Cyclosporine A inhibits TGF-β2-induced myofibroblasts of primary cultured human pterygium fibroblasts

Comparison of Biomarkers Playing a Role in Pterygium Development in Pterygium and Recurrent Pterygium Tissues

Background/Objectives: Pterygium is a nonneoplastic elastotic degeneration characterized by subepithelial growth. It manifests as an ocular lesion originating from the bulbar conjunctiva, extending to the corneal surface, and reaching the visual axis in some cases. Although the exact cause is unknown, prolonged exposure to ultraviolet radiation is considered the most significant contributing factor. Chronic irritation and actinic damage are likely responsible for the typical fibrovascular reactions observed in pterygium. Additionally, growth factors, cytokines, and matrix metalloproteinases play roles in the pathogenesis of pterygium. This study compared recurrent and primary pterygium cases at the molecular level to gain new insights into the etiology of pterygium. Methods: Total protein was extracted from surgical samples of patients with primary and recurrent pterygium, and the levels of transforming growth factor beta 1 (TGF-β1), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), IL-8, and IL-10 were analyzed using the enzyme-linked immunosorbent assay technique. Target gene expression levels were analyzed using the ΔΔCt method after cDNA synthesis from isolated RNA, with normalization to GAPDH and quantification performed with SYBR Green PCR Master Mix. Results: Among the studied cytokines, IL-10 levels were higher in primary pterygium than in recurrent pterygium (722.0 ± 600.9/421.4 ± 266.8) (p = 0.0054). Other cytokines (IL-6, IL-8, IL-1β, and TGF-β1) were detected at similar levels in both primary and recurrent pterygium (p = 0.2986). Additionally, the TGF-β1 gene expression was found to be significantly upregulated in recurrent pterygium tissue compared to primary pterygium tissue (p = 0.034). Conclusions: This increase suggests that TGF-β1 may contribute to the recurrence mechanisms of pterygium through processes such as fibroblast activation and tissue remodeling. The higher levels of IL-10 in primary pterygium compared to recurrent pterygium indicate an enhanced early protective response aimed at limiting pterygium progression and controlling the inflammatory process.

Role of αENaC in root resorption of adjacent teeth due to entirely impacted mandibular third molars

BACKGROUND

Entirely impacted mandibular third molar (EIM3M) concerns the pathological external root resorption (ERR) of the adjacent mandibular second molar (M2M) and formation of granulation tissue between two molars. The study aimed to clarify the effect of αENaC, a mechano-sensitive molecule, to explore the mechanical mechanism in this scenario.

METHODS

The force EIM3M exerted on M2M was proved by finite element analysis. αENaC expressions were tested by real-time polymerase chain reaction (PCR), immunoblotting and immunofluorescence. Inflammatory and epithelial-mesenchymal transition (EMT)-related molecules expressions were also detected by real-time PCR. The correlation was analyzed by Spearman's correlation analysis, and receiver-operator characteristic (ROC) curve was further exhibited.

RESULTS

The force was concentrated in the ERR area. αENaC was upregulated, positively correlated with ERR degree and localized to the fibroblasts in ERR granulation tissues. Moreover, αENaC was respectively and positively associated with elevated TNF-α and N-cadherin in ERR granulation tissues. More importantly, ROC analysis verified αENaC as a novel indication of the incidence of this disease.

CONCLUSIONS

Our finding revealed the force from EIM3M causing ERR of M2M, and elucidated the expression and localization of αENaC and its positive correlation with inflammation, EMT and disease severity, suggesting a novel indication in this disease.

Effect of Diquafosol on Hyperosmotic Stress-induced Tumor Necrosis Factor-α and Interleukin-6 Expression in Human Corneal Epithelial Cells

Purpose

Diquafosol is a pharmaceutical drug used for dry eye treatment with a novel mechanism of action. It is a purinergic P2Y2 receptor agonist that promotes the secretion of tears and healing of corneal epithelial wounds. However, its inhibitory effect on hyperosmotic stress-induced inflammation in human corneal epithelial cells (HCECs) remains unclear.

Methods

A hyperosmotic stress model was established by transferring HCECs from isosmotic (312 mOsm/kg to hyperosmotic medium (500 mOsm/kg). HCECs were incubated with 500 mOsm/kg hyperosmotic medium for 30 minutes, and then treated with diquafosol (0.6–6 mg/mL) for 4 or 24 hours. Cells were then harvested and analyzed by western blot, immunocytochemistry, and real-time polymerase chain reaction to evaluate the expression of interleukin-6, tumor necrosis factor-alpha, and the phosphorylation status of nuclear factor-kappa B.

Results

Diquafosol significantly decreased the mRNA and protein expression of hyperosmotic stress-induced tumor necrosis factor-alpha and interleukin-6. These results were supported by immunofluorescence staining and quantitative real-time polymerase chain reaction analysis. Furthermore, diquafosol inhibits nuclear factor-kappa B activation by suppressing the phosphorylation and degradation of the inhibitor of кB.

Conclusions

This study shows that diquafosol inhibits nuclear factor-kappa B signaling and inflammatory factors induced by hyperosmotic stress in HCECs. This suggests that using diquafosol for the improvement of dry eye syndrome could be effective in the treatment of inflammation-related corneal and conjunctival diseases.

Analysis of CRABP2 and FABP5 genes in primary and recurrent pterygium tissues

The etiology of pterygium remains unclear, but ultraviolet (UV) radiation is generally considered to be major risk factor. Pterygium has similarity features with many cancers, including inflammation, invasion, cell proliferation, anti-apoptosis, angiogenesis and recurrence after resection. Retinoic acid via cellular retinoic acid binding protein 2 (CRABP2) is involved in cell cycle arrest, apoptosis and differentiation, while it via fatty acid binding protein 5 (FABP5) is involved in survival, cell proliferation and angiogenesis, which pathway gets activated depends on the CRABP2/FABP5 ratio. Alterations of retinoid signaling were found in many cancer types. The deregulated retinoid signaling may also contribute to the development and/or recurrence of pterygium. The aim of our study was to determine mRNA and protein expressions of CRABP2 and FABP5 and ratio of CRABP2/FABP5 in primer and recurrent pterygium tissues. Pterygia tissues were collected from 30 eyes of 30 patients undergoing pterygium excision. CRABP2 and FABP5 mRNA and protein expression were assessed using Real-time PCR and Western blotting through examination of excised specimens from pterygium and conjunctiva tissues. The ratio of CRABP2/FABP5 gene expression was not altered when primary pterygium tissues compared normal conjunctival tissues (1.00-fold change). Whereas the ratio of CRABP2/ FABP5 gene expression was decreased when recurrent pterygium tissues compared normal conjunctival tissues (0.81-fold change). Understanding etiopathogenesis of pterygium may aid in the find of more promising treatments to prevent pterygium in earlier stages.

The Key Role of VEGF in the Cross Talk between Pterygium and Dry Eye and Its Clinical Significance

PURPOSE

To examine whether dry eye severity is a risk factor for pterygium activity and whether vascular endothelial growth factor (VEGF) is crucial in the cross talk between pterygium and dry eye.

METHODS

A total of 103 patients with primary pterygium (Pteg) were included in the study group; they were divided into 2 groups according to the complication of dry eye (DE) (Pteg + DE group, Pteg - DE group). Further, 60 patients with just dry eye (DE group) and 60 normal individuals (normal) were included as 2 control groups. DE severity and pterygium activity were measured, and unstimulated tear samples and pterygium tissues were collected for cytokine detection.

RESULTS

(1) Tear detection: VEGF expression increased in the Pteg + DE group compared to the Pteg - DE, DE, and normal control groups; VEGF was especially increased in the active Pteg + DE group. VEGF concentration was positively correlated with pterygium activity. (2) Tissue detection: the mRNA expression of VEGF was upregulated in the active pterygium group.

CONCLUSIONS

Inflammation played an important role in the development of dry eye and pterygium. VEGF was the core molecule in the cross talk, which might explain the high incidence of the coexistence of these 2 diseases.

[Medicamental correction of pathomorphological changes of the ocular surface in patients with steroid therapy intolerance after photorefractive keratectomy]

INTRODUCTION

The problems of controlling inflammatory and proliferative response of the retina and correcting tear production in the post-operative period after photorefractive keratectomy (PRK) have not been fully solved yet. Patients intolerable to local steroids require an alternative. One drug that covers those needs is Cyclosporine 0.05%.

PURPOSE

To analyze clinical effectiveness of Restasis eye drops in solving inflammatory-degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with steroid eye drops intolerance accompanied with increasing intraocular pressure (IOP).

PATIENTS AND METHODS

Retrospective analysis of 14 myopic patients (28 eyes) was conducted; mean patient age was 25.9±6 years; myopia was (-)5.65±1.5 Diopters of spherical equivalent (SE); corneal-compensated IOP was 16.98±3.68 mm Hg before the surgery. All patients underwent excimer laser correction (PRK or Trans-PRK) with Schwind Amaris (SCHWIND eye-tech-solutions). After epithelization, all patients were prescribed 0.1% Dexamethasone solution 4 times a day (with decreasing dosing frequency) for 2 months, as well as local lubricants. The article also describes a separate clinical case of subepithelial fibroplasia that occurred post-PRK and was successfully stopped.

RESULTS

All patients had transitory IOP increase caused by local steroid therapy. Mean IOP at 1-month post-op was 20.5±7 mm Hg. At that point local steroids were replaced with 'Restasis' 0.05% (Cyclosporine) eye drops prescribed 2 times per day for 2 months. As the result, IOP values decreased to 16.2±3.21 mm Hg (without any additional therapy); at 6 months mean uncorrected visual acuity reached 0.98±0.05, best corrected visual acuity achieved 1.03±0.06 and SE was 0.04±0.12 Diopters.

CONCLUSION

Local Cyclosporine ('Restasis') is the method of choice for regulation of inflammatory and degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with intolerance to steroid eye drops.

Modern Therapeutic Approaches for Noninfectious Ocular Diseases Involving Inflammation

Dry eye disease, age-related macular degeneration, and uveitis are ocular diseases that significantly affect the quality of life of millions of people each year. In these diseases, the action of chemokines, proinflammatory cytokines, and immune cells drives a local inflammatory response that results in ocular tissue damage. Multiple therapeutic strategies are developed to either address the symptoms or abate the underlying cause of these diseases. Herein, the challenges to deliver drugs to the relevant location in the eye for each of these diseases are reviewed along with current and innovative therapeutic approaches that attempt to restore homeostasis within the ocular microenvironment.