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Arana E, Gonzalo A, Andollo N, Goñi-de-Cerio F, Gómez-Fernández P, Salado C, Hernández G, Suárez-Cortés T. The new preservative-free ophthalmic formulation of bilastine 0.6% preserves the ocular surface epithelial integrity in a comparative in vitro study. Sci Rep 2024; 14:9598. [PMID: 38671063 PMCID: PMC11053002 DOI: 10.1038/s41598-024-59190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Allergic conjunctivitis (AC) is the most common form of allergic eye disease and an increasingly prevalent condition. Topical eye drop treatments are the usual approach for managing AC, although their impact on the ocular surface is not frequently investigated. The aim of this study was to perform a comparative physicochemical characterization, and in vitro biological evaluations in primary conjunctival and corneal epithelial cells of the new multidose preservative-free bilastine 0.6% and main commercially available eye drops. MTT assay was used to measure cell viability; oxidative stress was analyzed with a ROS-sensitive probe; and apoptosis was evaluated monitoring caspase 3/7 activation. Differences in pH value, osmolarity, viscosity and phosphate levels were identified. Among all formulations, bilastine exhibited pH, osmolarity and viscosity values closer to tear film (7.4, 300 mOsm/l and ~ 1.5-10 mPa·s, respectively), and was the only phosphates-free solution. Single-dose ketotifen did not induce ROS production, and single-dose azelastine and bilastine only induced a mild increase. Bilastine and single-dose ketotifen and azelastine showed high survival rates attributable to the absence of preservative in its formulation, not inducing caspase-3/7-mediated apoptosis after 24 h. Our findings support the use of the new bilastine 0.6% for treating patients with AC to preserve and maintain the integrity of the ocular surface.
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Affiliation(s)
- Eider Arana
- Research, Development and Innovation Department (R&D+I Department), Faes Farma, Av. Autonomía 10, 48940, Leioa, Bizkaia, Spain
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, Leioa, Spain
| | - Ana Gonzalo
- Research, Development and Innovation Department (R&D+I Department), Faes Farma, Av. Autonomía 10, 48940, Leioa, Bizkaia, Spain
| | - Noelia Andollo
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, Leioa, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
| | - Felipe Goñi-de-Cerio
- Biotechnology Area, GAIKER Technology Centre, Basque Research and Technology Alliance, Zamudio, Spain
| | - Paloma Gómez-Fernández
- Biotechnology Area, GAIKER Technology Centre, Basque Research and Technology Alliance, Zamudio, Spain
| | - Clarisa Salado
- Innoprot SL, Bizkaia Technology Park, Derio, Bizkaia, Spain
| | - Gonzalo Hernández
- Research, Development and Innovation Department (R&D+I Department), Faes Farma, Av. Autonomía 10, 48940, Leioa, Bizkaia, Spain
| | - Tatiana Suárez-Cortés
- Research, Development and Innovation Department (R&D+I Department), Faes Farma, Av. Autonomía 10, 48940, Leioa, Bizkaia, Spain.
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Yang B, Wen K, Li J, Zhang S, Fan Z, Liang X, Liang L. Quantitative evaluation of lipid layer thickness and blinking in children with allergic conjunctivitis. Graefes Arch Clin Exp Ophthalmol 2021; 259:2795-2805. [PMID: 34003361 PMCID: PMC8129599 DOI: 10.1007/s00417-021-05199-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/25/2021] [Accepted: 04/11/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose To quantitatively evaluate the lipid layer thickness (LLT) and blinking in children with or without allergic conjunctivitis (AC), and to compare those between the different types of AC. Methods For this case–control study, 81 children with symptomatic AC with an average age of 9.62 ± 2.67 years were enrolled and subdivided according to the subtypes of AC, including seasonal/perennial allergic conjunctivitis group and vernal keratoconjunctivitis (VKC)/atopic keratoconjunctivitis (AKC) group. Another 82 age-matched healthy children were enrolled as control group. All subjects underwent routine eye examination and measurements of LLT, the number of incomplete or total blinking, partial blinking rate by the LipiView interferometer over a 10-s period. Other ocular surface assessment included fluorescein tear breakup time (TBUT), lower tear meniscus height, meibomian gland loss (MGL), meibum expressibility and quality. Results Pediatric patients with AC had significant thinner LLT, shorter TBUT, decreased total blinking but increased partial blinking rate, especially in those with VKC/AKC (all P < 0.05). A significant deterioration of meibomian gland parameters was observed in AC group when compared with control subjects, demonstrated by severe upper and lower MGL, lid margin abnormalities, decreased meibum expressibility, and abnormal meibum quality, all of which were worse in the severe type of AC (all P < 0.05). Thinner LLT was significantly correlated with decreased TBUT (β = 3.666, P < 0.001) and severity of upper MGL (β = − 7.701, P = 0.002). Conclusion Decreased LLT and blinking disorders in pediatric patients with AC may contribute to lipid layer deficiency in the long run, which should be considered and appropriately diagnosed for a more precise treatment.
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Affiliation(s)
- Boyu Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China
| | - Kuiyao Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China
| | - Shiyao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China
| | - Zixin Fan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China.
| | - Lingyi Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong, China.
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Kim SI, Park CY, Fordjuor G, Lee JH, Lee JS, Lee JE. Comparison of cytotoxicities and anti-allergic effects of topical ocular dual-action anti-allergic agents. BMC Ophthalmol 2019; 19:217. [PMID: 31703568 PMCID: PMC6839072 DOI: 10.1186/s12886-019-1228-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/28/2019] [Indexed: 12/02/2022] Open
Abstract
Background To investigate the cytotoxicities of the topical ocular dual-action anti-allergic agents (alcaftadine 0.25%, bepotastine besilate 1.5%, and olopatadine HCL 0.1%) on human corneal epithelial cells (HCECs) and their anti-allergic effects on cultured conjunctival epithelial cells. Methods A Methylthiazolyltetrazolium(MTT)-based calorimetric assay was used to assess cytotoxicities using HCECs at concentrations of 10, 20 or 30% for exposure durations of 30 min, 1 h, 2 h, 12 h or 24 h. Cellular morphologies were evaluated by inverted phase-contrast and electron microscopy. Wound widths were measured 2 h, 18 h, or 24 h after confluent HCECs monolayers were scratched. Realtime PCR was used to quantify anti-allergic effects on cultured human conjunctival cells, in which allergic reactions were induced by treating them with Aspergillus antigen. Results Cell viabilities decreased in time- and concentration-dependent manners. Cells were detached from dishes and showed microvilli loss, cytoplasmic vacuoles, and nuclear condensation when exposed to antiallergic agents; alcaftadine was found to be least cytotoxic. Alcaftadine treated HCECs monolayers showed the best wound healing followed by bepotastine and olopatadine (p < 0.0001). All agents significantly reduced the gene expressions of allergic cytokines (IL-5, IL-25, eotaxin, thymus and activation-regulated chemokine, and thymic stromal lymphopoietin) and alcaftadine had the greatest effect (p < 0.0001 in all cases). Conclusions Alcaftadine seems to have less side effects and better therapeutic effects than the other two anti-allergic agents tested. It may be more beneficial to use less toxic agents for patients with ocular surface risk factors or presumed symptoms of toxicity.
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Affiliation(s)
- Sung Il Kim
- Department of Ophthalmology, School of Medicine, Pusan National University, Mulgumup, Yangsan, 50612, Gyeongnam Province, Republic of South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Choul Yong Park
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea
| | - Gladys Fordjuor
- Ophthalmology Unit, Department of Surgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Jong Soo Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Mulgumup, Yangsan, 50612, Gyeongnam Province, Republic of South Korea
| | - Ji Eun Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Mulgumup, Yangsan, 50612, Gyeongnam Province, Republic of South Korea. .,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
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Guzman-Aranguez A, Calvo P, Ropero I, Pintor J. In vitro effects of preserved and unpreserved anti-allergic drugs on human corneal epithelial cells. J Ocul Pharmacol Ther 2014; 30:790-8. [PMID: 25100331 DOI: 10.1089/jop.2014.0030] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Treatment with topical eye drops for long-standing ocular diseases like allergy can induce detrimental side effects. The purpose of this study was to investigate in vitro cytotoxicity of commercially preserved and unpreserved anti-allergic eye drops on the viability and barrier function of monolayer and stratified human corneal-limbal epithelial cells. METHODS Cells were treated with unpreserved ketotifen solution, benzalkonium chloride (BAC)-containing anti-allergic drugs (ketotifen, olopatadine, levocabastine) as well as BAC alone. 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay was used to determine cell viability. Effects of compounds on barrier function were analyzed measuring transepithelial electrical resistance (TEER) to determine paracellular permeability and rose bengal assays to evaluate transcellular barrier formation. RESULTS The BAC-preserved anti-allergic formulations and BAC alone significantly reduced cell viability, monolayer cultures being more sensitive to damage by these solutions. Unpreserved ketotifen induced the least diminution in cell viability. The extent of decrease of cell viability was clearly dependent of BAC presence, but it was also affected by the different types of drugs when the concentration of BAC was low and the short time of exposure. Treatment with BAC-containing anti-allergic drugs and BAC alone resulted in increased paracellular permeability and loss of transcellular barrier function as indicated by TEER measurement and rose bengal assays. CONCLUSIONS The presence of the preservative BAC in anti-allergic eye drop formulations contributes importantly to the cytotoxic effects induced by these compounds. Stratified cell cultures seem to be a more relevant model for toxicity evaluation induced on the ocular surface epithelia than monolayer cultures.
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Affiliation(s)
- Ana Guzman-Aranguez
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid , Madrid, Spain
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Patel A, Cholkar K, Agrahari V, Mitra AK. Ocular drug delivery systems: An overview. World J Pharmacol 2013; 2:47-64. [PMID: 25590022 PMCID: PMC4289909 DOI: 10.5497/wjp.v2.i2.47] [Citation(s) in RCA: 466] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 03/21/2013] [Accepted: 04/04/2013] [Indexed: 02/06/2023] Open
Abstract
The major challenge faced by today’s pharmacologist and formulation scientist is ocular drug delivery. Topical eye drop is the most convenient and patient compliant route of drug administration, especially for the treatment of anterior segment diseases. Delivery of drugs to the targeted ocular tissues is restricted by various precorneal, dynamic and static ocular barriers. Also, therapeutic drug levels are not maintained for longer duration in target tissues. In the past two decades, ocular drug delivery research acceleratedly advanced towards developing a novel, safe and patient compliant formulation and drug delivery devices/techniques, which may surpass these barriers and maintain drug levels in tissues. Anterior segment drug delivery advances are witnessed by modulation of conventional topical solutions with permeation and viscosity enhancers. Also, it includes development of conventional topical formulations such as suspensions, emulsions and ointments. Various nanoformulations have also been introduced for anterior segment ocular drug delivery. On the other hand, for posterior ocular delivery, research has been immensely focused towards development of drug releasing devices and nanoformulations for treating chronic vitreo-retinal diseases. These novel devices and/or formulations may help to surpass ocular barriers and associated side effects with conventional topical drops. Also, these novel devices and/or formulations are easy to formulate, no/negligibly irritating, possess high precorneal residence time, sustain the drug release, and enhance ocular bioavailability of therapeutics. An update of current research advancement in ocular drug delivery necessitates and helps drug delivery scientists to modulate their think process and develop novel and safe drug delivery strategies. Current review intends to summarize the existing conventional formulations for ocular delivery and their advancements followed by current nanotechnology based formulation developments. Also, recent developments with other ocular drug delivery strategies employing in situ gels, implants, contact lens and microneedles have been discussed.
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Herrero-Vanrell R, Vicario de la Torre M, Andrés-Guerrero V, Barbosa-Alfaro D, Molina-Martínez I, Bravo-Osuna I. Nano and microtechnologies for ophthalmic administration, an overview. J Drug Deliv Sci Technol 2013. [DOI: 10.1016/s1773-2247(13)50016-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Free radicals and the pH of topical glaucoma medications: a lifetime of ocular chemical injury? Eye (Lond) 2012; 26:734-41. [PMID: 22388593 DOI: 10.1038/eye.2012.25] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Preservatives in ophthalmic preparations are known to cause ocular surface damage. Excipients can also contribute to oxidative stress in the compromised ocular surface. We evaluated commonly used topical glaucoma medications to ascertain pH levels and the intrinsic presence of free radicals. METHODS Samples of 27 topical glaucoma preparations were analysed for total free radical presence using a Randox Kit for total antioxidant status. Analytical grade indicator paper was used to ascertain pH levels. RESULTS Free radical concentrations for these 27 glaucoma preparations ranged from 0 to 4.54 mmol/l, with a median value of 0.66 mmol/l (mean value of 0.662 mmol/l, SD 0.839). Levels of pH ranged from 4.0 to 7.4, with a median value of 6.5 (mean 6.252, SD 0.826). There was no evidence of a direct correlation between these two variables (r=0.232, P=0.275). CONCLUSION This study is the first to document the range of pH and concentrations of free radicals intrinsically present in commonly used glaucoma medications. Long-term exposure to preservatives, free radicals, and pH levels could all contribute to ocular surface damage. The effect of excipients could be responsible for patient intolerance when changing products in the compromised ocular surface.
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Abstract
Benzalkonium chloride (BAK) is the preservative used most commonly in eye drops. Although it is effective as an antimicrobial and antifungal agent, both in vitro and in vivo studies have demonstrated adverse effects on surface epithelial cell populations. This is of particular concern with regard to topical medications used over long periods for chronic conditions, such as glaucoma. Newer non-BAK-containing drops are becoming increasingly available, providing an alternative for patients needing long-term eye drop therapy.
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Affiliation(s)
- Robert Noecker
- Ophthalmic Consultants of Connecticut, Fairfield, CT 06824, USA.
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Cytotoxicity assays of new artificial tears containing 2-methacryloyloxyethyl phosphorylcholine polymer for ocular surface cells. Jpn J Ophthalmol 2011; 55:541-546. [PMID: 21830058 DOI: 10.1007/s10384-011-0073-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 05/23/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymer is a multifunctional agent with antiadhesive, antithrombogenetic, and strong hydrating properties. MPC polymer-containing eye drops are the first such ophthalmic product to be commercially available; they contain approximately 0.1% Lipidure-PMB (copolymer of MPC and butyl methacrylate; NOF Corporation, Tokyo, Japan). This study evaluated the cytotoxicity of this new product toward ocular surface cells. METHODS SIRC (rabbit cornea), BCE C/D-1b (bovine cornea), RC-1 (rabbit cornea), and Chang (human conjunctiva) cell lines were tested in this study. Cell viability was measured using both the MTT assay and the neutral red test in cells treated for 10, 30, or 60 min with MPC-containing eye drops and 4 commercial ophthalmic solutions containing sodium hyaluronate (SH) at various doses (undiluted, twofold diluted, and tenfold diluted). Cell viability scores were calculated. Cell viability was analyzed using ANOVA and the Dunnett test. RESULTS After treatment with the MPC eye drops, cell viability rates were maintained at over 80% irrespective of the cell lines, dilution rates, exposure times, and assays, and were similar to those of the clinically approved artificial tear products other than Hyalein 0.1%, although some significant differences were found. CONCLUSIONS The MPC eye drops were tolerable to ocular surface cells, and comparable to single doses of clinically approved drugs containing sodium hyaluronate.
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Ayaki M, Iwasawa A, Inoue Y. Toxicity of antiglaucoma drugs with and without benzalkonium chloride to cultured human corneal endothelial cells. Clin Ophthalmol 2010; 4:1217-22. [PMID: 21060675 PMCID: PMC2964961 DOI: 10.2147/opth.s13708] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The toxicity of antiglaucoma medications to ocular surface cells has been evaluated extensively; however, the toxicity to corneal endothelial cells (CECs) remains elusive. Our aim is to evaluate the toxicity of antiglaucoma medications to CECs using an in vitro toxicity assay. Methods Primary cultures of human (H) CECs derived from eye bank specimens were established. Following exposure of HCECs to test solutions for 10, 30, or 60 minutes, or 48 hours, we measured cell viability using a WST-1 assay. Test solutions were diluted in culture media and included 0.5% Timoptol®, preservative-free 0.5% timolol maleate, 1% Trusopt®, preservative-free 1% dorzolamide, Travatan®, Travatan Z®, Xalatan®, and benzalkonium chloride (BAK). To assess cell viability, the value of the test culture well after treatment was expressed as a percentage of that of the control well. Toxicity of each solution was compared using the cell viability score (CVS). Results After exposure to 10-fold dilutions of test solutions for 48 hours, HCEC viabilities were 48.5% for 0.5% Timoptol, 80.9% for preservative-free 0.5% timolol maleate, 47.0% for 1% Trusopt, 71.7% for preservative-free 1% dorzolamide, 55.5% for Travatan, 88.5% for Travatan Z, and 52.5% for Xalatan. Exposure to test solutions diluted 100-fold or more resulted in HCEC viabilities >80%, with the exception of preservative-free 1% dorzolamide, which resulted in a viability of 72.0% at a dilution of 100-fold. Based on CVS, the order of cell viability was Travatan Z ≥ preservative-free timolol maleate = preservative-free dorzolamide > 0.5% Timoptol = 1% Trusopt > Travatan ≥ Xalatan. Assessment of the combined effect of drug and BAK revealed that latanoprost reduced the toxicity of BAK. Conclusion Antiglaucoma eye drops produced HCEC toxicity that appeared to depend on the presence of BAK. Because dilution of the antiglaucoma solutions resulted in markedly lower HCEC toxicity, HCEC damage due to antiglaucoma medication may occur only in rare cases. The CVS was useful for comparison of the toxicity of the drugs.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Saitama National Hospital, Wako, Japan.
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