| | - Ian Major
- PRISM Research Institute, Technological University of the Shannon, N37 HD68 Athlone, Ireland
- Correspondence:
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16
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Ayyala RS, S Suner S, Bhethanabotla VR, Sahiner N. Fungal Keratitis Treatment Using Drug-Loaded Hyaluronic Acid Microgels. ACS APPLIED BIO MATERIALS 2022; 5:3806-3815. [PMID: 35862018 DOI: 10.1021/acsabm.2c00362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Antifungal drug-loaded hyaluronic acid (HA) microgels using conjugation and encapsulation drug-loading techniques were utilized in the treatment of fungal keratitis. Natamycin (NAT) and amphotericin B (AMB) drugs were chemically linked to HA microgels by employing a chemical coupling agent to obtain conjugated (C-) HA:NAT and HA:AMB microgels. Also, these drugs were loaded into the HA microgel network during HA microgel preparation to attain encapsulated (E-) HA:NAT and HA:AMB microgels. The conjugation of drug molecules was confirmed by FT-IR spectra of bare and drug-loaded HA microgels. It was determined that the AMB loading amount was about 4-fold higher for E-HA:AMB in comparison to C-HA:AMB microgels. Furthermore, the antifungal activity of drug conjugated and encapsulated HA:NAT and HA:AMB microgels was tested on Fusarium sp. and compared with the effect of bare drug molecules as control for up to 15 days of incubation time by means of the disc diffusion technique. The antifungal activity of 200 μL at 20 mg/mL concentration of C-HA:NAT and C-HA:AMB microgels was not found to effectively inhibit Fusarium sp. growth after 1 day of incubation, whereas the same concentration of E-HA:NAT and E-HA:AMB microgels totally killed Fusarium sp. for up to 15 days. These E-HA:NAT and E-HA:AMB microgels show no cytotoxicity on the L929 fibroblast cells up to 1000 μg/mL concentration, whereas the free drug molecules destroy the cells even at 100 μg/mL concentration.
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Affiliation(s)
- Ramesh S Ayyala
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida Eye Institute, 12901 Bruce B Down Blvd., MDC 21, Tampa, Florida 33612, United States
| | - Selin S Suner
- Department of Chemistry, Faculty of Sciences & Arts, and Nanoscience and Technology Research and Application Center (NANORAC), Canakkale Onsekiz Mart University Terzioglu Campus, Canakkale 17100, Turkey
| | - Venkat R Bhethanabotla
- Department of Chemical & Biomedical Engineering, Materials Science and Engineering Program, University of South Florida, Tampa, Florida 33620, United States
| | - Nurettin Sahiner
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida Eye Institute, 12901 Bruce B Down Blvd., MDC 21, Tampa, Florida 33612, United States.,Department of Chemistry, Faculty of Sciences & Arts, and Nanoscience and Technology Research and Application Center (NANORAC), Canakkale Onsekiz Mart University Terzioglu Campus, Canakkale 17100, Turkey.,Department of Chemical & Biomedical Engineering, Materials Science and Engineering Program, University of South Florida, Tampa, Florida 33620, United States
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17
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Casey-Power S, Ryan R, Behl G, McLoughlin P, Byrne ME, Fitzhenry L. Hyaluronic Acid: Its Versatile Use in Ocular Drug Delivery with a Specific Focus on Hyaluronic Acid-Based Polyelectrolyte Complexes. Pharmaceutics 2022; 14:pharmaceutics14071479. [PMID: 35890371 PMCID: PMC9323903 DOI: 10.3390/pharmaceutics14071479] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
Extensive research is currently being conducted into novel ocular drug delivery systems (ODDS) that are capable of surpassing the limitations associated with conventional intraocular anterior and posterior segment treatments. Nanoformulations, including those synthesised from the natural, hydrophilic glycosaminoglycan, hyaluronic acid (HA), have gained significant traction due to their enhanced intraocular permeation, longer retention times, high physiological stability, inherent biocompatibility, and biodegradability. However, conventional nanoformulation preparation methods often require large volumes of organic solvent, chemical cross-linkers, and surfactants, which can pose significant toxicity risks. We present a comprehensive, critical review of the use of HA in the field of ophthalmology and ocular drug delivery, with a discussion of the physicochemical and biological properties of HA that render it a suitable excipient for drug delivery to both the anterior and posterior segments of the eye. The pivotal focus of this review is a discussion of the formation of HA-based nanoparticles via polyelectrolyte complexation, a mild method of preparation driven primarily by electrostatic interaction between opposing polyelectrolytes. To the best of our knowledge, despite the growing number of publications centred around the development of HA-based polyelectrolyte complexes (HA-PECs) for ocular drug delivery, no review articles have been published in this area. This review aims to bridge the identified gap in the literature by (1) reviewing recent advances in the area of HA-PECs for anterior and posterior ODD, (2) describing the mechanism and thermodynamics of polyelectrolyte complexation, and (3) critically evaluating the intrinsic and extrinsic formulation parameters that must be considered when designing HA-PECs for ocular application.
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Affiliation(s)
- Saoirse Casey-Power
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, Waterford Campus, South East Technological University, X91 K0EK Waterford, Ireland; (R.R.); (G.B.); (P.M.); (L.F.)
- Correspondence:
| | - Richie Ryan
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, Waterford Campus, South East Technological University, X91 K0EK Waterford, Ireland; (R.R.); (G.B.); (P.M.); (L.F.)
| | - Gautam Behl
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, Waterford Campus, South East Technological University, X91 K0EK Waterford, Ireland; (R.R.); (G.B.); (P.M.); (L.F.)
| | - Peter McLoughlin
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, Waterford Campus, South East Technological University, X91 K0EK Waterford, Ireland; (R.R.); (G.B.); (P.M.); (L.F.)
| | - Mark E. Byrne
- Biomimetic & Biohybrid Materials, Biomedical Devices & Drug Delivery Laboratories, Department of Biomedical Engineering, Henry M. Rowan College of Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028, USA;
- Department of Chemical Engineering, Henry M. Rowan College of Engineering, Rowan University, 201 Mullica Hill Road, Glassboro, NJ 08028, USA
| | - Laurence Fitzhenry
- Ocular Therapeutics Research Group, Pharmaceutical and Molecular Biotechnology Research Centre, Waterford Campus, South East Technological University, X91 K0EK Waterford, Ireland; (R.R.); (G.B.); (P.M.); (L.F.)
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18
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Ilochonwu BC, Mihajlovic M, Maas-Bakker RF, Rousou C, Tang M, Chen M, Hennink WE, Vermonden T. Hyaluronic Acid-PEG-Based Diels-Alder In Situ Forming Hydrogels for Sustained Intraocular Delivery of Bevacizumab. Biomacromolecules 2022; 23:2914-2929. [PMID: 35735135 PMCID: PMC9277588 DOI: 10.1021/acs.biomac.2c00383] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Retinal diseases are the leading cause of visual impairment worldwide. The effectiveness of antibodies for the treatment of retinal diseases has been demonstrated. Despite the clinical success, achieving sufficiently high concentrations of these protein therapeutics at the target tissue for an extended period is challenging. Patients suffering from macular degeneration often receive injections once per month. Therefore, there is a growing need for suitable systems that can help reduce the number of injections and adverse effects while improving patient complacency. This study systematically characterized degradable "in situ" forming hydrogels that can be easily injected into the vitreous cavity using a small needle (29G). After intravitreal injection, the formulation is designed to undergo a sol-gel phase transition at the administration site to obtain an intraocular depot system for long-term sustained release of bioactives. A Diels-Alder reaction was exploited to crosslink hyaluronic acid-bearing furan groups (HAFU) with 4 arm-PEG10K-maleimide (4APM), yielding stable hydrogels. Here, a systematic investigation of the effects of polymer composition and the ratio between functional groups on the physicochemical properties of hydrogels was performed to select the most suitable formulation for protein delivery. Rheological analysis showed rapid hydrogel formation, with the fastest gel formation within 5 min after mixing the hydrogel precursors. In this study, the mechanical properties of an ex vivo intravitreally formed hydrogel were investigated and compared to the in vitro fabricated samples. Swelling and degradation studies showed that the hydrogels are biodegradable by the retro-Diels-Alder reaction under physiological conditions. The 4APM-HAFU (ratio 1:5) hydrogel formulation showed sustained release of bevacizumab > 400 days by a combination of diffusion, swelling, and degradation. A bioassay showed that the released bevacizumab remained bioactive. The hydrogel platform described in this study offers high potential for the sustained release of therapeutic antibodies to treat ocular diseases.
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Affiliation(s)
- Blessing C Ilochonwu
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
| | - Marko Mihajlovic
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
| | - Roel F Maas-Bakker
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
| | - Charis Rousou
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
| | - Miao Tang
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast BT9 7BL, U.K
| | - Mei Chen
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Queen's University, Belfast BT9 7BL, U.K
| | - Wim E Hennink
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
| | - Tina Vermonden
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO box 80082, 3508 TB Utrecht, The Netherlands
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19
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Recchioni A, Mocciardini E, Ponzini E, Tavazzi S. Viscoelastic properties of the human tear film. Exp Eye Res 2022; 219:109083. [PMID: 35460666 DOI: 10.1016/j.exer.2022.109083] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/25/2022] [Accepted: 04/18/2022] [Indexed: 12/21/2022]
Abstract
When considering eye blinking from a tribological perspective, tear viscosity is expected to play a fundamental role. The application of rheological techniques to describe the tear film dates back to the late 1980s, but there has been a continuous need of reappraisal due to new findings in tear film biochemistry and to the development of new methods of physico-chemical characterization. This review provides an overview on tear rheological behavior by analyzing the peer-reviewed literature on this topic. Specifically, examples of in-vitro and in-vivo viscosity measurements are detailed, highlighting experimental criticalities and the need of a standard convention for rheological techniques to compare data across different studies, of analyses on tears of single individuals even within the limits of the low volume available, and of a further development of in-vivo techniques. Then, the controversial role of specific tear components on viscosity is discussed, together with the alterations associated to dry eye disease and contact lens wear. Finally, an updated focus is reported on the viscosity of artificial tears formulations.
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Affiliation(s)
- Alberto Recchioni
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK; Optometry & Vision Sciences Group, School of Life & Health Sciences, Aston University, Birmingham, UK; Birmingham and Midland Eye Centre, Birmingham, UK
| | - Emanuele Mocciardini
- University of Milano Bicocca, Corso di laurea in Ottica e Optometria, via R. Cozzi 55, I-20125, Milan, Italy
| | - Erika Ponzini
- University of Milano Bicocca, Materials Science Department, via R. Cozzi 55, I-20125, Milan, Italy; University of Milano Bicocca, COMiB research center, via R. Cozzi 55, I-20125, Milan, Italy.
| | - Silvia Tavazzi
- University of Milano Bicocca, Materials Science Department, via R. Cozzi 55, I-20125, Milan, Italy; University of Milano Bicocca, COMiB research center, via R. Cozzi 55, I-20125, Milan, Italy
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20
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Labetoulle M, Benitez-del-Castillo JM, Barabino S, Herrero Vanrell R, Daull P, Garrigue JS, Rolando M. Artificial Tears: Biological Role of Their Ingredients in the Management of Dry Eye Disease. Int J Mol Sci 2022; 23:ijms23052434. [PMID: 35269576 PMCID: PMC8910031 DOI: 10.3390/ijms23052434] [Citation(s) in RCA: 35] [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: 11/23/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 12/21/2022] Open
Abstract
Dry eye disease (DED) is the most common ocular surface disease, characterized by insufficient production and/or instability of the tear film. Tear substitutes are usually the first line of treatment for patients with DED. Despite the large variety of tear substitutes available on the market, few studies have been performed to compare their performance. There is a need to better understand the specific mechanical and pharmacological roles of each ingredient composing the different formulations. In this review, we describe the main categories of ingredients composing tear substitutes (e.g., viscosity-enhancing agents, electrolytes, osmo-protectants, antioxidants, lipids, surfactants and preservatives) as well as their effects on the ocular surface, and we provide insight into how certain components of tear substitutes may promote corneal wound healing, and/or counteract inflammation. Based on these considerations, we propose an approach to select the most appropriate tear substitute formulations according to the predominant etiological causes of DED.
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Affiliation(s)
- Marc Labetoulle
- Service d’Ophtalmologie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, 94270 Le Kremlin Bicêtre, France;
| | | | - Stefano Barabino
- Centro Superficie Oculare e Occhio Secco, ASST Fatebenefratelli-Sacco, Ospedale L. Sacco, Università di Milano, 20157 Milan, Italy;
| | - Rocio Herrero Vanrell
- Research Group (UCM 920415), Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal), Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain;
| | - Philippe Daull
- Ophthalmic Innovation Center, Santen SAS, 91058 Evry, France;
| | | | - Maurizio Rolando
- Ocular Surface Centre, ISPRE (Instituto di Medicina Oftalmica) Ophthalmic, 16129 Genoa, Italy;
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Abdallah MM, Leonardo IC, Krstić L, Enríquez-de-Salamanca A, Diebold Y, González-García MJ, Gaspar FB, Matias AA, Bronze MR, Fernández N. Potential Ophthalmological Application of Extracts Obtained from Tuna Vitreous Humor Using Lactic Acid-Based Deep Eutectic Systems. Foods 2022; 11:foods11030342. [PMID: 35159492 PMCID: PMC8834193 DOI: 10.3390/foods11030342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 12/25/2022] Open
Abstract
A green technique was developed to extract hyaluronic acid (HA) from tuna vitreous humor (TVH) for its potential application in managing dry eye disease. Deep eutectic solvents (DES) were used to extract HA and were synthesized using natural compounds (lactic acid, fructose, and urea). The DES, the soluble fraction of TVH in DES (SF), and the precipitated extracts (PE) were evaluated for their potential use in dry eye disease treatment. In vitro experiments on human corneal epithelial cell lines and the effect on dry eye-associated microorganisms were performed. The influence of the samples on the HCE viability, their intracellular reactive oxygen species (ROS) scavenging capacity, inflammatory response, and antimicrobial properties were studied. According to the results, all samples displayed an antioxidant effect, which was significantly higher for PE in comparison to SF. Most of the tested samples did not induce an inflammatory response in cells, which confirmed the safety in ophthalmic formulations. In addition, the DES and SF proved to be efficient against the studied bacterial strains, while PE did not show an antimicrobial effect. Hence, both DES and SF at defined concentrations could be used as potential compounds in dry eye disease management.
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Affiliation(s)
- Maha M. Abdallah
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Avenida da República, Estação Agronómica Nacional, 2780-157 Oeiras, Portugal; (M.M.A.); (I.C.L.); (F.B.G.); (M.R.B.)
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
| | - Inês C. Leonardo
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Avenida da República, Estação Agronómica Nacional, 2780-157 Oeiras, Portugal; (M.M.A.); (I.C.L.); (F.B.G.); (M.R.B.)
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
| | - Luna Krstić
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, 47011 Valladolid, Spain; (L.K.); (A.E.-d.-S.); (Y.D.); (M.J.G.-G.)
| | - Amalia Enríquez-de-Salamanca
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, 47011 Valladolid, Spain; (L.K.); (A.E.-d.-S.); (Y.D.); (M.J.G.-G.)
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Yolanda Diebold
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, 47011 Valladolid, Spain; (L.K.); (A.E.-d.-S.); (Y.D.); (M.J.G.-G.)
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - María J. González-García
- Institute of Applied Ophthalmobiology (IOBA), University of Valladolid, 47011 Valladolid, Spain; (L.K.); (A.E.-d.-S.); (Y.D.); (M.J.G.-G.)
- Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Frédéric B. Gaspar
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Avenida da República, Estação Agronómica Nacional, 2780-157 Oeiras, Portugal; (M.M.A.); (I.C.L.); (F.B.G.); (M.R.B.)
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
| | - Ana A. Matias
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
| | - Maria Rosário Bronze
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Avenida da República, Estação Agronómica Nacional, 2780-157 Oeiras, Portugal; (M.M.A.); (I.C.L.); (F.B.G.); (M.R.B.)
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
- Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Naiara Fernández
- Instituto de Biologia Experimental e Tecnológica, Avenida da República, Quinta-do-Marquês, Estação Agronómica Nacional, Apartado 12, 2781-901 Oeiras, Portugal;
- Correspondence:
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22
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Jun JH, Bang SP, Park HS, Yoon D, Ahn JY, Kim SJ, Kim HK. A randomized multicenter clinical evaluation of sequential application of 0.3% and 0.15% hyaluronic acid for treatment of dry eye. Jpn J Ophthalmol 2021; 66:58-67. [PMID: 34843023 DOI: 10.1007/s10384-021-00885-x] [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] [Received: 01/14/2021] [Accepted: 09/17/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE We report the clinical efficacy of sequential applications of 0.3% and 0.15% unpreserved hyaluronic acid (HA) for the treatment of dry eye disease (DED). STUDY DESIGN Randomized clinical trial. METHODS Patients over 19 years of age with DED level 2 or higher, corneal fluorescein staining (CFS) score > 1, and tear break-up time (TBUT) < 10 s were included. Seventy-six patients were randomly assigned to the 0.15% HA group, 0.3% HA group, or combination group. Each group applied two drops of 0.15% or 0.3% HA, or a single drop of both 0.3% and 0.15% HA. Patients were evaluated using the ocular surface disease index (OSDI), CFS and conjunctival fluorescein stain score, TBUT, and blurring/discomfort after application at baseline, 4 weeks, and 8 weeks. RESULTS The combination group had the greatest improvement in CFS score from baseline to 8 weeks, compared with the 0.15% and 0.3% HA group (p < 0.001). The combined CFS-OSDI responder rates of the combination group (CFS score = 0 and OSDI ≥ 50% improvement at 8 weeks) were significantly higher than those of the 0.15% and 0.3% groups (p = 0.037). At 4 and 8 weeks, blurring after application in both the 0.3% and combination groups was significantly higher than in the 0.15% group, despite no difference between the 0.3% and combination groups. There were no differences in CFS and conjunctival staining score, TBUT, or OSDI within the three groups at baseline, 4 weeks, and 8 weeks. CONCLUSIONS Sequential application of 0.3% and 0.15% HA improved symptoms/signs in moderate to severe DED patients.
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Affiliation(s)
- Jong Hwa Jun
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Seung Pil Bang
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Han Sang Park
- Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Donghee Yoon
- Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ja Young Ahn
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Seong Jae Kim
- Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.,Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Hong Kyun Kim
- Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Republic of Korea. .,Department of Ophthalmology, School of Medicine, Kyungpook National University, #130 Dongdeok-ro, Joong-gu, Daegu, 41944, Republic of Korea.
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23
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Bertsch P, Bergfreund J, Windhab EJ, Fischer P. Physiological fluid interfaces: Functional microenvironments, drug delivery targets, and first line of defense. Acta Biomater 2021; 130:32-53. [PMID: 34077806 DOI: 10.1016/j.actbio.2021.05.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022]
Abstract
Fluid interfaces, i.e. the boundary layer of two liquids or a liquid and a gas, play a vital role in physiological processes as diverse as visual perception, oral health and taste, lipid metabolism, and pulmonary breathing. These fluid interfaces exhibit a complex composition, structure, and rheology tailored to their individual physiological functions. Advances in interfacial thin film techniques have facilitated the analysis of such complex interfaces under physiologically relevant conditions. This allowed new insights on the origin of their physiological functionality, how deviations may cause disease, and has revealed new therapy strategies. Furthermore, the interactions of physiological fluid interfaces with exogenous substances is crucial for understanding certain disorders and exploiting drug delivery routes to or across fluid interfaces. Here, we provide an overview on fluid interfaces with physiological relevance, namely tear films, interfacial aspects of saliva, lipid droplet digestion and storage in the cell, and the functioning of lung surfactant. We elucidate their structure-function relationship, discuss diseases associated with interfacial composition, and describe therapies and drug delivery approaches targeted at fluid interfaces. STATEMENT OF SIGNIFICANCE: Fluid interfaces are inherent to all living organisms and play a vital role in various physiological processes. Examples are the eye tear film, saliva, lipid digestion & storage in cells, and pulmonary breathing. These fluid interfaces exhibit complex interfacial compositions and structures to meet their specific physiological function. We provide an overview on physiological fluid interfaces with a focus on interfacial phenomena. We elucidate their structure-function relationship, discuss diseases associated with interfacial composition, and describe novel therapies and drug delivery approaches targeted at fluid interfaces. This sets the scene for ocular, oral, or pulmonary surface engineering and drug delivery approaches.
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24
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Huerta Ángeles G, Nešporová K. Hyaluronan and its derivatives for ophthalmology: Recent advances and future perspectives. Carbohydr Polym 2021; 259:117697. [DOI: 10.1016/j.carbpol.2021.117697] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/26/2022]
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25
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Chang WH, Liu PY, Lin MH, Lu CJ, Chou HY, Nian CY, Jiang YT, Hsu YHH. Applications of Hyaluronic Acid in Ophthalmology and Contact Lenses. Molecules 2021; 26:molecules26092485. [PMID: 33923222 PMCID: PMC8123179 DOI: 10.3390/molecules26092485] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022] Open
Abstract
Hyaluronic acid (HA) is a glycosaminoglycan that was first isolated and identified from the vitreous body of a bull’s eye. HA is ubiquitous in the soft connective tissues of animals and therefore has high tissue compatibility for use in medication. Because of HA’s biological safety and water retention properties, it has many ophthalmology-related applications, such as in intravitreal injection, dry eye treatment, and contact lenses. Due to its broad range of applications, the identification and quantification of HA is a critical topic. This review article discusses current methods for analyzing HA. Contact lenses have become a widely used medical device, with HA commonly used as an additive to their production material, surface coating, and multipurpose solution. HA molecules on contact lenses retain moisture and increase the wearer’s comfort. HA absorbed by contact lenses can also gradually release to the anterior segment of the eyes to treat dry eye. This review discusses applications of HA in ophthalmology.
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Affiliation(s)
- Wan-Hsin Chang
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Pei-Yi Liu
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Min-Hsuan Lin
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Chien-Ju Lu
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Hsuan-Yi Chou
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Chih-Yu Nian
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
| | - Yuan-Ting Jiang
- Research and Development Center, Yung Sheng Optical Company, Daya District, Taichung 42881, Taiwan; (W.-H.C.); (P.-Y.L.); (M.-H.L.); (C.-J.L.); (H.-Y.C.); (C.-Y.N.)
- Correspondence: (Y.-T.J.); (Y.-H.H.H.); Tel.: +886-4-25658384 (ext. 3706) (Y.-T.J.); +886-4-23590121 (ext. 32238) (Y.-H.H.H.)
| | - Yuan-Hao Howard Hsu
- Department of Chemistry, Tunghai University, Xitun District, Taichung 40704, Taiwan
- Correspondence: (Y.-T.J.); (Y.-H.H.H.); Tel.: +886-4-25658384 (ext. 3706) (Y.-T.J.); +886-4-23590121 (ext. 32238) (Y.-H.H.H.)
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26
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Yoon CH, Ryu JS, Moon J, Kim MK. Association between aging-dependent gut microbiome dysbiosis and dry eye severity in C57BL/6 male mouse model: a pilot study. BMC Microbiol 2021; 21:106. [PMID: 33832437 PMCID: PMC8033717 DOI: 10.1186/s12866-021-02173-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/24/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND While aging is a potent risk factor of dry eye disease, age-related gut dysbiosis is associated with inflammation and chronic geriatric diseases. Emerging evidence have demonstrated that gut dysbiosis contributes to the pathophysiology or exacerbation of ocular diseases including dry eye disease. However, the relationship between aging-related changes in gut microbiota and dry eye disease has not been elucidated. In this pilot study, we investigated the association between aging-dependent microbiome changes and dry eye severity in C57BL/6 male mice. RESULTS Eight-week-old (8 W, n = 15), one-year-old (1Y, n = 10), and two-year-old (2Y, n = 8) C57BL/6 male mice were used. Dry eye severity was assessed by corneal staining scores and tear secretion. Bacterial genomic 16 s rRNA from feces was analyzed. Main outcomes were microbiome compositional differences among the groups and their correlation to dry eye severity. In aged mice (1Y and 2Y), corneal staining increased and tear secretion decreased with statistical significance. Gut microbiome α-diversity was not different among the groups. However, β-diversity was significantly different among the groups. In univariate analysis, phylum Firmicutes, Proteobacteria, and Cyanobacteria, Firmicutes/Bacteroidetes ratio, and genus Alistipes, Bacteroides, Prevotella, Paraprevotella, and Helicobacter were significantly related to dry eye severity. After adjustment of age, multivariate analysis revealed phylum Proteobacteria, Firmicutes/Bacteroidetes ratio, and genus Lactobacillus, Alistipes, Prevotella, Paraprevotella, and Helicobacter to be significantly associated with dry eye severity. CONCLUSIONS Our pilot study suggests that aging-dependent changes in microbiome composition are related to severity of dry eye signs in C57BL/6 male mice.
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Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Suk Ryu
- Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jayoon Moon
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Ophthalmology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Laboratory of Ocular Regenerative Medicine and Immunology, Biomedical Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Categorization of Marketed Artificial Tear Formulations Based on Their Ingredients: A Rational Approach for Their Use. J Clin Med 2021; 10:jcm10061289. [PMID: 33800965 PMCID: PMC8003881 DOI: 10.3390/jcm10061289] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
Dry eye disease is a common ocular condition affecting millions of people worldwide. Artificial tears are the first line therapy for the management of dry eye disease. Artificial tear formulations contain a variety of active ingredients, biologically active excipients, and preservatives. Many of these formulations are also available as preservative-free. This study was conducted to inspect artificial tear formulations currently marketed in the United States for their active ingredients, biologically relevant excipients, and preservatives. The marketed artificial tears were examined at various US retail pharmacy chains and using the manufacturers’ website to compile information about active ingredients, inactive ingredients, and preservatives. The currently marketed artificial tears can be grouped into four categories based on their active ingredients. The artificial tears also contain biologically active chemicals listed as inactive ingredients, which have osmoprotectant, humectant, and tear film lipid layer or mucous layer mimicking properties. Most artificial tears contain vanishing type preservatives such as purite or sodium perborate and safer quaternary compound polyquaternium-1. The majority of these artificial tear formulations are also available as preservative-free single dose unit. The study provides a formulary of artificial tears based on active ingredients, biologically active excipients, and the preservative-free option. The formulary should assist healthcare providers in making a stepwise and rational selection of appropriate artificial tears for patients suffering from dry eye disease.
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28
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Crosslinked Hyaluronic Acid with Liposomes and Crocin Confers Cytoprotection in an Experimental Model of Dry Eye. Molecules 2021; 26:molecules26040849. [PMID: 33561944 PMCID: PMC7915152 DOI: 10.3390/molecules26040849] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
Dry eye disease (DED) is a multifactorial condition caused by tear deficiency and accompanied by ocular surface damage. Recent data support a key role of oxidative and inflammatory processes in the pathogenesis of DED. Hyaluronic acid (HA) is widely used in artificial tears to treat DED by improving ocular hydration and reducing surface friction. Crocin (Cr), the main constituent of saffron, is a renowned compound that exhibits potent antioxidant and anti-inflammatory effects. The present study was undertaken to assess the viscosity and muco-adhesiveness of a photoactivated formulation with crosslinked HA (cHA), Cr, and liposomes (cHA-Cr-L). Our aim was also to evaluate whether cHA-Cr-L may exert cytoprotective effects against oxidative and inflammatory processes in human corneal epithelial cells (HCECs). Viscosity was measured using a rotational rheometer, and then the muco-adhesiveness was evaluated. Under hyperosmolarity (450 mOsm), the HCECs were treated with cHA-Cr-L. Interleukin-1β (IL-1β) and tumor necrosis factor α (TNFα) were quantified by quantitative real-time polymerase chain reaction (RT-qPCR). The levels of reactive oxygen species (ROS) were measured using the DCF assay. The combined action of cHA-Cr-L produced a higher viscosity and muco-adhesiveness compared to the control. The anti-inflammatory effect of cHA-Cr-L was achieved through a significant reduction of IL-1β and TNFα (p < 0.001). The results also showed that cHA-Cr-L reduces ROS production under conditions of hyperosmolarity (p < 0.001). We conclude that cHA-Cr-L has potential as a therapeutic agent in DED, which should be further investigated.
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29
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van Setten GB, Stachs O, Dupas B, Turhan SA, Seitz B, Reitsamer H, Winter K, Horwath-Winter J, Guthoff RF, Müller-Lierheim WGK. High Molecular Weight Hyaluronan Promotes Corneal Nerve Growth in Severe Dry Eyes. J Clin Med 2020; 9:jcm9123799. [PMID: 33255350 PMCID: PMC7760610 DOI: 10.3390/jcm9123799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 12/31/2022] Open
Abstract
The purpose of this study was to investigate the effect of high molecular weight hyaluronan (HMWHA) eye drops on subbasal corneal nerves in patients suffering from severe dry eye disease (DED) and to evaluate the damage of subbasal corneal nerves associated with severe DED. Designed as an international, multicenter study, 16 patients with symptoms of at least an Ocular Surface Disease Index (OSDI) score of 33, and corneal fluorescein staining (CFS) of at least Oxford grade 3, were included and randomized into two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the baseline visit, and after eight weeks, the subbasal nerve plexus of 16 patients were assessed by confocal laser scanning microscopy (CSLM). The images were submitted to a masked reading center for evaluation. Results showed a significant increase of total nerve fiber lengths (CNFL) in the HMWHA group (p = 0.030) when compared to the control group, where the total subbasal CNFL did not significantly change from baseline to week 8. We concluded that in severe DED patients, HMWHA from topically applied eye drops could cross the epithelial barrier and reach the subbasal nerve plexus, where it exercised a trophic effect.
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Affiliation(s)
- Gysbert-Botho van Setten
- Department of Clininical Neuroscience, St. Eriks Eye Hospital, Karolinska Institutet, 11282 Stockholm, Sweden;
| | - Oliver Stachs
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.F.G.)
| | - Bénédicte Dupas
- Quinze-Vingts National Eye Hospital & Vision Institute, 75571 Paris, France;
| | - Semra Akkaya Turhan
- Department of Ophthalmology, Marmara University School of Medicine, 34899 Istanbul, Turkey;
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg/Saar, Germany;
| | - Herbert Reitsamer
- Department of Ophthalmology & Department of Experimental Ophthalmology and Glaucoma Research, University Clinic Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Karsten Winter
- Institute of Anatomy, Medical Faculty, University of Leipzig, 04103 Leipzig, Germany;
| | | | - Rudolf F. Guthoff
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.F.G.)
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30
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van Setten GB, Baudouin C, Horwath-Winter J, Böhringer D, Stachs O, Toker E, Al-Zaaidi S, Benitez-del-Castillo JM, Beck R, Al-Sheikh O, Seitz B, Barabino S, Reitsamer HA, Müller-Lierheim WG. The HYLAN M Study: Efficacy of 0.15% High Molecular Weight Hyaluronan Fluid in the Treatment of Severe Dry Eye Disease in a Multicenter Randomized Trial. J Clin Med 2020; 9:jcm9113536. [PMID: 33147751 PMCID: PMC7693312 DOI: 10.3390/jcm9113536] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/23/2020] [Accepted: 10/31/2020] [Indexed: 01/22/2023] Open
Abstract
The aim of the HYLAN M study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops. In this international, multicenter study, patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included. A total of 84 per-protocol patients were randomized in two study arms. The control group continued to use their individual optimum artificial tears over the study period of eight weeks; in the verum group, the artificial tears were substituted by eye drops containing 0.15% HMWHA. At the week 8 visit, the average OSDI of the verum group had improved by 13.5 as compared to the control group (p = 0.001). The best corrected visual acuity (BCVA) had improved by 0.04 logMAR (p = 0.033). CFS, tear film break-up time (TBUT), Schirmer I, lid wiper epitheliopathy (LWE), mucocutaneous junction (Yamaguchi score), and tear osmolarity were not significantly different between the verum and control groups (p > 0.050). We conclude that for most patients with severe DED, 0.15% HMWHA eye drops provide excellent improvement of symptoms without impairment of dry eye signs.
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Affiliation(s)
- Gysbert-Botho van Setten
- Karolinska Institutet, Department of Clinical Neuroscience, St. Eriks Eye Hospital, 11282 Stockholm, Sweden;
| | - Christophe Baudouin
- Quinze-Vingts National Eye Hospital & Vision Institute, IHU Foresight, 75571 Paris, France;
| | | | - Daniel Böhringer
- Eye Center, University Eye Hospital Freiburg and Medical Faculty, Albert Ludwigs University, 79106 Freiburg, Germany;
| | - Oliver Stachs
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.B.)
| | - Ebru Toker
- Department of Ophthalmology, Marmara University School of Medicine, 34899 Istanbul, Turkey;
| | - Sultan Al-Zaaidi
- Department of Ophthalmology, PSMMC Prince Sultan Military Medical City, MSD Medical Services Department, MODA Ministry of Defense and Aviation, Riyadh 12233, Saudi Arabia;
| | | | - Ria Beck
- Department of Ophthalmology, University Medical Center Rostock, 18057 Rostock, Germany; (O.S.); (R.B.)
| | - Osama Al-Sheikh
- KKESH–King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia;
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, 66421 Homburg/Saar, Germany;
| | - Stefano Barabino
- Ocular Surface & Dry Eye Center, Ospedale L. Sacco, University of Milan, 20157 Milan, Italy;
| | - Herbert A. Reitsamer
- Department of Ophthalmology & Department of Experimental Ophthalmology and Glaucoma Research, University Clinic Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria;
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Formulation of hyaluronan grafted with dodecanoic acid as a potential ophthalmic treatment. Carbohydr Polym 2020; 246:116578. [DOI: 10.1016/j.carbpol.2020.116578] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 01/05/2023]
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Mohammadi H, Alihosseini F, Hosseini SA. Improving physical and biological properties of nylon monofilament as suture by Chitosan/Hyaluronic acid. Int J Biol Macromol 2020; 164:3394-3402. [PMID: 32818569 DOI: 10.1016/j.ijbiomac.2020.08.081] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/02/2020] [Accepted: 08/08/2020] [Indexed: 01/02/2023]
Abstract
One way to give some properties such as antibacterial and good frictional properties to sutures is the application of natural antibacterial and hydrophilic components on their surfaces through layer by layer assembly (LBL) technique. In this regard, Chitosan as an antibacterial polycationic natural polymer along with Hyaluronic acid (HA) as a polyanionic polysaccharide could be used to form a polyelectrolyte complex. In this study, HA was extracted from rooster comb using different solvents. Characterization of the extracted HA by FTIR and GPC analysis showed extracted HA with Mw = 2.53 × 105 Da had no cytotoxicity. Then, a nylon monofilament (NMy) was coated by the extracted HA and chitosan with different concentrations using bilayer coating technique. Two dyes also were loaded to coating layer to investigate the release behavior of these two drug models. The morphology of coated layer showed that coating NMy by chitosan (4% w/v) following by HA (8% w/v) with roughness of 164 ± 129 nm and friction coefficient of 0.26 had suitable interaction between two layers to prevent from exfoliation of coating layers. The antibacterial activity and controlled release of coated NMy indicated how a NMy coated by Chitosan and HA is a promising material for using as a suture.
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Affiliation(s)
- Hassan Mohammadi
- Department of Textile Engineering, Isfahan University of Technology, Isfahan 8415683111, Iran
| | - Farzaneh Alihosseini
- Department of Textile Engineering, Isfahan University of Technology, Isfahan 8415683111, Iran.
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Müller-Lierheim WGK. Why Chain Length of Hyaluronan in Eye Drops Matters. Diagnostics (Basel) 2020; 10:E511. [PMID: 32717869 PMCID: PMC7459843 DOI: 10.3390/diagnostics10080511] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
The chain length of hyaluronan (HA) determines its physical as well as its physiological properties. Results of clinical research on HA eye drops are not comparable without this parameter. In this article methods for the assessment of the average molecular weight of HA in eye drops and a terminology for molecular weight ranges are proposed. The classification of HA eye drops according to their zero shear viscosity and viscosity at 1000 s-1 shear rate is presented. Based on the gradient of mucin MUC5AC concentration within the mucoaqueous layer of the tear film a hypothesis on the consequences of this gradient on the rheological properties of the tear film is provided. The mucoadhesive properties of HA and their dependence on chain length are explained. The ability of HA to bind to receptors on the ocular epithelial cells, and in particular the potential consequences of the interaction between HA and the receptor HARE, responsible for HA endocytosis by corneal epithelial cells is discussed. The physiological function of HA in the framework of ocular surface homeostasis and wound healing are outlined, and the influence of the chain length of HA on the clinical performance of HA eye drops is illustrated. The use of very high molecular weight HA (hylan A) eye drops as drug vehicle for the next generation of ophthalmic drugs with minimized side effects is proposed and its advantages elucidated. Consequences of the diagnosis and treatment of ocular surface disease are discussed.
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Yoon CH, Ryu JS, Hwang HS, Kim MK. Comparative Analysis of Age-Related Changes in Lacrimal Glands and Meibomian Glands of a C57BL/6 Male Mouse Model. Int J Mol Sci 2020; 21:ijms21114169. [PMID: 32545199 PMCID: PMC7313015 DOI: 10.3390/ijms21114169] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 12/21/2022] Open
Abstract
It is not known how biological changes in the lacrimal (LGs) and meibomian (MGs) glands contribute to dry eye disease (DED) in a time-dependent manner. In this study, we investigated time-sequenced changes in the inflammation, oxidative stress, and senescence of stem cells in both glands of an aging-related DED mouse model. Eight-week (8W)-, one-year (1Y)-, and two-year (2Y)-old C57BL/6 male mice were used. MG areas of the upper and lower eyelids were analyzed by transillumination meibography imaging. The number of CD45+, 8-OHdG+, Ki-67+, and BrdU+ cells was compared in both glands. Increased corneal staining and decreased tear secretion were observed in aged mice. The MG dropout area increased with aging, and the age-adjusted MG area in lower lids was negatively correlated with the National Eye Institute (NEI) score. Increased CD4+ interferon (IFN)-γ+ cells in LGs were found in both aged mice. An increase in 8-OHdG+ cells in both glands was evident in 2Y-old mice. Reduced Ki-67+ cells, but no change in CD45+ cells, was observed in the MGs of 1Y-old mice. Increased BrdU+ cells were observed in the LGs of aged mice. This suggests that age-dependent DED in C57BL/6 mice is related to inflammation of the LGs, the development of MG atrophy, and oxidative stress in both glands.
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Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Korea;
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Korea
| | - Jin Suk Ryu
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
- Correspondence: (H.S.H.); (M.K.K.); Tel.: +82-2-3779-1025 (H.S.H.); +82-2-2072-2665 (M.K.K.); Fax: +82-2-761-6869 (H.S.H.); +82-2-741-3187 (M.K.K.)
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul 03080, Korea;
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul 03080, Korea;
- Department of Ophthalmology, Seoul National University Hospital, Seoul 03080, Korea
- Correspondence: (H.S.H.); (M.K.K.); Tel.: +82-2-3779-1025 (H.S.H.); +82-2-2072-2665 (M.K.K.); Fax: +82-2-761-6869 (H.S.H.); +82-2-741-3187 (M.K.K.)
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