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Gyenes A, Tapasztó Z, Quirce S, Luna C, Frutos-Rincón L, Gallar J, Acosta MC, Kovács I. Cyclosporine A Decreases Dryness-Induced Hyperexcitability of Corneal Cold-Sensitive Nerve Terminals. Int J Mol Sci 2023; 24:13025. [PMID: 37629206 PMCID: PMC10455570 DOI: 10.3390/ijms241613025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Cyclosporine A (CsA) is used for the treatment of dry eye (DE) with good clinical results, improving tear secretion and decreasing subjective symptoms. These effects are attributed to the improved tear film dynamics, but there are no data on the effect of CsA on the abnormal sensory nerve activity characteristic in DE. Our purpose was to evaluate the CsA effect on the enhanced activity of corneal cold thermoreceptors in a tear-deficient DE animal model using in vitro extracellular recording of cold thermoreceptors nerve terminal impulses (NTIs) before and in the presence of CsA. NTI shape was also analyzed. Blinking frequency and tearing rate were also measured in awake animals before and after topical CsA. CsA increased the tearing and blinking of treated animals. CsA significantly decreased the peak response to cold of cold thermoreceptors. Neither their spontaneous NTIs discharge rate nor their cooling threshold were modified. CsA also seemed to reverse some of the changes in NTI shape induced by tear deficiency. These data suggest that, at least in part, the beneficial clinical effects of CsA in DE can be attributed to a direct effect on sensory nerve endings, although the precise mechanisms underlying this effect need further studies to be fully clarified.
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Affiliation(s)
- Andrea Gyenes
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Zsófia Tapasztó
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
| | - Susana Quirce
- Instituto de Neurociencias, Universidad Miguel Hernández—CSIC, 03550 San Juan de Alicante, Spain (C.L.); (L.F.-R.); (M.C.A.)
| | - Carolina Luna
- Instituto de Neurociencias, Universidad Miguel Hernández—CSIC, 03550 San Juan de Alicante, Spain (C.L.); (L.F.-R.); (M.C.A.)
| | - Laura Frutos-Rincón
- Instituto de Neurociencias, Universidad Miguel Hernández—CSIC, 03550 San Juan de Alicante, Spain (C.L.); (L.F.-R.); (M.C.A.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, 03010 Alicante, Spain
| | - Juana Gallar
- Instituto de Neurociencias, Universidad Miguel Hernández—CSIC, 03550 San Juan de Alicante, Spain (C.L.); (L.F.-R.); (M.C.A.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante-ISABIAL, 03010 Alicante, Spain
| | - M. Carmen Acosta
- Instituto de Neurociencias, Universidad Miguel Hernández—CSIC, 03550 San Juan de Alicante, Spain (C.L.); (L.F.-R.); (M.C.A.)
| | - Illés Kovács
- Department of Ophthalmology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY 10021, USA
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary
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2
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Zhuang D, Misra SL, Mugisho OO, Rupenthal ID, Craig JP. NLRP3 Inflammasome as a Potential Therapeutic Target in Dry Eye Disease. Int J Mol Sci 2023; 24:10866. [PMID: 37446038 DOI: 10.3390/ijms241310866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial ocular surface disorder arising from numerous interrelated underlying pathologies that trigger a self-perpetuating cycle of instability, hyperosmolarity, and ocular surface damage. Associated ocular discomfort and visual disturbance contribute negatively to quality of life. Ocular surface inflammation has been increasingly recognised as playing a key role in the pathophysiology of chronic DED. Current readily available anti-inflammatory agents successfully relieve symptoms, but often without addressing the underlying pathophysiological mechanism. The NOD-like receptor protein-3 (NLRP3) inflammasome pathway has recently been implicated as a key driver of ocular surface inflammation, as reported in pre-clinical and clinical studies of DED. This review discusses the intimate relationship between DED and inflammation, highlights the involvement of the inflammasome in the development of DED, describes existing anti-inflammatory therapies and their limitations, and evaluates the potential of the inflammasome in the context of the existing anti-inflammatory therapeutic landscape as a therapeutic target for effective treatment of the disease.
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Affiliation(s)
- Dian Zhuang
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Stuti L Misra
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Odunayo O Mugisho
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Ilva D Rupenthal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand
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3
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Padjasek M, Cisło-Sankowska A, Lis-Bartos A, Qasem B, Marycz K. PLDLA/TPU Matrix Enriched with Cyclosporine A as a Therapeutic Platform for Immune-Mediated Keratitis (IMMK) in Horses. Int J Mol Sci 2023; 24:ijms24065735. [PMID: 36982806 PMCID: PMC10057311 DOI: 10.3390/ijms24065735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/05/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
The purpose of this study was to describe the use of PLDLA/TPU matrix enriched with cyclosporine A (CsA) as a therapeutic platform in horses with immune-mediated keratitis (IMMK) with an in vitro evaluation CsA release and degradation of the blend as well as determination of the safety and efficacy of that platform used in the animal model. The kinetics of the CsA release from matrices constructed of thermoplastic polyurethane (TPU) polymer and a copolymer of L-lactide with DL-lactide (PLDLA) (80:20) in the TPU (10%) and a PLDL (90%) polymer blend were studied. Moreover, we used the STF (Simulated Tear Fluid) at 37 °C as a biological environment to assess the CsA release and its degradation. Additionally, the platform described above was injected subconjunctival in the dorsolateral quadrant of the globe after standing sedation of horses with diagnosed superficial and mid-stromal IMMK. The obtained results indicated that the CsA release rate in the fifth week of the study increased significantly by the value of 0.3% compared to previous weeks. In all of the cases, the TPU/PLA doped with 12 mg of the CsA platform effectively reduced the clinical symptoms of keratitis, leading to the complete remission of the corneal opacity and infiltration four weeks post-injection. The results from this study showed that the PLDLA/TPU matrix enriched with the CsA platform was well tolerated by the equine model and effective in treating superficial and mid-stromal IMMK.
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Affiliation(s)
- Martyna Padjasek
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Anna Cisło-Sankowska
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Anna Lis-Bartos
- Department of Biomaterials and Composites, Faculty of Material Science and Ceramics, AGH University of Science and Technology, Aleja Adama Mickiewicza 30, 30-059 Krakow, Poland
| | - Badr Qasem
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
| | - Krzysztof Marycz
- Department of Experimental Biology, The Faculty of Biology and Animal Science, The University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
- International Institute of Translational Medicine, Jesionowa 11 St., 55-124 Malin, Poland
- Correspondence:
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4
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James-Jenks EM, Pinard CL. Topical Ocular Therapeutics in Small Animals. Vet Clin North Am Small Anim Pract 2023; 53:473-492. [PMID: 36813396 DOI: 10.1016/j.cvsm.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This article reviews the administration of common topical ophthalmic medications, in relation to factors influencing absorption including composition of topical ophthalmic preparations, and potential systemic effects. Commonly prescribed, commercially available topical ophthalmic medications are discussed with respect to pharmacology, their indications for use, and adverse effects. Knowledge of topical ocular pharmacokinetics is essential for the management of veterinary ophthalmic disease.
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Affiliation(s)
- Elizabeth M James-Jenks
- Department of Clinical Studies, University of Guelph, Ontario Veterinary College, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada.
| | - Chantale L Pinard
- Department of Clinical Studies, University of Guelph, Ontario Veterinary College, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
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5
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Hisey EA, Galor A, Leonard BC. A comparative review of evaporative dry eye disease and meibomian gland dysfunction in dogs and humans. Vet Ophthalmol 2023; 26 Suppl 1:16-30. [PMID: 36786010 PMCID: PMC10175238 DOI: 10.1111/vop.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
Dry eye disease is a complex ophthalmic disorder that consists of two main subtypes, aqueous deficient dry eye (ADDE) and evaporative dry eye disease (EDED). Due to the complex underlying physiology, human dry eye disease can be difficult to model in laboratory animal species. Thus, the identification and characterization of a spontaneous large animal model of dry eye disease is desirable. Dogs have been described as an ideal spontaneous model of ADDE due to the similar pathophysiology between dogs and humans. Recently, EDED and meibomian gland dysfunction (MGD) have been increasingly recognized and reported in dogs. These reports on EDED and MGD in dogs have identified similarities in pathophysiology, clinical presentations, and diagnostic parameters to humans with the comparable disorders. Additionally, the tests that are used to diagnose EDED and MGD in humans are more easily applicable to dogs than to laboratory species due to the comparable globe sizes between dogs and humans. The reported response of dogs to EDED and MGD therapies are similar to humans, suggesting that they would be a valuable preclinical model for the development of additional therapeutics. Further research and clinical awareness of EDED and MGD in dogs would increase their ability to be utilized as a preclinical model, improving the positive predictive value of therapeutics for EDED and MGD in both humans and dogs.
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Affiliation(s)
- Erin A Hisey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA.,Miami Veterans Affairs Medical Center, Miami, Florida, USA
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
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6
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Iwashita H, Sebbag L, Leonard BC, Saito A. A review of diagnostic tests for qualitative and quantitative tear film deficiency in dogs. Vet Ophthalmol 2022; 26 Suppl 1:5-15. [PMID: 36575128 DOI: 10.1111/vop.13044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/22/2022] [Indexed: 12/29/2022]
Abstract
Dry eye disease (DED) is a complex multifactorial condition caused by loss of ocular surface homeostasis from quantitative and/or qualitative tear film deficiency. Schirmer tear test (STT) is often the only diagnostic test used to assess for DED in veterinary practice. STT is invaluable in the diagnosis and monitoring of quantitative tear film deficiency (i.e., keratoconjunctivitis sicca); however, it is not sufficient to optimize therapy and fully recognize other contributing factors for the disturbance in ocular surface homeostasis. The present work reviews diagnostic tests for assessing aqueous tear production in veterinary medicine, as well as the quality of tears, corneal epithelial barrier integrity, and the lacrimal functional unit.
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Affiliation(s)
| | - Lionel Sebbag
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, California, USA
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7
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Padjasek M, Qasem B, Cisło-Pakuluk A, Marycz K. Cyclosporine A Delivery Platform for Veterinary Ophthalmology—A New Concept for Advanced Ophthalmology. Biomolecules 2022; 12:biom12101525. [PMID: 36291734 PMCID: PMC9599649 DOI: 10.3390/biom12101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Cyclosporine A (CsA) is a selective and reversible immunosuppressant agent that is widely used as a medication for a wide spectrum of diseases in humans such as graft versus host disease, non-infectious uveitis, rheumatoid arthritis, psoriasis, and atopic dermatitis. Furthermore, the CsA is used to treat keratoconjunctivitis sicca, chronic superficial keratitis, immune-mediated keratitis and equine recurrent uveitis in animals. The selective activity of Cyclosporine A (CsA) was demonstrated to be an immunomodulation characteristic of T-lymphocyte proliferation and inhibits cytokine gene expression. Moreover, the lipophilic characteristics with poor bioavailability and low solubility in water, besides the side effects, force the need to develop new formulations and devices that will provide adequate penetration into the anterior and posterior segments of the eye. This review aims to summarize the effectiveness and safety of cyclosporine A delivery platforms in veterinary ophthalmology.
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8
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Gilger BC. How study of naturally occurring ocular disease in animals improves ocular health globally. J Am Vet Med Assoc 2022; 260:1887-1893. [PMID: 36198052 DOI: 10.2460/javma.22.08.0383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this article, which is part of the Currents in One Health series, the role of naturally occurring ocular disease in animals is reviewed with emphasis on how the understanding of these ocular diseases contributes to one health initiatives, particularly the pathogenesis and treatment of ocular diseases common to animals and humans. Animals spontaneously develop ocular diseases that closely mimic those in humans, especially dry eye disease, herpes virus infection (cats), fungal keratitis (horses), bacterial keratoconjunctivitis, uveitis, and glaucoma. Both uveitis and glaucoma are common in domestic animals and humans, and many similarities exist in pathogenesis, genetics, and response to therapy. Furthermore, the study of inherited retinal disease in animals has particularly epitomized the one health concept, specifically the collaborative efforts of multiple disciplines working to attain optimal health for people and animals. Through this study of retinal disease in dogs, innovative therapies such as gene therapy have been developed. A unique opportunity exists to study ocular disease in shared environments to better understand the interplay between the environment, genetics, and ocular disease in both animals and humans. The companion Currents in One Health by Gilger, AJVR, December 2022, addresses in more detail recent studies of noninfectious immune-mediated animal ocular disease and their role in advancing ocular health globally.
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9
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Wei LN, Wu CH, Lin CT, Liu IH. Topical applications of allogeneic adipose-derived mesenchymal stem cells ameliorate the canine keratoconjunctivitis sicca. BMC Vet Res 2022; 18:217. [PMID: 35689226 PMCID: PMC9185903 DOI: 10.1186/s12917-022-03303-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Canine keratoconjunctivitis sicca (KCS) is predominantly an immune-mediated disease. Current therapy of canine KCS is mainly by immunosuppressant, but the effectiveness was limited in some patients. In the past few years, some studies showed the results of the use of mesenchymal stem cells in treating canine KCS via periocular injections. However, the periocular injection procedure requires sedation or general anesthesia, and may lead to iatrogenic or incidental injury during the injection process. The aim of this study was to investigate the efficacy of topical allogenic canine adipose-derived mesenchymal stem cells (cAD-MSCs) in clinical patients of canine KCS. Results The cAD-MSCs used in this study were characterized for their capability of tri-lineage differentiation and immunomodulatory properties. In addition, preparation methods for eye drops of cAD-MSCs was developed and its optimal preservation was tested. The canine KCS patients were recruited for clinical trial and divided into two groups based on their history of previous treatment. All patients received topical cAD-MSCs treatment once per week for 6 consecutive weeks and complete ophthalmic examinations were performed 1 week before treatment (week 0) and at 3rd, 6th, 9th weeks, respectively. The results showed that the quantity and quality of tears have improved significantly following topical cAD-MSCs treatment based on Schirmers tear test-1 and tear break-up time. More than half of all patients were found improved in the tear quantity. In particular, 56.5% of the patients that were unresponsive to prior immunosuppressant therapy had an effective increase in tear volume. The severity of clinical signs was also ameliorated according to the numeric rating scale score from both patient owners and the clinician. Conclusion To sum up, topical cAD-MSCs may be beneficial especially in KCS patients with poor owner compliance for frequent daily use of eye drops or those who are unresponsive to immunosuppressant therapy.
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Affiliation(s)
- Li-Ning Wei
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, 106, Taiwan.,Department of Ophthalmology, National Taiwan University Veterinary Hospital, Taipei, 106, Taiwan
| | - Ching-Ho Wu
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, 106, Taiwan.,Department of Small Animal Surgery, National Taiwan University Veterinary Hospital, Taipei, 106, Taiwan
| | - Chung-Tien Lin
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, 106, Taiwan. .,Department of Ophthalmology, National Taiwan University Veterinary Hospital, Taipei, 106, Taiwan.
| | - I-Hsuan Liu
- Department of Animal Science and Technology, National Taiwan University, Taipei, 106, Taiwan. .,Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, 106, Taiwan.
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10
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Hermida-Prieto M, García-Castro J, Mariñas-Pardo L. Systemic Treatment of Immune-Mediated Keratoconjunctivitis Sicca with Allogeneic Stem Cells Improves the Schirmer Tear Test Score in a Canine Spontaneous Model of Disease. J Clin Med 2021; 10:jcm10245981. [PMID: 34945277 PMCID: PMC8709250 DOI: 10.3390/jcm10245981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 12/17/2022] Open
Abstract
Keratoconjunctivitis sicca (KCS) is characterized by ocular discomfort, conjunctival hyperaemia, and corneal scarring, causing reduced aqueous tear production that can be measured using the standard Schirmer tear test (STT). Canine adipose tissue-derived MSCs (cATMSCs) have been proposed as treatment due to their anti-inflammatory effect, by releasing cytokines and immunomodulatory soluble factors. PURPOSE The aim of this study was to evaluate the effect of the systemic administration of cATMSCs on tear production in dogs with immune-mediated KCS, compared to classical Cyclosporine A (CsA) treatment. METHODS Twenty-eight client-owned dogs with spontaneous KCS were allocated in the experimental group (n = 14, treated with systemic cATMSCs or control group (n = 14, treated with CsA). SST values increased significantly at days 15 (p = 0.002), 45 (p = 0.042) and 180 (p = 0.005) with no observed side-effects in the experimental group. Eyes with an initial STT value of 11-14 mm/min maintained significant improvement at day 180, needing only artificial tears as treatment. Eyes with an initial STT value <11 mm/min needed cyclosporin treatment at day 45, so follow-up was stopped. Control animals treated with CsA did not improve their STT at day 180. RESULTS AND CONCLUSIONS Systemic allogeneic cATMSCs application appeared to be a feasible and effective therapy with positive outcome in dogs with initial STT between 11-14 mm/min, with a significant improvement in tear production. The STT increment was maintained for at least 180 days, without needing additional medication, thus suggesting it could constitute an alternative therapy to classical immunosuppressive treatments.
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Affiliation(s)
- Manuel Hermida-Prieto
- Instituto de Investigación Biomédica de A Coruña—Universidade de A Coruña (INIBIC—UDC), 15006 A Coruna, Spain;
| | - Javier García-Castro
- Faculty of Veterinary Medicine, Universidad Alfonso X El Sabio (UAX), 28691 Villanueva de la Canada, Spain;
- Cellular Biotechnology Unit, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luis Mariñas-Pardo
- Instituto de Investigación Biomédica de A Coruña—Universidade de A Coruña (INIBIC—UDC), 15006 A Coruna, Spain;
- Correspondence:
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11
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Galley AP, Beltran E, Tetas Pont R. Neurogenic keratoconjunctivitis sicca in 34 dogs: A case series. Vet Ophthalmol 2021; 25:140-152. [PMID: 34870366 DOI: 10.1111/vop.12949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/03/2021] [Accepted: 10/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the clinical findings, imaging features, underlying conditions, treatment, and progression of dogs presented between 2010 and 2019 with neurogenic keratoconjunctivitis sicca (NKCS). METHODS Dogs diagnosed with NKCS were searched in the clinical database. Inclusion criteria were STT-1 readings <15 mm/min, clinical signs of KCS with concurrent ipsilateral xeromycteria. RESULTS Thirty-four cases were identified. Mean age at presentation was 8.2 years, median 8.9 years (0.3-14.7). Twenty dogs were male, and 14 dogs were female. Concurrent neurological deficits included facial neuropathy (n = 13, 38%), peripheral vestibular syndrome (n = 10, 29%), and Horner's syndrome (n = 5, 15%). Advanced imaging was acquired in 53% of cases (n = 18). Etiologies included idiopathic (n = 18, 53%), endocrinopathy (n = 6, 18%), otitis interna (n = 4, 12%), head trauma (n = 3, 9%), iatrogenic (post-TECA-LBO, n = 1, 3%), brainstem mass (n = 1, 3%), and an area of inflammation in the pterygopalatine fossa (n = 1, 3%). Treatment for NKCS was initiated in most cases (n = 30, 88%) including: oral pilocarpine 2% and lacrimostimulant (n = 19), oral pilocarpine 2% only (n = 3), or lacrimostimulant only (n = 8). A mean time follow-up of 3.7 months, median 3 months (1-14) was available in 23 cases (68%). Eleven cases with follow-up were responsive (48%) with resolution of the clinical signs in a median time 4 months (1-10), and all of them were treated with oral pilocarpine (±lacrimostimulant). CONCLUSIONS Most cases presented as idiopathic NKCS; in others, an underlying cause of facial neuropathy was identified. All responsive cases were treated with oral pilocarpine 2%.
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Affiliation(s)
- Amy P Galley
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
| | - Elsa Beltran
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
| | - Roser Tetas Pont
- Royal Veterinary College (RVC), Queen Mother Hospital for Animals (QMHA), London, UK
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12
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Sanchez RF, Everson R, Escanilla N, Cebrian P, Slenter IJM, Grinwis GCM, Göerig C. Progressive retrocorneal pigmentation in dogs: A clinical report of 34 cases. Vet Ophthalmol 2020; 23:943-949. [PMID: 33145924 DOI: 10.1111/vop.12826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/09/2020] [Accepted: 08/27/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe the signalment, ophthalmic examination findings, and follow-up of dogs affected with a previously unreported retrocorneal pigmentary lesion. MATERIALS AND METHODS Retrospective record evaluation spanning 2009-2019. RESULTS Retrocorneal pigmentary lesions were described in 34 patients (46 eyes). German Shepherds (n = 7), Jack Russel terriers (n = 5), and terrier crosses (n = 4) made up 16/34 (47.1%) of the cases. The mean age was 13.5 years (range 1.4-14.2 years), and 16/30 (53.3%) dogs were female. Most dogs were affected unilaterally (22/34 (64.7%)), the others bilaterally, and 5/34 (14.7%) were referred for it while the others were incidentally diagnosed. The lesions affected the ventral, peripheral, inner cornea and had a round/undulated leading edge. The number of corneal clock hours affected was known for 41/46 (89.1%) eyes and involved 1-3 clock hours in 32/41 (78.1%) eyes, 4-6 in 6/41 (14.6%), 7-9 in 2/41 (4.9%), and 10 in 1/41 (2.4%). The central cornea was affected in 9/46 (19.6%) eyes, and in 5/9 (55.6%), the median corneal clarity score was G2 (scale: G0-G4). The commonest additional findings included free-floating uveal cysts (11/34 dogs, 32.4%), cataracts (6/34 dogs, 17.6%), and primary glaucoma (5/34 dogs, 14.7%). Gonioscopy was available in 16/34 (47.1%) dogs and was normal except in primary glaucoma cases. Follow-up was documented in 13/34 (38.2%) dogs with a mean follow-up of 17 months (range: 5-26 months). Lesion progression was documented in 6/13 (46.2%) dogs. CONCLUSIONS Retrocorneal pigmentation occurs as a slowly progressive lesion of older dogs that could impact vision. Histological studies of affected eyes are warranted.
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Affiliation(s)
- Rick F Sanchez
- Specialistische Dierenkliniek Utrecht (SDU) - Anicura, Utrecht, The Netherlands
| | | | | | | | - Inge J M Slenter
- Department Clinical Sciences, Pathology, Faculty of Veterinary medicine, Utrecht University, Utrecht, The Netherlands
| | - Guy C M Grinwis
- Department Biomolecular Health Sciences, Faculty of Veterinary medicine, Utrecht University, Utrecht, The Netherlands
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13
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Knight LN, Ben-Shlomo G. Electrolyte composition of tears in normal dogs and its comparison to serum and plasma. Exp Eye Res 2020; 201:108265. [PMID: 32979395 DOI: 10.1016/j.exer.2020.108265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/26/2020] [Accepted: 09/20/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The dog is an important animal model for tear dysfunction diseases, however to-date the electrolyte composition of the dog's tears is unknown. The aim of this study was to analyze the electrolyte content of canine tears and compare it to serum and plasma. METHODS Tear samples were collected from 18 eyes of 9 dogs. Blood for serum was collected in tubes with no anticoagulants; plasma was obtained by using two different anticoagulants: Citrate-Phosphate-Dextrose (CPD) and heparin. The electrolytes were measured in all samples, analyzed, and compared. RESULTS Most of the electrolyte values in tears were statistically different (P < 0.05) from electrolyte values in serum and plasma. Potassium and chloride values were significantly higher in tears compared to serum and plasma, while calcium and phosphate values were significantly lower. Sodium values in tears were higher than in serum and heparinized-plasma, but lower than CPD-plasma. Bicarbonate values were lower in tears compared to serum and heparinized plasma, but was not statistically different than CPD-plasma. While magnesium values were lower in tears compared to serum and heparinized-plasma, the difference was not statistically different. CONCLUSIONS Herein, we report for the first time the electrolyte composition of the canine tears and its comparison to serum and plasma.
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Affiliation(s)
- LaTisha N Knight
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Gil Ben-Shlomo
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA.
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14
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Sebbag L, Mochel JP. An eye on the dog as the scientist's best friend for translational research in ophthalmology: Focus on the ocular surface. Med Res Rev 2020; 40:2566-2604. [PMID: 32735080 DOI: 10.1002/med.21716] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 12/15/2022]
Abstract
Preclinical animal studies provide valuable opportunities to better understand human diseases and contribute to major advances in medicine. This review provides a comprehensive overview of ocular parameters in humans and selected animals, with a focus on the ocular surface, detailing species differences in ocular surface anatomy, physiology, tear film dynamics and tear film composition. We describe major pitfalls that tremendously limit the translational potential of traditional laboratory animals (i.e., rabbits, mice, and rats) in ophthalmic research, and highlight the benefits of integrating companion dogs with clinical analogues to human diseases into preclinical pharmacology studies. This One Health approach can help accelerate and improve the framework in which ophthalmic research is translated to the human clinic. Studies can be conducted in canine subjects with naturally occurring or noninvasively induced ocular surface disorders (e.g., dry eye disease, conjunctivitis), reviewed herein, and tear fluid can be easily retrieved from canine eyes for various bioanalytical purposes. In this review, we discuss common tear collection methods, including capillary tubes and Schirmer tear strips, and provide guidelines for tear sampling and extraction to improve the reliability of analyte quantification (drugs, proteins, others).
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Affiliation(s)
- Lionel Sebbag
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Jonathan P Mochel
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
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15
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Comprehensive Clinical, Diagnostic, and Advanced Imaging Characterization of the Ocular Surface in Spontaneous Aqueous Deficient Dry Eye Disease in Dogs. Cornea 2020; 38:1568-1575. [PMID: 31369464 DOI: 10.1097/ico.0000000000002081] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To perform a comprehensive clinical, diagnostic, and imaging characterization of the ocular surface in West Highland White Terriers (WHWTs) diagnosed with aqueous deficient dry eye (ADDE) disease. METHODS Six ADDE-affected and 13 ADDE-unaffected WHWT dogs were enrolled and underwent clinical assessment and disease scoring, tear osmolarity, phenol red thread test, Schirmer tear test, tear film breakup time, fluorescein staining, Rose bengal and lissamine green vital dye staining, meibometry, corneal esthesiometry, ultrasound pachymetry, optical coherence tomography, in vivo confocal microscopy, and conjunctival biopsy. Subjective assessment of their condition was provided by owner-reported surveys. RESULTS ADDE-affected WHWT dogs had higher median clinical disease (conjunctiva: 5.75 vs. 0.00; cornea: 14.00 vs. 5.00; total: 17.50 vs. 5.00), vital staining (Rose bengal: 2.25 vs. 1.50; lissamine green: 2.00 vs. 1.00), and histologic disease (conjunctiva: 2 vs. 0) scores when compared with the controls. In addition, ADDE-affected WHWTs had significantly lower phenol red thread test (5.0 vs. 17.5, mm/15 s), Schirmer tear test (3 vs. 20, mm/min), tear film breakup time (3.6 vs. 13.9, s) values and higher area under the curve values for meibometry (394 vs. 245, meibometry units [MU]). There were no significant differences in other tear film tests performed. Advanced imaging revealed decreased tear meniscus height (optical coherence tomography) and variable pigment deposition within corneal epithelial cells (in vivo confocal microscopy). CONCLUSIONS This comprehensive assessment of ADDE-affected WHWTs depicts the ocular surface changes associated with quantitative lacrimal gland dysfunction. Importantly, ADDE-affected WHWTs may prove a valuable naturally occurring ADDE model for investigating underlying pathophysiological mechanisms and the development of novel therapeutics.
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16
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Neurotrophic effects of G M1 ganglioside, NGF, and FGF2 on canine dorsal root ganglia neurons in vitro. Sci Rep 2020; 10:5380. [PMID: 32214122 PMCID: PMC7096396 DOI: 10.1038/s41598-020-61852-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 03/04/2020] [Indexed: 01/26/2023] Open
Abstract
Dogs share many chronic morbidities with humans and thus represent a powerful model for translational research. In comparison to rodents, the canine ganglioside metabolism more closely resembles the human one. Gangliosides are components of the cell plasma membrane playing a role in neuronal development, intercellular communication and cellular differentiation. The present in vitro study aimed to characterize structural and functional changes induced by GM1 ganglioside (GM1) in canine dorsal root ganglia (DRG) neurons and interactions of GM1 with nerve growth factor (NGF) and fibroblast growth factor (FGF2) using immunofluorescence for several cellular proteins including neurofilaments, synaptophysin, and cleaved caspase 3, transmission electron microscopy, and electrophysiology. GM1 supplementation resulted in increased neurite outgrowth and neuronal survival. This was also observed in DRG neurons challenged with hypoxia mimicking neurodegenerative conditions due to disruptions of energy homeostasis. Immunofluorescence indicated an impact of GM1 on neurofilament phosphorylation, axonal transport, and synaptogenesis. An increased number of multivesicular bodies in GM1 treated neurons suggested metabolic changes. Electrophysiological changes induced by GM1 indicated an increased neuronal excitability. Summarized, GM1 has neurotrophic and neuroprotective effects on canine DRG neurons and induces functional changes. However, further studies are needed to clarify the therapeutic value of gangliosides in neurodegenerative diseases.
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17
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Abstract
Filtration surgery has, for the past 50 years been key in the treatment of glaucoma yet a significant issue in the long-term success of such surgery is fibrosis limiting aqueous drainage. Numerous methods have been used to reduce such scarring after filtration surgery and animal models have been important in the development of such techniques. First animal models have been central in understanding molecular and cellular changes occurring in fibrosis and thus which pathways might be valuable therapeutic. Secondly animal models have been critical in determining which of these therapies is likely to be most worthwhile. Having said that animals differ substantially from humans in the anatomy of their aqueous drainage pathways and in the mechanisms of fibrotic change. Rodents and lagomorphs vary more markedly from humans than do primates at an anatomic, biochemical and physiological level, and thus the latter might seem more appropriate as models for antifibrotic techniques. However the welfare implications, and thus ethical issues, in using primates are more concerning than with rodents or rabbits and efforts to refine, reduce and replace living animals in such model systems are crucially important. One problem is that the animal models normally involve healthy eyes, not ones with glaucoma. In veterinary ophthalmology we see large numbers of dogs with glaucoma, many of which have filtration implants placed. Potentially these could be a valuable animal model where benefits of antifibrotic treatment could benefit the animals involved and the research seeking to optimise such treatments.
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Affiliation(s)
- David L Williams
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, UK.
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18
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Sebbag L, Moody LM, Mochel JP. Albumin Levels in Tear Film Modulate the Bioavailability of Medically-Relevant Topical Drugs. Front Pharmacol 2020; 10:1560. [PMID: 32047429 PMCID: PMC6997149 DOI: 10.3389/fphar.2019.01560] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/03/2019] [Indexed: 02/02/2023] Open
Abstract
The breakdown of blood-tear barrier that occurs with ocular pathology allows for large amounts of albumin to leak into the tear fluid. This process likely represents an important restriction to drug absorption in ophthalmology, as only the unbound drug is transported across the ocular tissue barriers to exert its pharmacologic effect. We aimed to investigate the effects of albumin levels in tears on the bioavailability of two commonly used ophthalmic drugs: tropicamide, an antimuscarinic that produces mydriasis and cycloplegia, and latanoprost, a PGF2α analog used for the treatment of glaucoma. Eight female beagle dogs underwent a randomized, vehicle-controlled crossover trial. For each dog, one eye received 30 µl of artificial tears (control) or canine albumin (0.4 or 1.5%) at random, immediately followed by 30 µl of 1% tropicamide (2 days, 24 h washout) or 0.005% latanoprost (2 days, 72 h washout) in both eyes. Pupil diameter (digital caliper) and intraocular pressure (IOP; rebound tonometry) were recorded at various times following drug administration (0 to 480 min) and compared between both groups with a mixed model for repeated measures. Albumin in tears had a significant impact on pupillary diameter for both tropicamide (P ≤ 0.001) and latanoprost (P ≤ 0.047), with no differences noted between 0.4% and 1.5% concentrations. Reduction in the maximal effect (pupil size) and overall drug exposure (area under the effect time-curve of pupil size over time) were significant for tropicamide (6.2–8.5% on average, P ≤ 0.006) but not for latanoprost (P ≥ 0.663). The IOP, only measured in eyes receiving latanoprost, was not significantly impacted by the addition of either 0.4% (P = 0.242) or 1.5% albumin (P = 0.879). Albumin in tear film, previously shown to leak from the conjunctival vasculature in diseased eyes, may bind to topically administered drugs and reduces their intraocular penetration and bioavailability. Further investigations in clinical patients and other commonly used ophthalmic medications are warranted.
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Affiliation(s)
- Lionel Sebbag
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Leah M Moody
- Lloyd Veterinary Medical Center, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Jonathan P Mochel
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
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19
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Sebbag L, Kirner NS, Allbaugh RA, Reis A, Mochel JP. Kinetics of Fluorescein in Tear Film After Eye Drop Instillation in Beagle Dogs: Does Size Really Matter? Front Vet Sci 2019; 6:457. [PMID: 31921915 PMCID: PMC6930880 DOI: 10.3389/fvets.2019.00457] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/28/2019] [Indexed: 12/25/2022] Open
Abstract
The study aimed to determine the impact of drop size on tear film pharmacokinetics and assess important physiological parameters associated with ocular drug delivery in dogs. Two separate experiments were conducted in eight healthy Beagle dogs: (i) Instillation of one drop (35 μl) or two drops (70 μl) of 1% fluorescein solution in each eye followed by tear collections with capillary tubes from 0 to 180 min; (ii) Instillation of 10 to 100 μl of 0.1% fluorescein in each eye followed by external photography with blue excitation filter (to capture periocular spillage of fluorescein) and tear collections from 1 to 20 min (to capture tear turnover rate; TTR). Fluorescein concentrations were measured in tear samples with a fluorophotometer. The TTR was estimated based upon non-linear mixed-effects analysis of fluorescein decay curves. Tear film pharmacokinetics were not superior with instillation of two drops vs. one drop based on tear film concentrations, residual tear fluorescence, and area under the fluorescein-time curves (P ≥ 0.163). Reflex TTR varied from 20.2 to 30.5%/min and did not differ significantly (P = 0.935) among volumes instilled (10-100 μl). The volumetric capacity of the canine palpebral fissure (31.3 ± 8.9 μl) was positively correlated with the palpebral fissure length (P = 0.023). Excess solution was spilled over the periocular skin in a volume-dependent manner, predominantly in the lower eyelid, medial canthus and lateral canthus. In sum, a single drop is sufficient for topical administration in dogs. Any excess is lost predominantly by spillage over the periocular skin as well as accelerated nasolacrimal drainage.
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Affiliation(s)
- Lionel Sebbag
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Nicolette S Kirner
- Lloyd Veterinary Medical Center, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Rachel A Allbaugh
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Alysha Reis
- Lloyd Veterinary Medical Center, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Jonathan P Mochel
- Department of Biomedical Sciences, SMART Pharmacology, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
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20
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Félix NM, Gommeren K, Boysen S. Translational medicine between human and veterinary emergency and critical care medicine: a story meant to have a happy ending. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2019; 23:361. [PMID: 31744525 PMCID: PMC6864947 DOI: 10.1186/s13054-019-2659-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 10/23/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Nuno M Félix
- Departamento de Pediatria Hospital de Santarém, Departamento de Pediatria Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - K Gommeren
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
| | - S Boysen
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
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21
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Maini S, Everson R, Dawson C, Chang YM, Hartley C, Sanchez RF. Pigmentary keratitis in pugs in the United Kingdom: prevalence and associated features. BMC Vet Res 2019; 15:384. [PMID: 31666065 PMCID: PMC6822449 DOI: 10.1186/s12917-019-2127-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 10/01/2019] [Indexed: 11/15/2022] Open
Abstract
Background Pigmentary keratitis (PK) is commonly recognised in Pugs, but its aetiology is not completely understood. The aim of this study was to determine the prevalence and associated features of PK in Pugs in the United Kingdom (UK). Results A total of 210 Pugs (420 eyes) were recruited from 12 UK dog shows and social events. The median age of Pugs recruited was 2.50 years (range 0.25–16.25 years). Pigmentary keratitis was detected in 369/420 (87.8%) eyes and in at least one eye 193/210 (91.9%) Pugs, of which 17/193 (8.8%) were affected unilaterally and 176/193 (91.2%) bilaterally. Pigmentary keratitis was typically mild to moderate (46.3 and 49.9% of eyes, respectively). Detection of PK was significantly associated with increased age (P = 0.002) and the presence of medial entropion of the lower eyelid (MELE) (P = 0.001). Severity of PK was significantly associated with the grade of MELE (P < 0.001). There was also a correlation between the presence of limbal pigment and PK (P = 0.036) that warrants further study. Conclusions This study estimated a high disease prevalence of PK in UK Pugs, and demonstrated significant associations with age and the presence of MELE. These associations, which have not been previously reported, offer an insight into the underlying pathophysiology of this condition in Pugs. The results encourage further population research, such as prospective longitudinal studies. These findings also support the development of clinical and breeding strategies based on the reduction of MELE and, possibly, limbal pigment.
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Affiliation(s)
- S Maini
- Langford Veterinary Services, University of Bristol, Langford, Bristol, UK.
| | - R Everson
- North Downs Specialist Referrals, Bletchingley, UK
| | - C Dawson
- The Royal Veterinary College, Ophthalmology Service, Department of Clinical Science and Services, University of London, North Mymms, Herts, UK
| | - Y M Chang
- Research Office, The Royal Veterinary College, Camden Campus, London, UK
| | - C Hartley
- Langford Veterinary Services, University of Bristol, Langford, Bristol, UK
| | - R F Sanchez
- Ophthalmology Service, Specialistische Dierenkliniek Utrecht (part of Anicura), Utrecht, The Netherlands
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22
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Regan D, Garcia K, Thamm D. Clinical, Pathological, and Ethical Considerations for the Conduct of Clinical Trials in Dogs with Naturally Occurring Cancer: A Comparative Approach to Accelerate Translational Drug Development. ILAR J 2019; 59:99-110. [PMID: 30668709 DOI: 10.1093/ilar/ily019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/26/2018] [Indexed: 01/21/2023] Open
Abstract
The role of comparative oncology in translational research is receiving increasing attention from drug developers and the greater biomedical research community. Pet dogs with spontaneous cancer are important and underutilized translational models, owing to dogs' large size and relative outbreeding, combined with their high incidence of certain tumor histotypes with significant biological, genetic, and histological similarities to their human tumor counterparts. Dogs with spontaneous tumors naturally develop therapy resistance and spontaneous metastasis, all in the context of an intact immune system. These fundamental features of cancer biology are often lacking in induced or genetically engineered preclinical tumor models and likely contribute to their poor predictive value and the associated overall high failure rate in oncology drug development. Thus, the conduct of clinical trials in pet dogs with naturally occurring cancer represents a viable surrogate and valuable intermediary step that should be increasingly incorporated into the cancer drug discovery and development pipeline. The development of molecular-targeted therapies has resulted in an expanded role of the pathologist in human oncology trials, and similarly the expertise of veterinary pathologists will be increasingly valuable to all phases of comparative oncology trial design and conduct. In this review, we provide a framework of clinical, ethical, and pathology-focused considerations for the increasing integration of translational research investigations in dogs with spontaneous cancer as a means to accelerate clinical cancer discovery and drug development.
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Affiliation(s)
- Daniel Regan
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Kelly Garcia
- Biologic Resources Laboratory, University of Illinois, Chicago, Illinois
| | - Douglas Thamm
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
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23
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Sebbag L, Allbaugh RA, Wehrman RF, Uhl LK, Ben-Shlomo G, Chen T, Mochel JP. Fluorophotometric Assessment of Tear Volume and Turnover Rate in Healthy Dogs and Cats. J Ocul Pharmacol Ther 2019; 35:497-502. [PMID: 31381493 PMCID: PMC6842130 DOI: 10.1089/jop.2019.0038] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The study establishes normative data of tear volume (TV) and tear turnover rate (TTR) in healthy dogs and cats, 2 species commonly used for translational research in ophthalmology. Methods: Thirty-six dogs and 24 cats were enrolled, encompassing a variety of breeds with diverse skull conformations (brachycephalic, mesocephalic, and dolichocephalic). Two microliters of 10% fluorescein were instilled onto the upper bulbar conjunctiva of both eyes, followed by tear collection with 2-μL capillary tubes at 0, 2, 4, 6, 10, 15, and 20 min. Fluorescein concentrations were measured with a computerized scanning ocular fluorophotometer. The TV and TTR were estimated based upon nonlinear mixed-effects analysis of fluorescein decay curves. Results: In dogs, median (interquartile range) TV, basal TTR (bTTR), and reflex TTR (rTTR) were 65.3 μL (42.3–87.9), 12.2%/min (3.7–22.1), and 50.0%/min (25.9–172.3), respectively. In cats, median (interquartile range) TV, bTTR, and rTTR were 32.1 μL (29.5–39.9), 10.9%/min (3.0–23.7), and 50.0%/min (28.4–89.4), respectively. Body weight (r = 0.44) and age (r = 0.30) were positively correlated (P ≤ 0.019) with TV in dogs. Age was negatively correlated (P ≤ 0.018) with TTR in dogs (r = −0.33) and cats (r = −0.24). However, TV and TTR were not associated with skull conformation in either species. Conclusions: Dogs have greater TV than cats but similar basal and rTTR. Tear parameters were impacted by body weight and age, but not by skull conformation. In both clinical and research settings, successive lacrimal tests should be spaced by ≥10 min to provide sufficient time for the tear film to replenish, as bTTR is ∼11%/min–12%/min in both species.
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Affiliation(s)
- Lionel Sebbag
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa.,Department of Biomedical Sciences, SMART Pharmacology, Iowa State University, College of Veterinary Medicine, Ames, Iowa
| | - Rachel A Allbaugh
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa
| | - Rita F Wehrman
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa
| | - Lisa K Uhl
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa
| | - Gil Ben-Shlomo
- Department of Veterinary Clinical Sciences, Iowa State University, College of Veterinary Medicine, Ames, Iowa
| | - Thomas Chen
- Department of Small Animal Clinical Sciences, The University of Tennessee, College of Veterinary Medicine, Knoxville, Tennessee
| | - Jonathan P Mochel
- Department of Biomedical Sciences, SMART Pharmacology, Iowa State University, College of Veterinary Medicine, Ames, Iowa
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24
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de Oliveira JK, Williams DL, Bollmann C, de Seabra NM, Bortolini M, Montiani-Ferreira F. Comparative efficacy of topical oclacitinib 0.1% and tacrolimus 0.01% in canine keratoconjunctivitis sicca. Vet Ophthalmol 2019; 22:633-643. [PMID: 30724448 DOI: 10.1111/vop.12634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/29/2018] [Accepted: 11/07/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the efficacy of 0.1% oclacitinib as a single agent, and in combination with tacrolimus 0.01%, for the control of ophthalmic signs of keratoconjunctivitis sicca (KCS) in dogs. ANIMALS STUDIED Thirty-two dogs (57 eyes) diagnosed with idiopathic KCS were included. Inclusion criteria were Schirmer Tear Test 1 (STT-1) values <15 mm/min and concurrent clinical signs such as ocular hyperemia and discharge. PROCEDURES The animals were submitted to a randomized, open-label, 5-week study and divided into 3 treatment groups treated with the following ophthalmic solutions: (a) 0.1% oclacitinib, (b) 0.1% oclacitinib +0.01% tacrolimus, and (c) 0.01% tacrolimus. Eye drops were instilled twice daily (12-hour intervals). At each follow-up examination, STT-1, clinical signs, and potential drug side effects were assessed. RESULTS Oclacitinib did not significantly improve STT-1 values or clinical scores. Tacrolimus alone and in combination with oclacitinib increased mean STT-1 values by 11.84 ± 5.2 and 12.46 ± 5.3 mm/min, respectively (P = 0.0001). Clinical scores of ocular discharge and hyperemia also improved significantly in both groups receiving treatment with tacrolimus (P < 0.05). However, addition of oclacitinib to tacrolimus provided no additional improvement over tacrolimus alone. CONCLUSIONS Topical 0.1% oclacitinib twice daily is not effective in controlling the ocular signs of KCS in dogs. 0.01% tacrolimus increased STT-1 values significantly and could potentially be used as a treatment for mild-to-moderate cases of KCS. Synergism between drugs did not occur, and therefore the use of oclacitinib is not justified in cases of canine KCS.
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Affiliation(s)
| | - David L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Camila Bollmann
- Departamento de Medicina Veterinária, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | | | - Mariza Bortolini
- Departamento de Medicina Veterinária, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Fabiano Montiani-Ferreira
- Departamento de Medicina Veterinária, Universidade Federal do Paraná (UFPR), Curitiba, Brazil.,Department of Small Animal Clinical Sciences, Michigan State University, Veterinary Medical Center, East Lansing, Michigan
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25
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Lee HB, Choi HJ, Cho SM, Kang S, Ahn HK, Song YJ, Kim YJ, Son WC. Efficacy of HL036 versus Cyclosporine A in the Treatment of Naturally Occurring Canine Keratoconjunctivitis Sicca. Curr Eye Res 2018; 43:889-895. [PMID: 29634381 DOI: 10.1080/02713683.2018.1461909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSES To (i) evaluate the efficacy and safety of HL036, a tumor-necrosis factor (TNF)-α-blocking protein, in the treatment of naturally occurring canine keratoconjunctivitis sicca (KCS) and (ii) compare these features with those of 1% cyclosporine A (CsA). MATERIALS AND METHODS Dogs (n = 29) diagnosed with KCS were randomly assigned to receive one drop topical aqueous HL036 (0.2, 1, or 5 mg/mL) or 1% CsA in the affected eye(s) at 12-h intervals for 42 days. Schirmer's tear test (STT), fluorescein corneal staining (FCS), and clinical-sign scores were evaluated prior to application (day-0) and on days 14, 28, and 42 post-treatment. Of the 29 dogs enrolled, 19 (65.5%) received HL036 (HL036 group) and 10 (34.5%) received 1% CsA (CsA group). A linear mixed-effects model analysis was performed to determine score differences between groups and over time. RESULTS After treatment, clinical-sign scores and STT values had significantly improved compared with baseline levels in dogs of both treatment groups. Decreases in total clinical-sign scores for the HL036-group were greater than those of 1% CsA group. No severe adverse reactions were noted in either group. CONCLUSIONS Our findings suggest that topical aqueous HL036 is well-tolerated and more effective than 1% CsA for treating naturally occurring canine KCS.
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Affiliation(s)
- Han-Byul Lee
- a Asan Medical Center , Asan Institute for Life Sciences , Seoul , Korea.,b Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
| | - Hyun-Ji Choi
- a Asan Medical Center , Asan Institute for Life Sciences , Seoul , Korea.,b Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
| | - Sung-Min Cho
- a Asan Medical Center , Asan Institute for Life Sciences , Seoul , Korea.,b Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
| | - Suzie Kang
- b Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
| | - Hyea Kyung Ahn
- c Biopharmaceutical Research Center , Hanall Biopharma Co., Ltd ., Gyeonggi-do , Korea
| | - Yeon Jung Song
- c Biopharmaceutical Research Center , Hanall Biopharma Co., Ltd ., Gyeonggi-do , Korea
| | - Young Ju Kim
- c Biopharmaceutical Research Center , Hanall Biopharma Co., Ltd ., Gyeonggi-do , Korea
| | - Woo-Chan Son
- a Asan Medical Center , Asan Institute for Life Sciences , Seoul , Korea.,b Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
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Phenotypic Characterization of Corneal Endothelial Dystrophy in German Shorthaired and Wirehaired Pointers Using In Vivo Advanced Corneal Imaging and Histopathology. Cornea 2018; 37:88-94. [PMID: 29077583 DOI: 10.1097/ico.0000000000001431] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate corneal morphology using ultrasonic pachymetry (USP), Fourier-domain optical coherence tomography (FD-OCT), and in vivo confocal microscopy (IVCM) in 2 related canine breeds-German shorthaired pointers (GSHPs) and German wirehaired pointers (GWHPs)-with and without corneal endothelial dystrophy (CED). This condition is characterized by premature endothelial cell degeneration leading to concomitant corneal edema and is similar to Fuchs endothelial corneal dystrophy. METHODS Corneas of 10 CED-affected (4 GSHP and 6 GWHP) and 19 unaffected, age-matched (15 GSHP and 4 GWHP) dogs were examined using USP, FD-OCT, and IVCM. A 2-sample t test or Mann-Whitney rank-sum test was used to statistically compare parameters between both groups. Data are presented as mean ± SD or median (range). RESULTS Central corneal thickness determined using USP was significantly greater in CED-affected than in unaffected dogs at 1179 (953-1959) and 646 (497-737) μm, respectively (P < 0.001). Central epithelial thickness was found to be significantly decreased in CED-affected versus unaffected dogs at 47 ± 7.1 and 55 ± 7.1 μm, respectively (P = 0.011), using FD-OCT. With IVCM, corneal endothelial density was significantly less (P < 0.001) in 5 dogs with CED versus 19 unaffected controls at 499 ± 315 versus 1805 ± 298 cells/mm, respectively. CED-affected dogs exhibited endothelial pleomorphism and polymegethism, whereas CED-unaffected dogs had regular hexagonal arrangement of cells. CONCLUSIONS GSHPs and GWHPs with CED exhibit marked differences in corneal morphology when compared with age-matched control dogs. These 2 CED-affected breeds represent spontaneous, large animal models for human Fuchs endothelial corneal dystrophy.
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Baudouin C, Irkeç M, Messmer EM, Benítez-del-Castillo JM, Bonini S, Figueiredo FC, Geerling G, Labetoulle M, Lemp M, Rolando M, Van Setten G, Aragona P. Clinical impact of inflammation in dry eye disease: proceedings of the ODISSEY group meeting. Acta Ophthalmol 2018; 96:111-119. [PMID: 28390092 PMCID: PMC5836968 DOI: 10.1111/aos.13436] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/05/2017] [Indexed: 12/30/2022]
Abstract
Dry eye disease (DED) is a common, multifactorial ocular condition with major impact on vision and quality of life. It is now well recognized that the pathophysiology of chronic DED can include a cycle of inflammation involving both innate and adaptive immune responses. Recently, in vitro/in vivo models have been used to obtain a better understanding of DED‐related inflammatory processes at molecular/cellular levels although they do not truly reproduce the complex and chronic hallmarks of human DED. In clinical DED research, advanced techniques such as impression cytology, conjunctival biopsy, in vivo confocal microscopy and multiplex tear analyses have allowed an improved assessment of inflammation in DED patients. This was supported by the identification of reliable inflammatory markers including matrix metalloproteinase‐9, human leucocyte antigen‐DR or intercellular adhesion molecule‐1 in tears and impression cytology samples. One of the current therapeutic strategies focuses on breaking the inflammatory cycle perpetuating the ocular surface disease, and preclinical/clinical research has led to the development of promising anti‐inflammatory compounds. For instance, cyclosporine, already approved in the United States, has recently been authorized in Europe to treat DED associated with severe keratitis. In addition, other agents such as corticosteroids, doxycycline and essential fatty acids, through their anti‐inflammatory properties, show encouraging results. We now have a clearer understanding of the inflammatory processes involved in DED, and there is hope that the still emerging preclinical/clinical findings will be translated into new and highly effective therapies for patients in the near future.
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Affiliation(s)
- Christophe Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts; INSERM-DHOS CIC 503; Paris France
- UPMC Université Paris 06; UMR-S968; Institut de la Vision; Paris France
- CNRS; UMR-7210; Paris France
- Ambroise Paré Hospital, APHP; Dept Ophthalmology; F-92100 Boulogne France
- University of Versailles Saint Quentin en Yvelines; 78000, Versailles France
| | - Murat Irkeç
- Hacettepe University School of Medicine; Ankara Turkey
| | | | | | | | - Francisco C. Figueiredo
- Department of Ophthalmology; Royal Victoria Infirmary and Newcastle University; Newcastle upon Tyne UK
| | - Gerd Geerling
- Department of Ophthalmology; Heinrich Heine University; Düsseldorf Germany
| | | | - Michael Lemp
- Department of Ophthalmology; Georgetown University; Washington USA
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Gilger BC. Immune Relevant Models for Ocular Inflammatory Diseases. ILAR J 2018; 59:352-362. [DOI: 10.1093/ilar/ily002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/18/2018] [Accepted: 01/27/2018] [Indexed: 02/03/2023] Open
Abstract
Abstract
Ocular inflammatory diseases, such as dry eye and uveitis, are common, painful, difficult to treat, and may result in vision loss or blindness. Ocular side effects from the use of antiinflammatory drugs (such as corticosteroids or nonsteroidal antiinflammatories) to treat ocular inflammation have prompted development of more specific and safer medications to treat inflammatory and immune-mediated diseases of the eye. To assess the efficacy and safety of these new therapeutics, appropriate immune-relevant animal models of ocular inflammation are needed. Both induced and naturally-occurring models have been described, but the most valuable for translating treatments to the human eye are the animal models of spontaneous, immunologic ocular disease, such as those with dry eye or uveitis. The purpose of this review is to describe common immune-relevant models of dry eye and uveitis with an overview of the immuno-pathogenesis of each disease and reported evaluation of models from small to large animals. We will also review a selected group of naturally-occurring large animal models, equine uveitis and canine dry eye, that have promise to translate into a better understanding and treatment of clinical immune-relevant ocular disease in man.
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Affiliation(s)
- Brian C Gilger
- Professor of Ophthalmology, Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC, USA
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Yüksel B, Bozdağ B, Acar M, TopaloğLu E. Evaluation of the Effect of Topical Cyclosporine a with Impression Cytology in Dry Eye Patients. Eur J Ophthalmol 2018; 20:675-9. [DOI: 10.1177/112067211002000405] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose. This study evaluated the efficacy of topical cyclosporine A 0.05% treatment with impression cytology in dry eye patients. Methods. Forty eyes of 40 patients with dry eye were included. Schirmer, tear break-up time, and Ocular Surface Disease Index (OSDI) scores and goblet cell densities were noted before and after 6 months of topical cyclosporine A treatment. Patients were graded clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18; and grade 3, 10 patients. Results. Mean age was 57.1±11.8 (23.0–80.0) years. A total of 36 (90%) of the patients were female and 4 (10%) were male. Mean Schirmer test value was 3.2±1.6 (0.0–8.0) mm in the beginning and was 8.4±4.3 (1.0–19.0) mm after 6 months of cyclosporine A topical treatment (p=0.00). At the first visit, mean tear break-up time was 4.4±1.8 (2.0–8.0) seconds. It increased to 11.8±4.8 (2.0–20.0) seconds at the end of the sixth month (p=0.00). Mean clinical grading was 1.9±0.8 (1.0–3.0) and this value regressed to 0.8±1.2 (0.0–3.0) after the treatment (p=0.00). Mean OSDI score was 30.0±11.7 (9.0–50.0) before the treatment and 21.3±11.0 (4.0–47.0) after the treatment (p=0.00). Mean goblet cell density of all cases was 12.3±8.7 before the treatment (2.0–28.0). It increased to 33.0±25.4 (6–70) after the treatment (p=0.04). Conclusions. Topical cyclosporine A treatment is effective in grade 1 and grade 2 dry eye patients but results are poor in grade 3 patients.
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Affiliation(s)
- Bora Yüksel
- Eye Bank and Cornea Section, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir - Turkey
| | - Berkant Bozdağ
- Department of Ophthalmology, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir - Turkey
| | - Memed Acar
- Department of Ophthalmology, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir - Turkey
| | - Engin TopaloğLu
- Department of Ophthalmology, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir - Turkey
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Optimising tear replacement rheology in canine keratoconjunctivitis sicca. Eye (Lond) 2018; 32:195-199. [PMID: 29303147 DOI: 10.1038/eye.2017.272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 10/08/2017] [Indexed: 12/16/2022] Open
Abstract
Dry eye is a substantial problem in a large number of human and canine patients. Numerous laboratory models for tear deficiency exist using genetically predisposed rodent models, animals treated with topical anti-muscarinics, or those kept in environments with increased air flow to produce the ocular surface changes seen in human patients. Canine keratoconjunctivitis sicca, seen in many thousands of dogs kept as companion animals, can provide a valuable spontaneous model for testing tear replacement medications that might better model disease in human patients, existing as it does in an outbred population that live in the same environments as their owners. Here the development of a crosslinked hyaluronic acid topical drop is described together with the results of trials on dogs with spontaneous keratoconjunctivitis sicca. Although hyaluronic acid in its native form in tear replacement drops shows a Newtonian rheology, the crosslinked product described here behaves in a non-Newtonian manner, with the same shear thinning shown by the tear film itself. The crosslinked product thus shows itself as a potentially valuable tear replacement medication for the human dry eye population as well as for dogs with the same condition.
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Sebbag L, Pesavento PA, Carrasco SE, Reilly CM, Maggs DJ. Feline dry eye syndrome of presumed neurogenic origin: a case report. JFMS Open Rep 2018; 4:2055116917746786. [PMID: 29318025 PMCID: PMC5753927 DOI: 10.1177/2055116917746786] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Case summary A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS). The ocular surface of both eyes (OU) had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1 (STT-1) and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days) or orally (19 days), and topically applied 0.03% tacrolimus (47 days). Pilocarpine, especially when given orally, was associated with notable increases in STT-1 values, but corneal ulceration remained/recurred regardless of administration route, and oral pilocarpine resulted in gastrointestinal upset. Tacrolimus was not effective. After 93 days, the cat became weak and lame and a low thyroxine concentration was detected in serum. The cat was euthanized and a necropsy performed. Both lacrimal glands were histologically normal, but chronic neutrophilic keratitis and reduced conjunctival goblet cell density were noted OU. Relevance and novel information The final diagnosis was dry eye syndrome (DES) of presumed neurogenic origin, associated with corneal hypoesthesia. This report reinforces the importance of conducting tearfilm testing in cats with ocular surface disease, as clinical signs of DES were different from those described in dogs.
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Affiliation(s)
- Lionel Sebbag
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.,Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
| | - Patricia A Pesavento
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Sebastian E Carrasco
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Christopher M Reilly
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA.,Insight Veterinary Specialty Pathology, Austin, TX, USA
| | - David J Maggs
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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White CN, Downes MJ, Jones G, Wigfall C, Dean RS, Brennan ML. Use of clinical vignette questionnaires to investigate the variation in management of keratoconjunctivitis sicca and acute glaucoma in dogs. Vet Rec 2017; 182:21. [PMID: 29275324 DOI: 10.1136/vr.104390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 10/17/2017] [Accepted: 11/02/2017] [Indexed: 02/03/2023]
Abstract
There is little peer-reviewed research assessing therapeutic effectiveness in canine eye disease. Current treatments used in first opinion and ophthalmology referral practices are also somewhat poorly documented. The aim of this study was to investigate the current management of canine keratoconjunctivitis sicca (KCS) and acute primary angle-closure glaucoma (PACG) by veterinary surgeons. Questionnaires using clinical vignettes were administered to a cross section of general practitioners ('GPs') and veterinarians engaged in or training for postgraduate ophthalmology practice ('PGs'). Similar treatment recommendations for KCS (topical cyclosporine, lubricant, antibiotic) were given by both groups of veterinarians with the single exception of increased topical antibiotic use by GPs. Treatment of acute glaucoma diverged between groups: PGs were much more likely to recommend topical prostaglandin analogues and a wider array of both topical and systemic treatments were recommended by both groups. Systemic ocular hypotensive agents were suggested infrequently. Our results suggest that treatments may vary substantially in ocular conditions, particularly in conditions for which neither guidelines nor high-quality evidence exists. This study highlights the need for novel strategies to address evidence gaps in veterinary medicine, as well as for better evaluation and dissemination of current treatment experience.
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Affiliation(s)
| | - Martin J Downes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Meadowbrook, Queensland, Australia
| | | | | | - Rachel S Dean
- School of Veterinary Medicine and Science, Centre for Evidence-based Veterinary Medicine, University of Nottingham, Loughborough, UK
| | - Marnie L Brennan
- School of Veterinary Medicine and Science, Centre for Evidence-based Veterinary Medicine, University of Nottingham, Loughborough, UK
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Spatola R, Nadelstein B, Berdoulay A, English RV. The effects of topical aqueous sirolimus on tear production in normal dogs and dogs with refractory dry eye. Vet Ophthalmol 2017; 21:255-263. [DOI: 10.1111/vop.12503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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34
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Thomasy SM, Cortes DE, Hoehn AL, Calderon AC, Li JY, Murphy CJ. In Vivo Imaging of Corneal Endothelial Dystrophy in Boston Terriers: A Spontaneous, Canine Model for Fuchs' Endothelial Corneal Dystrophy. Invest Ophthalmol Vis Sci 2017; 57:OCT495-503. [PMID: 27454658 PMCID: PMC4968913 DOI: 10.1167/iovs.15-18885] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose Boston Terriers (BTs) have a greater prevalence of corneal endothelial dystrophy (CED), in comparison to other canine breeds. Similar to Fuchs' endothelial corneal dystrophy (FECD), this condition is characterized by endothelial cell degeneration with secondary corneal edema. This study assessed corneal morphology using in vivo confocal microscopy (IVCM) and Fourier-domain optical coherence tomography (FD-OCT) in BTs with and without CED. Methods The corneas of 16 BTs with CED and 15 unaffected, age-matched BTs underwent clinical evaluation and were imaged using IVCM and FD-OCT. A two-sample t-test or Mann-Whitney rank sum test were used to statistically compare parameters between groups. Data are presented as mean ± SD or median (range). Results Mean age did not significantly differ between affected and unaffected dogs at 10.0 ± 2.0 and 10.6 ± 2.4 years, respectively (P = 0.437). Females (69%) were overrepresented among the CED-affected dogs. In CED patients, IVCM demonstrated endothelial polymegathism and pleomorphism. Corneal endothelial density was significantly less (P < 0.001) in dogs with CED (1026 ± 260 cells/mm2) versus age-matched controls (2297 ± 372 cells/mm2). Fourier-domain OCT demonstrated a significant increase (P < 0.01) in central corneal and endothelium-Descemet's complex thickness in dogs with CED versus age-matched controls at 1019 (485–1550) or 536 (464–650) μm and 32 (22–56) or 25 (15–34) μm, respectively. Conclusions Corneal endothelial dystrophy in BTs is a bilateral, adult-onset condition that shares many similarities with FECD. Thus, CED could serve as a spontaneous disease model to study the pathogenesis of and develop novel treatments for FECD.
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Affiliation(s)
- Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Dennis E Cortes
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Alyssa L Hoehn
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Allison C Calderon
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States
| | - Jennifer Y Li
- Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, California, United States
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, United States 2Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, California, Uni
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Lallemand F, Schmitt M, Bourges JL, Gurny R, Benita S, Garrigue JS. Cyclosporine A delivery to the eye: A comprehensive review of academic and industrial efforts. Eur J Pharm Biopharm 2017; 117:14-28. [PMID: 28315447 DOI: 10.1016/j.ejpb.2017.03.006] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/09/2017] [Accepted: 03/11/2017] [Indexed: 11/20/2022]
Abstract
Local ocular delivery of cyclosporine A (CsA) is the preferred method for CsA delivery as a treatment for ocular inflammatory diseases such as uveitis, corneal healing, vernal keratoconjunctivitis and dry eye disease. However, due to the large molecular weight and hydrophobic nature of CsA and the natural protective mechanisms of the eye, achieving therapeutic levels of CsA in ocular tissues can be difficult. This review gives a comprehensive overview of the current products available to clinicians as well as emerging drug delivery solutions that have been developed at both the academic and industry levels.
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Affiliation(s)
| | | | - Jean-Louis Bourges
- Department of Ophthalmology, Paris Descartes School of Medicine, Assistance Publique-Hôpitaux de Paris, Cochin-Hôtel-Dieu Hospital, Université Sorbonne Paris Cité, Paris, France
| | - Robert Gurny
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Simon Benita
- The Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Ein Kerem, Israel
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Leonardi A, Flamion B, Baudouin C. Keratitis in Dry Eye Disease and Topical Ciclosporin A. Ocul Immunol Inflamm 2017; 25:577-586. [DOI: 10.1080/09273948.2016.1276933] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Andrea Leonardi
- Department of Neurosciences, Ophthalmology Unit, University of Padua, Padua, Italy
| | - Bruno Flamion
- Molecular Physiology Research Unit, Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Christophe Baudouin
- Quinze-Vingts National Ophthalmology Hospital, INSERM-DHOS CIC 1423, Paris, France
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Eroglu YI. A comparative review of Haute Autorité de Santé and National Institute for Health and Care Excellence health technology assessments of Ikervis® to treat severe keratitis in adult patients with dry eye disease which has not improved despite treatment with tear substitutes. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2017; 5:1336043. [PMID: 28839524 PMCID: PMC5560409 DOI: 10.1080/20016689.2017.1336043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 03/19/2017] [Accepted: 11/19/2016] [Indexed: 05/04/2023]
Abstract
UNLABELLED Background: In 2015, Ikervis® became the only EMA-approved cyclosporine A (CsA) eye-drop for the treatment of severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes. Since the 1980s, CsA has been used empirically for ocular conditions in veterinary medicine then in humans. However, its extremely low aqueous solubility led to its administration in vegetable oils, which is characterized by low ocular availability, poor intraocular penetration, poor tolerability and short shelf-life. Concentrations from 0.05% to 2% are compounded on an industrial scale and reimbursed throughout Europe. In France, Ikervis® has been granted an ASMR score of 5 by HAS, whereas in UK NICE endorsed its use. Objective: To review the dry eye disease environment, its challenges and available treatment options, and compare the NICE and HAS assessments to question HAS' decision to maintain full reimbursement of compounded CsA formulations in the absence of evidence, while reimbursing the EMA-approved drug at 15%. METHOD extensive search on PubMED. Results: Comparator selection, composite score assessment and use of CE model are key differentiators. Conclusion: In topical formulations, improvements to the vehicle are key innovations that can bring significant benefits. After the USA, a Compounding Act is needed in Europe.
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Affiliation(s)
- Yasmina Iffet Eroglu
- Laboratoire de Sante Publique, Faculte de Medecine, Aix-Marseille Universite, Marseille, France
- CONTACT Yasmina Iffet Eroglu Chemin des Hutins 20, 1295Mies, Switzerland
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Destefanis S, Giretto D, Muscolo MC, Di Cerbo A, Guidetti G, Canello S, Giovazzino A, Centenaro S, Terrazzano G. Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca. BMC Vet Res 2016; 12:214. [PMID: 27658509 PMCID: PMC5034585 DOI: 10.1186/s12917-016-0841-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 09/14/2016] [Indexed: 12/30/2022] Open
Abstract
Background Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms. Results Fifty dogs of different breeds affected by immune-mediated cKSC were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001). Conclusions Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in a significant amelioration of clinical signs and symptoms in cKSC. The beneficial effects, likely due to the presence of supplemented nutraceuticals in the diet, appeared to specifically reduce the immune-mediated ocular symptoms in those cKCS-affected dogs that were poorly responsive or unresponsive to classical immunosuppressive drugs. These data suggest that metabolic changes could affect the immune response orchestration in a model of immune-mediated ocular disease, as represented by cKSC.
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Affiliation(s)
- Simona Destefanis
- Clinica Veterinaria Porta Venezia, via Lambro 12, 20121, Milan, Italy
| | - Daniela Giretto
- Clinica Veterinaria Cartesio, viale Olanda 3B, Melzo, 20066, Milan, Italy
| | | | - Alessandro Di Cerbo
- School of Specialization in Clinical Biochemistry, "G. d'Annunzio" University, Chieti, Italy
| | - Gianandrea Guidetti
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy
| | - Sergio Canello
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy
| | - Angela Giovazzino
- Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy
| | - Sara Centenaro
- Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy.
| | - Giuseppe Terrazzano
- Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy.,Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
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Kol A, Arzi B, Athanasiou KA, Farmer DL, Nolta JA, Rebhun RB, Chen X, Griffiths LG, Verstraete FJM, Murphy CJ, Borjesson DL. Companion animals: Translational scientist's new best friends. Sci Transl Med 2016; 7:308ps21. [PMID: 26446953 DOI: 10.1126/scitranslmed.aaa9116] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Knowledge and resources derived from veterinary medicine represent an underused resource that could serve as a bridge between data obtained from diseases models in laboratory animals and human clinical trials. Naturally occurring disease in companion animals that display the defining attributes of similar, if not identical, diseases in humans hold promise for providing predictive proof of concept in the evaluation of new therapeutics and devices. Here we outline comparative aspects of naturally occurring diseases in companion animals and discuss their current uses in translational medicine, benefits, and shortcomings. Last, we envision how these natural models of disease might ultimately decrease the failure rate in human clinical trials and accelerate the delivery of effective treatments to the human clinical market.
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Affiliation(s)
- Amir Kol
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Davis, Davis, CA 95616, U.S.A. Department of Orthopedic Surgery, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Diana L Farmer
- Department of Surgery, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Jan A Nolta
- Department of Cell Biology and Human Anatomy, School of Medicine, University of California, Davis, Davis, CA 95616, USA. Department of Internal Medicine, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Robert B Rebhun
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Xinbin Chen
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA. Department of Internal Medicine, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Leigh G Griffiths
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Christopher J Murphy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA. Department of Ophthalmology and Vision Science, School of Medicine, University of California, Davis, Davis, CA 95616, USA
| | - Dori L Borjesson
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA 95616, USA.
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Vallone LV, Enders AM, Mohammed HO, Ledbetter EC. In vivo
confocal microscopy of brachycephalic dogs with and without superficial corneal pigment. Vet Ophthalmol 2016; 20:294-303. [DOI: 10.1111/vop.12416] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Lucien V. Vallone
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - Andrew M. Enders
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - Hussni O. Mohammed
- Department of Population Medicine and Diagnostic Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - Eric C. Ledbetter
- Department of Clinical Sciences; College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
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Modern approaches to the ocular delivery of cyclosporine A. Drug Discov Today 2016; 21:977-88. [DOI: 10.1016/j.drudis.2016.04.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/01/2016] [Accepted: 04/05/2016] [Indexed: 12/29/2022]
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Gilmore KM, Greer KA. Why is the dog an ideal model for aging research? Exp Gerontol 2015; 71:14-20. [PMID: 26325590 DOI: 10.1016/j.exger.2015.08.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/17/2015] [Accepted: 08/18/2015] [Indexed: 12/22/2022]
Abstract
With many caveats to the traditional vertebrate species pertaining to biogerontology investigations, it has been suggested that a most informative model is the one which: 1) examines closely related species, or various members of the same species with naturally occurring lifespan variation, 2) already has adequate medical procedures developed, 3) has a well annotated genome, 4) does not require artificial housing, and can live in its natural environment while being investigated, and 5) allows considerable information to be gathered within a relatively short period of time. The domestic dog unsurprisingly fits each criterion mentioned. The dog has already become a key model system in which to evaluate surgical techniques and novel medications because of the remarkable similarity between human and canine conditions, treatments, and response to therapy. The dog naturally serves as a disease model for study, obviating the need to construct artificial genetically modified examples of disease. Just as the dog offers a natural model for human conditions and diseases, simple observation leads to the conclusion that the canine aging phenotype also mimics that of the human. Genotype information, biochemical information pertaining to the GH/IGF-1 pathway, and some limited longitudinal investigations have begun the establishment of the domestic dog as a model of aging. Although we find that dogs indeed are a model to study aging and there are many independent pieces of canine aging data, there are many more "open" areas, ripe for investigation.
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Affiliation(s)
- Keiva M Gilmore
- Prairie View A&M University, PO Box 512, MS 2210, Prairie View, TX 77446, United States
| | - Kimberly A Greer
- Prairie View A&M University, PO Box 512, MS 2210, Prairie View, TX 77446, United States.
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Chen T, Powell CC. Effect of once daily topical 0.3% naltrexone on tear parameters and corneal sensitivity in dogs with uncontrolled keratoconjunctivitis sicca: a double-masked randomized placebo-controlled clinical trial. Vet Ophthalmol 2015; 18:497-501. [PMID: 25675975 DOI: 10.1111/vop.12255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine the effect of once daily topical 0.3% naltrexone (NTX) on tear production, tear film breakup time (TFBUT), and corneal sensitivity in dogs with uncontrolled keratoconjunctivitis sicca (KCS). ANIMALS STUDIED Sixteen dogs with uncontrolled KCS. PROCEDURES A randomized placebo-controlled trial was performed in 16 dogs with topical 0.3% NTX once daily or topical saline solution drops once daily. A baseline was obtained at week 0 for tear production (Schirmer tear test 1 and 2-STT1, STT2), TFBUT, and corneal sensitivity. STT1, STT2, and TFBUT were then subsequently measured at weeks 1, 2, and 4 while on NTX or saline drops. Corneal sensitivity measures were repeated at week 4. The drops were subsequently discontinued and all parameters rechecked at week 5. RESULTS There was no statistically significant difference in tear parameters or corneal sensitivity between the NTX-treated and the saline-treated groups. CONCLUSION Topical 0.3% NTX given as a once daily dose over 4 weeks did not alter tear production, tear film stability, or corneal sensitivity in dogs with uncontrolled KCS.
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Affiliation(s)
- Thomas Chen
- Department of Small Animal Clinical Sciences, C247 Veterinary Medical Center, University of Tennessee, Knoxville, TN, 37996, USA
| | - Cynthia C Powell
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W. Drake Rd., Fort Collins, CO, 80523, USA
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Coursey TG, de Paiva CS. Managing Sjögren's Syndrome and non-Sjögren Syndrome dry eye with anti-inflammatory therapy. Clin Ophthalmol 2014; 8:1447-58. [PMID: 25120351 PMCID: PMC4128848 DOI: 10.2147/opth.s35685] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Dry eye from Sjögren’s syndrome is a multifactorial disease that results in dysfunction of the lacrimal functional unit. Studies have shown changes in tear composition, including inflammatory cytokines, chemokines, and metalloproteinase. T-lymphocytes have been shown to increase in the conjunctiva and lacrimal glands in patient and animal models. This inflammation is in part responsible for the pathogenesis of the disease, which results in symptoms of eye irritation, ocular surface epithelial disease, and loss of corneal barrier function. There are a number of anti-inflammatory approaches for treating this disease. The current study reviews details of immune response and anti–inflammatory therapies used to control this disease.
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Affiliation(s)
- Terry G Coursey
- Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
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Han JW, Yoon JS, Jang SY. Short-term effects of topical cyclosporine A 0.05% (Restasis) in long-standing prosthetic eye wearers: a pilot study. Eye (Lond) 2014; 28:1212-7. [PMID: 25081289 DOI: 10.1038/eye.2014.174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/20/2014] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Long-standing prosthetic eye wearing induces ocular surface inflammation. We investigated the short-term effects of topical cyclosporine A 0.05% (Restasis) in patients with ocular discomfort resulting from long-standing prosthetic eye wearing. METHODS This was a prospective, interventional case series. Patients who were unilateral prosthetic eye wearers over a period of 5 years were enrolled at a single institution from March to July 2013. The subjects were instructed to instill topical cyclosporine A 0.05% twice per day. Measurements were made pre-treatment and after 1 and 3 months of treatment. Outcome measures were the ocular symptom score, the lid margin abnormality score, the Schirmer test, and the tear meniscus amount, using Fourier-domain optical coherence tomography. RESULTS In total, 20 consecutive patients (mean age: 60.1 years, 8 males, 12 females) were included. Ocular symptoms were improved after treatment for 1 month in all patients (ocular symptom score pre-treatment 76.83 vs 46.75 after treatment; P<0.001). There was no statistically significant difference in lid margin abnormality score or tear meniscus amount. The Schirmer test results were improved after treatment for 3 months (pre- and after treatment, 6.70 vs 11.40; P<0.001). CONCLUSIONS Topical cyclosporine A 0.05% showed a satisfactory effect in long-standing prosthetic eye wearers. Ocular symptoms were markedly relieved in all subjects after treatment for 1 month.
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Affiliation(s)
- J W Han
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon,Korea
| | - J S Yoon
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - S Y Jang
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon,Korea
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Williams DL, Mann BK. Efficacy of a crosslinked hyaluronic acid-based hydrogel as a tear film supplement: a masked controlled study. PLoS One 2014; 9:e99766. [PMID: 24914681 PMCID: PMC4051774 DOI: 10.1371/journal.pone.0099766] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 05/19/2014] [Indexed: 11/18/2022] Open
Abstract
Keratoconjunctivitis sicca (KCS), or dry eye, is a significant medical problem in both humans and dogs. Treating KCS often requires the daily application of more than one type of eye drop in order to both stimulate tear prodcution and provide a tear supplement to increase hydration and lubrication. A previous study demonstrated the potential for a crosslinked hyaluronic acid-based hydrogel (xCMHA-S) to reduce the clinical signs associated with KCS in dogs while using a reduced dosing regimen of only twice-daily administration. The present study extended those results by comparing the use of the xCMHA-S to a standard HA-containing tear supplement in a masked, randomized clinical study in dogs with a clinical diagnosis of KCS. The xCMHA-S was found to significantly improve ocular surface health (conjunctival hyperaemia, ocular irritation, and ocular discharge) to a greater degree than the alternative tear supplement (P = 0.0003). Further, owners reported the xCMHA-S treatment as being more highly effective than the alternative tear supplement (P = 0.0024). These results further demonstrate the efficacy of the xCMHA-S in reducing the clinical signs associated with KCS, thereby improving patient health and owner happiness.
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Affiliation(s)
- David L. Williams
- Department of Veterinary Medicine, Cambridge University, Cambridge, United Kingdom
- * E-mail:
| | - Brenda K. Mann
- SentrX Animal Care, Inc., Salt Lake City, Utah, United States of America
- Department of Bioengineering, University of Utah, Salt Lake City, Utah, United States of America
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Air exposure induced characteristics of dry eye in conjunctival tissue culture. PLoS One 2014; 9:e87368. [PMID: 24498087 PMCID: PMC3909183 DOI: 10.1371/journal.pone.0087368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 12/20/2013] [Indexed: 11/19/2022] Open
Abstract
There are several animal models illustrating dry eye pathophysiology. Current study would like to establish an ex vivo tissue culture model for characterizing dry eye. Human conjunctival explants were cultured under airlift or submerged conditions for up to 2 weeks, and only airlifted conjunctival cultures underwent increased epithelial stratification. Starting on day 4, the suprabasal cells displayed decreased K19 expression whereas K10 keratin became evident in airlift group. Pax6 nuclear expression attenuated already at 2 days, while its perinuclear and cytoplasmic expression gradually increased. MUC5AC and MUC19 expression dramatically decreased whereas the full thickness MUC4 and MUC16 expression pattern disappeared soon after initiating the airlift condition. Real time PCR showed K16, K10 and MUC16 gene up-regulated while K19, MUC5AC, MUC19 and MUC4 down-regulated on day 8 and day 14. On day 2 was the appearance of apoptotic epithelial and stromal cells appeared. The Wnt signaling pathway was transiently activated from day 2 to day 10. The inflammatory mediators IL-1β, TNF-α, and MMP-9 were detected in the conditioned media after 6 to 8 days. In conclusion, airlifted conjunctival tissue cultures demonstrated Wnt signaling pathway activation, coupled with squamous metaplasia, mucin pattern alteration, apoptosis and upregulation of proinflammatory cytokine expression. These changes mimic the pathohistological alterations described in dry eye. This correspondence suggests that insight into the pathophysiology of dry eye may be aided through the use of airlifted conjunctival tissue cultures.
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48
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Chan KY, Cho P, Boost M. Corneal epithelial cell viability of an ex vivo porcine eye model. Clin Exp Optom 2014; 97:337-40. [PMID: 24438477 DOI: 10.1111/cxo.12128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 10/22/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim was to assess the consistency of corneal epithelial cell viability of an ex vivo porcine eye model. METHOD Six porcine eye models (four test and two control) were prepared for each experiment. The model has a computer-controlled mechanical arm, which could move the eyelid of the porcine eye and apply phosphate buffered saline to simulate blinking and lacrimation. The four test eyes were set up to simulate evaporative dry eyes with simulated lacrimation and blinking (one blink and one drop of buffered saline per minute) over three hours. Control A models were set up to collect pre-experimental baseline data, while those of control B were the same as the test eyes but without lacrimation and blinking simulation. All porcine eyes were kept in a closed chamber with temperature and humidity well controlled. After three hours, the cells of all eyes (except control A, which were assessed immediately before commencement of the experiment) were assessed. The eyes were first dipped into 0.4 per cent trypan blue solution. Following the dissection and separation of the cells, the number of dead cells were then counted under the microscope with a field size of 0.25 mm(2). The experiment was repeated 11 times. RESULTS No significant differences were found in the number of dead cells among the four test eyes in both the central and peripheral cornea. There were significantly more dead cells in the test eyes compared to control A but significantly less when compared to control B. More dead cells were found in the central cornea than the peripheral cornea in the test eyes but the difference was not observed in controls A and B. CONCLUSION Epithelial cell viabilities among the four porcine eye models with simulated lacrimation and blinking were consistent. The majority of cells were viable before the experiment and simulated lacrimation and blinking maintained more viable cells over time.
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Affiliation(s)
- Ka Yin Chan
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Labelle AL, Dresser CB, Hamor RE, Allender MC, Disney JL. Characteristics of, prevalence of, and risk factors for corneal pigmentation (pigmentary keratopathy) in Pugs. J Am Vet Med Assoc 2013; 243:667-74. [DOI: 10.2460/javma.243.5.667] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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50
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Novack GD. Translating Drugs From Animals to Humans: Do We Need to Prove Efficacy? Transl Vis Sci Technol 2013; 2:1. [PMID: 24078898 PMCID: PMC3783258 DOI: 10.1167/tvst.2.6.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 08/02/2013] [Indexed: 01/30/2023] Open
Affiliation(s)
- Gary D Novack
- PharmaLogic Development, Inc., San Rafael, California
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