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Yang Y, Yan J, Yang J, Wang P, Liu Y, Wang X. Janus kinase inhibitor Abrocitinib as an Off-Label treatment for tattoo granuloma with uveitis (TAGU). Australas J Dermatol 2024; 65:297-299. [PMID: 38450752 DOI: 10.1111/ajd.14248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Yutong Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yeqiang Liu
- Department of Dermatopathology, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
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Obaru C, Kimura T, Yamamura M, Kuriyama H, Kashiwada-Nakamura K, Mizuhashi S, Matsumura T, Watanabe T, Inoue T, Fukushima S. A case of melanoma complicated with uveitis induced by two types of BRAF/MEK inhibitors and nivolumab treatment. J Dermatol 2024; 51:e115-e117. [PMID: 37927219 DOI: 10.1111/1346-8138.17015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Chiaki Obaru
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshihiro Kimura
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manami Yamamura
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Haruka Kuriyama
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kayo Kashiwada-Nakamura
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoru Mizuhashi
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomoyo Matsumura
- Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahiro Watanabe
- Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshihiro Inoue
- Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Bai YC, Perng WT, Huang JY, Liao PL, Wei JCC. Risk of uveitis in autoimmune diseases patients treated with hydroxychloroquine: A population-based retrospective cohort study. Int J Rheum Dis 2024; 27:e15099. [PMID: 38450965 DOI: 10.1111/1756-185x.15099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 01/01/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Uveitis is a common manifestation of various autoimmune diseases and can lead to severe visual impairment. Hydroxychloroquine (HCQ) is an antimalarial drug that is also used to treat autoimmune diseases. The aim of this study was to investigate the association between HCQ use and the incidence of uveitis in patients with autoimmune diseases, as well as to identify potential risk factors for the development of uveitis in this study. METHODS We conducted a population-based cohort study using a nationwide database to investigate the incidence of uveitis in patients with autoimmune diseases who received HCQ treatment. We selected non-HCQ comparison cohort at a 1:1 ratio by propensity score matching on age, sex, index date, urbanization, income, comorbidities, and medications. The data were analyzed using Cox proportional hazards models, and propensity score matching (PSM) was used to reduce selection bias. RESULTS Our study included 15 822 patients with autoimmune diseases. After 1:1 PSM, there were 4555 individuals in both the HCQ group (n = 4555) and the non-HCQ group (n = 4555). The multiple Cox proportional hazard regression analysis was used for the estimation of adjusted hazard ratios on uveitis. After PSM, the adjusted hazard ratio for the HCQ group was 0.74 (95% CI = 0.58-0.95). These findings suggest that HCQ may play a protective role in reducing the risk of uveitis in patients with autoimmune diseases, including rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus groups. The Kaplan-Meier survival curves also showed a significantly lower incidence of uveitis in the HCQ group (log-rank = 0.0229) after PSM. CONCLUSION HCQ use is associated with a lower incidence of uveitis in patients with autoimmune diseases. Further studies are needed to confirm this association and to investigate the underlying mechanisms.
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Affiliation(s)
- Yi-Chiao Bai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Wuu-Tsun Perng
- Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Graduate Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Pei-Lun Liao
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Thibault T, Ben Ghezala I, Freppel R, Rajillah A, Boulay C, Brunel P, Atzenhoffer M, Auvens C, Devilliers H, Grandvuillemin A. Drug-Induced Uveitis Related to Checkpoint Inhibitors and MAP-kinase Inhibitors. Ophthalmology 2024; 131:249-251. [PMID: 37820932 DOI: 10.1016/j.ophtha.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023] Open
Affiliation(s)
- Thomas Thibault
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France; Centre Régional de Pharmacovigilance de Bourgogne, University Hospital Dijon-Burgundy, Dijon, France; INSERM CIC-EC 1432, Clinical Investigation Center, University Hospital Dijon-Burgundy, Dijon, France.
| | - Inès Ben Ghezala
- Ophthalmology Department, University Hospital, University Hospital Dijon-Burgundy, Dijon, France; INSERM, CIC 1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Romane Freppel
- Centre Régional de Pharmacovigilance de Bourgogne, University Hospital Dijon-Burgundy, Dijon, France
| | - Abdessamad Rajillah
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Charlène Boulay
- Regional Centre of Pharmacovigilance and Pharmacoepidemiology, CHU de Rouen, Rouen, Normandie, France
| | - Pierre Brunel
- Centre de Pharmacovigilance et de Renseignements sur le médicament, CHU de Saint-Etienne, Saint-Etienne, Auvergne-Rhône-Alpes, France
| | - Marina Atzenhoffer
- Service Hospitalo-Universitaire de Pharmaco-Toxicologie, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Clément Auvens
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Hervé Devilliers
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France; INSERM CIC-EC 1432, Clinical Investigation Center, University Hospital Dijon-Burgundy, Dijon, France
| | - Aurélie Grandvuillemin
- Centre Régional de Pharmacovigilance de Bourgogne, University Hospital Dijon-Burgundy, Dijon, France
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Khopade AJ, Halder A, Patel V, Shah H, Shah A, Burade V, Zalawadia R, Patel A, Awati C, Zope M. A Comparative Preclinical Evaluation of a Novel Difluprednate 0.04% BID Ophthalmic Solution and Marketed 0.05% QID Ophthalmic Emulsion. J Ocul Pharmacol Ther 2024; 40:57-66. [PMID: 37922455 DOI: 10.1089/jop.2023.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Purpose: The purpose of this study was to compare the efficacy, and ocular pharmacokinetics of a new 0.04% w/v bis in die means twice a day (BID) ophthalmic solution and marketed 0.05% w/v quater in die means four times a day (QID) ophthalmic emulsion of difluprednate in New Zealand white (NZW) rabbits. Methods: The preclinical proof of concept was established in paracentesis-induced acute inflammation, endotoxin-induced acute uveitis, and bovine serum albumin-induced chronic uveitis in NZW rabbit animal models. A comparison of clinical score, total cell count, and total protein was performed to determine efficacy. An ocular pharmacokinetic study was conducted to study the influence of the vehicle on the ocular absorption of the drug. Results: In both uveitis models, the new solution formulation and marketed emulsion formulation inhibited total clinical score, total cell count, PGE2, and total protein significantly more than the placebo and lipopolysaccharide (disease control) groups and were comparable. In an ocular pharmacokinetic study, the Cmax and AUC0-t of difluoroprednisolone 17-butyrate in humor were ∼2-fold higher after 14 days' instillation of new solution formulation (0.04% w/v, BID) compared with 14 days' instillation of marketed emulsion (0.05% w/v, QID). Conclusions: The study demonstrated that the efficacy of the solution formulation at a lower dose and reduced dosing regimen were comparable to that of the emulsion formulation. The reduction in strength and regimen may result in improved patient adherence and outcomes.
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Affiliation(s)
- Ajay J Khopade
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Arindam Halder
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Vivek Patel
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Harsh Shah
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Ankit Shah
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Vinod Burade
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Rishit Zalawadia
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Alpesh Patel
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Chandan Awati
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
| | - Murlidhar Zope
- Department of Formulation R&D Non-Orals, Sun Pharmaceutical Industries Ltd., Vadodara, India
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Marino A, Marelli L, Nucci P, Caporali R, Miserocchi E. Subcutaneous Tocilizumab in Juvenile Idiopathic Arthritis Associated Uveitis. Ocul Immunol Inflamm 2023; 31:1997-2000. [PMID: 36657742 DOI: 10.1080/09273948.2022.2161916] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/19/2022] [Indexed: 01/21/2023]
Abstract
AIM To describe the efficacy and safety of subcutaneous tocilizumab (SC-TCZ) in a cohort of juvenile idiopathic arthritis (JIA) patients with refractory uveitis. METHODS Retrospective observational monocentric study including patients with JIA-associated uveitis treated with SC-TCZ. RESULTS Thirteen patients were enrolled. The rate of uveitis flare/year per each patient was 1.6 ± 2.0 on the last bDMARDs before SC-TCZ, while it decreased to 0.4 ± 0.7 on SC-TCZ. Nine out of thirteen patients (69%) required the introduction of SC-TCZ only for active uveitis at baseline. Among these patients, five (56%) achieved complete treatment response. No uveitis relapses were observed in patients (4/13, 31%) requiring the introduction of SC-TCZ for active arthritis during follow-up (30.48 ± 21.6 months). Overall, SC-TCZ was safe, and no side effects were observed during the treatment. CONCLUSION SC-TCZ can be effective and safe in patients with JIA and uveitis recalcitrant to several bDMARDs.
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Affiliation(s)
| | | | - Paolo Nucci
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Roberto Caporali
- Pediatric Rheumatology, ASST G.Pini-CTO, Milan, Italy
- Department of Clinical Sciences and Community Health and Research Center for Pediatric and Adult Rheumatic Diseases (RECAP.RD), University of Milan, Milan, Italy
| | - Elisabetta Miserocchi
- Ophthalmology Department, Ospedale San Raffaele, University Vita-Salute, Milan, Italy
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Neri P, Pichi F. COVID, the end of pandemic and vaccine-induced Uveitis: is this the showdown? Int Ophthalmol 2023; 43:4395-4397. [PMID: 37926764 DOI: 10.1007/s10792-023-02879-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Piergiorgio Neri
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
- Cleveland Clinic Lerner College of Medicine, Case Western University, Cleveland, OH, USA.
| | - Francesco Pichi
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Cleveland Clinic Lerner College of Medicine, Case Western University, Cleveland, OH, USA
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Kang TK, Le TT, Kwon H, Park G, Kim KA, Ko H, Hong S, Lee WB, Jung SH. Lithospermum erythrorhizon Siebold & Zucc. extract reduces the severity of endotoxin-induced uveitis. Phytomedicine 2023; 121:155133. [PMID: 37812852 DOI: 10.1016/j.phymed.2023.155133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Uveitis is an inflammatory eye condition that threatens vision, and effective anti-inflammatory treatments with minimal side effects are necessary to treat uveitis. PURPOSE This study aimed to investigate the effects of Lithospermum erythrorhizon Siebold & Zucc. against endotoxin-induced uveitis in rat and mouse models. METHODS Endotoxin-induced uveitis models of rats and mice were used to evaluate the effects of l. erythrorhizon treatment. Clinical inflammation scores and retinal thickness were assessed in the extract of l. erythrorhizon-treated rats. Histopathological examination revealed inflammatory cell infiltration into the ciliary body. Protein concentration, cellular infiltration, and prostaglandin-E2 levels were measured in the aqueous humor of the extract of l. erythrorhizon-treated rats. Protective effects of l. erythrorhizon on the anterior segment of the eye were examined in mice with endotoxin-induced uveitis. Additionally, we investigated the effect of l. erythrorhizon on the expression of pro-inflammatory cytokines [tumor necrosis factor alpha, interleukin-6, and interleukin-8] in lipopolysaccharide-stimulated THP1 human macrophages and examined the involvement of nuclear factor kappaB/activator protein 1 and interferon regulatory factor signaling pathways. Furthermore, three components of l. erythrorhizon were identified and assessed for their inhibitory effects on LPS-induced inflammation in RAW264.7 macrophage cells. RESULTS Treatment of the extract of l. erythrorhizon significantly reduced clinical inflammation scores and retinal thickening in rats with endotoxin-induced uveitis. Histopathological examination revealed decreased inflammatory cell infiltration into the ciliary body. The extract of l. erythrorhizon effectively reduced the protein concentration, cellular infiltration, and PG-E2 levels in the aqueous humor of rats with endotoxin-induced uveitis. In mice with endotoxin-induced uveitis, the extract of l. erythrorhizon demonstrated a protective effect on the anterior segment of the eye by reducing inflammation and retinal thickening. The extract of l. erythrorhizon suppressed the expression of pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin-6, and interleukin-8) in lipopolysaccharide-induced inflammation in THP1 human macrophages, by modulating nuclear factor kappaB/activator protein 1 and interferon regulatory factor signaling pathways. Moreover, shikonin, acetylshikonin, and β, β-dimethylacryloylshikonin showed dose-dependent inhibition of nitric oxide, tumor necrosis factor alpha and interleukin-6 production in RAW264.7 macrophage cells. CONCLUSION The extract of l. erythrorhizon is a potential therapeutic agent for uveitis management. Administration of the extract of l. erythrorhizon led to reduced inflammation, retinal thickening, and inflammatory cell infiltration in rat and mouse models of uveitis. The compounds (shikonin, acetylshikonin, and β, β-dimethylacryloylshikonin) identified in this study played crucial roles in mediating the anti-inflammatory effects of l. erythrorhizon. These findings indicate that the extract of l. erythrorhizon and its constituent compounds are promising candidates for further research and development of novel treatment modalities for uveitis.
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Affiliation(s)
- Tae Kyeom Kang
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea
| | - Tam Thi Le
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology, Gangneung 25451, Republic of Korea
| | - Hyukjoon Kwon
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea
| | - Geon Park
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea
| | - Kyung-A Kim
- Division of Medical Oncology, Department of Internal Medicine, Graduate School of Medical Science Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyejin Ko
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea
| | - Suhee Hong
- Department of Aquatic Life Medicine, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea
| | - Wook-Bin Lee
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology, Gangneung 25451, Republic of Korea.
| | - Sang Hoon Jung
- Natural Product Research Center, Korea Institute of Science & Technology, Gangneung 25451, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology, Gangneung 25451, Republic of Korea.
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Du Y, Zhou L, Wen Z, Feng L, Zhang S, Zhang T. Slit2 suppresses endotoxin-induced uveitis by inhibiting the PI3K/Akt/IKK/NF-κB pathway. Scand J Immunol 2023; 98:e13319. [PMID: 38441217 DOI: 10.1111/sji.13319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/17/2023] [Accepted: 07/18/2023] [Indexed: 03/07/2024]
Abstract
Uveitis is a devastating intraocular inflammatory disease. The secreted leucine-rich repeat protein slit homologue 2 (Slit2) has been found to be an essential regulator of inflammation. This study aimed to analyse the anti-inflammatory effects and the underlying mechanisms of Slit2 in an endotoxin-induced uveitis (EIU) rat model. In this study, rats with EIU pretreated recombinant human Slit2 (rhSlit2) or a control vehicle by intravitreal injection. The clinical scores were graded under a slit lamp. The protein concentrations and total number of cells in the aqueous humour (AqH) were examined, and the retinal expression of various inflammatory mediators was detected. The levels of nuclear factor-kappa B (NF-κB), phosphorylated NF-κB, IkappaB-a (IκB-a), phosphorylated IκB-a, IKK, phosphorylated IKK, PI3Kp85, phosphorylated PI3Kp85, Akt and phosphorylated Akt were evaluated by western blotting. Treatment with rhSlit2 dramatically diminished the clinical scores of EIU, with significant decreases in inflammatory cell infiltration, protein concentrations, cellulose-like exudates, the production of ICAM-1, MCP-1, TNF-α and IL-6 in the AqH; and adhesion of leucocytes. The PI3K/Akt/IKK/NF-κB pathway was found to be activated in EIU. However, the pre-treatment of rhSlit2 significantly inhibited the production of ICAM-1, MCP-1, TNF-α, and IL-6, and inhibited leucocyte adhesion by modulating the PI3K/Akt/IKK/NF-κB pathway. In conclusion, the intravitreal injection of rhSlit2 alleviated EIU-related inflammation in Sprague-Dawley rats by reducing the proinflammatory cytokines and leucocyte adhesion; in particular, rhSlit2 may inhibit LPS-induced inflammation by inhibiting the activation of PI3K/Akt/IKK/NF-κB signalling pathway. Therefore, rhSlit2 shows significant potential for effectively alleviating immune inflammatory responses in vivo.
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Affiliation(s)
- Yong Du
- Chongqing Key Lab of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Linbin Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zijun Wen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lujia Feng
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Ting Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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10
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Arıkan S, Guven S, Sehitoglu MH, Elmas S. The possible effect of topically applied azithromycin and moxifloxacin on the alleviation of uveitis. Int Ophthalmol 2023; 43:4451-4460. [PMID: 37642800 DOI: 10.1007/s10792-023-02845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 07/27/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE To investigate the inhibitory effect of topically administered azithromycin (AZM), and moxifloxacin (MXF) against tumor necrosis factor-α (TNF-α) production in a rat model of endotoxin-induced uveitis (EIU). METHODS Thirty-six Wistar albino rats were divided into 6 equal groups. Groups 1, 2 and 3 were determined as sham, control group for topical AZM application and control group for topical MXF application, respectively. Sterile saline, topical AZM 1.5%, and topical MXF 0.5% were instilled 5 times daily for totally 6 days on both eyes of the rats in Group 4, Group 5, and Group 6, before and after inducing EIU by intravitreal injections of lipopolysaccharide, respectively. At 24 h after intravitreal injections, aqueous humor was collected from both eyes of each rat for the assessment of TNF-α concentration. Also, density of nuclear factor kappa B (NF-κB) in ciliary body, and the number of cells infiltrating the posterior segment of EIU rat eyes was assessed in one eye of each rat. RESULTS There was a significant reduction in mean aqueous humor concentration of TNF-α in EIU rats pretreated with topical AZM in comparison with those pretreated with sterile saline (139 ± 38.6 in Group 4 vs. 72 ± 12.6 in Group 5, p = 0.006). There was also a marked decrease in mean aqueous humor concentration of TNF-α in EIU rats pretreated with topical MXF (139 ± 38.6 in Group 4 vs.86.1 ± 35.5 in Group 6, p = 0.025). Also, evident suppressions were determined in mean density of NF-κB, and in mean number of cells in EIU rats pretreated either with topical AZM, or topical MXF. CONCLUSIONS Topically applied AZM or MXF may be beneficial in the suppression of TNF-α production in aqueous humor.
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Affiliation(s)
- Sedat Arıkan
- Department of Ophthalmology, Kayseri City Training and Research Hospital, Muhsin Yazıcıoglu Aveniu, Seker Street, No:77, Kocasinan, 38038, Kayseri, Turkey.
| | - Soner Guven
- Department of Ophthalmology, Kayseri City Training and Research Hospital, Muhsin Yazıcıoglu Aveniu, Seker Street, No:77, Kocasinan, 38038, Kayseri, Turkey
| | - Muserref Hilal Sehitoglu
- Department of Medical Biochemistry, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Sait Elmas
- Experimental Research Application and Research Center, Canakkale Onsekiz Mart University, Canakkale, Turkey
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Sada I, Harada Y, Hiyama T, Mizukami M, Kan T, Kawai M, Kiuchi Y. Uveitis associated with immune checkpoint inhibitors or BRAF/MEK inhibitors in patients with malignant melanoma. Melanoma Res 2023; 33:539-546. [PMID: 37788106 DOI: 10.1097/cmr.0000000000000933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
The objective of this study was to evaluate the frequency and characteristics of uveitis associated with immune checkpoint inhibitors (ICIs) or BRAF/MEK inhibitors (B/MIs) in patients with malignant melanoma. Patients diagnosed with malignant melanoma who underwent radical or local resection for malignant melanoma, regardless of clinical stage or postoperative adjuvant therapy, at Hiroshima University Hospital from January 2015 to June 2021 were enrolled in a retrospective cohort. The medical records of patients were collected to estimate the prevalence of ocular adverse events. The clinical characteristics of patients who developed uveitis were reviewed. Among 152 patients, 54 and 12 were treated with ICIs and B/MIs, respectively. Four patients developed uveitis; 1 in the ICI group and 3 in the B/MI group, while there were no uveitis cases among patients who did not receive ICIs or B/MIs. Three patients had Vogt-Koyanagi-Harada disease-like findings. Uveitis was improved by steroid therapy with or without oncological treatment interruption. Oncological treatment could be resumed. Patients with melanoma treated with ICIs or B/MIs had a higher risk of uveitis compared with those who did not receive them. Oncological treatment could be resumed in all patients who developed uveitis.
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Affiliation(s)
- Ikuyo Sada
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University
| | - Yosuke Harada
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University
| | - Tomona Hiyama
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University
| | - Mina Mizukami
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University
| | - Takanobu Kan
- Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Mikio Kawai
- Department of Dermatology, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University
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12
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Pockar S, Leal I, Chhabra R, Jones NP, Steeples LR. Intravitreal Fluocinolone 0.19mg Implant in the Management of Chronic Non-Infectious Uveitis: 12-Month Outcomes from a Single Tertiary Centre. Ocul Immunol Inflamm 2023; 31:1572-1578. [PMID: 34124978 DOI: 10.1080/09273948.2021.1922707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
AIM To present efficacy and safety of 0.19 mg fluocinolone acetonide insert (FAi) to treat chronic noninfectious uveitis (NIU) in a single referral center. METHODS A retrospective observational clinical study of 11 eyes with NIU complicated by chronic cystoid macular edema (CMO). RESULTS The main indication for treatment was chronic CMO in all 11 eyes. The mean central retinal thickness (CRT) at baseline was 435 μm ± 176, improving to 296 μm ± 67 at 12 months. Raised intraocular pressure (IOP) was the commonest adverse event. An IOP >21 mmHg was observed in three eyes, and >30 mmHg in one eye, managed with topical therapy. The mean best corrected visual acuity (BCVA) was stable at 12 months. There were no observed recurrences of uveitis. Two eyes received adjunctive treatment for worsening CRT. CONCLUSIONS Our results suggest FAi is an effective maintenance treatment for NIU with favorable functional and anatomical outcomes.
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Affiliation(s)
- Sasa Pockar
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Inês Leal
- Ophthalmology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro de Estudos das Ciências da Visão, Clínica Universitária de Oftalmologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ramandeep Chhabra
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Nicholas P Jones
- Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Laura R Steeples
- Manchester Royal Eye Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
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13
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Mahmud H, Ahmad TR, Gonzales JA, Stewart JM. Efficacy of the Fluocinolone Acetonide (Yutiq) Intravitreal Implant as Monotherapy for Uveitis. Ocul Immunol Inflamm 2023; 31:1603-1607. [PMID: 35793136 DOI: 10.1080/09273948.2022.2076131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 05/04/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the efficacy of the fluocinolone acetonide intravitreal implant (Yutiq) as monotherapy for uveitis. DESIGN Retrospective cohort study. PARTICIPANTS Patients at a single academic health-care institution. METHODS Medical record review of patients with non-infectious uveitis actively suppressed on an alternative anti-inflammatory regimen who received a fluocinolone acetonide implant. The primary outcome was continued control of inflammation based on clinical examination, optical coherence tomography, and fluorescein angiography. RESULTS Thirteen patients (19 eyes) received an implant. Median follow-up was 6 months. Uveitis control was achieved in 14 eyes (74%), though three (21%) required a topical steroid after insertion. The remaining five eyes (26%) required additional intraocular treatments. CONCLUSION The fluocinolone acetonide implant may not suffice as monotherapy for all patients with uveitis, but it may be effective as an adjunctive treatment. We propose a clinical workflow for the selection and treatment of patients who may benefit from it.
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Affiliation(s)
- Hamidah Mahmud
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, Department of Ophthalmology, San Francisco, California, USA
| | - Tessnim R Ahmad
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, Department of Ophthalmology, San Francisco, California, USA
| | - John A Gonzales
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco,California, USA
| | - Jay M Stewart
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Zuckerberg San Francisco General Hospital and Trauma Center, Department of Ophthalmology, San Francisco, California, USA
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14
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Colao M, Migotto C, Gilardi S, Erasmi F, Borettaz I, Boso M, Giuliani E, Tiboldo R. [Clozapine-induced Tubulointerstitial Nephritis]. G Ital Nefrol 2023; 40:2023-vol4. [PMID: 37910212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Tubulointerstitial nephritis is a common cause of acute renal failure, in two thirds of cases it is associated with drugs (mostly antimicrobials and NSAIDs), in 5-10% of cases it is associated with infections (bacterial/viral/parasitic), in 5-10% of cases it is idiopathic (this is the case of the TINU syndrome characterized by interstitial nephritis and bilateral uveitis, and the anti-glomerular basal membrane antibody syndrome), and finally in 10% of cases it is associated with systemic diseases (sarcoidosis, by Sjogren, LES). The pathogenesis is based on a cell-mediated immune response and in most cases removing the causative agent is the gold standard of therapy. However, a percentage of patients, in a variable range from 30% to 70% of cases, do not fully recover renal function, due to the rapid transformation of the interstitial cell infiltrate into vast areas of fibrosis. Clozapine is a second generation atypical antipsycothic usually used for the treatment of schizophrenia resistant to other types of treatment; it can cause severe adverse effects among which the best known is a severe and potentially fatal neutropenia, furthermore a series of uncommon adverse events are recognized including hepatitis, pancreatitis, vasculitis. Cases of acute interstitial tubular nephritis associated with the use of clozapine have been described in the literature, although this complication is rare. Medical personnel using this drug need to be aware of this potential and serious side effect. We describe the case of a 48-year-old man who developed acute renal failure after initiation of clozapine.
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Affiliation(s)
- Maria Colao
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
| | - Clara Migotto
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
| | - Susanna Gilardi
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
| | - Fulvia Erasmi
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
| | - Ilaria Borettaz
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
| | - Marianna Boso
- U.O. Pschiatria, Ospedale Vizzolo Predabissi, Italia
| | | | - Renza Tiboldo
- U.O Nefrologia e Dialisi, Ospedale Vizzolo Predabissi, Italia
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15
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Otaka Y, Kanai K, Okada D, Nagai N, Yamashita Y, Ichikawa Y, Tajima K. Sodium Ferrous Citrate and 5-Aminolevulinic Acid Exert a Therapeutic Effect on Endotoxin-Induced Uveitis in Rats. Int J Mol Sci 2023; 24:13525. [PMID: 37686331 PMCID: PMC10487957 DOI: 10.3390/ijms241713525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
The metabolism of 5-aminolevulinic acid (ALA) is more efficient when combined with sodium ferrous citrate (SFC). Our previous study revealed that oral administration of ALA, which has anti-inflammatory properties, and SFC (ALA/SFC) immediately before lipopolysaccharide (LPS) inoculation suppressed endotoxin-induced uveitis (EIU) in rats. However, the therapeutic effect of ALA/SFC post-administration remains unexplored. Hence, this study aimed to evaluate the therapeutic efficacy of ALA/SFC on EIU in rats, which were administered with a gastric gavage of ALA/SFC (100/157 mg/kg) or prednisolone (Pred, 10 mg/kg) after 4 h of LPS inoculation. The treatment groups showed ameliorated clinical scores, inflammatory cells, protein levels in the aqueous humor (AqH), and histopathologic evaluation 24 h after LPS inoculation. Furthermore, the treatment groups had reduced tumor necrosis factor-α, nitric oxide, prostaglandin E2, and interleukin-6 levels in the AqH. ALA/SFC demonstrated an anti-inflammatory effect equivalent to that demonstrated by Pred. These findings indicate that ALA/SFC exerts a therapeutic effect on EIU in rats, indicating its clinical usefulness in uveitis treatment.
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Affiliation(s)
- Yuya Otaka
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
| | - Kazutaka Kanai
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
| | - Daiki Okada
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashiosaka 577-8502, Osaka, Japan;
| | - Yohei Yamashita
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
| | - Yoichiro Ichikawa
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
| | - Kazuki Tajima
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 Ban-Cho, Towada 034-8628, Aomori, Japan; (Y.O.); (D.O.); (Y.Y.); (Y.I.); (K.T.)
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16
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Kaymak NZ, Kaplan AT. Vogt-Kayanagi-Harada-Like Uveitis Induced by Dabrafenib/Trametinib Therapy for Cutaneous Malignant Melanoma. Ophthalmic Surg Lasers Imaging Retina 2023; 54:477-480. [PMID: 37535619 DOI: 10.3928/23258160-20230524-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
A 54-year-old woman with cutaneous malignant melanoma developed Vogt-Kayanagi-Harada (VKH)-like uveitis induced by dabrafenib/trametinib therapy. Dabrafenib was discontinued but she continued to use trametinib due to the risk of disease progression. Intraocular inflammation resolved after cessation of dabrafenib and administration of topical and systemic corticosteroids. Our patient outlines the importance of recognizing VKH-like uveitis as a consequence of dabrafenib/trametinib therapy in melanoma patients and highlights a question about the potential role of each drug in developing uveitis. [Ophthalmic Surg Lasers Imaging Retina 2023;54:477-480.].
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17
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Chacko G, Kota S, Kumar S, Ohri N, Omene C, Ganesan S, Toppmeyer DL, George MA. Uveitis, a rare but important complication of adjuvant zoledronic acid for early-stage breast cancer. Anticancer Drugs 2023; 34:592-594. [PMID: 36846985 DOI: 10.1097/cad.0000000000001503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Bisphosphonates such as zoledronic acid are an important part of adjuvant therapy to reduce the risk of recurrence in early-stage breast cancer. Uveitis remains one of the lesser-known side effects of zoledronic acid; prompt recognition is essential to ensure patients receive appropriate and timely care to help prevent permanent vision loss. We report a case of anterior uveitis in a postmenopausal woman who presented with visual symptoms after receiving the first dose of zoledronic acid. This case report serves to educate and increase awareness of the risk of uveitis in patients who are given zoledronic acid. This is the first and only reported case of zoledronic acid when used in the adjuvant setting for the treatment of breast cancer.
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Affiliation(s)
- Geena Chacko
- Rutgers Robert Wood Johnson Medical School, Department of Medicine
| | - Srigowri Kota
- Rutgers Cancer Institute of New Jersey, Department of Surgery
| | - Shicha Kumar
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology
| | - Nisha Ohri
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology
| | - Coral Omene
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Shridar Ganesan
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Deborah L Toppmeyer
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Mridula A George
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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18
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Nakayama M, Okada AA, Hayashi I, Keino H. COVID-19 vaccination-related intraocular inflammation in Japanese patients. Graefes Arch Clin Exp Ophthalmol 2023; 261:897-899. [PMID: 36280611 PMCID: PMC9592537 DOI: 10.1007/s00417-022-05866-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Makiko Nakayama
- Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Annabelle A Okada
- Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Isami Hayashi
- Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroshi Keino
- Department of Ophthalmology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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19
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Nelson MC, Manos CK. Secukinumab Therapy in Refractory Juvenile Idiopathic Arthritis. J Investig Med High Impact Case Rep 2023; 11:23247096231200403. [PMID: 37731263 PMCID: PMC10515513 DOI: 10.1177/23247096231200403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/07/2023] [Accepted: 08/19/2023] [Indexed: 09/22/2023] Open
Abstract
Juvenile idiopathic arthritis (JIA), the most common chronic rheumatologic condition in childhood, remains a cause of significant morbidity, particularly in those with spondyloarthropathy, including psoriatic arthritis (PsA) and enthesitis-related arthritis (ERA). While secukinumab was recently approved for the treatment of children and adolescents with ERA and PsA, there is limited published data on its use in JIA, particularly in refractory cases, despite its efficacy in the treatment of adult arthritis. We aim to examine the use of this therapy in JIA in a single pediatric rheumatology center. A retrospective chart review was performed and 10 JIA patients who received treatment with secukinumab were identified. Data extracted included disease activity, patient demographics, comorbidities, medications, and laboratory data. Seven ERA, 2 PsA, and 1 poly JIA patient were treated with secukinumab at our center between April 2011 and July 2021. These patients had notably resistant disease, with a mean disease-modifying antirheumatic drug (DMARD) failure rate of 3.8. One hundred percent of patients who underwent magnetic resonance imaging (MRI) after being on at least 3 months of secukinumab therapy demonstrated improvement in their MRI findings. One patient developed a flare of uveitis while on secukinumab therapy, with no other adverse events recorded in our patients. Secukinumab therapy was recently approved for children and adolescents with ERA and PsA, and may offer an efficacious option given its demonstrated improvement in imaging and joint examination, as well as qualitative reports of pain, even in those who have failed other therapies. However, caution may be warranted in those with a history of uveitis and warrants further study.
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Affiliation(s)
- Meghan Corrigan Nelson
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, GA, USA
| | - Cynthia K. Manos
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, GA, USA
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20
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Jabs DA, Berkenstock MK, Altaweel MM, Holbrook JT, Sugar EA. The Conundrum of Clinical Trials for the Uveitides: Appropriate Outcome Measures for One Treatment Used in Several Diseases. Epidemiol Rev 2022; 44:2-16. [PMID: 35442407 PMCID: PMC10362938 DOI: 10.1093/epirev/mxac001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 12/29/2022] Open
Abstract
The uveitides consist of >30 diseases characterized by intraocular inflammation. Noninfectious intermediate, posterior, and panuveitides typically are treated with oral corticosteroids and immunosuppression, with a similar treatment approach for most diseases. Because these uveitides collectively are considered a rare disease, single-disease trials are difficult to impractical to recruit for, and most trials have included several different diseases for a given protocol treatment. However, measures of uveitis activity are disease specific, resulting in challenges for trial outcome measures. Several trials of investigational immunosuppressive drugs or biologic drugs have not demonstrated efficacy, but design problems with the outcome measures have limited the ability to interpret the results. Successful trials have included diseases for which a single uveitis activity measure suffices or a composite measure of uveitis activity is used. One potential solution to this problem is the use of a single, clinically relevant outcome, successful corticosteroid sparing, defined as inactive uveitis with a prednisone dose ≤7.5 mg/day coupled with disease-specific guidelines for determining inactive disease. The clinical relevance of this outcome is that active uveitis is associated with increased risks of visual impairment and blindness, and that prednisone doses ≤7.5 mg/day have a minimal risk of corticosteroid side effects. The consequence of this approach is that trial visits require a core set of measures for all participants and a disease-specific set of measures, both clinical and imaging, to assess uveitis activity. This approach is being used in the Adalimumab Versus Conventional Immunosuppression (ADVISE) Trial.
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21
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Buhl L, Thurau S, Kern C. Fluocinolone acetonide 0.19-mg implant for the treatment of noninfectious uveitis with involvement of the posterior segment: a real-world study. Graefes Arch Clin Exp Ophthalmol 2022; 261:1101-1108. [PMID: 36399176 PMCID: PMC10050064 DOI: 10.1007/s00417-022-05893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/31/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Purpose
To evaluate the effectiveness of 0.19-mg fluocinolone acetonide implant (FAi) for preventing inflammatory relapses in noninfectious uveitis with posterior segment involvement in standard clinical practice. Further, to assess the value of remission induction therapy with intraocular and periorbital administered high-dose corticosteroids before FAi.
Methods
A retrospective cohort study in a tertiary referral center specialized in uveitis management. The primary study outcomes were the best-corrected visual acuity (BVCA) and central retinal thickness (CRT) within a 12-month observation period. The secondary outcomes were intraocular pressure (IOP) and intraocular inflammation. The main safety measures were IOP increase and cataract formation.
Results
In total, 76 eyes of 57 patients received FAi. Locally administered high-dose corticosteroids were applied in 68.4% of all eyes before FAi. BCVA remained stable within the 12-month observation period (63.21 vs. 62.95, difference 0.26 letters; 95% CI: − 6.31 to 6.84; p > 0.9). Significant CRT reduction upon FAi was sustained after 12 months (362.7 vs. 309.1 μm, difference 53.57 μm; 95% CI: 1.55 to 105.6; p = 0.04). Intraocular inflammation was reduced until 9 months of follow-up (0.82 vs. 0.3, difference 0.53; 95% CI: 0.11 to 0.95; p = 0.007). A mean IOP increase (13.68 vs. 15.6; difference − 1.92; 95% CI: − 3.85 to 0.004; p = 0.0507) and cataract development (20% of all phakic eyes) were noted.
Conclusion
We observed similar levels of FAi effectiveness for the treatment of noninfectious uveitis in standard clinical practice compared to previous randomized clinical trials. Moreover, remission induction therapy before FAi can benefit patients with increased baseline uveitis activity.
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Affiliation(s)
- Lara Buhl
- Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany.
| | - Stephan Thurau
- Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Christoph Kern
- Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
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22
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AlBloushi AF, Alfawaz AM, Abu El Asrar AM. Implications of COVID-19 infection on patients with uveitis under biologic treatment. Br J Ophthalmol 2022; 106:1538-1541. [PMID: 33931386 PMCID: PMC8098233 DOI: 10.1136/bjophthalmol-2020-318577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/11/2021] [Accepted: 04/22/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIMS To investigate the incidence, severity of COVID-19 infection and the outcomes in patients with uveitis treated with biologic agents during COVID-19 pandemic. METHODS In this prospective study, we included all patients with uveitis treated with biologic agents and tested for COVID-19 infection between May 2020 and October 2020. RESULTS A total of 59 patients were identified. Behçet's disease was the most common diagnosis (64.4%). Infliximab was the most frequent biologic agent used (61%). Nine (15.3%) patients were tested positive for COVID-19. None of the patients with positive COVID-19 test developed any COVID-19-related symptoms during follow-up. Of the nine patients with positive COVID-19 test, only two patients had uveitis flare-up after the biologic suspension. CONCLUSION Uveitis patients under biologic therapy can be silent carriers for COVID-19.
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Affiliation(s)
- Abdulrahman F AlBloushi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Alfawaz
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed M Abu El Asrar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Dr. Nasser Al-Rashid Research Chair in Ophthalmology, Riyadh, Saudi Arabia
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23
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Chu KO, Chan KP, Yip YWY, Chu WK, Wang C, Pang CP. Systemic and Ocular Anti-Inflammatory Mechanisms of Green Tea Extract on Endotoxin-Induced Ocular Inflammation. Front Endocrinol (Lausanne) 2022; 13:899271. [PMID: 35909558 PMCID: PMC9335207 DOI: 10.3389/fendo.2022.899271] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Green tea extract (GTE) alleviated ocular inflammations in endotoxin-induced uveitis (EIU) rat model induced by lipopolysaccharide (LPS) but the underlying mechanism is unclear. Objectives To investigate the systematic and local mechanisms of the alleviation by untargeted metabolomics using liquid chromatography-tandem mass spectrometry. Methods Sprague-Dawley rats were divided into control group, LPS treatment group, and LPS treatment group treated with GTE two hours after LPS injection. The eyes were monitored by slip lamp and electroretinography examination after 24 hours. The plasma and retina were collected for metabolomics analysis. Results In LPS treated rats, the iris showed hyperemia. Plasma prostaglandins, arachidonic acids, corticosteroid metabolites, and bile acid metabolites increased. In the retina, histamine antagonists, corticosteroids, membrane phospholipids, free antioxidants, and sugars also increased but fatty acid metabolites, N-acetylglucosamine-6-sulphate, pyrocatechol, and adipic acid decreased. After GTE treatment, the a- and b- waves of electroretinography increased by 13%. Plasma phosphorylcholine lipids increased but plasma prostaglandin E1, cholanic metabolites, and glutarylglycine decreased. In the retina, tetranor-PGAM, pantothenic derivatives, 2-ethylacylcarinitine, and kynuramine levels decreased but anti-oxidative seleno-peptide level increased. Only phospholipids, fatty acids, and arachidonic acid metabolites in plasma and in the retina had significant correlation (p < 0.05, r > 0.4 or r < -0.4). Conclusions The results showed GTE indirectly induced systemic phosphorylcholine lipids to suppress inflammatory responses, hepatic damage, and respiratory mitochondrial stress in EIU rats induced by LPS. Phospholipids may be a therapeutic target of GTE for anterior chamber inflammation.
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Affiliation(s)
- Kai On Chu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kwok Ping Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yolanda Wong Ying Yip
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Kit Chu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Science, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Bello NR, LaMattina KC, Minor JM, Utz VM, Dong K, Levin AV. The risk of uveitis due to prostaglandin analogs in pediatric glaucoma. J AAPOS 2022; 26:126.e1-126.e5. [PMID: 35550862 DOI: 10.1016/j.jaapos.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE To examine the incidence of uveitis in children prescribed prostaglandin analogs (PGAs) for glaucoma. METHODS In this dual-center cohort study, the medical records of consecutive patients <18 years old treated with a PGA between January 1, 2012, and December 31, 2018, were reviewed retrospectively. Patients with all forms of glaucoma, including those with a prior history of uveitis, were included. Patients who had been on a PGA prior to their first recorded visit were excluded. Patient charts were reviewed for new or recurrent uveitis during the first year of PGA therapy. RESULTS A total of 103 children (147 eyes) were included, with a total PGA exposure of 1,352 child-months. Ninety-eight children (142 eyes) tolerated the PGA without an episode of uveitis. Five patients with a documented prior history of uveitis experienced a unilateral episode of uveitis. A review of their medical records identified prescribed or unscheduled decrease in topical steroids or immunosuppressive medication as the most likely cause of uveitis recurrence. CONCLUSIONS This study provides further evidence that PGAs are unlikely to induce uveitis in children being treated for glaucoma and suggests that this may also be true in those with a history of uveitis. We are unable to evaluate whether PGAs make recurrence more likely or the tapering of steroids more difficult.
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Affiliation(s)
- Nicholas R Bello
- Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Kara C LaMattina
- Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
| | - Jade M Minor
- Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Virginia Miraldi Utz
- Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kaylin Dong
- Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
| | - Alex V Levin
- Pediatric Ophthalmology and Ocular Genetics, Flaum Eye Institute, Pediatric Genetics, Golisano Children's Hospital, University of Rochester, Rochester, New York.
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Maalouf G, Andrillon A, Leclercq M, Sève P, Bielefeld P, Gueudry J, Sené T, Titah C, Moulinet T, Rouvière B, Sène D, Desbois AC, Domont F, Touhami S, Thibault T, Chamieh CE, Cacoub P, Kodjikian L, Biard L, Bodaghi B, Saadoun D. Lower Relapses Rate With Infliximab Versus Adalimumab in Sight-Threatening Uveitis: A Multicenter Study of 330 Patients. Am J Ophthalmol 2022; 238:173-180. [PMID: 35172172 DOI: 10.1016/j.ajo.2022.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/21/2022] [Accepted: 02/02/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare the relapse rate of sight-threatening noninfectious uveitis (NIU) in patients treated with infliximab (IFX) or adalimumab (ADA). DESIGN Observational retrospective multicenter study. METHODS A total of 330 patients (median age, 36 years; interquartile range, 27-54), 45.2% men) with sight-threatening NIU (ie, retinal vasculitis and/or macular edema) treated with anti-tumor necrosis factor [TNF]-α agents (IFX intravenously at 5 mg/kg at weeks 0, 2, 6, and every 4 to 6 weeks or ADA subcutaneously at 80 mg, then 40 mg every 2 weeks). Data were obtained retrospectively from patients' medical records. Main outcome measures were relapse rate, complete response of NIU, corticosteroid sparing effect, and safety. RESULTS Main etiologies of uveitis included Behçet disease (27%), idiopathic juvenile arthritis (5.8%), and sarcoidosis (5.5%). The estimated relapse rate at 6 months after introduction of biological agents was 13% (95% CI = 0.009-0.16). IFX was associated with less relapse risk than ADA (hazard ratio [HR] = 0.52, 95% CI = 0.36- 0.77, P = .001). ADA and IFX were comparable in terms of complete response rate of NIU as well as corticosteroid-sparing effect. Behçet disease was associated with higher odds of complete response (HR = 2.04, 95% CI = 1.16 -3.60, P = .01] and lower relapse rate (HR = 0.53, 95% CI = 0.33-0.85, P = .009) than other causes of NIU with anti-TNF-α agents. CONCLUSIONS In sight-threatening NIU, IFX seems to be associated with a lower relapse rate than ADA.
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Affiliation(s)
- Georgina Maalouf
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Anaïs Andrillon
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Mathilde Leclercq
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France; Internal Medicine Department, CHU Rouen, Rouen, France
| | - Pascal Sève
- Internal Medicine Department, Hôpital de la Croix- Rousse, Hospices Civils de Lyon, Lyon Cedex, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard-Lyon 1, Lyon, France
| | - Philip Bielefeld
- Internal Medicine and Systemic Diseases Department (Medicine Interne 2), Dijon University hospital, Dijon, France
| | - Julie Gueudry
- Ophthalmology Department, Hospital Charles Nicolle, CHU Rouen, Rouen, France; EA7510, UFR Santé, Rouen University, Rouen, France
| | - Thomas Sené
- Internal Medicine Department, Fondation Rothschild, Paris, France
| | - Cherif Titah
- Ophthalmology Department, Fondation Rothschild, Paris, France
| | - Thomas Moulinet
- Department of Internal Medicine, CHRU de Nancy, Nancy, France; Université de Lorraine, Inserm UMR_S 1116, Nancy, France
| | - Bénédicte Rouvière
- Internal Medicine and Pneumology Department, CHU de Brest, Hôpital La Cavale Blanche, Brest Cedex, France
| | - Damien Sène
- Internal Medicine Department, Lariboisière Hospital, Paris, France; INSERM UMR, Paris Diderot University, Paris, France
| | - Anne-Claire Desbois
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Fanny Domont
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Sara Touhami
- Ophthalmology Department, DHU View Restore, Pitié Salpêtrière Hospital, Paris, France
| | - Thomas Thibault
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Carolla El Chamieh
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Patrice Cacoub
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Laurent Kodjikian
- Ophthalmology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon Cedex, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard-Lyon 1, Lyon, France
| | - Lucie Biard
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, DHU View Restore, Pitié Salpêtrière Hospital, Paris, France
| | - David Saadoun
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France.
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Weng TH, Ke CC, Huang YS. Anti-Inflammatory Effects of GM1 Ganglioside on Endotoxin-Induced Uveitis in Rats. Biomolecules 2022; 12:biom12050727. [PMID: 35625654 PMCID: PMC9138562 DOI: 10.3390/biom12050727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Exogenous ganglioside GM1 has been reported to exert an immunomodulatory effect. We investigated the anti-inflammatory effect of GM1 ganglioside on endotoxin-induced uveitis (EIU) in rats and RAW 264.7 macrophages. Methods: EIU was induced in Lewis rats by administering a subcutaneous injection of lipopolysaccharide (LPS). GM1 was injected intraperitoneally for three consecutive days prior to the LPS injection. Twenty-four hours after the LPS injection, the integrity of the blood-aqueous barrier was evaluated by determining the protein concentration and number of infiltrating cells in the aqueous humor (AqH). Immunohistochemical and Western blot analyses of the iris-ciliary body (ICB) were performed to evaluate the effect of GM1 on the LPS-induced expression of cyclooxygenase-2 (COX-2) and intercellular adhesion molecule-1 (ICAM-1). The effect of GM1 on proinflammatory mediators and signaling cascades was examined in LPS-stimulated RAW 264.7 cells using Western blotting and immunofluorescence staining to further clarify the underlying anti-inflammatory mechanism. Results: GM1 significantly reduced the protein concentration and number of infiltrating cells in the AqH of rats with EIU. GM1 also decreased the LPS-induced expression of the ICAM-1 and COX-2 proteins in the ICB. In RAW 264.7 cells, GM1 inhibited the proinflammatory mediators induced by LPS, including inducible nitric oxide synthase (iNOS), COX-2, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6), and this inhibitory effect was potentially mediated by suppressing transforming growth factor-β-activated kinase 1 (TAK1) and reactive oxygen species (ROS)-mediated activation of nuclear factor-κB (NF-κB) and mitogen-activated protein kinases (MAPKs). Conclusions: Based on this study, GM1 may be a potential anti-inflammatory agent for ocular inflammatory diseases.
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Affiliation(s)
- Tzu-Heng Weng
- Department of Ophthalmology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan; (T.-H.W.); (C.-C.K.)
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chang-Chih Ke
- Department of Ophthalmology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan; (T.-H.W.); (C.-C.K.)
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yuahn-Sieh Huang
- Department of Biology and Anatomy, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-87923100 (ext. 18735)
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Yakin M, Kumar A, Kodati S, Jones L, Sen HN. Risk of Elevated Intraocular Pressure With Difluprednate in Patients With Non-Infectious Uveitis. Am J Ophthalmol 2022; 240:232-238. [PMID: 35381204 PMCID: PMC9308646 DOI: 10.1016/j.ajo.2022.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 02/10/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the risk factors associated with clinically important intraocular pressure (IOP) elevation with topical difluprednate treatment in patients with non-infectious uveitis. DESIGN Retrospective cohort study. METHODS Fifty-four eyes of 54 patients with non-infectious uveitis treated with topical difluprednate at the current institution were included. Demographics and clinical characteristics of uveitis patients were collected. The main outcome measure was development of clinically important IOP elevation defined as IOP ≥21 mmHg and an increase of ≥10 mmHg from baseline. RESULTS A clinically important IOP elevation was observed in 17 patients (31.5%). The mean time to clinically important IOP elevation was 7.4±4.8 weeks (range 3-19). Statistically significant risk factors for incident clinically important IOP elevation were being a child (adjusted hazard ratio [aHR] 7.85 [95% CI 1.48-41.56], P = .02) and concurrent use of systemic steroids (aHR 5.31 [95% CI 1.18-24.00], P = .03). Patients with concurrent systemic corticosteroids developed clinically important IOP elevation earlier than those without systemic corticosteroid (mean 5.7±3.4 [range 3-14] vs 10.4±5.7 [range 4-19] weeks, P = .05). Incident IOP ≥30 mmHg occurred in 7 patients (13.0%). All patients responded well to the cessation of difluprednate and/or use of topical antiglaucomatous agents and no eyes required glaucoma surgery. CONCLUSIONS This study demonstrated that clinically important IOP elevation is common in uveitis patients with topical difluprednate treatment. Children and patients with concurrent systemic corticosteroids are at substantial risk of developing clinically important IOP elevation.
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Affiliation(s)
- Mehmet Yakin
- From the National Eye Institute, National Institutes of Health, Bethesda, MD, USA (M.Y, A.K, S.K, H.N.S); University of Health Sciences, Ankara Training and Research Hospital, Ophthalmology Department, Ankara, Turkey (M.Y)
| | - Aman Kumar
- From the National Eye Institute, National Institutes of Health, Bethesda, MD, USA (M.Y, A.K, S.K, H.N.S); Albany Medical College, Albany, NY (A.K)
| | - Shilpa Kodati
- From the National Eye Institute, National Institutes of Health, Bethesda, MD, USA (M.Y, A.K, S.K, H.N.S)
| | - Leslie Jones
- Howard University College of Medicine, Ophthalmology Department, Washington DC, USA (L.J)
| | - H Nida Sen
- From the National Eye Institute, National Institutes of Health, Bethesda, MD, USA (M.Y, A.K, S.K, H.N.S).
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Affiliation(s)
- Emmett T Cunningham
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, California
- The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California
| | - Ramana S Moorthy
- Associated Vitreoretinal and Uveitis Consultants, Indianapolis, Indiana
- Department of Ophthalmology, Indiana University Medical Center, Indianapolis, Indiana
- St. Vincent Hospital and Health Services, Indianapolis, Indiana
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29
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Li H, Zhu L, Wang R, Xie L, Chen Y, Duan R, Liu X, Huang Z, Chen B, Li Z, Wang X, Su W. Therapeutic Effect of IL-38 on Experimental Autoimmune Uveitis: Reprogrammed Immune Cell Landscape and Reduced Th17 Cell Pathogenicity. Invest Ophthalmol Vis Sci 2021; 62:31. [PMID: 34967854 PMCID: PMC8727319 DOI: 10.1167/iovs.62.15.31] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to elucidate the effects of interleukin (IL)-38 on experimental autoimmune uveitis (EAU) and its underlying mechanisms. Methods Mice with EAU were treated with IL-38, and the retinas and cervical draining lymph nodes (CDLNs) were analyzed by flow cytometry. Single-cell RNA sequencing (scRNA-seq) was conducted to analyze the immune cell profiles of CDLNs from normal, EAU, and IL-38-treated mice. Results Administration of IL-38 attenuated EAU symptoms and reduced the proportion of T helper 17 (Th17) and T helper 1 (Th1) cells in the retinas and CDLNs. In scRNA-seq analysis, IL-38 downregulated the IL-17 signaling pathway and reduced the expression of Th17 cell pathogenicity-related genes (Csf2 and Il23r), findings which were also confirmed by flow cytometry. In vitro, IL-38 reduced the granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulation function of IL-23 and inhibited IL-23R expression in Th17 cells. Moreover, when co-cultured with Th17 cells, IL-38 prevented IL-23 production in antigen-presenting cells (APCs). Conclusions Our data demonstrate the therapeutic effect of IL-38 on EAU, and suggest that the effect of IL-38 may be caused by dampening of the GM-CSF/IL-23R/IL-23 feedback loop between Th17 cells and APCs.
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Affiliation(s)
- He Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Lei Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Lihui Xie
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yuxi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Runping Duan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xiuxing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Zhaohao Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Binyao Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Zhaohuai Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xianggui Wang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China
| | - Wenru Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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30
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Girol AP, de Freitas Zanon C, Caruso ÍP, de Souza Costa S, Souza HR, Cornélio ML, Oliani SM. Annexin A1 Mimetic Peptide and Piperlongumine: Anti-Inflammatory Profiles in Endotoxin-Induced Uveitis. Cells 2021; 10:3170. [PMID: 34831393 PMCID: PMC8625584 DOI: 10.3390/cells10113170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/23/2022] Open
Abstract
Uveitis is one of the main causes of blindness worldwide, and therapeutic alternatives are worthy of study. We investigated the effects of piperlongumine (PL) and/or annexin A1 (AnxA1) mimetic peptide Ac2-26 on endotoxin-induced uveitis (EIU). Rats were inoculated with lipopolysaccharide (LPS) and intraperitoneally treated with Ac2-26 (200 µg), PL (200 and 400 µg), or Ac2-26 + PL after 15 min. Then, 24 h after LPS inoculation, leukocytes in aqueous humor, mononuclear cells, AnxA1, formyl peptide receptor (fpr)1, fpr2, and cyclooxygenase (COX)-2 were evaluated in the ocular tissues, along with inflammatory mediators in the blood and macerated supernatant. Decreased leukocyte influx, levels of inflammatory mediators, and COX-2 expression confirmed the anti-inflammatory actions of the peptide and pointed to the protective effects of PL at higher dosage. However, when PL and Ac2-26 were administered in combination, the inflammatory potential was lost. AnxA1 expression was elevated among groups treated with PL or Ac2-26 + PL but reduced after treatment with Ac2-26. Fpr2 expression was increased only in untreated EIU and Ac2-26 groups. The interaction between Ac2-26 and PL negatively affected the anti-inflammatory action of Ac2-26 or PL. We emphasize that the anti-inflammatory effects of PL can be used as a therapeutic strategy to protect against uveitis.
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Affiliation(s)
- Ana Paula Girol
- Department of Physical and Morphological Sciences, University Center Padre Albino (UNIFIPA), Catanduva 15809-144, SP, Brazil; (A.P.G.); (S.d.S.C.); (H.R.S.)
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil;
- Post Graduate Program in Structural and Functional Biology, Escola Paulista de Medicina (UNIFESP-EPM), Federal University of São Paulo, São Paulo 04023-062, SP, Brazil
| | - Caroline de Freitas Zanon
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil;
| | - Ícaro Putinhon Caruso
- Department of Phisics, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil; (Í.P.C.); (M.L.C.)
| | - Sara de Souza Costa
- Department of Physical and Morphological Sciences, University Center Padre Albino (UNIFIPA), Catanduva 15809-144, SP, Brazil; (A.P.G.); (S.d.S.C.); (H.R.S.)
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil;
| | - Helena Ribeiro Souza
- Department of Physical and Morphological Sciences, University Center Padre Albino (UNIFIPA), Catanduva 15809-144, SP, Brazil; (A.P.G.); (S.d.S.C.); (H.R.S.)
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil;
| | - Marinônio Lopes Cornélio
- Department of Phisics, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil; (Í.P.C.); (M.L.C.)
| | - Sonia Maria Oliani
- Department of Biology, Institute of Biosciences, Humanities and Exact Sciences (Ibilce), São Paulo State University, (UNESP), São José do Rio Preto 15054-000, SP, Brazil;
- Post Graduate Program in Structural and Functional Biology, Escola Paulista de Medicina (UNIFESP-EPM), Federal University of São Paulo, São Paulo 04023-062, SP, Brazil
- Advanced Research Center in Medicine (CEPAM), União das Faculdades dos Grandes Lagos (Unilago), São José do Rio Preto 15030-070, SP, Brazil
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31
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Toledo CR, Paiva MRB, Castro BFM, Pereira VV, Cenachi SPDF, Vasconcelos-Santos DV, Fialho SL, Silva-Cunha A. Intravitreal lupeol: A new potential therapeutic strategy for noninfectious uveitis. Biomed Pharmacother 2021; 143:112145. [PMID: 34507119 DOI: 10.1016/j.biopha.2021.112145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022] Open
Abstract
Lupeol is a pentacyclic triterpene with known anti-inflammatory effects. However, its role in the treatment of noninfectious uveitis has not been explored. This work investigated anti-inflammatory activity of lupeol in ocular tissues with in vitro and in vivo models. First, we evaluated the effect of lupeol (100 µM) on inflammatory response induced by lipopolysaccharide (LPS) in retinal pigment epithelium cells (ARPE-19) by measuring levels of released interleukins (IL-6 and IL-8). Then, we investigated the anti-inflammatory action of intravitreal lupeol in a rodent model of panuveitis induced by Mycobacterium bovis Calmette-Guérin Bacillus (BCG). Rats were submitted to electroretinography and clinical analyses on days 3, 7, and 15 after uveitis induction. In addition, histopathological analysis, and indirect quantification of myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) in the posterior segment were performed. Treatment with lupeol (100 µM) significantly decreased IL-6 and IL-8 levels in comparison to untreated LPS-activated ARPE-19 cells. This reduction was similar to that detected in ARPE-19 cells treated with dexamethasone. The results of the in vivo assay demonstrated that intravitreal lupeol is able to modulate inflammation in the anterior and posterior segment of the rat eyes, indicating that it should be further investigated as a novel potential candidate for management of uveitis.
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Affiliation(s)
- Cibele Rodrigues Toledo
- Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | | | - Brenda Fernanda Moreira Castro
- Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Vinicius Viana Pereira
- Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Sarah Pereira de Freitas Cenachi
- Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Daniel Vítor Vasconcelos-Santos
- Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Sílvia Ligório Fialho
- Pharmaceutical Research and Development, Ezequiel Dias Foundation, Belo Horizonte, Minas Gerais, Brazil.
| | - Armando Silva-Cunha
- Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Woltsche N, Kruger MA, Weger M, Wolf IH, Seidel G. Intravitreal Steroid Treatment for Uveitis Associated with Dabrafenib and Trametinib for Metastatic Cutaneous Melanoma. Ocul Immunol Inflamm 2021; 29:845-847. [PMID: 31906779 DOI: 10.1080/09273948.2019.1695860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 01/21/2023]
Abstract
Purpose: To report a case of bilateral retinal inflammation under long-term therapy with dabrafenib/trametinib for metastatic cutaneous melanoma.Methods: Retrospective chart review.Results: A 59-year-old patient with metastatic cutaneous melanoma diagnosed in 2004 under treatment with dabrafenib/trametinib since 2014 presented to our department with intraretinal hemorrhage and extrafoveal macula edema on the right eye and optic disc swelling on the left eye. The patient did not report visual complaints. After cessation of dabrafenib/trametinib and subconjunctival and intravitreal corticosteroid injections, optic disc swelling on the left eye recovered after 6 months. The macula edema on the right eye was treated with one intravitreal anti-VEGF (vascular endothelial growth factor) injection after encroaching upon the fovea 10 months after initial presentation. The final visual acuity was 20/20 on both eyes.Conclusion: Even after years of treatment with low dose dabrafenib/trametinib, ocular toxicity can develop. Such cases can respond well to intravitreal corticosteroids.
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Affiliation(s)
- Nora Woltsche
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Martin Weger
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Gerald Seidel
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
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Dimitriou F, Urner-Bloch U, Eggenschwiler C, Mitsakakis N, Mangana J, Dummer R, Urner M. The association between immune checkpoint or BRAF/MEK inhibitor therapy and uveitis in patients with advanced cutaneous melanoma. Eur J Cancer 2021; 144:215-223. [PMID: 33373866 DOI: 10.1016/j.ejca.2020.11.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/20/2020] [Accepted: 11/15/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Treatment with immune checkpoint and BRAF/MEK inhibitors has significantly improved the survival of patients with advanced cutaneous melanoma and other metastatic malignancies. Therapy-related uveitis is a rare ocular adverse event, which may potentially lead to legal blindness. The epidemiology of treatment-related uveitis is currently insufficiently known. PATIENTS AND METHODS In this cohort study, we asked whether exposure to either immune checkpoint or BRAF/MEK inhibitors was associated with a higher risk of developing uveitis compared with the general population. Based on a Bayesian framework, we estimated the probability of developing uveitis with a right-censored, exponential survival model using data from the Zurich Melanoma Registry. The registry included all adult patients treated for advanced cutaneous melanoma between January 2008 and December 2018 at the University Hospital of Zurich, Switzerland. RESULTS In total, 304 patients (64%) were treated with immune checkpoint and 186 patients (38%) with BRAF/MEK inhibitors. Median follow-up time was 74 days (interquartile range: 57-233 days). Eleven patients developed uveitis and 30 patients died. We estimated the probability of developing uveitis per year in the general population as 0.05% (95% credibility interval [CrI]: 0.02%-0.1%). Corresponding posterior probabilities of treatment-related uveitis were 3.48% (95% CrI: 0.93%-7.49%) and 5.04% (95% CrI: 2.07%-9.19%) for immune checkpoint or BRAF/MEK inhibitors (posterior probability for difference: 76%). CONCLUSIONS Immune checkpoint and particularly BRAF/MEK inhibitor therapies are associated with an increase in the risk of developing uveitis. Treatment-related uveitis is not associated with systemic adverse events of immune checkpoint or BRAF/MEK inhibitors.
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Affiliation(s)
- Florentia Dimitriou
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Ursula Urner-Bloch
- Private Ophthalmic Practice in Cooperation with the Skin Cancer Unit, University Hospital of Zurich, Zurich, Switzerland
| | | | - Nicholas Mitsakakis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Joanna Mangana
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
| | - Martin Urner
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
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Zhuang X, Ma J, Xu S, Sun Z, Zhang R, Zhang M, Xu G. SHP-1 suppresses endotoxin-induced uveitis by inhibiting the TAK1/JNK pathway. J Cell Mol Med 2021; 25:147-160. [PMID: 33207073 PMCID: PMC7810969 DOI: 10.1111/jcmm.15888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 12/14/2022] Open
Abstract
We investigated how Src-homology 2-domain phosphatase-1 (SHP-1) regulates the inflammatory response in endotoxin-induced uveitis (EIU), and the signalling pathways involved. One week after intravitreal injection of short hairpin RNA targeting SHP-1 or SHP-1 overexpression lentivirus in rats, we induced ocular inflammation with an intravitreal injection of lipopolysaccharide (LPS). We then assessed the extent of inflammation and performed full-field electroretinography. The concentrations and retinal expression of various inflammatory mediators were examined with enzyme-linked immunosorbent assays and Western blotting, respectively. SHP-1 overexpression and knockdown were induced in Müller cells to study the role of SHP-1 in the LPS-induced inflammatory response in vitro. Retinal SHP-1 expression was up-regulated by LPS. SHP-1 knockdown exacerbated LPS-induced retinal dysfunction and increased the levels of proinflammatory mediators in the retina, which was abrogated by a c-Jun N-terminal kinase (JNK) inhibitor (SP600125). SHP-1 overexpression had the opposite effects. In Müller cells, the LPS-induced inflammatory response was enhanced by SHP-1 knockdown and suppressed by SHP-1 overexpression. SHP-1 negatively regulated the activation of the transforming growth factor-β-activated kinase-1 (TAK1)/JNK pathway, but not the nuclear factor-κB pathway. These results indicate that SHP-1 represses EIU, at least in part, by inhibiting the TAK1/JNK pathway and suggest that SHP-1 is a potential therapeutic target for uveitis.
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Affiliation(s)
- Xiaonan Zhuang
- Department of OphthalmologyEye & ENT HospitalFudan UniversityShanghaiChina
| | - Jun Ma
- Eye InstituteEye & ENT HospitalFudan UniversityShanghaiChina
| | - Sisi Xu
- Department of OphthalmologyEye & ENT HospitalFudan UniversityShanghaiChina
| | - Zhongcui Sun
- Department of OphthalmologyEye & ENT HospitalFudan UniversityShanghaiChina
| | - Rong Zhang
- Eye InstituteEye & ENT HospitalFudan UniversityShanghaiChina
| | - Meng Zhang
- Department of OphthalmologyEye & ENT HospitalFudan UniversityShanghaiChina
| | - Gezhi Xu
- Department of OphthalmologyEye & ENT HospitalFudan UniversityShanghaiChina
- Shanghai Key Laboratory of Visual Impairment and RestorationFudan UniversityShanghaiChina
- NHC Key Laboratory of MyopiaFudan UniversityShanghaiChina
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Choi EY, Lee M, Lee CS. Uveitis occurrence in patients with ankylosing spondylitis according to the type of tumour necrosis factor inhibitor: a cohort study of 175 patients. Clin Exp Rheumatol 2020; 38:1132-1137. [PMID: 32828140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To compare the occurrence of non-infectious uveitis based on the type of tumour necrosis factor (TNF) inhibitor used to manage spondyloarthritis in ankylosing spondylitis (AS) patients. METHODS The occurrence (new-onset and recurrence) of uveitis was reviewed retrospectively in AS patients receiving different TNF inhibitor therapies (adalimumab [ADA], infliximab [IFX], etanercept [ETN], and golimumab [GOL]) for the management of spondyloarthritis from 2005 to 2018. Kaplan-Meier analysis was performed to calculate the cumulative occurrence rates of uveitis during TNF inhibitor therapy, and a log-rank test was used to analyse differences between the survival curves. Multivariable Cox proportional-hazards models were used to compute hazard ratios (HRs) of different TNF agents for uveitis occurrence after adjusting for concurrent confounding factors. RESULTS The three-year cumulative occurrence rates of uveitis were significantly different according to the type of anti-TNFs used (23.1% in IFX, 18.5% in ETN, and 11.9% in ADA+GOL group) (p=0.020). The risk of new-onset uveitis was similar for different drugs. However, the IFX group showed a 5.4 times higher risk of recurrence than the ADA+GOL group (p=0.022). After adjusting for other confounding factors, IFX use was independently associated with a more frequent occurrence of uveitis in AS patients (HR=2.01; p=0.011). CONCLUSIONS A significant number of AS patients who received anti-TNF therapy developed uveitis. Different types of anti-TNF drugs were associated with uveitis recurrence. Particularly, chimeric mouse-human monoclonal antibody (IFX) was found to increase the risk of uveitis occurrence compared to humanised monoclonal antibody (ADA or GOL).
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, The Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Minwoo Lee
- Department of Ophthalmology, The Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, The Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Hu J, Vu JT, Hong B, Gottlieb C. Uveitis and cystoid macular oedema secondary to topical prostaglandin analogue use in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2020; 104:1040-1044. [PMID: 32532763 PMCID: PMC7577108 DOI: 10.1136/bjophthalmol-2019-315280] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/30/2019] [Accepted: 12/27/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Of the side effects of prostaglandin analogues (PGAs), uveitis and cystoid macular oedema (CME) have significant potential for vision loss based on postmarket reports. Caution has been advised due to concerns of macular oedema and uveitis. In this report, we researched and summarised the original data suggesting these effects and determined their incidence. METHODS Preferred Reporting Items for Systematic review and Meta-Analyses guidelines were followed. Studies evaluating topical PGAs in patients with ocular hypertension or open angle glaucoma were included. MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, LILACS and ClinicalTrials.gov were searched between 1946 and 2019. Experimental studies, animal studies and randomised studies with other intraocular pressure-lowering eye drops were excluded. RESULTS 214 studies (28 232 patients) met the inclusion criteria. Using prospective data, the incidence of uveitis and CME among PGA users were 62/28 232 (0.22%) and 25/28 232 (0.09%), respectively. A higher frequency of both uveitis and CME were found among latanoprost users compared with bimatoprost. There were 21 case studies reporting CME including 48 eyes in 43 patients. 47 of 48 eyes (97.9%) had previous incisional ocular surgery. 8 eyes were re-challenged, of which 7 (87.5%) recurred. 7 case studies reported uveitis in 15 eyes of 10 patients. 7 of 15 eyes (46.7%) were either pseudophakic or aphakic. 6 eyes were re-challenged, and all 6 (100%) recurred. CONCLUSIONS Cases of uveitis or CME revealed a confounding effect of ocular surgery, aphakia or subluxed intraocular lens. PGAs may be used in non-surgical patients without concern of causing CME or uveitis. The incidences of PGA-associated CME and uveitis are rare with limited prospective studies on the cause-effect relationship.
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Affiliation(s)
- Jason Hu
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - James Thinh Vu
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Brian Hong
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Chloe Gottlieb
- University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
- University of Ottawa Eye Institute, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Eser Öztürk H, Süllü Y. Sarcoid-like Granulomatous Intraocular Inflammation Caused by Vemurafenib Treatment for Metastatic Melanoma. Turk J Ophthalmol 2020; 50:50-52. [PMID: 32167264 PMCID: PMC7086091 DOI: 10.4274/tjo.galenos.2019.79026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 12/03/2019] [Indexed: 12/22/2022] Open
Abstract
Vemurafenib is a potent inhibitor of genetically activated BRAF, which is responsible for tumoral proliferation in cutaneous melanoma. A 56-year-old man receiving vemurafenib therapy presented with uveitis. Over the course of the disease, he developed bilateral, granulomatous uveitis with multiple peripheral chorioretinal lesions. Serum angiotensin-converting enzyme levels increased. The patient was diagnosed with probable ocular sarcoidosis related to vemurafenib and was treated with an intravitreal dexamethasone implant. This case is the first report that shows the clinical and angiographic features of a patient with vemurafenib-related sarcoid-like granulomatous uveitis.
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Affiliation(s)
- Hilal Eser Öztürk
- Ondokuz Mayıs University Faculty of Medicine, Department of Ophthalmology, Samsun, Turkey
| | - Yüksel Süllü
- Ondokuz Mayıs University Faculty of Medicine, Department of Ophthalmology, Samsun, Turkey
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38
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Bostan C, Robert MC. Severe inflammatory reaction following corneal collagen cross-linking in a patient with glucose-6-phosphate dehydrogenase deficiency. Can J Ophthalmol 2019; 54:e234-e237. [PMID: 31564364 DOI: 10.1016/j.jcjo.2018.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/07/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Cristina Bostan
- Centre Hospitalier de l'Université de Montréal, Montreal, Que..
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39
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Porter RF, Szczesniak AM, Toguri JT, Gebremeskel S, Johnston B, Lehmann C, Fingerle J, Rothenhäusler B, Perret C, Rogers-Evans M, Kimbara A, Nettekoven M, Guba W, Grether U, Ullmer C, Kelly MEM. Selective Cannabinoid 2 Receptor Agonists as Potential Therapeutic Drugs for the Treatment of Endotoxin-Induced Uveitis. Molecules 2019; 24:molecules24183338. [PMID: 31540271 PMCID: PMC6767236 DOI: 10.3390/molecules24183338] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 12/21/2022] Open
Abstract
(1) Background: The cannabinoid 2 receptor (CB2R) is a promising anti-inflammatory drug target and development of selective CB2R ligands may be useful for treating sight-threatening ocular inflammation. (2) Methods: This study examined the pharmacology of three novel chemically-diverse selective CB2R ligands: CB2R agonists, RO6871304, and RO6871085, as well as a CB2R inverse agonist, RO6851228. In silico molecular modelling and in vitro cell-based receptor assays were used to verify CB2R interactions, binding, cell signaling (ß-arrestin and cAMP) and early absorption, distribution, metabolism, excretion, and toxicology (ADMET) profiling of these receptor ligands. All ligands were evaluated for their efficacy to modulate leukocyte-neutrophil activity, in comparison to the reported CB2R ligand, HU910, using an in vivo mouse model of endotoxin-induced uveitis (EIU) in wild-type (WT) and CB2R-/- mice. The actions of RO6871304 on neutrophil migration and adhesion were examined in vitro using isolated neutrophils from WT and CB2R-/- mice, and in vivo in WT mice with EIU using adoptive transfer of WT and CB2R-/- neutrophils, respectively. (3) Results: Molecular docking studies indicated that RO6871304 and RO6871085 bind to the orthosteric site of CB2R. Binding studies and cell signaling assays for RO6871304 and RO6871085 confirmed high-affinity binding to CB2R and selectivity for CB2R > CB1R, with both ligands acting as full agonists in cAMP and ß-arrestin assays (EC50s in low nM range). When tested in EIU, topical application of RO6871304 and RO6871085 decreased leukocyte-endothelial adhesion and this effect was antagonized by the inverse agonist, RO6851228. The CB2R agonist, RO6871304, decreased in vitro neutrophil migration of WT neutrophils but not neutrophils from CB2R-/-, and attenuated adhesion of adoptively-transferred leukocytes in EIU. (4) Conclusions: These unique ligands are potent and selective for CB2R and have good immunomodulating actions in the eye. RO6871304 and RO6871085, as well as HU910, decreased leukocyte adhesion in EIU through inhibition of resident ocular immune cells. The data generated with these three structurally-diverse and highly-selective CB2R agonists support selective targeting of CB2R for treating ocular inflammatory diseases.
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MESH Headings
- Animals
- Anti-Inflammatory Agents/administration & dosage
- Anti-Inflammatory Agents/chemistry
- Anti-Inflammatory Agents/pharmacology
- Cannabinoid Receptor Agonists/administration & dosage
- Cannabinoid Receptor Agonists/chemistry
- Cannabinoid Receptor Agonists/pharmacology
- Cell Adhesion/drug effects
- Cells, Cultured
- Disease Models, Animal
- Endotoxins/adverse effects
- Leukocytes/drug effects
- Leukocytes/metabolism
- Male
- Mice
- Mice, Knockout
- Models, Molecular
- Molecular Docking Simulation
- Molecular Structure
- Neutrophils/drug effects
- Neutrophils/metabolism
- Receptor, Cannabinoid, CB2/antagonists & inhibitors
- Receptor, Cannabinoid, CB2/chemistry
- Receptor, Cannabinoid, CB2/genetics
- Signal Transduction
- Uveitis/chemically induced
- Uveitis/drug therapy
- Uveitis/immunology
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Affiliation(s)
| | | | - James Thomas Toguri
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Simon Gebremeskel
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Brent Johnston
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Pediatrics, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Christian Lehmann
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Anesthesia, Pain Management and Perioperative Care, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Jürgen Fingerle
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Benno Rothenhäusler
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Camille Perret
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Mark Rogers-Evans
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Atsushi Kimbara
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Matthias Nettekoven
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Wolfgang Guba
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Uwe Grether
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Christoph Ullmer
- Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland.
| | - Melanie E M Kelly
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Anesthesia, Pain Management and Perioperative Care, Dalhousie University, Halifax, NS B3H 4R2, Canada.
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS B3H 2Y9, Canada.
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Abstract
Uveitis can affect individuals of all ages, genders, and races and accounts for 10-15% of all cases of blindness. Uveitis represents a diverse array of intraocular inflammatory conditions that can be associated with complications from autoimmune diseases, bacterial infections, viral infections, chemical injuries, and metabolic issues. In rodents, endotoxin-induced uveitis (EIU) is an efficient experimental model to study pathological mechanisms associated with the disease and evaluate the pharmacological efficacy of potential new drug agents. In the EIU model, uveitis is characterized by clinically relevant inflammation, including inflammatory exudates and cells infiltrated into the anterior and vitreous eye chambers. EIU in small animal models, including rats, mice, and rabbits, is characterized by a short-lived uveal inflammation. This inflammation can be facilitated using bacterial endotoxins, such as lipopolysaccharide (LPS). In this chapter, we present a reliable, reproducible, and simplified protocol to induce EIU in mice. This method is flexible and can be applied for EIU induction in other small animals and rodents.
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Affiliation(s)
- Umesh C S Yadav
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Kota V Ramana
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA.
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41
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Lee AR, Sharma S, Mahmoud TH. TUBULOINTERSTITIAL NEPHRITIS AND UVEITIS SYNDROME WITH A PRIMARY PRESENTATION OF ACUTE POSTERIOR MULTIFOCAL PLACOID PIGMENT EPITHELIOPATHY. Retin Cases Brief Rep 2017; 11:100-103. [PMID: 26967965 DOI: 10.1097/icb.0000000000000299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To report a case of tubulointerstitial nephritis and uveitis syndrome with a primary presentation of acute posterior multifocal placoid pigment epitheliopathy after use of lamotrigine. METHODS Retrospective case report with ultra-widefield fundus imaging, optical coherence tomography, and fluorescein angiography. RESULTS A 19-year-old woman presented with decreased visual acuity and acute renal failure after starting lamotrigine. Her examination demonstrated 1+ anterior chamber cell and numerous white deep retinal plaque-like lesions predominantly in the macula in both eyes. After extensive ophthalmic and systemic evaluation, the patient was diagnosed with tubulointerstitial nephritis and uveitis syndrome with a primary presentation of acute posterior multifocal placoid pigment epitheliopathy. She had excellent visual recovery with topical and systemic steroids. CONCLUSION Acute posterior multifocal placoid pigment epitheliopathy is a rare but important clinical presentation of tubulointerstitial nephritis and uveitis syndrome. Oral corticosteroid treatment can be considered for tubulointerstitial nephritis but is generally not necessary for acute posterior multifocal placoid pigment epitheliopathy.
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Affiliation(s)
- Andrew R Lee
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
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42
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Crowley NJ, Hagan JC, Dyer JA, Brundige TF. Uveitis Following Treatment of Verruca Vulgaris with Intralesional Candida Antigen. Mo Med 2017; 114:394-395. [PMID: 30228642 PMCID: PMC6140177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This is a first literature report of a case of uveitis along with severe systemic symptoms following verruca vulgaris treatment with intralesional Candida antigen. We believe the Candida injection was causative.
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Affiliation(s)
- Nicholas J Crowley
- Nicholas J. Crowley, MD, is with the University of Missouri School of Medicine, Department of Dermatology
| | - John C Hagan
- John C. Hagan III, MD, MSMA member since 1977, Ophthalmologist with Discover Vision Centers, Kansas City, Mo
| | - Jonathan A Dyer
- Jonathan A. Dyer, MD, MSMA member since 2006, is with the University of Missouri School of Medicine, Department of Dermatology and Department of Child Health
| | - Tyler F Brundige
- Tyler F. Brundige, MD, MSMA member since 1996, Ophthalmologist with Discover Vision Centers, Kansas City, Mo
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Chen CL, Chen JT, Liang CM, Tai MC, Lu DW, Chen YH. Silibinin treatment prevents endotoxin-induced uveitis in rats in vivo and in vitro. PLoS One 2017; 12:e0174971. [PMID: 28376126 PMCID: PMC5380317 DOI: 10.1371/journal.pone.0174971] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/17/2017] [Indexed: 11/18/2022] Open
Abstract
Uveitis, an intraocular inflammatory disease, occurs mostly in young people and can result in the loss of socioeconomic capabilities. Silibinin has been shown to exert anti-inflammatory effects in human retinal pigment epithelial (RPE) cells. The present study investigated the anti-inflammatory effect of silibinin pretreatment on endotoxin-induced uveitis (EIU) in rats and the mechanisms by which it exerts these effects. Uveitis was induced via injection of lipopolysaccharides (LPS) into Lewis rats. Twenty-four hours after the LPS injection, histological examination showed that silibinin decreased inflammatory cell infiltration in the anterior segment of the eyes of LPS-treated rats. Analyses of the aqueous humor showed that silibinin decreased cell infiltration, protein concentration, nitric oxide (NO), and prostaglandin (PG)-E2 production. Western blot analysis indicated that silibinin decreased the expression of inducible NO synthase (iNOS), cyclooxygenase (COX-2), and phosphorylated IkB in the iris-ciliary body (ICB). Immunohistochemistry showed that silibinin decreased intercellular adhesion molecule (ICAM-1) expression in the ICB. In addition, western blot analysis showed that silibinin attenuated the expression of iNOS, COX-2, ICAM-1, and nuclear p65 in LPS-treated RAW cells. In conclusion, silibinin pretreatment prevents EIU and the subsequent production of proinflammatory mediators and ICAM-1, at least in part, by blocking the NF-κB–dependent signaling pathway both in vivo and in vitro. These effects may contribute to the silibinin-mediated preventive effects on intraocular inflammatory diseases such as acute uveitis.
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Affiliation(s)
- Ching-Long Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Min Liang
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Da-Wen Lu
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hao Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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44
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Rappoport D, Leiba H. [BISPHOSPHONATES AND OCULAR INFLAMMATION]. Harefuah 2017; 156:71-73. [PMID: 28551891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Bisphosphonates are a group of drugs used for treatment in several bone diseases such as osteoporosis in women, Paget's disease, hypercalcemia of malignancy, primary malignancies of the bone and metastatic bone disease (breast and prostate carcinoma). Numerous reports in the medical literature described ocular side effects in patients treated with these drugs. We report on two patients, treated with bisphosphonates due to malignancy, who presented with unilateral and bilateral uveitis. Treatment of the ocular inflammation should include local and systemic treatment and stopping the systemic use of bisphosphonates. Another alternative is switching to another bisphosphonate with less ocular side effects.
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Affiliation(s)
- Daniel Rappoport
- Department of Ophthalmology, Kaplan Medical Center, Rehovot
- The Faculty of Medicine, the Hebrew University, Jerusalem
| | - Hana Leiba
- Department of Ophthalmology, Kaplan Medical Center, Rehovot
- The Faculty of Medicine, the Hebrew University, Jerusalem
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Van Hove I, Lefevere E, De Groef L, Sergeys J, Salinas-Navarro M, Libert C, Vandenbroucke R, Moons L. MMP-3 Deficiency Alleviates Endotoxin-Induced Acute Inflammation in the Posterior Eye Segment. Int J Mol Sci 2016; 17:ijms17111825. [PMID: 27809288 PMCID: PMC5133826 DOI: 10.3390/ijms17111825] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 01/04/2023] Open
Abstract
Matrix metalloproteinase-3 (MMP-3) is known to mediate neuroinflammatory processes by activating microglia, disrupting blood-central nervous system barriers and supporting neutrophil influx into the brain. In addition, the posterior part of the eye, more specifically the retina, the retinal pigment epithelium (RPE) and the blood-retinal barrier, is affected upon neuroinflammation, but a role for MMP-3 during ocular inflammation remains elusive. We investigated whether MMP-3 contributes to acute inflammation in the eye using the endotoxin-induced uveitis (EIU) model. Systemic administration of lipopolysaccharide induced an increase in MMP-3 mRNA and protein expression level in the posterior part of the eye. MMP-3 deficiency or knockdown suppressed retinal leukocyte adhesion and leukocyte infiltration into the vitreous cavity in mice subjected to EIU. Moreover, retinal and RPE mRNA levels of intercellular adhesion molecule 1 (Icam1), interleukin 6 (Il6), cytokine-inducible nitrogen oxide synthase (Nos2) and tumor necrosis factor α (Tnfα), which are key molecules involved in EIU, were clearly reduced in MMP-3 deficient mice. In addition, loss of MMP-3 repressed the upregulation of the chemokines monocyte chemoattractant protein (MCP)-1 and (C-X-C motif) ligand 1 (CXCL1). These findings suggest a contribution of MMP-3 during EIU, and its potential use as a therapeutic drug target in reducing ocular inflammation.
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Affiliation(s)
- Inge Van Hove
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
- Laboratory of Experimental Ophthalmology, Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium.
| | - Evy Lefevere
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
- Laboratory of Experimental Ophthalmology, Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium.
| | - Lies De Groef
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
- Laboratory of Experimental Ophthalmology, Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium.
| | - Jurgen Sergeys
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
- Laboratory of Experimental Ophthalmology, Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium.
| | - Manuel Salinas-Navarro
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
| | - Claude Libert
- Inflammation Research Center, VIB, B-9052 Ghent, Belgium.
- Department of Biomedical Molecular Biology, Ghent University, B-9052 Ghent, Belgium.
| | - Roosmarijn Vandenbroucke
- Inflammation Research Center, VIB, B-9052 Ghent, Belgium.
- Department of Biomedical Molecular Biology, Ghent University, B-9052 Ghent, Belgium.
| | - Lieve Moons
- Neural Circuit Development and Regeneration Research Group, Department of Biology, Katholieke Universiteit Leuven (KU Leuven), B-3000 Leuven, Belgium.
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Klímová A, Seidler Štangová P, Svozílková P, Kučera T, Heissigerová J. [The Clinical Signs of Experimental Autoimmune Uveitis]. Cesk Slov Oftalmol 2016; 72:276-282. [PMID: 27041283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Autoimmune uveitis is a sight threatening disease which in many cases fails to respond to conventional immunosuppressive or biological therapy. The research in experimental models of autoimmune uveitis helps to find new therapeutical strategies. The aim of this study is to present the clinical and histological signs of experimental autoimmune uveitis (EAU) in mice. METHODS EAU was induced in C57BL/6 mice by subcutaneous application of IRBP (interphotoreceptor retinoid binding protein) in complete Freunds adjuvant and intraperitoneal application of pertussis toxin. Clinical evaluation of uveitis was performed in vivo using special imaging system with otoscope. Histological evaluation of uveitis was performed at day 35 post induction of EAU on hematoxylin and eosin stained frozen sections. Clinical and histological grading was used to assess the inflammation intensity of EAU. RESULTS The intensity of inflammation is depicted on representative fundus images and histological images of retina at day 35 post induction. CONCLUSION The model of EAU is robust and reproducible and allows us to study the immunopathological mechanisms of inflammation and its regulation. The inflammatory signs in our model are similar to findings of posterior uveitis of autoimmune etiology in humans, thus we may apply our experimental results in human medicine.
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Fang C, Zhou D, Zhan S, He Y, Lin Z, Huang C, Li J. [Effects of leflunomide on experimental autoimmune uveitis in Lewis rats]. Zhonghua Yan Ke Za Zhi 2015; 51:754-761. [PMID: 26693771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To investigate the protective efficacy of leflunomide on the Lewis rats with experimental autoimmune uveitis (EAU). METHODS Complete randomized controlled trials research. Lewis rats were immunized with interphotoreceptor retinoid-binding peptide (IRBP) in order to build the model of EAU. Rats were randomized assigned into four groups, that is control group as A, model group without leflunomide as B, model group with leflunomide administrations as C, and model group with cyclosporine A as D. Rats in group C received intragastric administration of three doses of leflunomide at 3mg/kg/d; 6mg/kg/d; 12mg/kg/d. Rats in group D received 10 mg/kg cyclosporin A were considered as a positive control. Each group has 6 to 8 rats. At the second day of immunization with IRBP, rats were intragastric administrated one time every day till day 13. Rats were investigated for EAU symptoms under slit lamp. Enucleated eyes were collected for sections with HE staining as histopathological evidences at the peak point of disease activity day 14. Treatment effectiveness was evaluated referred by Agarwal standard for clinical EAU and histopathological scoring. The expression of IL-17 in ocular sections was detected by immunohistochemistry (SP method). The expression levels of IL-17 and IFN-γ in the serum were quantified by ELISA. Intracellular expression of IL-17 in the activated CD4+T cells was assessed by flow cytometry. Ocular of rats were harvested and mRNA expression of IL-17 and IFN-γ were quantified through RT-PCR. Continuous variables were reported as mean ± SD. The comparison among groups was done by using analysis of students't test. Nonparametric test was used in Hierarchical data comparison and multiple comparison method was Bonferroni. RESULTS The model of EAU disease was built successfully in Lewis rats. With giving IRBP for 14 days, the clinic EAU scores were lower in model rats than those without leflunomide. Moreover, the effects of leflunomide on the clinic EAU scores was dose-dependent. Comparing to vehicle-treated eyes, treatment with leflunomide significantly prevented the onset of EAU-induced ocular inflammation [1.5 (1,2) vs. 3 (3,4), P = 0.0006, P < α', α' = 0.05/15]. The pathological examination showed model rats eye characterized by severe inflammatory cells infiltration and all layers of retina damaged. The pathologic grade was significant higher in model group than in medium dose leflunomide. [3(3, 4) vs. 2(1,3), P = 0.0014, P < α', α' = 0.05/15]. IL-17 was positively expressed in iris, ciliary and retina in model group. While, it was markedly reduced in leflunomide-treated eyes. Flow cytometry detection found that compared with normal group, Th17 cells rates in rats' spleen of model group also increased significantly (8.5% ± 1.3% vs. 0.5% ± 0.2%; t = 8.057, P = 0.000, P < α', α' = 0.05/15). Compared with model group, Th17 cells in spleen of rats in leflunomide groups showed a decreased number by flow cytometry. And it showed dosage dependent. It was significant different between different doses leflunomide treated group compared with control group. The results showed as below, in low dose group (4.1% ± 0.6% vs. 8.5% ± 1.3%; t = 6.372, P = 0.01, P < α', α' = 0.05/15), in medium dose group (2.8% ± 0.2% vs. 8.5% ± 1.3%; t = 4.49, P = 0.002, P < α', α' = 0.05/15) and in high dose group (1.8% ± 0.2% vs. 8.5% ± 1.3%; t = 5.743, P = 0.000, P < α', α' = 0.05/15). Gene expression of IL-17 and IFN-γ were markedly reduced in leflunomide-treated eyes. Leflunomide significantly decreased the serum levels of IL-17 and IFN-γ. Compared with model group, in leflunomide-treated low dosage group (0.603 ± 0.03 vs. 0.787 ± 0.104; t = 0.183, P = 0.002, P < α', α' = 0.05/15), medium dosage group (0.535 ± 0.048 vs. 0.787 ± 0.104; t = 0.252, P = 0.000, P < α', α' = 0.05/15) and high dosage group (0.374 ± 0.051 vs. 0.787 ± 0.104; t = 0.412, P = 0.000, P < α', α' = 0.05/15), IL-17 mRNA showed lower expression. Moreover, IFN-γ mRNA in the tissue of EAU eyes were suppressed by medium dosage leflunomide group (0.375 ± 0.018 vs. 0.427 ± 0.056; t = 0.69, P = 0.001, P < α', α' = 0.05/15) and high leflunomide dosage group respectively (0.367 ± 0.018 vs. 0.427 ± 0.056; t = 0.077, P = 0.000, P < α', α' = 0.05/15). The difference was statistically significant. All the results suggested that IL-17, which was secreted by Th17 cell, a subtype of T lymphocytes, might play an important role in the pathogenesis of uveitis. CONCLUSIONS Oral administration of leflunomide effectively suppressed IRBP-induced uveitis in rats, not only reduced exudation in iris but also alleviated the infiltration damage of inflammation cells in fundus. It might be ascribed to the effect that leflunomide could treat inflammation by down-regulating the expressions of IL-17 and IFN-γ. Therefore, it suggested that leflunomide had protective effects against EAU in Lewis rats.
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Affiliation(s)
- Chengbo Fang
- Department of Ophthalmology, the 1st Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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Zanon CDF, Sonehara NM, Girol AP, Gil CD, Oliani SM. Protective effects of the galectin-1 protein on in vivo and in vitro models of ocular inflammation. Mol Vis 2015; 21:1036-50. [PMID: 26392742 PMCID: PMC4556161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/31/2015] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Galectin-1 (Gal-1) is a β-galactoside-binding protein with diverse biological activities in the pathogenesis of inflammation but has been poorly investigated in terms of ocular inflammation. In the present study, we monitored the anti-inflammatory effects of Gal-1 using the in vivo rodent model of endotoxin-induced uveitis (EIU) and in vitro assays with human RPE (ARPE-19) cells. METHODS For this purpose, EIU was induced by subcutaneous sterile saline injection of 0.1 ml of lipopolysaccharide (LPS, 1 mg/Kg) in the rat paw, which was maintained under these conditions for 24 h. The therapeutic efficacy of recombinant Gal-1 (rGal-1) was tested in the EIU animals by intraperitoneal inoculation (3 µg/100 µl per animal) 15 min after the LPS injection. In vitro studies were performed using LPS-stimulated ARPE-19 cells (10 μg/ml) for 2, 8, 24 and 48 h, treated or not with rGal-1 (4 μg/ml) or dexamethasone (Dex, 1.0 μM). RESULTS Gal-1 treatment attenuated the histopathological manifestation of EIU via the inhibition of polymorphonuclear cells (PMN) infiltration in the eye and by causing an imbalance in adhesion molecule expression and suppressing interleukin (IL)-1β, IL-6, and monocyte chemotactic protein-1 (MCP-1) productions. Immunohistochemical and western blotting analyses revealed significant upregulation of Gal-1 in the eyes induced by EIU after 24 h. In the retina, there was no difference in the Gal-1 expression, which was high in all groups, demonstrating its structural role in this region. To better understand the effects of Gal-1 in the retina, in vitro studies were performed using ARPE-19 cells. Ultrastructural immunocytochemical analyses showed decreased levels of endogenous Gal-1 in LPS-stimulated cells (24 h), while Dex treatment upregulated this protein. The protective effects of rGal-1 on LPS-stimulated cells were associated with the significant reduction of the release of cytokines (IL-8 and IL-6), similar to Dex treatment. Furthermore, rGal-1 and Dex inhibited cyclooxygenase-2 (COX-2) expression in LPS-stimulated cells, as shown by immunofluorescence. CONCLUSIONS Overall, this study identified potential roles for Gal-1 in ocular inflammation, especially uveitis, and may lead to future therapeutic approaches.
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Affiliation(s)
- Caroline de Freitas Zanon
- Departament of Biology, Instituto de Biociências, Letras e Ciências Exatas; São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
| | - Nathália Martins Sonehara
- Departament of Biology, Instituto de Biociências, Letras e Ciências Exatas; São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
| | - Ana Paula Girol
- Departament of Biology, Instituto de Biociências, Letras e Ciências Exatas; São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
- Department of Physical and Biological Sciences, Integrated College Padre Albino Foundation (FIPA), Rua dos Estudantes, 225, Catanduva, SP, Brazil
| | - Cristiane Damas Gil
- Department of Morphology and Genetics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sonia Maria Oliani
- Departament of Biology, Instituto de Biociências, Letras e Ciências Exatas; São Paulo State University (UNESP), São José do Rio Preto, SP, Brazil
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50
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Liang D, Zuo A, Shao H, Chen M, Kaplan HJ, Sun D. Anti-inflammatory or proinflammatory effect of an adenosine receptor agonist on the Th17 autoimmune response is inflammatory environment-dependent. J Immunol 2014; 193:5498-505. [PMID: 25367119 PMCID: PMC4299924 DOI: 10.4049/jimmunol.1401959] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Adenosine is a key endogenous signaling molecule that regulates a wide range of physiological functions, including immune system function and inflammation. Studies have shown that adenosine receptor (AR) agonists can be either anti-inflammatory or proinflammatory in immune responses and in inflammation, and the clarification of the mechanisms causing these opposing effects should provide a better guide for therapeutic intervention. Whereas previous studies mostly examined the effects of AR agonists on Th1-type immune responses, in this study, we compared their effect on Th17 and Th1 autoimmune responses in experimental autoimmune uveitis, a mouse model of human uveitis induced by immunization with the human interphotoreceptor retinoid-binding protein peptides 1-20. We showed that injection of mice with a nonselective AR agonist, 5'-N-ethylcarboxamidoadenosine (NECA), at an early stage after immunization had an inhibitory effect on both Th1 and Th17 responses, whereas injection of the same amount of NECA at a late stage inhibited the Th1 response but had an enhancing effect on the Th17 response. We also showed that the effects of NECA on Th1 and Th17 responses were completely dissociated, that the enhancing effect of NECA on Th17 responses was modulated by γδ T cells, and that the response of γδ T cells to NECA was determined by their activation status. We conclude that the inflammatory environment has a strong impact on converting the effect of AR agonist on the Th17 autoimmune response from anti-inflammatory to proinflammatory. Our observation should help in the designing of better AR-targeted therapies.
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MESH Headings
- Adenosine-5'-(N-ethylcarboxamide)/administration & dosage
- Animals
- Anti-Inflammatory Agents/administration & dosage
- Autoantigens/immunology
- Autoimmune Diseases/chemically induced
- Autoimmune Diseases/immunology
- Autoimmune Diseases/therapy
- Cells, Cultured
- Eye Proteins/immunology
- Female
- Humans
- Immunomodulation/drug effects
- Immunomodulation/genetics
- Inflammation Mediators/administration & dosage
- Lymphocyte Activation/drug effects
- Lymphocyte Activation/genetics
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Models, Animal
- Peptide Fragments/immunology
- Purinergic P1 Receptor Agonists/administration & dosage
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- Retinol-Binding Proteins/immunology
- Th1 Cells/drug effects
- Th1 Cells/immunology
- Th17 Cells/drug effects
- Th17 Cells/immunology
- Uveitis/chemically induced
- Uveitis/immunology
- Uveitis/therapy
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Affiliation(s)
- Dongchun Liang
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA 90033; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA 90033; and
| | - Aijun Zuo
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA 90033; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA 90033; and
| | - Hui Shao
- Department of Ophthalmology and Visual Sciences, Kentucky Lions Eye Center, University of Louisville, Louisville, KY 40202
| | - Mingjiazi Chen
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA 90033; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA 90033; and
| | - Henry J Kaplan
- Department of Ophthalmology and Visual Sciences, Kentucky Lions Eye Center, University of Louisville, Louisville, KY 40202
| | - Deming Sun
- Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA 90033; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA 90033; and
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