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Evaluation of moxifloxacin-induced cytotoxicity on human corneal endothelial cells. Sci Rep 2021; 11:6250. [PMID: 33737688 PMCID: PMC7973544 DOI: 10.1038/s41598-021-85834-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/05/2021] [Indexed: 12/24/2022] Open
Abstract
Moxifloxacin hydrochloride (MXF) is widely used for the prevention of bacterial endophthalmitis after intraocular surgeries. However, the safety issue of intracameral injection of MXF for human corneal endothelial cells (HCECs) is still debatable. In this study, we investigated concentration-dependent cytotoxicity (0.05–1 mg/ml) of MXF for immortalized HCECs (B4G12 cell) and the underlying mechanism. Reactive oxygen generation (ROS) and cell viability after MXF exposure was measured. Flow cytometric analysis and TUNEL assay was used to detect apoptotic HCECs after MXF exposure. Ultrastructure of damaged HCECs by MXF was imaged by transmission electron microscope. Western blot analysis and caspase 2, 3 and 8 analysis were used to reveal the underlying mechanism of MXF induced damage in HCECs. We found that MXF induced dose-dependent cytotoxicity in HCECs. MXF exposure increased ROS generation and induced autophagy in HCECs. Increased LDH release represented the cellular membrane damage by MXF. In addition, caspases activation, Bax/Bcl-xL-dependent apoptosis pathway and apoptosis inducing factor nuclear translocation were all involved in MXF induced HCECs’ damage, especially after exposure to high dose of MXF (0.5 and 1.0 mg/ml). These findings suggest that MXF toxicity on HCECs should be thoroughly considered by ophthalmologists when intracameral injection of MXF is planned.
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Jiang GJ, Fan TJ. Novel techniques to prevent apoptosis and improve regeneration in corneal endothelial cells. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1794821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Guo-Jian Jiang
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Qingdao, Shandong Province, China
| | - Ting-Jun Fan
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Qingdao, Shandong Province, China
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Yang T, Fan TJ, Xu B. Norfloxacin induces apoptosis and necroptosis in human corneal epithelial cells. Toxicol In Vitro 2020; 66:104868. [PMID: 32320760 DOI: 10.1016/j.tiv.2020.104868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/30/2020] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
Norfloxacin (NOR) is applied clinically to treat keratitis. However, NOR has brought severe side-effects for human corneal epithelium (HCEP) due to overdose and potential toxicity. In this study, two in vitro experimental models including monolayer HCEP cells and tissue-engineered human corneal epithelium (TE-HCEP) were used to explore the cytotoxicity and its related mechanisms. The HCEP cells treated with NOR at concentrations from 0.1875 to 3.0 mg/mL displayed abnormal morphology, declined viability, and increased plasma membrane permeability. Moreover, 0.75 mg/mL NOR induced chromatin condensation, S phase arrest, phosphatidylserine externalization, and formation of apoptotic body through activation of caspase-2/-8/-9/-3, downregulation of Bcl-2 and Bcl-xL, upregulation of Bad and Bax, mitochondrial transmembrane potential disruption and release of cytochrome c and apoptosis inducing factor into cytosol, whereas 1.5 mg/mL and 3.0 mg/mL NOR upregulated the expressions of receptor-interacting protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain-like (MLKL) together with inactivation of caspase-2/-8. Furthermore, 0.1875-3.0 mg/mL NOR destroyed the multilayer structure of TE-HCEP model due to a dose-dependent cytotoxicity, which validated the above results. Overall, low-dose (0.1875-0.75 mg/mL) NOR induced apoptosis through mitochondrion-dependent and death receptor-mediated pathways, and high-dose (1.5-3.0 mg/mL) NOR triggered necroptosis via RIPK1-RIPK3-MLKL cascade in HCEP cells.
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Affiliation(s)
- Ting Yang
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Shandong Province, Qingdao 266003, China
| | - Ting-Jun Fan
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Shandong Province, Qingdao 266003, China
| | - Bin Xu
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Shandong Province, Qingdao 266003, China.
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Insights into mechanisms of pranoprofen-induced apoptosis and necroptosis in human corneal stromal cells. Toxicol Lett 2019; 320:9-18. [PMID: 31765691 DOI: 10.1016/j.toxlet.2019.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022]
Abstract
Pranoprofen (PPF) is a wildly used anti-inflammatory ophthalmic drug. It was reported that PPF could decrease early epithelialization of scrape wounds in rabbit cornea and could reduce cell activities of cultured human corneal endothelial cells. However, effects of PPF on corneal stromal cells playing important roles in corneal wound healing remain unknown. In this study,in vitro model of cultured human corneal stomal (HCS) cells and in vivo model of rabbit corneas were used to investigate the effects and underlying mechanisms of PPF. Our findings showed that high concentrations of PPF treatment (0.1 % to 0.0125 %) caused limited chromatin condensation and quickly decreased cell viability that was proved to initiate necroptosis in HCS cells through activating receptor interacting protein kinase (RIPK) and mixed lineage kinase domain-like (MLKL). While low concentrations of PPF treatment (0.00625 %) induced DNA fragmentation, apoptotic body formation, ROS generation, activation of caspases and increase in cytoplasmic content of Bad, Bax and cytoplasmic cytochrome c that suggested apoptosis happened through ROS-mediated caspase-dependent and caspase-independent pathways. Studies of rabbit corneas treated with 0.1 % PPF (the clinical concentration) showed that PPF could induce apoptosis of rabbit corneal stromal cells. This work would be helpful for better understanding cytotoxic effects PPF on human corneal cells.
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Fan TJ, Wu SX, Jiang GJ. Apoptotic effects of norfloxacin on corneal endothelial cells. Naunyn Schmiedebergs Arch Pharmacol 2019; 393:77-88. [PMID: 31420720 DOI: 10.1007/s00210-019-01711-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/07/2019] [Indexed: 01/17/2023]
Abstract
Norfloxacin, a frequently used ocular antibiotic, might have cytotoxic effect on human corneal endothelial cells (HCECs), subsequently damage the cornea and finally impair human vision. However, the possible mechanisms of cytotoxicity of norfloxacin to HCEC line are unclear. Herein, we investigated the cytotoxicity of norfloxacin and its underlying cellular and molecular mechanisms using in vitro cultured non-transfected HCECs and verified the cytotoxicity with cat corneal endothelium in vivo. In the present study, the cytotoxicity of norfloxacin in the in vitro cultured HCECs was recognized by causing abnormal morphology such as cell shrinkage and detachment from plate bottom, and decline of viability of in vitro cultured HCECs. Then, its cytotoxicity was verified by inducing reduction of cell density and morphological abnormality of in vivo cat corneal endothelial cells. Furthermore, the cytotoxicity of norfloxacin in HCECs was corroborated as apoptosis by elevation of plasma membrane permeability, S phase arrest, phosphatidylserine externalization, DNA fragmentation, and apoptotic body formation in in vitro cultured HCECs and apoptosis-like swollen cells in the in vivo model. Moreover, norfloxacin induced extrinsic death receptor-mediated apoptosis pathway by activating caspase-2/-8/-3 and intrinsic mitochondrion-dependent apoptosis pathway by downregulating anti-apoptotic Bcl-2 and upregulating of pro-apoptotic Bad, which disrupted mitochondrial transmembrane potential, subsequently upregulated cytoplasmic cytochrome c and apoptosis-inducing factor and finally activated caspase-9/-3. Generally, norfloxacin induces HCE cell apoptosis via a death receptor-mediated and mitochondrion-dependent signaling pathway.
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Affiliation(s)
- Ting-Jun Fan
- Key Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Yushan Road No. 5, Qingdao, 266003, China
| | - Shu-Xian Wu
- Key Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Yushan Road No. 5, Qingdao, 266003, China
| | - Guo-Jian Jiang
- Key Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China, Yushan Road No. 5, Qingdao, 266003, China.
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Ding T, Chou Y, Jiang X, Qiu W, Shi D, Wu F, Li X. A case of blurred vision and viral keratitis postcataract surgery. Future Virol 2018. [DOI: 10.2217/fvl-2018-0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
An 84-year-old woman underwent cataract surgery. In 3 weeks, the right eye presented with blurred vision, corneal irritation and photophobia. After 5 weeks, symptoms in the right eye worsened and ganciclovir was prescribed. Based on clinical findings, viral keratitis was suspected; real-time PCR (RT-PCR) assay of tear samples from the right eye was performed. Thereafter 1 week, the left eye also exhibited similar symptoms. The RT-PCR was performed using a sample from the left eye; the results suggested the presence of Epstein–Barr virus and cytomegalovirus. A combination of confocal microscopy and RT-PCR assay of tear samples can supplement slit-lamp observation and help diagnose atypical and refractory postcataract surgery viral keratitis.
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Affiliation(s)
- Tong Ding
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
| | - Yilin Chou
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
| | - Xiaodan Jiang
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
| | - Weiqiang Qiu
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
| | - Danna Shi
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
| | - Feng Wu
- Department of Ophthalmology, Fuyang Sixth People’s Hospital, Anhui, PR China
| | - Xuemin Li
- Departmentof Ophthalmology, Peking University Third Hospital, Beijing, PR China
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Alio JL, Rodriguez AE, De Arriba P, Gisbert S, Abdelghany AA. Treatment with platelet-rich plasma of surgically related dormant corneal ulcers. Eur J Ophthalmol 2018; 28:515-520. [PMID: 29566537 DOI: 10.1177/1120672117747042] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess the effectiveness of autologous platelet-rich plasma for the treatment of dormant corneal ulcers secondary to corneal surgery and unresponsive to conventional treatment. SETTING VISSUM, Ophthalmology Institute of Alicante, Alicante, Spain. DESIGN Prospective nonrandomized, observational consecutive study. METHODS A total of 44 eyes of 28 patients with dormant corneal ulcers secondary to corneal surgery were included in a prospective study and treated with autologous platelet-rich plasma during 6 weeks. Wilcoxon signed-rank test was used to compare the effect of the treatment. RESULTS In all, 28 patients (65.1%) improved their visual acuity at least one line in Snellen chart, 26 (59.09%) had a decrease in the size of the ulcer or even a total closure, and 40 (90.9%) experienced an improvement in their symptoms. The results are also provided for the four groups of patients (keratoplasty, refractive surgery, cross-linking, and chronic postsurgical corneal edema). CONCLUSION Platelet-rich plasma eye drops shows to be a good option for the treatment of dormant corneal ulcers secondary to corneal surgery.
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Affiliation(s)
- Jorge L Alio
- 1 Research, Development and Innovation Department, VISSUM, Alicante, Spain.,3 Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | | | - Pablo De Arriba
- 1 Research, Development and Innovation Department, VISSUM, Alicante, Spain
| | - Sandra Gisbert
- 2 Department of Cornea and Refractive Surgery, VISSUM, Alicante, Spain
| | - Ahmed A Abdelghany
- 1 Research, Development and Innovation Department, VISSUM, Alicante, Spain.,4 Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt
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Descemet’s Membrane Detachment with Schisis Induced by Phacoemulsification. Optom Vis Sci 2016; 93:1562-1566. [DOI: 10.1097/opx.0000000000000993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fernández-Ferreiro A, Santiago-Varela M, Gil-Martínez M, Parada TGC, Pardo M, González-Barcia M, Piñeiro-Ces A, Rodríguez-Ares MT, Blanco-Mendez J, Lamas MJ, Otero-Espinar FJ. Ocular safety comparison of non-steroidal anti-inflammatory eye drops used in pseudophakic cystoid macular edema prevention. Int J Pharm 2015; 495:680-91. [PMID: 26423177 DOI: 10.1016/j.ijpharm.2015.09.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 01/09/2023]
Abstract
Non-steroidal anti-inflammatory drug (NSAID) eye drops are widely used to treat ocular inflammatory conditions related to ophthalmic surgical procedures, such as pseudophakic cystoid macular edema, and they have been used for off-label treatments. The most commonly used NSAIDs are diclofenac and ketorolac and the new molecules bromfenac and nepafenac have also been used. We used primary human keratocytes in cell culture in combination with a novel technology that evaluates dynamic real-time cytotoxicity through impedance analysis. This study also included classic cell viability tests (WST-1(®) and AlamarBlue(®)), wound healing assay, Hen's Egg Test and an ex vivo histopathological assay. NSAIDs were shown to have important cytotoxicities and to retard the healing response. Furthermore, the new eye drops containing bromfenac and nepafenac were more cytotoxic than the more classical eye drops. Nevertheless, no immuno-histochemical changes or acute irritation processes were observed after the administration of any eye drops tested. Due to cytotoxicity and the total absence of discomfort and observable injuries after the administration of these drugs, significant corneal alterations, such as corneal melts, can develop without any previous warning signs of toxicity.
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Affiliation(s)
- Anxo Fernández-Ferreiro
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - María Santiago-Varela
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - María Gil-Martínez
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - Tomas García-Caballero Parada
- Pathological Anatomy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - María Pardo
- Obesidomic Group Instituto de Investigación Sanitaria (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Miguel González-Barcia
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Antonio Piñeiro-Ces
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - María Teresa Rodríguez-Ares
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - José Blanco-Mendez
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 15701, Spain
| | - M J Lamas
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Francisco J Otero-Espinar
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 15701, Spain.
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Li YH, Wen Q, Fan TJ, Ge Y, Yu MM, Sun LX, Zhao Y. Dose dependent cytotoxicity of pranoprofen in cultured human corneal endothelial cells by inducing apoptosis. Drug Chem Toxicol 2014; 38:16-21. [PMID: 24641202 DOI: 10.3109/01480545.2014.900067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Pranoprofen (PPF), a non-steroidal anti-inflammatory drugs (NSAIDs), is often used in keratitis treatment in clinic. Several studies have assessed in vitro the cytotoxicity of topical NSAIDs to corneal epithelial cells due to its importance for predicting human corneal toxicity. Damage by cytotoxic drugs can result in excessive loss of human corneal endothelial (HCE) cells which lead to decompensation of the endothelium and eventual loss of visual acuity. However, the endothelial cytotoxicity of PPF has not yet been reported using an in vitro model of HCE cells. This study assessed the cytotoxicity of PPF to HCE cells and its underlying mechanism. Cellular viability was determined using inverted phase contrast light microscopy, and plasma membrane permeability, genomic DNA fragmentation, and ultrastructure were detected by acridine orange/ethidium bromide staining, DNA agarose gel electrophoresis, and transmission electron microscopy (TEM), respectively. The results on cellular viability showed that PPF at concentrations ranging from 0.0625 to 1.0 g/l had poignant cytotoxicity to HCE cells, and the extent of its cytotoxicity was dose- and time-dependent. Further characterization indicated that PPF induced plasma membrane permeability elevation, DNA fragmentation, and apoptotic body formation, proving its apoptosis inducing effect on HCE cells. In conclusion, PPF above 0.0625 g/l has poignant cytotoxicity on HCE cells in vitro by inducing cell apoptosis, and should be carefully employed in eye clinic.
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Affiliation(s)
- Yi-Han Li
- Laboratory for Corneal Tissue Engineering, College of Marine Life Sciences, Ocean University of China , Qingdao , China and
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Cunha PAFD, Shinzato FA, Tecchio GT, Weber SLP, Brasil A, Avakian A. Efficacy and tolerability of a gatifloxacin/prednisolone acetate fixed combination for topical prophylaxis and control of inflammation in phacoemulsification: a 20-day-double-blind comparison to its individual components. Clinics (Sao Paulo) 2013; 68:834-9. [PMID: 23778476 PMCID: PMC3674263 DOI: 10.6061/clinics/2013(06)18] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 03/06/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To compare the efficacy and tolerability of a fixed combination of 0.3% gatifloxacin and 1% prednisolone(ZypredH) versus the individual components used separately (Zymar® and Predfort® ) for infection prophylaxis and inflammation control after cataract surgery with intraocular lens implantation [corrected]. METHODS A prospective, randomized, double-blind, parallel-group study of 108 patients who underwent phacoemulsification and intraocular lens implantation was conducted. After random assignment, 47 eyes received the fixed combination of topical 0.3% gatifloxacin/1% prednisolone drops, and 61 eyes received the same doses of the individual components as separate solutions four times a day for 15 days. Baseline and postoperative assessments were made on postoperative days 1, 7, 15, and 20. RESULTS All objective (best corrected visual acuity, sign of active ocular inflammation, central and incisional corneal edema, the number of cells per high-power field in the anterior chamber, and intraocular pressure) and subjective (eye pain, photophobia, burning sensation, itching, and foreign body sensation) criteria of efficacy were similar in both groups, with no significant differences. Group I included 47 eyes that received the fixed combination of gatifloxacin/prednisolone acetate eye drops and a placebo eye drop solution. Group II included 61 eyes that were treated with 0.3% gatifloxacin and 1% prednisolone acetate eye drops separately. The intraocular pressure was slightly higher in Group II (p<0.05). CONCLUSION Treatment with the fixed-dose combination of gatifloxacin/prednisolone eye drops was as effective as the non-fixed combination in preventing infection and controlling inflammation after phacoemulsification and intraocular lens implantation.
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Ayaki M, Iwasawa A, Niwano Y. Comparative assessment of the cytotoxicity of six anti-inflammatory eyedrops in four cultured ocular surface cell lines, as determined by cell viability scores. Clin Ophthalmol 2012. [PMID: 23185116 PMCID: PMC3501841 DOI: 10.2147/opth.s36968] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Anti-inflammatory eyedrops are often used in the treatment of corneal epithelial disorders. In the present study, we evaluated the cytotoxicity of six anti-inflammatory eyedrops in four ocular surface cell lines. Methods The cytotoxicity of six commercially available anti-inflammatory ophthalmic solutions (ie, diclofenac, bromfenac, pranoprofen, betamethasone, and fluoromethorone) was assessed in three corneal cell lines and one conjunctival cell line. Cell viability was determined by the 3-(4,5-dimethyl-2 thiazoyl)-2,5-diphenyl-2H-tetrazolium bromide and neutral red assays after exposing the cells to 10, 30, and 60 minutes of onefold, twofold, and tenfold dilutions of the drugs. Cytotoxicity was compared using the cell viability score (CVS), an integrated cytotoxic parameter that takes various factors into account, such as dilution by tear fluid or concentration by evaporation, drug exposure time, and ocular surface cell type. Results Based on the CVS scores, the order of the anti-inflammatory eyedrops tested from least to most cytotoxic, with the active ingredient %CVS50, and %CVS40/80 for each solution given in parentheses, was as follows: Rinderon® (betamethasone, 100%, 100%) >0.02% Flumethoron® (fluoromethorone, 68%, 22%) = 0.1% Flumethoron® (fluoromethorone, 76%, 22%) >Bronuck® (0.1% bromfenac, 53%, −8%) = Diclod® (0.1% diclofenac, 44%, −15%) = Niflan® (pranoprofen, 50%, −19%). Rinderon® exhibited the least toxicity of all the anti-inflammatory eyedrops tested. Eyedrops containing non-steroidal anti-inflammatory drugs exhibited greater cytotoxicity than those containing steroids with benzalkonium at comparable concentrations. Concentration was the most significant factor affecting cell viability. Conclusion The cytotoxicity of the anti-inflammatory eyedrops evaluated in the present study depended on both the pharmaceutical components and preservatives. The CVS is a concise indicator of drug cytotoxicity.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, International University of Health and Welfare, Mita Hospital, Tokyo
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AYAKI MASAHIKO, IWASAWA ATSUO, NIWANO YOSHIMI. In vitro Assessment of the Cytotoxicity of Six Topical Antibiotics to Four Cultured Ocular Surface Cell Lines. Biocontrol Sci 2012; 17:93-9. [DOI: 10.4265/bio.17.93] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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14
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Ayaki M, Iwasawa A, Yaguchi S, Koide R. In vitro assessment of the cytotoxicity of anti-allergic eye drops using 5 cultured corneal and conjunctival cell lines. J Oleo Sci 2011; 60:139-44. [PMID: 21343662 DOI: 10.5650/jos.60.139] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to evaluate the cytotoxicity of anti-allergic eye drops for human corneal endothelial cells (HCEC) and commercially available ocular surface cells. A primary HCEC culture was derived from human eye bank specimens. SIRC (rabbit corneal epithelium), BCE C/D-1b (bovine corneal epithelial cells), RC-1 (rabbit corneal epithelium), and Chang (human conjunctival cells) were obtained commercially. The WST-1 assay was used to measure HCEC viability, and the viability of other cells was measured using the MTT assay. Cells were treated with 7 commercially available anti-allergic eye drops for 48 h and cell viability was measured and calculated as a percentage of control. The degree of toxicity for each eye-drop solution was based on the cell viability score (CVS). HCECs treated with a 1000-fold dilution of the eye-drop solution had a viability score of 67% for Rizaben and ≥80% for the other solutions with Zepelin being the least toxic. Cell viability in response to eye-drop solutions preserved with benzalkonium chloride (BAK) was dependent on the concentration of the drug solution and exposure time. Treatment of ocular surface cells with a 20-fold dilution of the eye-drop solution resulted in the following order of cell viability as determined by their CVS: Zepelin > Ketas = Zaditen ≥ Tramelas PF = Patanol ≥ Rizaben ≥ Livostin. This order was similar to that observed for HCECs, and cell viability was found to be concentration-dependent. Based on the penetration of the drug into eye tissues, HCECs are only likely to be pharmaceutically damaging in rare cases. Epithelial cell viability depends primarily on the concentration of BAK rather than on the action of the active component in the eye-drop solution. CVS values were useful for comparison of toxicity.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Saitama National Hospital, Suma, Wako city, Saitama, Japan.
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Moisseiev E, Varssano D. Comparison of ocular tolerability between preserved and preservative-free diclofenac sodium drops. J Ocul Pharmacol Ther 2011; 27:333-7. [PMID: 21702687 DOI: 10.1089/jop.2011.0001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To compare the tolerability of preserved diclofenac sodium 0.1% (Voltaren Ophtha) and preservative-free diclofenac (Dicloftil). METHODS Thirty healthy volunteers received a single drop of Voltaren Ophtha in 1 eye, and a single drop of Dicloftil in the other. Both drops were instilled at the same time, in a single-blind manner. Visual analog scale grading was used to measure ocular discomfort, itch, burn, and pain. Grading was obtained before drop instillation and after 15 s, 1 min, 5 min, 15 min, and 30 min. RESULTS Both preparations caused discomfort, itch, burn, and pain, with a peak effect on all 4 parameters at 15 min. However, preservative-free Dicloftil proved to be more tolerable than preserved Voltaren Ophtha. Data show significantly lower reported levels of discomfort and itch up to 15 min, lower levels of burn at the first minute, and less pain immediately after instillation. CONCLUSION This is the first study to compare subjective ocular tolerability of a single drop. Our results indicate that Dicloftil has better tolerability than Voltaren Ophtha. Ophthalmologists should be aware of this significant difference when prescribing diclofenac, especially in patients with low compliance or who require prolonged therapy.
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Affiliation(s)
- Elad Moisseiev
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
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