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Zhang M, Wang Y, Miao C, Lin S, Zheng Y, Lin X, Wang Y, Lin X, Zhu X, Weng S. Dextran guanidinylated carbon dots with antibacterial and immunomodulatory activities as eye drops for the topical treatment of MRSA-induced infectious keratitis. Acta Biomater 2025:S1742-7061(25)00357-5. [PMID: 40374136 DOI: 10.1016/j.actbio.2025.05.032] [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: 01/16/2025] [Revised: 04/15/2025] [Accepted: 05/11/2025] [Indexed: 05/17/2025]
Abstract
Bacterial keratitis (BK) develops rapidly and can cause serious consequences, requiring timely and efficient treatment. As the main treatment strategy, antibiotic eye drops are still plagued by bacterial resistance by biofilms and failure to modulate immunity. Herein, dextran guanidinylated carbon dots (DG-CDs) with antimicrobial and immunomodulatory properties were developed. DG-CDs with the graphitized core-like structure with the ordered arrangement of carbon atoms and surface groups of CN, COC, and -OH were thoroughly characterized and modeled as a graphene-like sheet. DG-CDs exhibited strong antimicrobial and anti-biofilm activities with a minimum inhibitory concentration (MIC) of 5 μg/mL against methicillin-resistant Staphylococcus aureus (MRSA). Molecular docking based on well-characterized structures of DG-CDs revealed that DG-CDs had strong affinity for key bacterial proteins including FtsA, IcaA and ArgA, which were confirmed by corresponding RT-qPCR and transcriptomics. Furthermore, DG-CDs regulated macrophage polarization by inhibiting the M1 subtype and promoting the transition to the M2 subtype. In vivo experiments illustrated that DG-CDs used as eye drops significantly attenuated corneal infection, enhanced the expression of anti-inflammatory factors, and effectively promoted corneal repair in MRSA-infected BK. Overall, this study provides a promising antibacterial nanomaterial with clarified properties and acting mechanism for treating BK as eye drops. STATEMENT OF SIGNIFICANCE: Besides bacterial invasion, bacterial keratitis (BK) also suffers from immune imbalance, which further impairs corneal healing. Current antibiotic eye drops are plagued by bacterial resistance and their inability to modulate immunity. Herein, dextran guanidinylated carbon dots (DG-CDs) with dual functions of antimicrobial and immunomodulatory were developed for treating MRSA infected BK. DG-CDs, with clarified structure and surface groups, exhibited strong antimicrobial activity and no detectable resistance. Molecular docking, based on well-characterized structures of DG-CDs, was achieved to reveal the antibacterial mechanism, which was subsequently confirmed by RT-qPCR and transcriptomics. In addition, DG-CDs exhibited an effective healing ability in an MRSA-infected rat keratitis model by exerting antibacterial activity and regulating macrophage polarization from M1 type to M2 type. DG-CDs represent a promising antibacterial nanomedicine with clarified properties and acting mechanism for treating bacterial infection.
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Affiliation(s)
- Menghan Zhang
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Yiyang Wang
- Department of Oral Maxillo-Facial Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China; Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Chenfang Miao
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Shuwei Lin
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China
| | - Ying Zheng
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Xiaoyan Lin
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Yao Wang
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Xinhua Lin
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Xiaofeng Zhu
- Department of Oral Maxillo-Facial Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China; Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Shaohuang Weng
- Department of Pharmaceutical Analysis, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China.
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Qian S, Wang X, Guo Y, He W, Yang J, Chen H, Li R, Su L, Wang X, Shao Y, Wang B. Synchronous Sterilization and Immunoreaction Termination for Corneal Transparency Protection in Treating Pseudomonas aeruginosa Induced Bacterial Keratitis. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2025; 37:e2419209. [PMID: 40166821 DOI: 10.1002/adma.202419209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Revised: 03/24/2025] [Indexed: 04/02/2025]
Abstract
In the treatment of infectious keratitis, therapeutic strategies often prioritize enhancing bactericidal efficacy. However, endotoxins released from Gram-negative bacteria cause inflammatory reaction, leading to corneal structural damage and scar formation. Given that polymyxin B (PMB) can bind and neutralize lipopolysaccharide (LPS), this study employs large-pore mesoporous silica nanoparticles (lMSNs) grafted with PMB as carriers for cationic antibacterial carbon quantum dots (CQDs) to prepare CQD@lMSN-PMB, which enables synchronous sterilization and endotoxin neutralization. In the acidic infectious microenvironment, the accelerated release of CQDs eliminates 99.88% bacteria within 2 h, effectively substituting immune mediated sterilization. Notably, CQD@lMSN-PMB exhibits exceptional LPS neutralization performance (2.22 µg LPS/mg CQD@lMSN-PMB) due to its high specific surface area. In an infectious keratitis model, inflammation subsides significantly within the first day of CQD@lMSN-PMB intervention and is completely resolved by day 3. By day 2, interleukin-1β, interleukin-6 and tumor necrosis factor-α in CQD@lMSN-PMB group decrease by 86.99%, 91.15%, and 77.56%, respectively, compared to the CQDs-only sterilization group. Ultimately, corneal integrity and transparency are preserved, with suppressed expressions of fibrosis-related factors including matrix metalloproteinase 9, transforming growth factor-β and α-smooth muscle actin. Therefore, this synchronous sterilization and endotoxin neutralization strategy outperforms monotherapy strategies focused solely on sterilization or endotoxin neutralization.
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Affiliation(s)
- Siyuan Qian
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xuan Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yishun Guo
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Wenfang He
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jianhua Yang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Renlong Li
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Lili Su
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xinyi Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yi Shao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, 200080, China
| | - Bailiang Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, 325000, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Medical Devices and Drug for Ophthalmic Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
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Farhadi F, Salehi-Pourmehr H, Arasteh A, Taheri N, Pashazadeh F, Mostafaie A. Corneal cross-linking for infectious keratitis of various causes: an umbrella review. BMC Ophthalmol 2025; 25:238. [PMID: 40269767 PMCID: PMC12016060 DOI: 10.1186/s12886-025-04038-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Accepted: 04/03/2025] [Indexed: 04/25/2025] Open
Abstract
OBJECTIVE To explore the therapeutic role of corneal cross-linking (CXL) for infectious keratitis. METHODS This is an umbrella review of the systematic reviews and meta-analysis concerning the role of corneal CXL in treating infectious keratitis. Appropriate keywords were carefully selected following the identification of PICO (Population: People who have corneal cross-linking for infectious keratitis; Intervention: corneal cross-linking; Comparison: other treatments such as antibiotic therapy; Outcome: Primary outcome was considered as the efficacy of treatment using re-epithelization and heal rate, and secondary outcome was considered need to penetrating keratoplasty (PK)). The electronic search across various databases, including Cochrane, PubMed, MEDLINE, Embase, SCOPUS, CINAHL, Psychoinfo, and ProQuest, was performed until August 2024. RESULTS Five systematic reviews out of 53 identified records are included in the umbrella review. Due to the structure of the included studies, statistical analysis was not possible to be conducted. Four studies were included that mainly evaluated the role of adjuvant corneal CXL in bacterial keratitis, and the other study focused mainly on fungal keratitis. The studies reported heterogeneous results. Two systematic reviews reported a shorter period for corneal epithelium healing in the adjuvant CXL group compared to the standard antibiotic therapy (SAT), especially in fungal keratitis. However, two studies showed no significant change in re-epithelization duration. One meta-analysis reported a reduction in corneal infiltrate size 7 days after adjuvant corneal CXL compared to the SAT. None of the included studies reported a difference in corneal complications, such as perforation and the need for PK in the CXL group compared to SAT. CONCLUSION The corneal CXL in infectious keratitis has no uniform protocol, especially regarding the de-epithelization procedure before CXL, leading to heterogeneity in the trial results. However, it seems the adjuvant corneal CXL next to SAT is not inferior to the unaccompanied SAT and may be superior in some cases, including fungal etiologies, regarding faster corneal healing.
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Affiliation(s)
- Fereshteh Farhadi
- Iranian EBM Centre, JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
- Ophthalmology Department, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Salehi-Pourmehr
- Iranian EBM Centre, JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Arasteh
- Ophthalmology Department, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Nazli Taheri
- Ophthalmology Department, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Pashazadeh
- Iranian EBM Centre, JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Mostafaie
- Iranian EBM Centre, JBI Centre of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran.
- Ophthalmology Department, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
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Gowtham L, Sheba E, Sharma S, Mishra DK, Bagga B. Efficacy of 265 nm ultraviolet C light in the treatment of multi-drug resistant Pseudomonas aeruginosa keratitis in vitro and in an in vivo murine model. Cont Lens Anterior Eye 2025:102417. [PMID: 40221350 DOI: 10.1016/j.clae.2025.102417] [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: 02/11/2025] [Revised: 03/25/2025] [Accepted: 04/01/2025] [Indexed: 04/14/2025]
Abstract
BACKGROUND This study evaluated the in vitro and in vivo efficacy of 265 nanometer (nm) ultraviolet C (UVC) light using 1.93 mW/cm2 against multi-drug-resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) keratitis. METHODS The effect of UVC light was studied on two clinical isolates of P. aeruginosa. Isolate 1 was ciprofloxacin-susceptible, and isolate 2 was MDR (but ceftazidime-susceptible). For the in vitro evaluation, P. aeruginosa isolates (100 μl, 1*108 CFU/ml) were spread on Muller-Hinton solid agar surface and exposed to UVC light for 1, 5, 10, 15, and 30 seconds (s). For the in vivo study, the right eyes of C57BL mice were infected with the P. aeruginosa isolates (5 μL, 1*108 CFU/ml) in two sets with isolates 1 and 2, respectively. The first set (n = 24) was randomized into four groups: a) untreated, b) UVC light 15 s exposure twice daily for two days, c) topical ciprofloxacin 0.3 %w/v twice daily for two days, d) topical ciprofloxacin 0.3 %w/v two-hourly for two days. The second set with MDR P. aeruginosa (n = 24) was treated similarly except for group d (which received topical ceftazidime 5 %w/v two hourly for two days). The left eyes were used to evaluate the safety of applied treatments without inducing infection. At 48 hours (hrs), eyes were enucleated and subjected to microbiological and histopathology analysis. RESULTS In vitro, the UVC light exposure resulted in a clear inhibition area for exposures of 15 and 30 s. In the in vivo murine model, UVC light prevented overall clinical severity (p < 0.05) at 24 and 48 hrs by both isolates. Microbiological assessment at 48 hrs showed no growth of organisms in UVC light-treated corneas of either of the sets, similar to an observed treatment with ciprofloxacin (set 1) and ceftazidime (set 2). CONCLUSION 265 nm UVC light showed an exposure-dependent in vitro bactericidal effect on P. aeruginosa. The in vivo studies showed that UVC light eliminated both strains of P. aeruginosa with an equivalent efficacy.
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Affiliation(s)
- Lakshminarayanan Gowtham
- Dr. Chigurupathi Nageshwara Rao Ocular Pharmcology Research Centre, LV Prasad Eye Institute, Hyderabad, India; Ramoji Foundation Centre for Ocular Infections, LV Prasad Eye Institute, Hyderabad, India
| | - Esther Sheba
- Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Dilip Kumar Mishra
- Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, India
| | - Bhupesh Bagga
- Dr. Chigurupathi Nageshwara Rao Ocular Pharmcology Research Centre, LV Prasad Eye Institute, Hyderabad, India; Ramoji Foundation Centre for Ocular Infections, LV Prasad Eye Institute, Hyderabad, India; Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, India; Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, India.
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5
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Lu Y, Geng W, Li L, Xie F, Zhang M, Xie H, Cai J. Enhanced antibacterial and antibiofilm activities of quaternized ultra-highly deacetylated chitosan against multidrug-resistant bacteria. Int J Biol Macromol 2025; 298:140052. [PMID: 39832600 DOI: 10.1016/j.ijbiomac.2025.140052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 01/13/2025] [Accepted: 01/16/2025] [Indexed: 01/22/2025]
Abstract
Multidrug-resistant (MDR) bacterial infections pose a severe threat to global public health and present significant challenges in the treatment of bacterial keratitis. The escalation of antimicrobial resistance (AMR) underscores the urgent need for alternative therapeutic strategies. In this study, we report the homogeneous synthesis of quaternized ultra-highly deacetylated chitosan (QUDCS) using a sequential acid-base combination approach. The optimized QUDCS-2 exhibits broad-spectrum antibacterial activity through a membrane-disruption mechanism driven by electrostatic, hydrogen bonding, and hydrophobic interactions, while maintaining low cytotoxicity and high selectivity. Compared to less deacetylated counterparts, QUDCS-2 demonstrates superior stability in enzyme-rich environments and effectively inhibits and eradicates mature biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Furthermore, QUDCS-2 exhibits a remarkable ability to prevent the development of antimicrobial resistance. In a mouse keratitis model, QUDCS-2 shows excellent biocompatibility and significant antibacterial efficacy, providing strong support for its potential as a long-term, effective antimicrobial agent.
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Affiliation(s)
- Yiwen Lu
- Institute of Hepatobiliary Diseases, Transplant Center, Zhongnan Hospital, Hubei Engineering Center of Natural Polymers-based Medical Materials, Key Laboratory of Biomedical Polymers of Ministry of Education, College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China
| | - Wen Geng
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lili Li
- Institute of Hepatobiliary Diseases, Transplant Center, Zhongnan Hospital, Hubei Engineering Center of Natural Polymers-based Medical Materials, Key Laboratory of Biomedical Polymers of Ministry of Education, College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China
| | - Fang Xie
- Institute of Hepatobiliary Diseases, Transplant Center, Zhongnan Hospital, Hubei Engineering Center of Natural Polymers-based Medical Materials, Key Laboratory of Biomedical Polymers of Ministry of Education, College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China
| | - Mingchang Zhang
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Huatao Xie
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Jie Cai
- Institute of Hepatobiliary Diseases, Transplant Center, Zhongnan Hospital, Hubei Engineering Center of Natural Polymers-based Medical Materials, Key Laboratory of Biomedical Polymers of Ministry of Education, College of Chemistry and Molecular Sciences, Wuhan University, Wuhan 430072, China.
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6
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Wang L, Guo Y, Chen B, Lu S, Yang J, Jin Y, Wang X, Sun X, Wang S, Wang B. An annular corneal microneedle patch for minimally invasive ophthalmic drug delivery. SCIENCE ADVANCES 2025; 11:eadv1661. [PMID: 40053577 PMCID: PMC11887842 DOI: 10.1126/sciadv.adv1661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2024] [Accepted: 01/31/2025] [Indexed: 03/09/2025]
Abstract
Microneedles directly penetrating into the cornea inevitably cause pain, corneal structure damage, and reduced light transmittance. In this work, a minimally invasive annular microneedle (A-MN) patch was developed avoiding direct puncture into the central cornea for ophthalmic drug delivery. The feasible mechanical strength of A-MNs was achieved by adjusting the ratio of PVP-β-CD and PVA to puncture the cornea barrier. Through effective diffusion to corneal stroma, bioavailability of hydrophilic small-molecule drugs, hydrophobic drugs, and macromolecular protein drugs through an A-MN patch was 24.36, 17.47, and 5.36 times higher than that of free drug administration. A-MNs effectively maintained light transmittance of the cornea with a light transmittance of 96.33 to 100%, which was higher than that of S-MNs. Furthermore, A-MNs effectively avoided corneal tissue and nerve damage along with the pain. The efficiency and safety of A-MNs were also examined through both an in vitro cell experiment and an in vivo animal experimental model, which showed great potential in clinical application.
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Affiliation(s)
- Lu Wang
- Affiliated Yueqing Hospital of Wenzhou Medical University, Wenzhou 325600, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yishun Guo
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Ben Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Si Lu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jianhua Yang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yingying Jin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xinyi Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xinyue Sun
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Shuting Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Bailiang Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
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7
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Qu S, Zheng S, Muhammad S, Huang L, Guo B. An exploration of the ocular mysteries linking nanoparticles to the patho-therapeutic effects against keratitis. J Nanobiotechnology 2025; 23:184. [PMID: 40050881 PMCID: PMC11887204 DOI: 10.1186/s12951-025-03230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2024] [Accepted: 02/11/2025] [Indexed: 03/09/2025] Open
Abstract
Microbial keratitis, a sight-threatening corneal infection, remains a significant global health concern. Conventional therapies using antimicrobial agents often suffers from limitations such as poor drug penetration, side effects, and occurrence of drug resistance, with poor prognosis. Novel treatment techniques, with their unique properties and targeted delivery capabilities, offers a promising solution to overcome these challenges. This review delves into timely update of the state-of-the-art advance therapeutics for keratitis treatment. The diverse microbial origins of keratitis, including viral, bacterial, and fungal infections, exploring their complex pathogenic mechanisms, followed by the drug resistance mechanisms in keratitis pathogens are reviewed briefly. Importantly, the emerging therapeutic techniques for keratitis treatment including piezodynamic therapy, photothermal therapy, photodynamic therapy, nanoenzyme therapy, and metal ion therapy are summarized in this review showcasing their potential to overcome the limitations of traditional treatments. The challenges and future directions for advance therapies and nanotechnology-based approaches are discussed, focusing on safety, targeting strategies, drug resistance, and combination therapies. This review aims to inspire researchers to revolutionize and accelerate the development of functional materials using different therapies for keratitis treatment.
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Affiliation(s)
- Siying Qu
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai City, Guangdong Province, 519000, China
| | - Shuihua Zheng
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai City, Guangdong Province, 519000, China
| | - Sibtain Muhammad
- School of Science, Shenzhen Key Laboratory of Advanced Functional Carbon Materials Research and Comprehensive Application, Harbin Institute of Technology, Shenzhen, 518055, China
| | - Liang Huang
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai City, Guangdong Province, 519000, China.
| | - Bing Guo
- School of Science, Shenzhen Key Laboratory of Advanced Functional Carbon Materials Research and Comprehensive Application, Harbin Institute of Technology, Shenzhen, 518055, China.
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8
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Zhang H, Li D, Ren H, Ma Z, Meng S, Qiao Y, Yang J, Wang Y, Zhou Q, Xie L. A Bioinspired Virus-Like Mechano-Bactericidal Nanomotor for Ocular Multidrug-Resistant Bacterial Infection Treatment. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2025; 37:e2408221. [PMID: 39806835 DOI: 10.1002/adma.202408221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 11/28/2024] [Indexed: 01/16/2025]
Abstract
Multidrug-resistant (MDR) bacteria and their associated biofilms are major causative factors in eye infections, often resulting in blindness and presenting considerable global health challenges. Presently, mechano-bactericidal systems, which combine distinct topological geometries with mechanical forces to physically induce bacterial apoptosis, show promising potential. However, the physical interaction process between current mechano-bactericidal systems and bacteria is generally based on passive diffusion or Brownian motion and lacks the force required for biofilm penetration; thus, featuring low antibacterial efficacy. Here, a biomimetic mechano-bactericidal nanomotor (VMSNT) is synthesized by functionalizing COOH-PEG-phenylboronic acid (PBA) on virus-like mesoporous silica, with subsequent partial coating of Au caps. Enhanced by self-thermophoresis capabilities and virus-like topological shapes, VMSNT significantly improves mechanical antibacterial effects and biofilm penetration. In addition, scanning electron microscope (SEM) and confocal laser scanning microscope (CLSM) analyses demonstrate that VMSNT can precisely target bacteria within the infection microenvironment, facilitated by PBA's ability to recognize and bind to the peptidoglycan on bacterial surfaces. Remarkably, VMSNT is also effective in eliminating MDR bacteria and reducing inflammation in mice models of methicillin-resistant Staphylococcus aureus (MRSA)-infected keratitis and endophthalmitis, with minimal adverse effects. Overall, such a nanomotor presents a promising approach for addressing the challenges of ocular MDR bacterial infections.
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Affiliation(s)
- Hengrui Zhang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Dewei Li
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Huifang Ren
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Zhenrui Ma
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Shuqin Meng
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Yujie Qiao
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Jiabao Yang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Yao Wang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Qingjun Zhou
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
| | - Lixin Xie
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Qingdao, 266071, P. R. China
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9
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Singh RB, Atta S, Srikumaran D, Jhanji V. Demographic Characteristics, Clinical Presentations, and Risk Factors Impacting Visual Outcomes in Peripheral Ulcerative Keratitis. Cornea 2024; 43:1528-1533. [PMID: 38483828 DOI: 10.1097/ico.0000000000003541] [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: 11/01/2023] [Accepted: 02/13/2024] [Indexed: 11/06/2024]
Abstract
PURPOSE To assess the demographic characteristics, ophthalmic and systemic presentations, and risk factors impacting the outcomes in patients diagnosed with peripheral ulcerative keratitis (PUK). METHODS This retrospective study includes patients diagnosed with PUK at a tertiary care center over 13 years. A descriptive analysis of the demographics, clinical history, and presentation was performed. A reverse risk analysis was performed to assess the PUK resolution in patients with underlying autoimmune and non-autoimmune etiologies. Finally, we evaluated the correlation between treatment duration and final best corrected visual acuity (BCVA) and continuous and categorical variables. RESULTS A total of 58 eyes of 51 patients with a mean age of 59.67 ± 13.41 years diagnosed with PUK were included in the study; 58.82% were female. The resolution duration was significantly shorter in patients with autoimmune etiologies (vs. non-autoimmune etiologies, P = 0.028) and female patients (vs. male patients, P = 0.008). The BCVA worsened in patients with non-autoimmune etiologies after treatment ( P = 0.17). Despite worse BCVA at presentation in patients with underlying autoimmune etiologies, significantly better final vision outcomes were observed ( P = 0.04). Linear regression analysis showed that longer treatment duration ( P = 0.001; R 2 = 0.1704) and worse vision ( P = 0.002; R 2 = 0.1502) at presentation were the primary risk factors of poor vision outcomes. Similarly, the treatment duration was significantly longer in male compared with female patients ( P < 0.001; R 2 = 0.2027). CONCLUSIONS The clinical outcomes in PUK with underlying autoimmune disorders were observed to be better than non-autoimmune etiologies, which may be attributed to the early detection of the PUK-related changes and aggressive medical management. A delayed diagnosis of PUK leads to poor vision outcomes.
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Affiliation(s)
- Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
- Department of Ophthalmology, Leiden University Medical Center, ZA Leiden, the Netherlands
- Discipline of Ophthalmology and Visual Sciences, Adelaide Medical School, University of Adelaide, Australia
| | - Sarah Atta
- Department of Ophthalmology, Eye and Ear Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA; and
| | - Divya Srikumaran
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vishal Jhanji
- Department of Ophthalmology, Eye and Ear Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA; and
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10
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Mohammadi M, Rahmani S, Ebrahimi Z, Nowroozi G, Mahmoudi F, Shahlaei M, Moradi S. In Situ Forming Hydrogel Reinforced with Antibiotic-Loaded Mesoporous Silica Nanoparticles for the Treatment of Bacterial Keratitis. AAPS PharmSciTech 2024; 25:254. [PMID: 39443345 DOI: 10.1208/s12249-024-02969-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 10/02/2024] [Indexed: 10/25/2024] Open
Abstract
Bacterial keratitis (BK) is a serious ocular infection that can lead to vision impairment or blindness if not treated promptly. Herein, we report the development of a versatile composite hydrogel consisting of silk fibroin and sodium alginate, reinforced by antibiotic-loaded mesoporous silica nanoparticles (MSNs) for the treatment of BK. The drug delivery system is constructed by incorporating vancomycin- and ceftazidime-loaded MSNs into the hydrogel network. The synthesized MSNs were found to be spherical in shape with an average size of about 95 nm. The loading capacities of both drugs were approximately 45% and 43%, for vancomycin and ceftazidime respectively. Moreover, the formulation exhibited a sustained release profile, with 92% of vancomycin and 90% of ceftazidime released over a 24 h period. The cytocompatibility of the drug carrier was also confirmed by MTT assay results. In addition, we performed molecular dynamics (MD) simulations to better reflect the drug-drug and drug-MSN interactions. The results obtained from RMSD, number of contacts, and MSD analyses perfectly corroborated the experimental findings. In brief, the designed drug-MSN@hydrogel could mark an intriguing new chapter in the treatment of BK.
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Affiliation(s)
- Mohammad Mohammadi
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shokoufeh Rahmani
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zohre Ebrahimi
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Nowroozi
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Mahmoudi
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Shahlaei
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Sajad Moradi
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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11
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Zhou J, Zhang L, Wei Y, Wu Q, Mao K, Wang X, Cai J, Li X, Jiang Y. Photothermal Iron-Based Riboflavin Microneedles for the Treatment of Bacterial Keratitis via Ion Therapy and Immunomodulation. Adv Healthc Mater 2024; 13:e2304448. [PMID: 39012057 DOI: 10.1002/adhm.202304448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/23/2024] [Indexed: 07/17/2024]
Abstract
Bacterial biofilm formation protects bacteria from antibiotics and the immune system, excessive inflammation further complicates treatment. Here, iron-based metal-organic framework (MIL-101)-loaded riboflavin nanoparticles are designed for the therapeutic challenge of biofilm infection and hyperinflammation in bacterial keratitis. Specifically, MIL-101 produces a thermal effect under exogenous near-infrared light irradiation, which synergizes with ferroptosis-like bacterial death induced by iron ions to exert an effective biofilm infection eradication effect. On the other hand, the disintegration of MIL-101 sustains the release of riboflavin, which inhibits the pro-inflammatory response of macrophage over-activation by modulating their phenotypic switch. In addition, to solve the problems of short residence time, poor permeability, and low bioavailability of corneal medication, the MR@MN microneedle patch is further prepared by loading nanoparticles into SilMA hydrogel, which ultimately achieves painless, transepithelial, and highly efficient drug delivery. In vivo and ex vivo experiments demonstrate the effectiveness of this approach in eliminating bacterial infection and promoting corneal healing. Therefore, the MRMN patch, acting as an ocular drug delivery system with the ability of rapid corneal healing, promises a cost-effective solution for the treatment of bacterial keratitis, which may also lead to a new approach for treating bacterial keratitis in clinics.
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Affiliation(s)
- Jun Zhou
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China
| | - Lisha Zhang
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China
| | - Yaqi Wei
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, China
| | - Kaibo Mao
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
| | - Xiaoli Wang
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
| | - Jinfeng Cai
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
| | - Xia Li
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, P. R. China
| | - Yongxiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
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12
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He X, Zhang Z, Hu M, Lin X, Weng X, Lu J, Fang L, Chen X. Liquiritin Alleviates Inflammation in Lipopolysaccharide-Induced Human Corneal Epithelial Cells. Curr Eye Res 2024; 49:930-941. [PMID: 38767463 DOI: 10.1080/02713683.2024.2353263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/09/2024] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE This research was designed to elucidate the anti-inflammatory impacts of liquiritin on lipopolysaccharide (LPS)-activated human corneal epithelial cells (HCECs). METHODS The Cell Counting kit-8 (CCK-8) assay was adopted to assess cell viability. The enzyme-linked immunosorbent assay (ELISA) was used to detect the secretion levels of the proinflammatory cytokines IL-6, IL-8, and TNF-α. Transcriptome analysis was conducted to identify the genes that exhibited differential expression between different treatment. The model group included cells treated with LPS (10 µg/mL), the treatment group comprised cells treated with liquiritin (80 µM) and LPS (10 µg/mL), and the control group consisted of untreated cells. To further validate the expression levels of the selected genes, including CSF2, CXCL1, CXCL2, CXCL8, IL1A, IL1B, IL24, IL6, and LTB, quantitative real-time PCR was performed. The expression of proteins related to the Akt/NF-κB signaling pathway was assessed through western blot analysis. NF-κB nuclear translocation was evaluated through immunofluorescence staining. RESULTS The secretion of IL-6, IL-8, and TNF-α in LPS-induced HCECs was significantly downregulated by liquiritin. Based on the transcriptome analysis, the mRNA expression of pro-inflammatory cytokines, namely IL-6, IL-8, IL-1β, IL-24, TNF-α, and IL-1α was overproduced by LPS stimulation, and suppressed after liquiritin treatment. Furthermore, the Western blot results revealed a remarkable reduction in the phosphorylation degrees of NF-κB p65, IκB, and Akt upon treatment with liquiritin. Additionally, immunofluorescence analysis confirmed liquiritin's inhibition of LPS-induced p65 nuclear translocation. CONCLUSIONS Collectively, these findings imply that liquiritin suppresses the expression of proinflammatory cytokines, and the anti-inflammatory impacts of liquiritin may be caused by its repression of the Akt/NF-κB signaling pathway in LPS-induced HCECs. These data indicate that liquiritin could provide a potential therapeutic application for inflammation-associated corneal diseases.
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Affiliation(s)
- Xian He
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
- Key Laboratory of Safety Evaluation of Medical Devices of Zhejiang Province, Hangzhou, Zhejiang Province, China
| | - Ziyang Zhang
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
| | - Meili Hu
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
| | - Xinyi Lin
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
| | - Xu Weng
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
| | - Jiajun Lu
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
| | - Li Fang
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
- Key Laboratory of Safety Evaluation of Medical Devices of Zhejiang Province, Hangzhou, Zhejiang Province, China
| | - Xianhua Chen
- Zhejiang Institute of Medical Device Supervision and Testing, Hangzhou, Zhejiang Province, China
- Key Laboratory of Safety Evaluation of Medical Devices of Zhejiang Province, Hangzhou, Zhejiang Province, China
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13
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Chai N, Stachon T, Berger T, Li Z, Amini M, Suiwal S, Seitz B, Langenbucher A, Szentmáry N. Rose Bengal Photodynamic Therapy (RB-PDT) Modulates the Inflammatory Response in LPS-Stimulated Human Corneal Fibroblasts By Influencing NF-κB and p38 MAPK Signaling Pathways. Curr Eye Res 2024; 49:803-814. [PMID: 38646925 DOI: 10.1080/02713683.2024.2342600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To investigate the effect of rose bengal photodynamic therapy on lipopolysaccharide-induced inflammation in human corneal fibroblasts. Furthermore, to analyze potential involvement of the mitogen-activated protein kinase and nuclear factor kappa B signaling pathways in this process. METHODS Human corneal fibroblast cultures underwent 0-2.0 µg/mL lipopolysaccharide treatment, and 24 h later rose bengal photodynamic therapy (0.001% RB, 565 nm wavelength illumination, 0.17 J/cm2 fluence). Interleukin-6, interleukin-8, intercellular adhesion molecule-1, interferon regulatory factor-3, interferon α2, and interferon β1 gene expressions were determined by quantitative PCR. Interleukin-6, interleukin-8, and C-C motif chemokine ligand-4 concentrations in the cell culture supernatant were measured by enzyme-linked immunosorbent assays and intercellular adhesion molecule-1 protein level in human corneal fibroblasts by western blot. In addition, the nuclear factor kappa B and mitogen-activated protein kinase signaling pathways were investigated by quantitative PCR and phosphorylation of nuclear factor kappa B p65 and p38 mitogen-activated protein kinase by western blot. RESULTS Rose bengal photodynamic therapy in 2.0 µg/mL lipopolysaccharide-stimulated human corneal fibroblasts triggered interleukin-6 and interleukin-8 mRNA (p < .0001) and interleukin-6 protein increase (p < .0001), and downregulated intercellular adhesion molecule-1 expression (p < .001). C-C motif chemokine ligand-4, interferon regulatory factor-3, interferon α2, and interferon β1 expressions remained unchanged (p ≥ .2). Rose bengal photodynamic therapy increased IκB kinase subunit beta, nuclear factor kappa B p65, extracellular signal-regulated kinases-2, c-Jun amino terminal kinase, and p38 transcription (p ≤ .01), and triggered nuclear factor kappa B p65 and p38 mitogen-activated protein kinase phosphorylation (p ≤ .04) in lipopolysaccharide treated human corneal fibroblasts. CONCLUSION Rose bengal photodynamic therapy of lipopolysaccharide-stimulated human corneal fibroblasts can modify the inflammatory response by inducing interleukin-6 and interleukin-8 expression, and decreasing intercellular adhesion molecule-1 production. C-C motif chemokine ligand-4, interferon regulatory factor-3, and interferon α and β expressions are not affected by rose bengal photodynamic therapy in these cells. The underlying mechanisms may be associated with nuclear factor kappa B and p38 mitogen-activated protein kinase pathway activation.
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Affiliation(s)
- Ning Chai
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
- Department of Plastic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
| | - Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany
| | - Zhen Li
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
| | - Maryam Amini
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
| | - Shweta Suiwal
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany
| | | | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Aniridia Research, Saarland University, Homburg, Germany
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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14
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Zheng L, Chen Y, Han Y, Lin J, Fan K, Wang M, Teng T, Yang X, Ke L, Li M, Guo S, Li Z, Wu Y, Li C. Thermosensitive Polyhedral Oligomeric Silsesquioxane Hybrid Hydrogel Enhances the Antibacterial Efficiency of Erythromycin in Bacterial Keratitis. Biomater Res 2024; 28:0033. [PMID: 39040621 PMCID: PMC11260774 DOI: 10.34133/bmr.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/26/2024] [Indexed: 07/24/2024] Open
Abstract
Bacterial keratitis is a serious ocular infection that can impair vision or even cause blindness. The clinical use of antibiotics is limited due to their low bioavailability and drug resistance. Hence, there is a need to develop a novel drug delivery system for this infectious disease. In this study, erythromycin (EM) was encapsulated into a bifunctional polyhedral oligomeric silsesquioxane (BPOSS) with the backbone of the poly-PEG/PPG urethane (BPEP) hydrogel with the aim of improving the drug efficiency in treating bacterial keratitis. A comprehensive characterization of the BPEP hydrogel was performed, and its biocompatibility was assessed. Furthermore, we carried out the evaluation of the antimicrobial effect of the BPEP-EM hydrogel in S. aureus keratitis using in vivo mouse model. The BPEP hydrogel exhibited self-assembling and thermogelling properties, which assisted the drug loading of drug EM and improved its water solubility. Furthermore, the BPEP hydrogel could effectively bind with mucin on the ocular surface, thereby markedly prolonging the ocular residence time of EM. In vivo testing confirmed that the BPEP-EM hydrogel exerted a potent therapeutic action in the mouse model of bacterial keratitis. In addition, the hydrogel also exhibited an excellent biocompatibility. Our findings demonstrate that the BPEP-EM hydrogel showed a superior therapeutic effect in bacterial keratitis and demonstrated its potential as an ophthalmic formulation.
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Affiliation(s)
- Lan Zheng
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
| | - Ying Chen
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology,
School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, PR China
| | - Yi Han
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
- Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, PR China
| | - Jingwei Lin
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
| | - Kai Fan
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology,
School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, PR China
| | - Mengyuan Wang
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
| | - Ting Teng
- Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, PR China
| | - Xiuqin Yang
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology,
School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, PR China
| | - Lingjie Ke
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology,
School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, PR China
| | - Muyuan Li
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117,Shandong Province, PR China
| | - Shujia Guo
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
| | - Zibiao Li
- Huaxia Eye Hospital of Quanzhou, Quanzhou, Fujian 362000, China
| | - Yunlong Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology,
School of Pharmaceutical Sciences, Xiamen University, Xiamen 361102, PR China
| | - Cheng Li
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science & Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center & Affiliated First Hospital, School of Medicine,
Xiamen University, Xiamen 361102, PR China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250117,Shandong Province, PR China
- Huaxia Eye Hospital of Quanzhou, Quanzhou, Fujian 362000, China
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15
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Geng X, Zhang N, Li Z, Zhao M, Zhang H, Li J. Iron-doped nanozymes with spontaneous peroxidase-mimic activity as a promising antibacterial therapy for bacterial keratitis. SMART MEDICINE 2024; 3:e20240004. [PMID: 39188699 PMCID: PMC11236036 DOI: 10.1002/smmd.20240004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 04/23/2024] [Indexed: 08/28/2024]
Abstract
The development of non-antibiotic pharmaceuticals with biocompatible and efficient antibacterial properties is of great significance for the treatment of bacterial keratitis. In this study, we have developed antibacterial iron-doped nanozymes (Fe3+-doped nanozymes, FNEs) with distinguished capacity to fight against bacterial infections. The iron-doped nanozymes are composed of Fe3+ doped zeolitic imidazolate framework-8 (Fe/ZIF-8) and polyethylene imide (PEI), which were functionally coated on the surface of Fe/ZIF-8 and imparted the FNEs with improved water dispersibility and biocompatibility. FNEs possess a significant spontaneous peroxidase-mimic activity without the need for external stimulation, thus elevating cellular reactive oxygen species level by catalyzing local H2O2 at the infection site and resulting in bacteria damaged to death. FNEs eliminated 100% of Staphylococcus aureus within 6 h, and significantly relieved inflammation and bacterial infection levels in mice bacterial keratitis, exhibiting higher bioavailability and a superior therapeutic effect compared to conventional antibiotic eye drops. In addition, the FNEs would not generate drug resistance, suggesting that FNEs have great potential in overcoming infectious diseases caused by antimicrobial resistant bacteria.
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Affiliation(s)
- Xiwen Geng
- Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
- Pharmaceutical Sciences LaboratoryFaculty of Science and EngineeringÅbo Akademi UniversityTurkuFinland
- Turku Bioscience CentreUniversity of Turku and Åbo Akademi UniversityTurkuFinland
| | - Nan Zhang
- Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
- Henan Eye HospitalZhengzhouChina
| | - Zhanrong Li
- Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
- Henan Eye HospitalZhengzhouChina
| | - Mengyang Zhao
- Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
- Henan Eye HospitalZhengzhouChina
| | - Hongbo Zhang
- Pharmaceutical Sciences LaboratoryFaculty of Science and EngineeringÅbo Akademi UniversityTurkuFinland
- Turku Bioscience CentreUniversity of Turku and Åbo Akademi UniversityTurkuFinland
| | - Jingguo Li
- Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhouChina
- Henan Eye HospitalZhengzhouChina
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16
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Sun R, Zhang J, Chen X, Deng Y, Gou J, Yin T, He H, Tang X, Ni X, Yang L, Zhang Y. An adaptive drug-releasing contact lens for personalized treatment of ocular infections and injuries. J Control Release 2024; 369:114-127. [PMID: 38521167 DOI: 10.1016/j.jconrel.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/04/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
This research introduces an innovative solution to address the challenges of bacterial keratitis and alkali burns. Current treatments for bacterial keratitis and alkali burns rely on the frequent use of antibiotics and anti-inflammatory eye drops. However, these approaches suffer from poor bioavailability and fluctuating concentrations, leading to limited efficacy and potential drug resistance. Our approach presents an adaptive drug-releasing contact lens responsive to reactive oxygen species (ROS) at ocular inflammation sites, synchronously releasing Levofloxacin and Diclofenac. During storage, minimal drug release occurred, but over 7 days of wear, the lens maintained a continuous, customizable drug release rate based on disease severity. This contact lens had strong antibacterial activity and biofilm prevention, effectively treating bacterial keratitis. When combined with autologous serum, this hydrophilic, flexible lens aids corneal epithelial regeneration, reducing irritation and promoting healing. In summary, this ROS-responsive drug-releasing contact lens combines antibacterial and anti-inflammatory effects, offering a promising solution for bacterial keratitis and alkali burns.
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Affiliation(s)
- Rong Sun
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Jie Zhang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Xi Chen
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Yaxin Deng
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Jingxin Gou
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Tian Yin
- School of Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Haibing He
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Xing Tang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China
| | - Xianpu Ni
- School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China.
| | - Li Yang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China.
| | - Yu Zhang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, PR China.
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Cabrera-Aguas M, Chidi-Egboka N, Kandel H, Watson SL. Antimicrobial resistance in ocular infection: A review. Clin Exp Ophthalmol 2024; 52:258-275. [PMID: 38494451 DOI: 10.1111/ceo.14377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/19/2024]
Abstract
Antimicrobial resistance (AMR) is a global public health threat with significant impact on treatment outcomes. The World Health Organization's Global Action Plan on AMR recommended strengthening the evidence base through surveillance programs and research. Comprehensive, timely data on AMR for organisms isolated from ocular infections are needed to guide treatment decisions and inform researchers and microbiologists of emerging trends. This article aims to provide an update on the development of AMR in ocular organisms, AMR in bacterial ocular infections and on AMR stewardship programs globally. The most common ocular pathogens are Pseudomonas aeruginosa, Staphylococcus spp., Streptococcus pneumoniae, and Haemophilus influenzae in ocular infections. A variety of studies and a few surveillance programs worldwide have reported on AMR in these infections over time. Fluoroquinolone resistance has increased particularly in Asia and North America. For conjunctivitis, the ARMOR cumulative study in the USA reported a slight decrease in resistance to ciprofloxacin. For keratitis, resistance to methicillin has remained stable for S. aureus and CoNS, while resistance to ciprofloxacin has decreased for MRSA globally. Methicillin-resistance and multidrug resistance are also emerging, requiring ongoing monitoring. Antimicrobial stewardship (AMS) programmes have a critical role in reducing the threat of AMR and improving treatment outcomes. To be successful AMS must be informed by up-to-date AMR surveillance data. As a profession it is timely for ophthalmology to act to prevent AMR leading to greater visual loss through supporting surveillance programmes and establishing AMS.
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Affiliation(s)
- Maria Cabrera-Aguas
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Ngozi Chidi-Egboka
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Himal Kandel
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie L Watson
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, Sydney, New South Wales, Australia
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Guo RQ, Yang J, Yang YB, Chen YN, Xiao YY, Xiang P, Dong MJ, He MF, Wang YT, Xiao YL, Ke HQ, Liu H. Spectrum and antibiotic sensitivity of bacterial keratitis: a retrospective analysis of eight years in a Tertiary Referral Hospital in Southwest China. Front Cell Infect Microbiol 2024; 14:1363437. [PMID: 38529473 PMCID: PMC10961451 DOI: 10.3389/fcimb.2024.1363437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose The objective of this study was to investigate the epidemiological characteristics, distribution of isolates, prevailing patterns, and antibiotic susceptibility of bacterial keratitis (BK) in a Tertiary Referral Hospital located in Southwest China. Methods A retrospective analysis was conducted on 660 cases of bacterial keratitis occurring between January 2015 and December 2022. The demographic data, predisposing factors, microbial findings, and antibiotic sensitivity profiles were examined. Results Corneal trauma emerged as the most prevalent predisposing factor, accounting for 37.1% of cases. Among these cases, bacterial culture results were positive in 318 cases, 68 species of bacteria were identified. The most common Gram-Positive bacteria isolated overall was the staphylococcus epidermis and the most common Gram-Negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-Resistant Staphylococci accounted for 18.1% of all Gram-Positive bacteria. The detection rate of P. aeruginosa showed an increasing trend over time (Rs=0.738, P=0.037). There was a significant decrease in the percentage of Gram-Negative microorganisms over time (Rs=0.743, P=0.035). The sensitivity of Gram-Positive bacteria to linezolid, vancomycin, tigecycline, quinupristin/dalfopristin, and rifampicin was over 98%. The sensitivity rates of Gram-Negative bacteria to amikacin, meropenem, piperacillin/tazobactam, cefoperazone sodium/sulbactam, ceftazidime, and cefepime were all above 85%. In patients with a history of vegetative trauma, the possibility of BK should be taken into account in addition to the focus on fungal keratitis. Conclusion The microbial composition primarily consists of Gram-Positive cocci and Gram-Negative bacilli. Among the Gram-Positive bacteria, S. epidermidis and Streptococcus pneumoniae are the most frequently encountered, while P. aeruginosa is the predominant Gram-Negative bacteria. To combat Gram-Positive bacteria, vancomycin, linezolid, and rifampicin are considered excellent antimicrobial agents. When targeting Gram-Negative pathogens, third-generation cephalosporins exhibit superior sensitivity compared to first and second-generation counterparts. As an initial empirical treatment for severe cases of bacterial keratitis and those unresponsive to fourth-generation fluoroquinolones in community settings, the combination therapy of vancomycin and tobramycin is a justifiable approach. Bacterial keratitis can be better managed by understanding the local etiology and antibacterial drug susceptibility patterns.
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Affiliation(s)
- Rui-Qin Guo
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Ji Yang
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Ya-Bin Yang
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Ya-Nan Chen
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Yu-Yuan Xiao
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Ping Xiang
- Yunnan Province Innovative Research Team of Environmental Pollution, Food Safety, and Human Health, Institute of Environmental Remediation and Human Health, School of Ecology and Environment, Southwest Forestry University, Kunming, China
| | - Meng-Jie Dong
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Min-Fang He
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Yin-Ting Wang
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Yun-Ling Xiao
- Department of Ophthalmology, Honghe County People’s Hospital, Honghe, China
| | - Hong-Qin Ke
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
| | - Hai Liu
- Department of Ophthalmology, Second People’s Hospital of Yunnan Province, The Affiliated Hospital of Yunnan University, The Eye Disease Clinical Medical Research Center of Yunnan Province, The Eye Disease Clinical Medical Center of Yunnan Province, Kunming, China
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Shen X, Huang C, Bai J, Wen J. Targeted Bacterial Keratitis Treatment with Polyethylene Glycol-Dithiothreitol-Boric Acid Hydrogel and Gatifloxacin. Curr Drug Deliv 2024; 21:1548-1558. [PMID: 38425110 DOI: 10.2174/0115672018279105240226050253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/18/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION/OBJECTIVE To prolong the ocular residence time of gatifloxacin and enhance its efficacy against bacterial keratitis, this study developed a velocity-controlled polyethylene glycol-dithiothreitol-boric acid (PDB) hydrogel loaded with gatifloxacin. METHODS First, the basic properties of the synthesized PDB hydrogel and the gatifloxacin-loaded PDB hydrogel were assessed. Secondly, the in vitro degradation rate of the drug-loaded PDB was measured in a simulated body fluid environment with pH 7.4/5.5. The release behavior of the drug-loaded PDB was studied using a dialysis method with PBS solution of pH 7.4/5.5 as the release medium. Finally, a mouse model of bacterial keratitis was established, and tissue morphology was observed using hematoxylin-eosin staining. Additionally, mouse tear fluid was extracted to observe the antibacterial effect of the gatifloxacin-loaded PDB hydrogel. RESULTS The results showed that the PDB hydrogel had a particle size of 124.9 nm and a zeta potential of -23.3 mV, with good porosity, thermosensitivity, viscosity distribution, rheological properties, and high cell compatibility. The encapsulation of gatifloxacin did not alter the physical properties of the PDB hydrogel and maintained appropriate swelling and stability, with a high drug release rate in acidic conditions. Furthermore, animal experiments demonstrated that the gatifloxacin- loaded PDB hydrogel exhibited superior therapeutic effects compared to gatifloxacin eye drops and displayed strong antibacterial capabilities against bacterial keratitis. CONCLUSION This study successfully synthesized PDB hydrogel and developed a gatifloxacin drug release system. The hydrogel exhibited good thermosensitivity, pH responsiveness, stability, and excellent biocompatibility, which can enhance drug retention, utilization, and therapeutic effects on the ocular surface.
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Affiliation(s)
- Xiao Shen
- Department of Ophthalmology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Chunlian Huang
- Department of Ophthalmology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Jianhai Bai
- Department of Ophthalmology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
| | - Jing Wen
- Department of Ophthalmology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, Zhejiang, China
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Meng S, Hu H, Qiao Y, Wang F, Zhang BN, Sun D, Zhou L, Zhao L, Xie L, Zhang H, Zhou Q. A Versatile Hydrogel with Antibacterial and Sequential Drug-Releasing Capability for the Programmable Healing of Infectious Keratitis. ACS NANO 2023; 17:24055-24069. [PMID: 38044579 DOI: 10.1021/acsnano.3c09034] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Hydrogels have attracted tremendous attention as favorable corneal substitutes for treating severe infectious keratitis (IK). However, current hydrogel-based corneal substitutes were majorly designed to promote the single stage of corneal regeneration, which falls short in meeting the clinical management needs of severe IK including the multiple phases of corneal wound healing. Herein, we introduce a versatile hybrid hydrogel (SQPV) composed of silk fibroin and chitosan, which exhibits spatiotemporal properties for drug release. The SQPV is fabricated by incorporating verteporfin-loaded poly(lactic-co-glycolic)-polyethylene glycol-o-nitrobenzene micelles into a hydrogel network, which is formed from methacrylate silk fibroin and glycidyl methacrylate functionalized quaternized chitosan containing polydeoxyribonucleotide. This double network approach results in a material with exceptional anti-inflammatory, antibacterial, and proliferative stimulation and tissue remodeling regulation capabilities. Furthermore, SQPV showcases mechanical strength and transparency akin to those of native cornea. Extensive in vitro and in vivo studies validate SQPV's ability to effectively eliminate residual bacteria, mitigate inflammation, foster regeneration of corneal epithelium and stroma, prevent corneal scarring, and ultimately expedite wound healing. In summary, the SF/CS-based hybrid hydrogel may represent a promising substitute for comprehensive corneal repair and regeneration in severe IK.
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Affiliation(s)
- Shuqin Meng
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Hao Hu
- Institute of Biomedical Materials and Engineering, College of Materials Science and Engineering, Qingdao University, Qingdao 266071, P.R. China
| | - Yujie Qiao
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Fuyan Wang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Bi Ning Zhang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Difang Sun
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Longfang Zhou
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Long Zhao
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Lixin Xie
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Hengrui Zhang
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
| | - Qingjun Zhou
- Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao 266071, P.R. China
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Atta S, Singh RB, Samanthapudi K, Perera C, Omar M, Nayyar S, Kowalski RP, Jhanji V. Clinical Characterization and Outcomes of Culture- and Polymerase Chain Reaction-Negative Cases of Infectious Keratitis. Diagnostics (Basel) 2023; 13:2528. [PMID: 37568892 PMCID: PMC10417528 DOI: 10.3390/diagnostics13152528] [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: 05/20/2023] [Revised: 07/11/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE To examine the clinical presentation, management, and outcomes of culture and polymerase chain reaction (PCR) negative cases of infectious keratitis. METHODS In this retrospective case series, we evaluated the laboratory and medical records of culture- and PCR-negative cases (2016-2020) reported to a tertiary care center, which were presumed to be infectious keratitis on the basis of clinical history and presentation. RESULTS A total of 121 cases with culture-negative keratitis were included in this study. The mean age of the patients was 48.42 ± 1.89 years, and 53.72% were female. At presentation, the presumed etiology was viral in 38.01%, bacterial in 27.27%, fungal in 8.26%, Acanthamoeba in 6.61%, and unlisted in 28.92% of cases. The most common risk factors were a previous history of ocular surface diseases (96.69%) and contact lens use (37.19%). In total, 61.98% of the patients were already on antimicrobial medication at presentation. The initial management was altered in 79 cases (65.29%) during the treatment course. Average presenting and final (post-treatment) visual acuities (VA) were 0.98 ± 0.04 (LogMAR) and 0.42 ± 0.03 (LogMAR), respectively. A significantly higher frequency of patients with a final VA worse than 20/40 (Snellen) had worse VA at initial presentation (p < 0.0001). A history of ocular surface disease, cold sores, and recurrent infection (p < 0.05) were more commonly associated with a presumed diagnosis of viral keratitis. The patients with presumed bacterial etiology were younger and had a history of poor contact lens hygiene (p < 0.05). CONCLUSIONS We observed a distinct difference in clinical features among patients with culture-negative and PCR-negative keratitis managed for presumed viral and bacterial infections. Although there was significant variability in presentation and management duration in this cohort, the visual outcomes were generally favorable.
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Affiliation(s)
- Sarah Atta
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
| | - Rohan Bir Singh
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02115, USA;
- Department of Ophthalmology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Keerthana Samanthapudi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
| | - Chandrashan Perera
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Mahmoud Omar
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
| | - Shannon Nayyar
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
- The Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Regis P. Kowalski
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
- The Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (S.A.); (K.S.); (M.O.); (S.N.); (R.P.K.)
- The Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
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Zhang Y, Zhou N, Jiao Y, Lin G, Li X, Gao S, Zhou P, Liu J, Nan J, Zhang M, Yang S. Targeting Noncanonical Pyroptosis With a Small Molecular Inhibitor Alleviates Inflammation in the LPS-Induced Keratitis Mouse Model. Invest Ophthalmol Vis Sci 2023; 64:1. [PMID: 36595275 PMCID: PMC9819737 DOI: 10.1167/iovs.64.1.1] [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] [Indexed: 01/04/2023] Open
Abstract
Purpose Pyroptosis, a novel proinflammatory programmed cell death, has been implicated in some ocular diseases. Of special note is the noncanonical pyroptosis that has recently been recognized to play a critical role in microbial keratitis. We previously discovered a new potent small molecular pyroptosis inhibitor, J114. In this investigation, we will explore whether J114 is able to inhibit the noncanonical pyroptosis and the underlying mechanism. Then a lipopolysaccharide (LPS)-induced keratitis mouse model will be used to evaluate the therapeutic effect of J114 in vivo. Methods In vitro, macrophages originating from humans or mice were stimulated with intracellular LPS to induce noncanonical pyroptosis activation. in vivo, acute keratitis in mouse was induced by LPS intrastromal injection. We verified the protective effect of J114 on noncanonical pyroptosis. Clinical scoring, histological observation, macrophage localization, and quantification of pyroptotic markers in the cornea were used to characterize the therapeutic effects. Results J114 substantially inhibited the noncanonical pyroptosis and the release of inflammatory cytokines by suppressing the activation of caspase-4/5/11 and the noncanonical NLRP3 inflammasome through blocking the NLRP3-ASC interaction. in vivo, J114 protected against LPS-induced noncanonical pyroptosis of acute keratitis, as manifested by alleviated clinical manifestations and histological disorders, and relieved inflammatory reactions. Conclusions In this study, we found that J114 could efficiently inhibit LPS-induced noncanonical pyroptosis and revealed the underlying mechanism. This compound displayed significant anti-inflammatory activity in the LPS-induced keratitis mouse model. All the findings indicated that J114 could be a potential lead compound for drug development against inflammatory ocular surface diseases.
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Affiliation(s)
- Yun Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Nenghua Zhou
- Key Laboratory of Drug Targeting and Drug Delivery System of Ministry of Education, West China School of Pharmacy, Sichuan University, China
| | - Yan Jiao
- Laboratory of Anesthesia and Critical Care Medicine, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Guifeng Lin
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xun Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Sheng Gao
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Pei Zhou
- Key Laboratory of Drug Targeting and Drug Delivery System of Ministry of Education, West China School of Pharmacy, Sichuan University, China
| | - Jingming Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jinshan Nan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Shengyong Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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