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Milovanova E, Gomon S, Rocha G. Classic lattice corneal dystrophy: a brief review and summary of treatment modalities. Graefes Arch Clin Exp Ophthalmol 2024; 262:1667-1681. [PMID: 37934291 DOI: 10.1007/s00417-023-06297-6] [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: 04/10/2023] [Revised: 10/10/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE To provide a brief summary and comparison of the most recent literature on available and theorized treatment modalities for classic lattice corneal dystrophy (LCD). This paper aims to support practitioners in their management of this disease. METHODS A search was carried out on available literature through PubMed and Google Scholar of English language articles up to January 2023 that relate to the treatment of LCD. Due to scarcity of literature regarding specific novel therapies for LCD, results from other corneal pathologies (granular corneal dystrophy, corneal scarring) are sometimes included for contrast, which is clearly denoted. RESULTS LCD is a slowly progressive disease that leads to recurrent epithelial corneal erosions, stromal haze, corneal opacification, substantial discomfort, and visual impairment. Due to its autosomal-dominant inheritance pattern, this disease can persist throughout ancestral lines and requires consistent treatment and follow-up. An optimal management plan is necessary to (1) prolong years of life with best achievable visual acuity; (2) treat painful recurrent corneal erosions as they occur; (3) ensure proper follow-up throughout the life of a patient, as well as monitor at-risk offspring; and (4) monitor efficacy of treatment. CONCLUSIONS This paper addresses (1) treatment for early disease including corneal epithelial debridement, photo therapeutic keratectomy (PTK), femtosecond laser-assisted lamellar keratectomy (FLK), and others; (2) treatment for late disease including full thickness keratoplasties and anterior lamellar keratoplasties; and (3) potential future treatment considerations including a wide variety of topical/systemic, genetic, and regenerative approaches.
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Affiliation(s)
- Ekaterina Milovanova
- Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Stanislav Gomon
- Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Guillermo Rocha
- Department of Ophthalmology & Visual Sciences, McGill University, Montréal, Canada
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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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Vaidakis D, Papapanou M, Siristatidis CS. Autologous platelet-rich plasma for assisted reproduction. Cochrane Database Syst Rev 2024; 4:CD013875. [PMID: 38682756 PMCID: PMC11057220 DOI: 10.1002/14651858.cd013875.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Autologous platelet-rich plasma (PRP) consists of plasma and a concentrate of platelets extracted from fresh whole blood of the person being treated. Research has suggested that intrauterine or intraovarian infusion/injection of PRP before embryo transfer may improve endometrial receptivity and response to ovarian stimulation in women undergoing assisted reproduction. We compared these interventions to standard treatment, placebo, or other interventions (mechanical or pharmacological). OBJECTIVES To assess the effectiveness and safety of intrauterine and intraovarian infusion/injection of platelet-rich plasma in infertile women undergoing assisted reproductive technology cycles. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group's Specialised Register, CENTRAL, MEDLINE, Embase, and the Epistemonikos database in January 2023. We also searched the reference lists of relevant articles and contacted the trial authors and experts in the field for any additional trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) that evaluated the application of PRP in the uterine cavity, ovaries, or both versus no intervention, placebo, or any other intervention (either mechanical or pharmacological) in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles. DATA COLLECTION AND ANALYSIS We followed standard methodological procedures recommended by Cochrane, including use of the updated risk of bias tool (RoB 2). The primary outcomes were live birth (or ongoing pregnancy) and miscarriage. The secondary outcomes were clinical pregnancy, complications of the procedure, multiple pregnancy, ectopic pregnancy, fetal growth restriction, preterm delivery, and fetal abnormality. We estimated the average effect of the interventions by fitting a Der Simonian-Laird's random-effects meta-analysis model. We reported pooled odds ratios (ORs) with 95% confidence intervals (CIs). We restricted the primary analyses to trials at low risk of bias for the outcomes and performed sensitivity analyses that included all studies. MAIN RESULTS We included 12 parallel-group RCTs that recruited a total of 1069 women. We identified three different comparison groups. Using GRADE, we assessed the certainty of evidence as very low for almost all outcomes. Intrauterine injection/infusion of platelet-rich plasma versus no intervention or placebo Nine studies evaluated intrauterine PRP versus no intervention or placebo. Eight included women with at least two or three previous implantation failures. Only one was assessed at low risk of bias for each outcome. This study provided very low-certainty evidence about the effect of intrauterine PRP injection versus no intervention on live birth (OR 1.10, 95% CI 0.38 to 3.14; 94 women) and miscarriage (OR 0.96, 95% CI 0.13 to 7.09; 94 women). If the likelihood of live birth following no intervention is assumed to be 17%, then the likelihood following intrauterine PRP would be 7% to 40%; and if the risk of miscarriage following no intervention is 4%, then the risk following intrauterine PRP would be 1% to 24%. When we analyzed all studies (regardless of risk of bias), we found very low-certainty evidence about the effect of intrauterine PRP compared with placebo or no intervention on live birth or ongoing pregnancy (OR 2.38, 95% CI 1.16 to 4.86; I² = 54%; 6 studies, 564 women) and miscarriage (OR 1.54, 95% CI 0.59 to 4.01; I² = 0%; 5 studies, 504 women). The study at low risk of bias provided very low-certainty evidence about the effect of intrauterine PRP compared with no intervention on clinical pregnancy (OR 1.55, 95% CI 0.64 to 3.76; 94 women) and ectopic pregnancy (OR 2.94, 95% CI 0.12 to 73.95; 94 women). The synthesis of all studies provided very low-certainty evidence about the effect of intrauterine PRP compared with placebo or no intervention on clinical pregnancy (OR 2.22, 95% CI 1.50 to 3.27; I² = 24%; 9 studies, 824 women), multiple pregnancy (OR 2.68, 95% CI 0.81 to 8.88; I² = 0%; 2 studies, 240 women), and ectopic pregnancy (OR 2.94, 95% CI 0.12 to 73.95; 1 study, 94 women; very low-certainty evidence). Intrauterine infusion of PRP may increase the risk of preterm delivery compared with no intervention (OR 8.02, 95% CI 1.72 to 37.33; 1 study, 120 women; low-certainty evidence). No studies reported pain, infection, allergic reaction, fetal growth restriction, or fetal abnormality. Intrauterine infusion of platelet-rich plasma versus intrauterine infusion of granulocyte colony-stimulating factor Two RCTs evaluated intrauterine PRP versus intrauterine granulocyte colony-stimulating factor (G-CSF); both included women with thin endometrium, and neither was judged at low risk of bias for any outcome. We are uncertain about the effect of intrauterine PRP compared with intrauterine G-CSF on live birth (OR 0.88, 95% CI 0.43 to 1.81; 1 study, 132 women; very low-certainty evidence), miscarriage (OR 1.94, 95% CI 0.63 to 5.96; 1 study, 132 women; very low-certainty evidence), and clinical pregnancy (OR 1.24, 95% CI 0.66 to 2.35; 2 studies, 172 women; very low-certainty evidence). Neither study reported adverse outcomes other than miscarriage. Intraovarian injection of platelet-rich plasma versus no intervention One RCT evaluated PRP injection into both ovaries versus no intervention; it was judged at high risk of bias for the two outcomes it reported. We are uncertain about the effect of intraovarian PRP injection compared with no intervention on ongoing pregnancy (OR 1.09, 95% CI 0.33 to 3.63; 73 women; very low-certainty evidence) and clinical pregnancy (OR 0.90, 95% CI 0.31 to 2.60; 73 women; very low-certainty evidence). The study examined no safety outcomes. AUTHORS' CONCLUSIONS We are uncertain about the effect of intrauterine or intraovarian administration of PRP on outcomes of assisted reproduction technology in infertile women. The pooled results should be interpreted with caution. Only one of the 12 included studies was judged at low risk of bias. Other limitations of the included trials were failure to report live birth, poor reporting of methods, lack of prospective protocol registration, low precision due to the small number of enrolled participants, indirectness due to the specific subpopulations and settings studied, and insufficient or absent safety data.
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Affiliation(s)
- Dennis Vaidakis
- Department of Basic and Clinical Sciences, Medical School, University of Nicosia, Nicosia, Cyprus
| | - Michail Papapanou
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Obstetrics, Gynecology and Reproductive Medicine Working Group, Society of Junior Doctors, Athens, Greece
| | - Charalampos S Siristatidis
- Assisted Reproduction Unit, 2nd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Lozano-Sanroma J, Barros A, Alcalde I, Alvarado-Villacorta R, Sánchez-Ávila RM, Queiruga-Piñeiro J, Cueto LFV, Anitua E, Merayo-Lloves J. Efficacy and Safety of Plasma Rich in Growth Factor in Patients with Congenital Aniridia and Dry Eye Disease. Diseases 2024; 12:76. [PMID: 38667534 PMCID: PMC11048876 DOI: 10.3390/diseases12040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Congenital aniridia is a rare bilateral ocular malformation characterized by the partial or complete absence of the iris and is frequently associated with various anomalies, including keratopathy, cataract, glaucoma, and foveal and optic nerve hypoplasia. Additionally, nearly 50% of individuals with congenital aniridia experience symptoms of ocular dryness. Traditional treatment encompasses artificial tears and autologous serum. This study aimed to assess the effectiveness and safety of using platelet rich in growth factors (PRGF) plasma in patients with congenital aniridia and ocular dryness symptoms. METHODS The included patients underwent two cycles of a 3-month PRGF treatment. At 6 months, symptomatology was evaluated using the OSDI and SANDE questionnaires, and ocular surface parameters were analyzed. RESULTS The OSDI and SANDE values for frequency and severity demonstrated statistically significant improvements (p < 0.05). Ocular redness, corneal damage (corneal staining), and tear volume (Schirmer test) also exhibited statistically significant improvements (p < 0.05). No significant changes were observed in visual acuity or in the grade of meibomian gland loss. CONCLUSION The use of PRGF in patients with congenital aniridia and ocular dryness symptoms led to significant improvements in symptomatology, ocular redness, and ocular damage. No adverse effects were observed during the use of PRGF.
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Affiliation(s)
- Javier Lozano-Sanroma
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
| | - Alberto Barros
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
| | - Ignacio Alcalde
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, 33011 Oviedo, Spain
| | - Rosa Alvarado-Villacorta
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
| | - Ronald M. Sánchez-Ávila
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), 01007 Vitoria, Spain; (R.M.S.-Á.); (E.A.)
| | - Juan Queiruga-Piñeiro
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
| | - Luis Fernández-Vega Cueto
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, 33011 Oviedo, Spain
| | - Eduardo Anitua
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), 01007 Vitoria, Spain; (R.M.S.-Á.); (E.A.)
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, 33012 Oviedo, Spain; (A.B.); (I.A.); (J.Q.-P.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, 33011 Oviedo, Spain
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5
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Anitua E, Pino A, Prado R, Muruzabal F, Alkhraisat MH. Biochemical and biomechanical characterization of an autologous protein-based fibrin sealant for regenerative medicine. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:15. [PMID: 38456966 PMCID: PMC10923958 DOI: 10.1007/s10856-024-06780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024]
Abstract
Accidental events or surgical procedures usually lead to tissue injury. Fibrin sealants have proven to optimize the healing process but have some drawbacks due to their allogeneic nature. Autologous fibrin sealants present several advantages. The aim of this study is to evaluate the performance of a new autologous fibrin sealant based on Endoret®PRGF® technology (E-sealant). One of the most widely used commercial fibrin sealants (Tisseel®) was included as comparative Control. E-sealant´s hematological and biological properties were characterized. The coagulation kinetics and the microstructure were compared. Their rheological profile and biomechanical behavior were also recorded. Finally, the swelling/shrinkage capacity and the enzymatic degradation of adhesives were determined. E-sealant presented a moderate platelet concentration and physiological levels of fibrinogen and thrombin. It clotted 30 s after activation. The microstructure of E-sealant showed a homogeneous fibrillar scaffold with numerous and scattered platelet aggregates. In contrast, Control presented absence of blood cells and amorphous protein deposits. Although in different order of magnitude, both adhesives had similar rheological profiles and viscoelasticity. Control showed a higher hardness but both adhesives presented a pseudoplastic hydrogel nature with a shear thinning behavior. Regarding their adhesiveness, E-sealant presented a higher tensile strength before cohesive failure but their elastic stretching capacity and maximum elongation was similar. While E-sealant presented a significant shrinkage process, Control showed a slight swelling over time. In addition, E-sealant presented a high enzymatic resorption rate, while Control showed to withstand the biodegradation process in a significant way. E-sealant presents optimal biochemical and biomechanical properties suitable for its use as a fibrin sealant with regenerative purposes.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Ander Pino
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Roberto Prado
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Francisco Muruzabal
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
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6
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Shahraki T, Baradaran-Rafii A, Ayyala R, Arabi A, Jarstad J, Memar F. New advances in medical management of dry eye: optimizing treatment strategies for enhanced relief. Int Ophthalmol 2024; 44:49. [PMID: 38337030 DOI: 10.1007/s10792-024-02978-1] [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: 05/13/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Dry eye disease (DED) is a prevalent ocular surface disease that is conventionally characterized by tear film hyperosmolarity and instability. This review presents a summarized classification of DED, followed by a comprehensive discussion of the most recent topical and systemic medications and clinical recommendations for selecting the most appropriate option for each patient. METHODS An extensive literature search was conducted on electronic databases, such as PubMed, Scopus, and Web of Science, using keywords including "dry eye syndrome," "ocular surface disease," "medical management," "artificial tears," "topical immunomodulators," and "meibomian gland dysfunction." RESULTS The underlying reasons for DED can range from insufficient aqueous tear production to increased tear evaporation. Recent literature has provided a more in-depth understanding of the pathophysiology of DED by examining the tear film's lipid, aqueous, and mucin layers. However, despite these advancements, medical management of patients with symptomatic DED has not fully reflected this modernized knowledge of its pathophysiology. CONCLUSION To develop a rationalized strategy for treating DED, it is crucial to have updated knowledge of therapeutic options, their mechanisms of actions, and indications based on the DED type and underlying causes.
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Affiliation(s)
- Toktam Shahraki
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran.
| | - Alireza Baradaran-Rafii
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Ramesh Ayyala
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
| | - Amir Arabi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, Iran
| | - John Jarstad
- Department of Ophthalmology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA
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Hosny OH, Abd-Elkareem M, Ali MM, Ahmed AF. Advanced platelet-rich fibrin promotes healing of induced corneal ulcer in donkeys (Equus asinus). Sci Rep 2023; 13:21824. [PMID: 38071242 PMCID: PMC10710484 DOI: 10.1038/s41598-023-48933-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Ulcerative keratitis is a common disease in horses which may cause blindness. To prevent secondary bacterial and fungal infections and promote quick re-growth of the epithelial layer, different treatment approaches have been employed. This study aimed to examine the effects of advanced platelet-rich fibrin (A-PRF) gel on the healing process of experimentally induced corneal ulcers in donkeys. Nine healthy adult donkeys were used for the study. The donkeys were divided into two groups: the control group, where no medication was applied to the corneal ulcer, and the A-PRF gel group, where A-PRF gel was applied once a day on specific days after ulcer induction. The healing process was evaluated through various examinations and analyses. The results demonstrated that the A-PRF gel group showed significant improvement in the corneal ulcer area, with epithelial and stromal regeneration. At day 35, about 60% of the A-PRF group showed negative fluorescein uptake. Additionally, fewer complications were observed during the healing process compared to the control group. In conclusion, A-PRF gel is an important and safe therapeutic option for controlling ocular surface infection and promoting corneal healing. We recommend using A-PRF gel as an alternative approach, avoiding eyelid suturing, and minimizing corneal irritation.
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Affiliation(s)
- Omar H Hosny
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt.
| | - Mahmoud Abd-Elkareem
- Department of Cell and Tissues, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Magda M Ali
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Ahmed F Ahmed
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
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Alonso-Alonso S, Vázquez N, Chacón M, Caballero-Sánchez N, Del Olmo-Aguado S, Suárez C, Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Nagy L, Merayo-Lloves J, Meana A. An effective method for culturing functional human corneal endothelial cells using a xenogeneic free culture medium. Sci Rep 2023; 13:19492. [PMID: 37945668 PMCID: PMC10636196 DOI: 10.1038/s41598-023-46590-2] [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: 07/12/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
Endothelial dysfunction is a leading cause of corneal blindness in developed countries and the only available treatment is the endothelial transplantation. However, the limited availability of suitable donors remains a significant challenge, driving the exploration of alternative regenerative therapies. Advanced Therapy Medicinal Products show promise but must adhere to strict regulations that prohibit the use of animal-derived substances. This study investigates a novel culture methodology using Plasma Rich in Growth Factors (PRGF) as the only source of growth factors for primary cultures of human corneal endothelial cells (CECs). CECs were obtained from discarded corneas or endothelial rings and cultured in two different media: one supplemented with xenogeneic factors and other xenogeneic-free, using PRGF. Comprehensive characterization through immunofluorescence, morphological analyses, trans-endothelial electrical resistance measurements, RNA-seq, and qPCR was conducted on the two groups. Results demonstrate that CECs cultured in the xenogeneic-free medium exhibit comparable gene expression, morphology, and functionality to those cultured in the xenogeneic medium. Notably, PRGF-expanded CECs share 46.9% of the gene expression profile with native endothelium and express all studied endothelial markers. In conclusion, PRGF provides an effective source of xenogeneic-free growth factors for the culture of CECs from discarded corneal tissue. Further studies will be necessary to demonstrate the applicability of these cultures to cell therapies that make clinical translation possible.
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Affiliation(s)
- S Alonso-Alonso
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
| | - N Vázquez
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain.
| | - M Chacón
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
| | - N Caballero-Sánchez
- Doctoral School of Molecular Cell and Immunobiology. Faculty of Medicine, University of Debrecen, Nagyerdei Krt, Debrecen, 4032, Hungary
- Department of Biochemistry and Molecular Biology, Nuclear Receptor Research Laboratory, Faculty of Medicine, University of Debrecen, Nagyerdei Krt, Debrecen, 4032, Hungary
| | - S Del Olmo-Aguado
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
| | - C Suárez
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
| | - B Alfonso-Bartolozzi
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
- Instituto Oftalmológico Fernández-Vega. Avenida Doctores Fernández-Vega, 33012, Oviedo, Asturias, Spain
| | - L Fernández-Vega-Cueto
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
- Instituto Oftalmológico Fernández-Vega. Avenida Doctores Fernández-Vega, 33012, Oviedo, Asturias, Spain
| | - L Nagy
- Department of Biochemistry and Molecular Biology, Nuclear Receptor Research Laboratory, Faculty of Medicine, University of Debrecen, Nagyerdei Krt, Debrecen, 4032, Hungary
- Department of Medicine and Biological Chemistry, Johns Hopkins University School of Medicine, and Institute for Fundamental Biomedical Research, Johns Hopkins All Children's Hospital, 6Th Ave S, St. Petersburg, FL, 33701, USA
| | - J Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
| | - A Meana
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Avenida Doctores Fernández Vega, 33012, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Avenida del Hospital Universitario, 33011, Oviedo, Asturias, Spain
- Unidad de Ingeniería Tisular, Centro Comunitario Sangre y Tejidos de Asturias (CCST), Unidad 714 CIBERER, Calle Emilio Rodríguez Vigil, 33006, Oviedo, Asturias, Spain
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9
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Kang MJ, Lee JH, Hwang J, Chung SH. Efficacy and safety of platelet-rich plasma and autologous-serum eye drops for dry eye in primary Sjögren's syndrome: a randomized trial. Sci Rep 2023; 13:19279. [PMID: 37935760 PMCID: PMC10630514 DOI: 10.1038/s41598-023-46671-2] [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: 06/15/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023] Open
Abstract
We compared the efficacy and safety of autologous-serum (AS) and platelet-rich plasma (PRP) eye drops for dry eye (DE) treatment in primary Sjögren's syndrome (SS). This prospective, randomized, double-blinded clinical study included patients diagnosed with primary SS DE. Thirty-eight participants were randomly assigned to the AS or PRP groups. Corneal and conjunctival staining scores, Schirmer I test, tear film break-up time (TBUT), and ocular surface disease index (OSDI) scores were evaluated at 4 and 12 weeks. Conjunctival impression cytology (CIC) metaplasia grade and goblet cell density grade at 12 weeks were compared with those at baseline. Corneal and conjunctival staining scores and TBUT significantly improved at 4 and 12 weeks in both groups (all p < 0.005). No significant difference between the AS and PRP groups was observed at 4 and 12 weeks. The Schirmer I values, OSDI scores, CIC metaplasia grade, and goblet cell density grade did not significantly change at 4 and 12 weeks in either group. Both AS and PRP eye drops are effective for primary SS DE without a significant difference. Considering that the preparation time of PRP is shorter than that of AS, PRP can be a good alternative treatment for primary SS DE.
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Affiliation(s)
- Min-Ji Kang
- Department of Ophthalmology, College of Medicine, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea
| | - Jee Hye Lee
- Department of Ophthalmology, College of Medicine, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea
| | - Jehyung Hwang
- Department of Ophthalmology, College of Medicine, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea
| | - So-Hyang Chung
- Department of Ophthalmology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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10
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Wong J, Govindasamy G, Prasath A, Hwang W, Ho A, Yeo S, Tong L. Allogeneic Umbilical Cord Plasma Eyedrops for the Treatment of Recalcitrant Dry Eye Disease Patients. J Clin Med 2023; 12:6750. [PMID: 37959215 PMCID: PMC10648694 DOI: 10.3390/jcm12216750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Dry eye disease is a significant disease in Singapore. While there have been studies using allogenic cord serum for the treatment of dry eye disease, treatment of dry eyes with allogenic umbilical cord plasma drops has yet to be started in Singapore. PURPOSE To evaluate the effectiveness of umbilical cord plasma eyedrops for the treatment of recalcitrant dry eyes in a local Singaporean context. METHODS This is an observational, longitudinal, interventional study for dry eye patients who did not show clear improvement after standard therapy. Patients were recruited from 2020 to 2023 from the dry eye clinic of the Singapore National Eye Center. Umbilical cord plasma was delivered frozen to patients and stored in home freezers. All participants underwent a standardized clinical evaluation for dry eye, and data were collected. RESULTS There were 40 participants (7 males and 33 females). The duration of follow-up was 5.52 ± 1.57 months. Kerato-epitheliopathy staining score, TBUT (tear breakup time), and SPEED (Standard Patient Evaluation of Eye Dryness Questionnaire) scores significantly improved after treatment. No statistically significant improvement was found in terms of visual acuity, according to Schirmer's score. CONCLUSION Cord plasma eye drops significantly improved kerato-epitheliopathy staining scores in recalcitrant dry eye patients. Allogeneic plasma is a promising form of treatment for recalcitrant dry eye.
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Affiliation(s)
- Joy Wong
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
| | - Gayathri Govindasamy
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
| | - Arun Prasath
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
| | - William Hwang
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
- Department of Haematology, Singapore General Hospital, 31 Third Hospital Avenue, Singapore 168753, Singapore
| | - Aloysius Ho
- Singapore Cord Blood Bank, 100 Bukit Timah Road, KK Women’s & Children’s Hospital Women’s Tower, Women’s Specialist Clinics, Level 1, Singapore 229899, Singapore; (A.P.); (W.H.); (A.H.)
- Department of Haematology, Singapore General Hospital, 31 Third Hospital Avenue, Singapore 168753, Singapore
| | - Sharon Yeo
- Singapore Eye Research Institute, 20 College Road Discovery Tower Level 6, The Academia, Singapore 169856, Singapore;
| | - Louis Tong
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; (J.W.); (G.G.)
- Singapore Eye Research Institute, 20 College Road Discovery Tower Level 6, The Academia, Singapore 169856, Singapore;
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
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11
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Lozano-Sanroma J, Barros A, Alcalde I, Sánchez-Ávila RM, Queiruga-Piñeiro J, Fernández-Vega Cueto L, Merayo-Lloves J. Impact of Plasma Rich in Growth Factors (PRGF) Eye Drops on Ocular Redness and Symptomatology in Patients with Dry Eye Disease. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050928. [PMID: 37241160 DOI: 10.3390/medicina59050928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/19/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Dry eye disease (DED) is a common and very symptomatic pathology that affects normal daily activity. The aim of the study was to evaluate the efficacy of plasma rich in growth factors (PRGF) added to one routine treatment protocol for DED (artificial tears substitutes, lid hygiene, and anti-inflammatory therapy). Materials and Methods: Patients were divided into two groups of treatment: standard treatment group (n = 43 eyes) and PRGF group (n = 59). Patients' symptomatology (inferred from OSDI and SANDE questionnaires), ocular inflammation, tear stability, and ocular surface damage were analyzed at baseline and after 3 months of treatment. Results: OSDI test scores were significantly lower in both groups (p < 0.001). SANDE frequency test scores also improved statistically, with differences between groups (p = 0.0089 SANDE frequency and p < 0.0119 SANDE severity). There was a greater reduction in ocular redness (ocular inflammation) in the PRGF group (p < 0.0001) and fluorescein tear break-up time was significantly improved in the PRGF group (p = 0.0006). No significant changes were found in terms of ocular surface damage. No adverse events were obtained in either group. Conclusions: The addition of PRGF to the standard treatment of DED, according to the results obtained, proved to be safe and produced an improvement in ocular symptomatology and signs of inflammation, particularly in moderate and severe cases, when compared to standard treatment.
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Affiliation(s)
| | - Alberto Barros
- Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain
| | - Ignacio Alcalde
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | | | | | - Luis Fernández-Vega Cueto
- Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Surgery and Medical-Surgical Specialties, Universidad de Oviedo, 33006 Oviedo, Spain
| | - Jesús Merayo-Lloves
- Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Department of Surgery and Medical-Surgical Specialties, Universidad de Oviedo, 33006 Oviedo, Spain
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12
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Ghasemian Nafchi H, Azizi Y, Amjadi F, Halvaei I. In vitro effects of plasma rich in growth factors on human teratozoospermic semen samples. Syst Biol Reprod Med 2023:1-9. [PMID: 36919463 DOI: 10.1080/19396368.2023.2180455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
There is a correlation between teratozoospermia and production of reactive oxygen species leading to poor assisted reproductive techniques outcomes. This study aimed to examine the effect of plasma-rich in growth factors (PRGF) on teratozoospermic samples. Twenty-five teratozoospermic samples were included in this study. After sperm preparation, it was divided into four groups, including 0 (control), 1, 5, and 10% PRGF. Sperm motility, viability (eosin-nigrosin staining), morphology (Papanicolaou staining), DNA fragmentation (sperm chromatin dispersion test), mitochondrial membrane potential (JC-1 staining by flow cytometry), and lipid peroxidation (measurement of malondialdehyde, MDA) were evaluated before and after 1 h of incubation with or without PRGF. Our results showed that after 1 h of incubation, the addition of 1% PRGF improved sperm progressive motility (47.72 ± 13.76%) compared to the control group (17.36 ± 8.50%) (p < 0.001). Also, 1% PRGF preserved the sperm's total motility (77.50 ± 13.28% vs. 65.63 ± 19.03%, for 1% PRGF and control, respectively) and viability after incubation. The rate of normal sperm morphology was the same between different groups. Higher mitochondrial membrane potential and lower DNA fragmentation were also observed in sperm treated with different concentrations of PRGF compared to the control group, but the differences were non-significant. The MDA levels were significantly decreased in PRGF-treated groups compared to the control group (0.99 ± 0.62, 0.95 ± 0.33, 0.95 ± 0.79, and 1.49 ± 0.27 for 1% PRGF, 5% PRGF, 10% PRGF and control, respectively). Based on our results, it seems that PRGF incubation can improve sperm parameters and especially decrease the level of malondialdehyde as an indicator of oxidative stress, which is one of the main problems of teratozoospermic samples.
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Affiliation(s)
| | - Yaser Azizi
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amjadi
- Department of Anatomy, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Iman Halvaei
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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13
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Gabriel C, Marks DC, Henschler R, Schallmoser K, Burnouf T, Koh MBC. Eye drops of human origin-Current status and future needs: Report on the workshop organized by the ISBT Working Party for Cellular Therapies. Vox Sang 2023; 118:301-309. [PMID: 36847186 DOI: 10.1111/vox.13413] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Serum eye drops (SEDs) are used to treat ocular surface disease (OSD) and to promote ocular surface renewal. However, their use and production are not standardized, and several new forms of human eye drops have been developed. MATERIALS AND METHODS The International Society for Blood Transfusion Working Party (ISBT WP) for Cellular Therapies held a workshop to review the current types of eye drops of human origin (EDHO) status and provide guidance. RESULTS The ISBT WP for Cellular Therapies introduced the new terminology 'EDHO' to emphasize that these products are analogous to 'medical products of human origin'. This concept encompasses their source (serum, platelet lysate, and cord blood) and the increasingly diverse spectrum of clinical usage in ophthalmology and the need for traceability. The workshop identified the wide variability in EDHO manufacturing, lack of harmonized quality and production standards, distribution issues, reimbursement schemes and regulations. EDHO use and efficacy is established for the treatment of OSD, especially for those refractory to conventional treatments. CONCLUSION Production and distribution of single-donor donations are cumbersome and complex. The workshop participants agreed that allogeneic EDHO have advantages over autologous EDHO although more data on clinical efficacy and safety are needed. Allogeneic EDHOs enable more efficient production and, when pooled, can provide enhanced standardization for clinical consistency, provided optimal margin of virus safety is ensured. Newer products, including platelet-lysate- and cord-blood-derived EDHO, show promise and benefits over SED, but their safety and efficacy are yet to be fully established. This workshop highlighted the need for harmonization of EDHO standards and guidelines.
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Affiliation(s)
- Christian Gabriel
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria.,Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Vienna, Austria
| | - Denese C Marks
- Research and Development, The Australian Red Cross Lifeblood, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Reinhard Henschler
- Institute of Transfusion Medicine, University Hospital and Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Katharina Schallmoser
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University (PMU), Salzburg, Austria.,Department of Blood Group Serology and Transfusion Medicine, Universitätsklinikum, Salzburger Landeskliniken GesmbH (SALK), Salzburg, Austria
| | - Thierry Burnouf
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.,International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Mickey B C Koh
- Institute for Infection and Immunity, St. George's University of London, Cranmer Terrace, Jenner Wing, London, UK
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14
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Recovery of Corneal Innervation after Treatment in Dry Eye Disease: A Confocal Microscopy Study. J Clin Med 2023; 12:jcm12051841. [PMID: 36902628 PMCID: PMC10003258 DOI: 10.3390/jcm12051841] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
PURPOSE To analyze the changes in corneal innervation by means of in vivo corneal confocal microscopy (IVCM) in patients diagnosed with Evaporative (EDE) and Aqueous Deficient Dry Eye (ADDE) and treated with a standard treatment for Dry Eye Disease (DED) in combination with Plasma Rich in Growth Factors (PRGF). METHODS Eighty-three patients diagnosed with DED were enrolled in this study and included in the EDE or ADDE subtype. The primary variables analyzed were the length, density and number of nerve branches, and the secondary variables were those related to the quantity and stability of the tear film and the subjective response of the patients measured with psychometric questionnaires. RESULTS The combined treatment therapy with PRGF outperforms the standard treatment therapy in terms of subbasal nerve plexus regeneration, significantly increasing length, number of branches and nerve density, as well as significantly improving the stability of the tear film (p < 0.05 for all of them), and the most significant changes were located in the ADDE subtype. CONCLUSIONS the corneal reinnervation process responds in a different way depending on the treatment prescribed and the subtype of dry eye disease. In vivo confocal microscopy is presented as a powerful technique in the diagnosis and management of neurosensory abnormalities in DED.
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15
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Anitua E, Muruzabal F, de la Fuente M, Merayo-Lloves J, Alkhraisat MH. Development of a new plasma rich in growth factors membrane with improved optical properties. Ann Anat 2023; 248:152071. [PMID: 36801366 DOI: 10.1016/j.aanat.2023.152071] [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: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE The aim of the present work was to develop a fibrin membrane using plasma rich in growth factors (PRGF) technology with improved optical properties to be used for the treatment of ocular surface diseases. BASIC PROCEDURES Blood was drawn from three healthy donors, and the volume of PRGF obtained from each donor was divided into two main groups: i) PRGF or ii) platelet-poor plasma (PPP). Each membrane was then used pure or diluted to 90 %, 80 %, 70 %, 60 % and 50 %. The transparency of each of the different membranes was evaluated. The degradation and morphological characterization of each membrane was also performed. Finally, a stability study of the different fibrin membranes was performed. MAIN FINDINGS The transmittance test showed that the fibrin membrane with the best optical characteristics was obtained after removal of platelets and dilution of fibrin to 50 % (50 % PPP). No significant differences (p > 0.05) were observed between the different membranes in the fibrin degradation test. The stability test showed that the membrane at 50 % PPP retains its optical and physical characteristics after storage at - 20 °C for 1 month compared to storage at 4 °C. PRINCIPAL CONCLUSIONS The present study describes the development and characterization of a new fibrin membrane with improved optical characteristics while maintaining mechanical and biological characteristics. The physical and mechanical properties of the newly developed membrane are preserved after storage for at least 1 month at - 20 °C.
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Affiliation(s)
- Eduardo Anitua
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), Vitoria, Spain; Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain.
| | - Francisco Muruzabal
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), Vitoria, Spain; Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - María de la Fuente
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), Vitoria, Spain; Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Jesús Merayo-Lloves
- Instituto Oftalmológico Fernández-Vega. Fundación de Investigación Oftalmológica. Universidad de Oviedo, Oviedo, Spain
| | - Mohammad H Alkhraisat
- Regenerative Medicine Laboratory, Biotechnology Institute (BTI), Vitoria, Spain; Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
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16
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Anitua E, de la Fuente M, Sánchez-Ávila RM, de la Sen-Corcuera B, Merayo-Lloves J, Muruzábal F. Beneficial Effects of Plasma Rich in Growth Factors (PRGF) Versus Autologous Serum and Topical Insulin in Ocular Surface Cells. Curr Eye Res 2023; 48:456-464. [PMID: 36695530 DOI: 10.1080/02713683.2023.2173237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE In the last few decades, several blood derived products such as platelet-rich plasma (PRP), plasma rich in growth factors (PRGF) and autologous serum (AS) have been used for the treatment of ocular surface disorders. Recently, insulin has been proposed to be used as an alternative for the treatment of ocular surface diseases. The aim of this study was to evaluate the biological potential of PRGF eye drops in comparison with AS and insulin on ocular surface cells. METHODS Blood from three healthy young donors was collected to obtain autologous serum (AS) eye drops and plasma rich in growth factors (PRGF) eye drops. Insulin (Actrapid®) was diluted at 1 and 0.2 IU/mL. The biological potential of PRGF, AS and insulin was assessed by proliferation in HCE, HK and HConF cells. Wound healing assay was performed in HCE cells after incubation with the different treatments. HConF and HK cells were differentiated to myofibroblast after treatment with 2.5 ng/mL of TGF-β1 and then incubated with all treatments. RESULTS PRGF eye drops induced significantly higher proliferation rate compared to AS or insulin in HConF and HK cells, but not in HCE cells. In addition, the percentage of wound healing area was significantly reduced after PRGF treatment in comparison with AS or insulin treatment. Furthermore, PRGF significantly reduced the number of myodifferentiated cells compared to AS and insulin at both concentrations analyzed. CONCLUSION The results obtained in the present study show that PRGF increases the biological activity of the ocular surface cells and reduces the expression of fibrosis marker compared to insulin or AS. TRANSLATIONAL RELEVANCE The present study suggests that plasma rich in growth factors eye drops are a more effective therapy than insulin and autologous serum eye drops for the treatment of ocular surface diseases.
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Affiliation(s)
- Eduardo Anitua
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - María de la Fuente
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | | | - Borja de la Sen-Corcuera
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Universidad de Oviedo, Oviedo, Spain.,Fundación para la Investigación y la Innovación Biosanitaria de Asturias (FINBA), Oviedo, Spain
| | - Francisco Muruzábal
- BTI Biotechnology Institute, Vitoria, Spain.,University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
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17
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Xu L, Wang H, Luo L, Deng J, Chen F, Wang Y, Tang J, Wu Z, Zhou Q, Chen J. Aspartic acid and epidermal growth factor modified decellularized rabbit conjunctiva for conjunctival reconstruction. BIOMATERIALS ADVANCES 2022; 143:213164. [PMID: 36343391 DOI: 10.1016/j.bioadv.2022.213164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 08/31/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Conjunctival reconstruction is an indispensable part of ocular surface regeneration. Decellularized matrix has been considered as an ideal conjunctival substitution for conjunctival reconstruction. In the present study, we report the use of a decellularized rabbit conjunctiva (DRC) for conjunctival reconstruction in the rabbit surgical trauma model. Prepared by the phospholipase A2 decellularized method, the DRC was nearly DNA free while the collagen structure and natural extracellular matrix (ECM) were well preserved. In order to improve the performance of DRC, aspartic acid (Asp) was used as a spacer arm to crosslink epidermal growth factor (EGF) on the DRC to obtain DRC-Asp-EGF. The conjunctival epithelial cells cultured on the DRC-Asp-EGF showed a higher survival rates and a greater potential to differentiate into conjunctival goblet cells (CGCs) than those on the DRC. Finally, three groups were set to evaluate the transplantation effects in the rabbit surgical trauma model for 28 days: DRC-Asp-EGF group, amniotic membrane (AM) group, and ungrafted group. The DRC-Asp-EGF group was completely re-epithelized, and more CGCs were regenerated than the AM group, while no significant improvements were observed in the ungrafted group. Intact collagen structure, angiogenesis, and no scar formation were also observed in the DRC-Asp-EGF group. These results suggest that DRC-Asp-EGF is a feasible and effective transplant for conjunctival reconstruction and ocular surface regeneration.
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Affiliation(s)
- Liling Xu
- Key Laboratory for Regenerative Medicine, Ministry of Education, Department of Developmental and Regenerative Biology, Jinan University, Guangzhou, China
| | - Hua Wang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lishi Luo
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China; Shenzhen Eye Hospital, Affiliated Hospital of Jinan University, Shenzhen, China
| | - Jingyue Deng
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Ophthalmology, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Fangyuan Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yingwei Wang
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Junjie Tang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zheng Wu
- Key Laboratory for Regenerative Medicine, Ministry of Education, Department of Developmental and Regenerative Biology, Jinan University, Guangzhou, China.
| | - Qing Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Jian Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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18
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Mini-Conjunctival Limbal Autograft (Mini-CLAU) Using Platelet-Rich Plasma Eye Drops (E-PRP): A Case Series. Cornea 2022:00003226-990000000-00145. [PMID: 36730781 DOI: 10.1097/ico.0000000000003156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/14/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of this study was to introduce a new method of limbal stem cell transplantation using autologous platelet-rich plasma (E-PRP) eye drops for unilateral total limbal stem cell deficiency. METHODS Patients with total unilateral limbal stem cell deficiency due to chemical burn underwent mini-conjunctival limbal autograft using autologous E-PRP drops. One small limbal block, measuring 2 × 2 mm, was harvested from the patients' contralateral healthy eye and transplanted to the diseased eye. All patients received E-PRP drops until achieving complete corneal epithelialization. Subsequent corneal transplantation was performed in eyes with significant stromal opacification. Corneal buttons obtained during corneal transplantation underwent immunohistochemistry for the evaluation of limbal stem cell markers (ABCG2 and P63). Visual acuity, epithelial healing, corneal clarity, and regression of corneal conjunctivalization/vascularization were evaluated after surgery. RESULTS Ten patients with acid (n = 7) or alkali (n = 3) burn were included. The mean follow-up period was 21.7 ± 5.8 months (range, 12-32 months). Corneas were completely reepithelialized within 14.9 ± 3.5 days (range, 11-21 days). Corneal conjunctivalization/vascularization dramatically regressed 1 to 2 months after surgery in all cases, and corneal clarity considerably improved in 7 patients. In the 3 eyes with significant stromal opacification, subsequent optical penetrating keratoplasty was performed. The ocular surface was stable throughout the follow-up period in all eyes. BSCVA improved to 0.60 ± 0.0.32 and 0.46 ± 0.0.25 logMAR in eyes with and without corneal transplantation, respectively, at the final follow-up visit. ABCG2 and P63 markers were detected on corneal buttons after keratoplasty. CONCLUSIONS Based on our clinical and laboratory findings, mini-conjunctival limbal autograft using E-PRP can be considered as a promising alternative to ocular surface reconstruction.
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Król-Grzymała A, Sienkiewicz-Szłapka E, Fiedorowicz E, Rozmus D, Cieślińska A, Grzybowski A. Tear Biomarkers in Alzheimer's and Parkinson's Diseases, and Multiple Sclerosis: Implications for Diagnosis (Systematic Review). Int J Mol Sci 2022; 23:10123. [PMID: 36077520 PMCID: PMC9456033 DOI: 10.3390/ijms231710123] [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: 07/27/2022] [Revised: 08/19/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Biological material is one of the most important aspects that allow for the correct diagnosis of the disease, and tears are an interesting subject of research because of the simplicity of collection, as the well as the relation to the components similar to other body fluids. In this review, biomarkers for Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS) in tears are investigated and analyzed. Records were obtained from the PubMed and Google Scholar databases in a timeline of 2015-2022. The keywords were: tear film/tear biochemistry/tear biomarkers + diseases (AD, PD, or MS). The recent original studies were analyzed, discussed, and biomarkers present in tears that can be used for the diagnosis and management of AD, PD, and MS diseases were shown. α-synTotal and α-synOligo, lactoferrin, norepinephrine, adrenaline, epinephrine, dopamine, α-2-macroglobulin, proteins involved in immune response, lipid metabolism and oxidative stress, apolipoprotein superfamily, and others were shown to be biomarkers in PD. For AD as potential biomarkers, there are: lipocalin-1, lysozyme-C, and lacritin, amyloid proteins, t-Tau, p-Tau; for MS there are: oligoclonal bands, lipids containing choline, free carnitine, acylcarnitines, and some amino acids. Information systematized in this review provides interesting data and new insight to help improve clinical outcomes for patients with neurodegenerative disorders.
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Affiliation(s)
- Angelika Król-Grzymała
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | | | - Ewa Fiedorowicz
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Dominika Rozmus
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Anna Cieślińska
- Faculty of Biology and Biotechnology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 10-719 Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61-553 Poznan, Poland
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Anitua E, Pino A, Azkargorta M, Elortza F, Merayo-Lloves J, Muruzabal F. Differential Protein Content between Fresh and Freeze-Dried Plasma Rich in Growth Factors Eye Drops. Biomolecules 2022; 12:biom12091215. [PMID: 36139054 PMCID: PMC9496081 DOI: 10.3390/biom12091215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to analyze the proteomic composition of plasma rich in growth factors eye drops (PRGF) in comparison to lyophilized PRGF eye drops (PRGF lyo). The differential protein expression of keratocyte (HK) cells after PRGF or PRGF lyo treatment was also determined. Blood from different donors was collected and processed to obtain PRGF and PRGF lyo eye drops. Then, HK cells were treated with both formulations. A proteomic analysis was performed to evaluate the differential proteomic profile between PRGF and PRGF lyo, and the differential protein expression by HK cells after treatment with both blood-derived products. About 280 proteins were detected between both blood-derived formulation, with only 8 of them reaching significant differences. Furthermore, 101 out of 3213 proteins showed statistically significant deregulation in HK cells after treatment with PRGF or PRGF lyo. Gene Ontology analysis showed that these significant deregulated proteins were involved in 30 functional processes. However, the Ingenuity Pathway Analysis showed that no significant differences were found in any of the identified processes. In summary, the present study show that no significant differences were found in the proteomic profile or in the signaling pathways activation in HK cells between PRGF and PRGF lyo.
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Affiliation(s)
- Eduardo Anitua
- BTI—Biotechnology Institute, 01007 Vitoria, Spain
- Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
- Correspondence:
| | - Ander Pino
- BTI—Biotechnology Institute, 01007 Vitoria, Spain
- Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160 Derio, Spain
| | - Felix Elortza
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160 Derio, Spain
| | - Jesús Merayo-Lloves
- Fundación de Investigación Oftalmológica, Instituto Oftalmológico Fernández-Vega, 33012 Oviedo, Spain
| | - Francisco Muruzabal
- BTI—Biotechnology Institute, 01007 Vitoria, Spain
- Research and Development Department, University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
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García-Millan C, Pino A, Rodrigues R, Segurado-Miravalles G, Alegre-Sánchez A, Jaén P, Anitua E. An Autologous Topical Serum Derived from Platelet-Rich Plasma Therapy for the Management of Sensitive Skin Alterations: A Case Series Report. Clin Cosmet Investig Dermatol 2022; 15:2077-2086. [PMID: 36199385 PMCID: PMC9528915 DOI: 10.2147/ccid.s379323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022]
Abstract
Background Although the underlying pathophysiology of sensitive skin remains unknown, it presents clinical symptoms like erythema, burning and dryness associated with other inflammatory dermatoses such as dermatitis or rosacea. Objective The aim of the present report was to provide preliminary data about the efficacy of Endoret-Serum (ES) as an autologous therapy for the topical management of sensitive skin alterations. Materials and Methods Five patients underwent a daily topical ES treatment that was maintained for three months. Clinical assessment was carried out using validated dermatological surveys (DLQI, IGA, Likert, PGI-I). Additionally, skin hydration measurement and high-resolution topographic and reflectance confocal imaging analysis were carried out. Results No adverse events were observed during the treatment. At the end of the follow-up period, surveys highlighted a significant therapeutic effect compared to baseline. Skin hydration was also improved, and topographic images showed a decrease in patient’s underlying inflammatory and vascular condition. Conclusion This preliminary report suggests that Endoret-Serum may be useful in the management of clinical symptoms derived from sensitive skin alterations.
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Affiliation(s)
| | - Ander Pino
- BTI Biotechnology Institute, Vitoria, Spain
| | | | | | | | - Pedro Jaén
- Grupo de Dermatología Pedro Jaén, Madrid, Spain
- University Hospital Ramon y Cajal, Madrid, Spain
| | - Eduardo Anitua
- BTI Biotechnology Institute, Vitoria, Spain
- Correspondence: Eduardo Anitua, BTI Biotechnology Institute, Jacinto Quincoces 39, Vitoria, Spain, Email
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22
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Wang M, Yennam S, Pflugfelder S. Initial experiences using plasma rich in growth factors to treat keratoneuralgia. Front Med (Lausanne) 2022; 9:946828. [PMID: 36091697 PMCID: PMC9448984 DOI: 10.3389/fmed.2022.946828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/01/2022] [Indexed: 11/22/2022] Open
Abstract
Keratoneuralgia, a clinical diagnosis of sensitized corneal pain without visible ocular surface damage, generally has minimal response to conventional therapies. Causes include refractive surgery and chronic dry eye. We evaluated the efficacy of Plasma Rich in Growth Factors (PRGF), a novel treatment prepared using a commercially available kit, in patients with keratoneuralgia. A retrospective chart review identified patients who had the clinical diagnosis of keratoneuralgia and were treated with PRGF for at least 3 months from October 2015 to April 2020 at a single academic institution. Both objective eye exam findings and concurrent treatments were obtained at baseline, 3 months, and final visit (if available). A questionnaire was administered to identified patients, including symptoms scores measured with a visual analog scale. The results of this survey and other objective findings were compared before and after PRGF treatment. 16 out of 32 patients (50%) with a mean follow-up period of 33 ± 26 months answered the questionnaire. Refractive surgeries were the cause of keratoneuralgia in 14 patients (87.5%), with LASIK the most common procedure (11 patients, 69%). There were no adverse events recorded or reported. Symptom scored by VAS in a modified Symptoms Assessment in Dry Eye questionnaire significantly decreased after PRGF use (85 ± 16 to 45 ± 33, p = 0.0002). Ten patients (63%) reported PRGF is superior to other therapy and would recommend to others. There were no significant trends in visual acuity, objective exam findings, or concurrent treatments after PRGF treatment. PRGF is safe and can potentially alleviate symptoms in patients with keratoneuralgia, a rare but devastating complication after refractive surgery. Prospective trial is indicated to explore PRGF as a potentially useful treatment for keratoneuralgia.
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Mohammed MA, Allam IY, Shaheen MS, Lazreg S, Doheim MF. Lacrimal gland injection of platelet rich plasma for treatment of severe dry eye: a comparative clinical study. BMC Ophthalmol 2022; 22:343. [PMID: 35964112 PMCID: PMC9375917 DOI: 10.1186/s12886-022-02554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background We aimed to assess the efficacy of the injections of platelet rich plasma (PRP) for the treatment of severe dry eye disease (DED). Results In this retrospecitve interventional clinincal study, we included 28 eyes of 14 patients with severe DED who were diagnosed with Sjogren syndrome. Each patient received unilateral lacrimal gland injection of PRP at days 0, 30, 60 and 90 days while the other eye served as control group who received preservative free eye drops. We objectively assessed parameters at baseline, 1 month, 2 months and 3 months including ocular surface analyzer (OSA) namely; noninvasive tear breakup times (NIBUT), tear meniscus height (TMH), lipid layer thickness (LLT) in addition to the Schirmer test I, corneal fluorescein staining (CFS) and meiboscore. The mean age was 43.4 ± .7.85 years. Comparing different parameters, baseline data showed non-significant difference between injected eye group and control group. After 1 and 3 months of follow up, there were significant differences between both groups regarding NITBUT, TMH, LLT, CFS and Schirmer test, with p < 0.001 in favor of PRP group. Conclusion Injection of PRP in lacrimal gland is simple, safe, and effective technique in treatment of severe dry eye; proved by improvement of tear film parameters through subjective and objective assessment. Further studies are needed to standardize the technique and to confirm these results.
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Affiliation(s)
- Mai A Mohammed
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Ibrahim Y Allam
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Sihem Lazreg
- Cabinet Ophtalmologie, Alger Centre, Algiers, Algeria
| | - Mohamed Fahmy Doheim
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Effects of Autologous Platelet-Rich Plasma on Healing of Peptic Ulcers: A Randomized Controlled Trial. Gastroenterol Res Pract 2022; 2022:7944849. [PMID: 35873352 PMCID: PMC9307395 DOI: 10.1155/2022/7944849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Peptic ulcer is a multifactorial and complex disease and affects a wide range of people worldwide. We provided a novel therapeutic approach for peptic ulcer and observed its effect. Methods Peptic ulcer patients were enrolled from 2016 to 2017 in Chongqing and randomly assigned to two groups: a control group that used only rabeprazole and a platelet-rich plasma (PRP) group that received a combination therapy of autologous PRP (aPRP) and rabeprazole. The therapeutic effect was assessed via the ulcer size and symptom score. Results A total of 27 patients were included (12 patients in the control group and 15 patients in the PRP group) in this study. Our results showed that all participants have healed in 30 days, and there was no significant difference in healing time between the PRP group and the control group in different independent variables. However, regression analysis revealed that the healing time was 6.99 days shorter in the PRP group than that in the control group, and patients with higher symptom scores in the initial examination need more time to heal during treatment. Endoscopic results showed that the repaired ulcer in the PRP group was more similar to the normal gastric mucosa tissue than that the control group. Conclusion This study showed an encouraging preliminary result that aPRP has a positive result in patients with peptic ulcer and seems to be a better choice for refractory peptic ulcer treatment. Although further follow-up studies are needed to determine the duration of efficacy of aPRP, the approach will be helpful in improving the clinical treatment of peptic ulcer.
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25
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Surgical Techniques for Refractory Macular Holes. Int Ophthalmol Clin 2022; 62:103-117. [PMID: 35752889 DOI: 10.1097/iio.0000000000000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Comparison of epitheliotrophic factors in platelet-rich plasma versus autologous serum and their treatment efficacy in dry eye disease. Sci Rep 2022; 12:8906. [PMID: 35618742 PMCID: PMC9135723 DOI: 10.1038/s41598-022-12879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Current treatment of severe dry eye disease (DED) includes blood-derived eye drops, such as autologous serum (AS), which lubricate the eyes and provide factors that improve ocular surface and aid in wound healing. Recent studies indicated that platelet-rich plasma (PRP) was also effective. This study aims to compare the concentration and stability of epitheliotrophic factors in AS and PRP and their efficacy in DED patients. Epitheliotrophic factors of interest are epidermal growth factor (EGF), fibronectin, platelet-derived growth factor-AB (PDGF-AB), and transforming growth factor-beta1 (TGF-β1). We determined that all epitheliotrophic factors were present in AS and PRP at baseline and did not decrease in concentrations in all storage conditions (4 °C for 1 week and at − 20 °C for 1 and 3 months). However, differences in concentrations in AS and PRP were observed. PRP was also shown not to be inferior to AS in terms of efficacy in DED treatment in a prospective randomized control trial which evaluated ocular surface disease index, dry eye questionnaire, ocular surface staining, tear breakup time, and Schirmer test at baseline and at 1-month follow-up. Therefore, with its shorter preparation time, PRP could be considered as an alternative to AS for the treatment of DED.
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27
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Magistretti P, Bertossi D, Pirayesh A, Magistretti A, Chirumbolo S. Exokine and the Youth-Boosting Treatment Based on One's Own Serum: Wheat and Chaff. Facial Plast Surg 2022; 38:177-181. [PMID: 35453156 DOI: 10.1055/s-0042-1747970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Within the field of skin rejuvenation, clinicians have broadened the application of proven therapies toward antiaging medicine. Specifically, both platelet-rich plasma (PRP) and autologous-conditioned serum (ACS) have received great consideration among experts for novel indications. While the medical research focused on ACS is strengthened in their evidence and supported by promising outcomes, much more debates exist regarding the efficacy of PRP. Despite limited supporting literature to date, physicians and surgeons should be encouraged to explore the use of these approaches and in shedding further light on their potential benefits by contributing new evidence from basic and clinical scientific investigation.
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Affiliation(s)
| | - Dario Bertossi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology and Head of Maxillofacial Plastic Surgery Unit, University of Verona, Italy
| | - Ali Pirayesh
- Amsterdam Plastic Surgery, Amsterdam, The Netherlands
| | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
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Brief incubation of corneal grafts in activated platelet rich plasma enhances corneal endothelial cell survival and regeneration. Exp Eye Res 2022; 220:109100. [DOI: 10.1016/j.exer.2022.109100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/28/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
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Acera A, Abad B, Pereiro X, Rodríguez FD, Ruzafa N, Duran JA, Vecino E. Comparative study of the lipid profile of tears and plasma enriched in growth factors. Exp Eye Res 2022; 219:109061. [DOI: 10.1016/j.exer.2022.109061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 01/05/2023]
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30
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Yang Y, Lockwood A. Topical ocular drug delivery systems: Innovations for an unmet need. Exp Eye Res 2022; 218:109006. [DOI: 10.1016/j.exer.2022.109006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/06/2022] [Accepted: 02/20/2022] [Indexed: 02/07/2023]
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Plasma Rich in Growth Factors in Macular Hole Surgery. Clin Pract 2022; 12:57-69. [PMID: 35076502 PMCID: PMC8788286 DOI: 10.3390/clinpract12010007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/15/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to evaluate the use of PRGF (plasma rich in growth factors) as an adjuvant to PPV (pars plana vitrectomy) in recurrent, persistent, or poor prognosis MH (macular hole). Patients with MH were treated with PPV plus adjuvant therapy (PRGF membrane (mPRGF) and injectable liquid PRGF (iPRGF)). The anatomical closure of MH and postoperative BCVA (best-corrected visual acuity) were evaluated. Eight eyes (eight patients) were evaluated: myopic MH (MMH, n = 4), idiopathic MH (IMH, n = 2), iatrogenic n = 1, traumatic n = 1. The mean age was 53.1 ± 19.3 years. Hence, 66.7% (n = 4) of patients previously had internal limiting membrane peeling. Five patients (62.5%) received mPRGF and iPRGF, and three patients (37.5%) received iPRGF. Gas tamponade (C3F8) was placed in seven cases and one case of silicone oil. Anatomic closure of MH was achieved in seven eyes (87.5%) and BCVA improved in six cases. In the MMH group, visual acuity improved in two lines of vision. Follow-up time was 27.2 ± 9.0 months. No adverse events or MH recurrences were recorded during follow-up. The use of PRGF as an adjuvant therapy to PPV can be useful to improve anatomical closure and visual acuity in MH surgery.
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Hirabayashi T, Shibato J, Kimura A, Yamashita M, Takenoya F, Shioda S. Potential Therapeutic Role of Pituitary Adenylate Cyclase-Activating Polypeptide for Dry Eye Disease. Int J Mol Sci 2022; 23:664. [PMID: 35054857 PMCID: PMC8775530 DOI: 10.3390/ijms23020664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 12/27/2022] Open
Abstract
Dry eye disease (DED) is caused by a reduction in the volume or quality of tears. The prevalence of DED is estimated to be 100 million in the developed world. As aging is a risk factor for DED, the prevalence of DED is expected to grow at a rapid pace in aging populations, thus creating an increased need for new therapies. This review summarizes DED medications currently in clinical use. Most current medications for DED focus on stimulating tear secretion, mucin secretion, or suppressing inflammation, rather than simply replenishing the ocular surface with moisture to improve symptoms. We recently reported that the neuropeptide PACAP (pituitary adenylate cyclase-activating polypeptide) induces tear secretion and suppresses corneal injury caused by a reduction in tears. Moreover, it has been reported that a PACAP in water and a 0.9% saline solution at +4 °C showed high stability and achieved 80-90% effectiveness after 2 weeks of treatment. These results reveal PACAP as a candidate DED medication. Further research on the clinical applications of PACAP in DED is necessary.
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Affiliation(s)
- Takahiro Hirabayashi
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Junko Shibato
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Ai Kimura
- Clinical Medicine Research Laboratory, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
| | - Michio Yamashita
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Fumiko Takenoya
- Department of Physiology and Molecular Sciences, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
| | - Seiji Shioda
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, 16-48, Kamishinano, Totsuka-ku, Yokohama 244-0806, Japan
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Membrane of Plasma Rich in Growth Factors in Primary Pterygium Surgery Compared to Amniotic Membrane Transplantation and Conjunctival Autograft. J Clin Med 2021; 10:jcm10235711. [PMID: 34884413 PMCID: PMC8658705 DOI: 10.3390/jcm10235711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/24/2021] [Accepted: 12/04/2021] [Indexed: 12/20/2022] Open
Abstract
This prospective and comparative study aimed to compare the use of a conjunctival autograft (CAG), plasma rich in growth factors fibrin membrane (mPRGF) or amniotic membrane transplantation (AMT) in primary pterygium surgery. Patients were assigned for surgery with CAG (group A), mPRGF (group B), or AMT (group C). Pterygium recurrence, Best Corrected Visual Acuity (BCVA), graft size (measured with anterior segment optical coherence tomography (AS-OCT)), and ocular surface symptoms (visual analogue scale (VAS) and ocular surface disease index (OSDI)) were evaluated. Thirteen eyes in group A, 26 in group B, and 10 in group C were evaluated. No changes in BCVA (p > 0.05) were found. Recurrence cases for groups A, B, and C were none, two, and two, respectively, and three cases of pyogenic granulomas in group A. The horizontal/vertical graft size was lower in group B vs group A (p < 0.05) from months 1 to 12. The improvement in VAS frequency for groups A, B, and C was: 35.5%, 86.2%, and 39.1%, respectively. The OSDI scale reduction for groups A, B, and C was: 12.7%, 39.0%, and 84.1%. The use of the three surgical techniques as a graft for primary pterygium surgery was safe and effective, showing similar results. The mPRGF graft represents an autologous novel approach for pterygium surgery.
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Hagenau F, Luft N, Nobl M, Vogt D, Klaas JE, Schworm B, Siedlecki J, Kreutzer TC, Priglinger SG. Improving morphological outcome in lamellar macular hole surgery by using highly concentrated autologous platelet-rich plasma. Graefes Arch Clin Exp Ophthalmol 2021; 260:1517-1524. [PMID: 34870734 PMCID: PMC9007791 DOI: 10.1007/s00417-021-05486-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose To evaluate the use of highly concentrated autologous platelet-rich plasma (PRP) in lamellar macular hole (LMH) surgery with regard to function and morphology. Methods We included 12 eyes of 12 patients with progressive LMH in this interventional case series. After 23/25-gauge pars plana vitrectomy, 0.1ml highly concentrated autologous platelet-rich plasma was applied under air tamponade. Induction of posterior vitreous detachment and peeling of tractive epiretinal membranes were performed whenever present. Phacovitrectomy was undertaken in cases of phakic lens status. Postoperatively, all patients were instructed to rest in a supine position for the first two postoperative hours. Best-corrected visual acuity (BCVA) testing, microperimetry, spectral-domain optical coherence tomography (SD-OCT), and fundus photography were carried out preoperatively and 6 months postoperatively. Results Foveal configuration was restored in 10 of 12 patients (83.3%) at 6 months postoperatively. Two patients who had not undergone ILM peeling showed a recurring defect at 6-month follow-up. Best-corrected visual acuity improved significantly from 0.29 ± 0.08 to 0.14 ± 0.13 logMAR (Wilcoxon: p=0.028). Microperimetry remained unchanged (23.38 ± 2.53 preoperatively; 23.0 ± 2.49 dB postoperatively; p=0.67). No patient experienced vision loss after surgery, and no significant intra- or postoperative complications occurred. Conclusion The application of PRP in the surgical therapy of LMH results in good morphological and functional outcomes. Additional peeling of the ILM seems to be mandatory when using PRP to prevent the recurrence of LMH. Strict postoperative supine positioning for 2 h avoids PRP dislocation. Larger sample sizes are needed to confirm the results.
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Affiliation(s)
- Felix Hagenau
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Nikolaus Luft
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Matthias Nobl
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Denise Vogt
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Julian E Klaas
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Benedikt Schworm
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Jakob Siedlecki
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Thomas C Kreutzer
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany
| | - Siegfried G Priglinger
- University Eye Hospital, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany.
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Preparation and growth factor characterization of cord blood-derived plasma, serum, growth factor-rich plasma and induced serum. Cytokine 2021; 149:155756. [PMID: 34763157 DOI: 10.1016/j.cyto.2021.155756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND In recent years, there has been a significant decline in the demand for cord blood units (CBUs). This trend has led to cord blood banks (CBBs) exploring complementary uses of CBUs in order to exploit the full potential of this unique, valuable, and readily available product. The aim of this study was to establish standardized protocols for the preparation of four cord blood (CB) derivatives: plasma (CB-P), serum (CB-S), induced-serum (CB-IS) and growth factor-rich plasma (GFRP); to measure their respective growth-factor content and their potential as cell culture supplements, and finally, to identify the characteristics of each derivative beyond their growth-factor composition, in the context of optimizing CBBs resources. STUDY DESIGN AND METHOD To this end, CB plasma and serum were prepared and their concentrations for ten growth factors (TGF-β1, TGF-β2, TGF-β3, EGF, HGF, PDGF-BB, VEGF-A, VEGF-D, IGF-I, IGF-II) were determined using a multiplex bead array, and compared to adult plasma and serum. Protocols for the preparation of CB-IS and GFRP with reverse anticoagulation using CaCl2·2H2O were also established, and all four derivatives were compared for their EGF and TGF-β1 content by enzyme-linked immunosorbent assay (ELISA), and also for their cell culture supplement capacity. RESULTS CB plasma was shown to be richer than adult plasma for TGF-β2 and TGF-β3, with a lower concentration of IGF-I and IGF-II. CB serum was shown to be richer than adult serum for TGF-β2, TGF-β3, EGF, HGF, PDGF-BB, and VEGF-A and D, and poorer in IGF-I and II. The measure of EGF and TGF-β1 concentrations has shown that CB serum is the most concentrated (1874 pg/ml and 41 094 pg/ml) of the CB derivatives, followed by induced-serum (405 pg/ml and 16 735 pg/ml), growth factor-rich plasma (131 and 7947 pg/ml) and plasma (8 and 2845 pg/ml). All four CB derivatives were shown to be superior to FBS in sustaining cell growth at low doses. CONCLUSION Our study shows that four CB derivatives can be easily prepared and pooled to provide significant volume of products that vary in their growth factor composition. A cord blood bank interested in introducing such manufacturing will need to evaluate the financial and processing characteristics of each derivative. The use of standardized manufacturing protocols such as the ones we suggest could help research initiatives exploring the potential therapeutic uses of such rich and high-quality starting material.
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Anitua E, Muruzabal F, Pino A, Prado R, Azkargorta M, Elortza F, Merayo-Lloves J. Proteomic Characterization of Plasma Rich in Growth Factors and Undiluted Autologous Serum. Int J Mol Sci 2021; 22:ijms222212176. [PMID: 34830053 PMCID: PMC8618701 DOI: 10.3390/ijms222212176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022] Open
Abstract
Over the last three decades, there has been special interest in developing drugs that mimic the characteristics of natural tears for use it in the treatment of several ocular surface disorders. Interestingly, the composition of blood plasma is very similar to tears. Therefore, different blood-derived products like autologous serum (AS) and plasma rich in growth factors (PRGF) have been developed for the treatment of diverse ocular pathologies. However, scarce studies have been carried out to analyze the differences between both types of blood-derived products. In the present study, blood from three healthy donors was drawn and processed to obtain AS and PRGF eye drops. Then, human corneal stromal keratocytes (HK) were treated with PRGF or undiluted AS. Proteomic analysis was carried out to analyze and characterize the differential protein profiles between PRGF and AS, and the differentially expressed proteins in HK cells after PRGF and AS treatment. The results obtained in the present study show that undiluted AS induces the activation of different pathways related to an inflammatory, angiogenic, oxidative stress and scarring response in HK cells regarding PRGF. These results suggest that PRGF could be a better alternative than AS for the treatment of ocular surface disorders.
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Affiliation(s)
- Eduardo Anitua
- BTI—Biotechnology Institute, 01007 Vitoria, Spain; (F.M.); (A.P.); (R.P.)
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
- Correspondence:
| | - Francisco Muruzabal
- BTI—Biotechnology Institute, 01007 Vitoria, Spain; (F.M.); (A.P.); (R.P.)
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Ander Pino
- BTI—Biotechnology Institute, 01007 Vitoria, Spain; (F.M.); (A.P.); (R.P.)
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Roberto Prado
- BTI—Biotechnology Institute, 01007 Vitoria, Spain; (F.M.); (A.P.); (R.P.)
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160 Derio, Spain; (M.A.); (F.E.)
| | - Felix Elortza
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, 48160 Derio, Spain; (M.A.); (F.E.)
| | - Jesús Merayo-Lloves
- Instituto Oftalmológico Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33012 Oviedo, Spain;
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Anitua E, Zalduendo M, Troya M, Tierno R, Alkhraisat MH. The inclusion of leukocytes into platelet rich plasma reduces scaffold stability and hinders extracellular matrix remodelling. Ann Anat 2021; 240:151853. [PMID: 34767933 DOI: 10.1016/j.aanat.2021.151853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/14/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Scaffolds should have controllable degradation rate and allow cells to produce their own extracellular matrix. Platelet rich plasma (PRP) is a source of autologous growth factors and proteins embedded in a 3D fibrin scaffold. There is no consensus regarding the obtaining conditions and composition of PRPs. The aim of this study was to evaluate how the inclusion of leukocytes (L-PRP) in plasma rich in growth factors (PRGF) may alter the process of fibrinolysis. The effect of different combinations of cellular phenotypes with PRGF and L-PRP clots on both the fibrinolysis and matrix deposition process was also determined. METHODS PRGF and L-PRP clots were incubated for 14 days and D-dimer and type I collagen were determined in their conditioned media to evaluate clots' stability. For remodelling assays, gingival fibroblasts, alveolar osteoblasts and human umbilical vein endothelial cells (HUVEC) were seeded onto the two types of clots for 14 days. D-dimer, type I collagen, and laminin α4 were measured by ELISA kits in their conditioned media. Morphological and histological analysis were also performed. Cell proliferation was additionally determined RESULTS: PRGF clots preserved their stability as shown by the low levels of both D-dimer and collagen type I compared to those obtained for L-PRP clots. The inclusion of both gingival fibroblasts and alveolar osteoblasts stimulated a higher fibrinolysis in the PRGF clots. In contrast to this, the degradation rates of both PRGF and L-PRP clots remained unchanged after culturing with the endothelial cells. In all cases, type I collagen and laminin α4 levels were in line with the degree of clots' degradation. In all phenotypes, cell proliferation was significantly higher in PRGF than in L-PRP clots. CONCLUSION The inclusion of leukocytes in PRGF scaffolds reduced their stability, decreased cell number and slowed down cell remodelling.
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Affiliation(s)
- Eduardo Anitua
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain.
| | - Mar Zalduendo
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | | | - Roberto Tierno
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Mohammad H Alkhraisat
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine & Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
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Parker BJ, Rhodes DI, O'Brien CM, Rodda AE, Cameron NR. Nerve guidance conduit development for primary treatment of peripheral nerve transection injuries: A commercial perspective. Acta Biomater 2021; 135:64-86. [PMID: 34492374 DOI: 10.1016/j.actbio.2021.08.052] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
Commercial nerve guidance conduits (NGCs) for repair of peripheral nerve discontinuities are of little use in gaps larger than 30 mm, and for smaller gaps they often fail to compete with the autografts that they are designed to replace. While recent research to develop new technologies for use in NGCs has produced many advanced designs with seemingly positive functional outcomes in animal models, these advances have not been translated into viable clinical products. While there have been many detailed reviews of the technologies available for creating NGCs, none of these have focussed on the requirements of the commercialisation process which are vital to ensure the translation of a technology from bench to clinic. Consideration of the factors essential for commercial viability, including regulatory clearance, reimbursement processes, manufacturability and scale up, and quality management early in the design process is vital in giving new technologies the best chance at achieving real-world impact. Here we have attempted to summarise the major components to consider during the development of emerging NGC technologies as a guide for those looking to develop new technology in this domain. We also examine a selection of the latest academic developments from the viewpoint of clinical translation, and discuss areas where we believe further work would be most likely to bring new NGC technologies to the clinic. STATEMENT OF SIGNIFICANCE: NGCs for peripheral nerve repairs represent an adaptable foundation with potential to incorporate modifications to improve nerve regeneration outcomes. In this review we outline the regulatory processes that functionally distinct NGCs may need to address and explore new modifications and the complications that may need to be addressed during the translation process from bench to clinic.
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Affiliation(s)
- Bradyn J Parker
- Department of Materials Science and Engineering, Monash University, 22 Alliance Lane, Clayton, Victoria 3800, Australia; Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Research Way, Clayton, Victoria 3168, Australia
| | - David I Rhodes
- Department of Materials Science and Engineering, Monash University, 22 Alliance Lane, Clayton, Victoria 3800, Australia; ReNerve Pty. Ltd., Brunswick East 3057, Australia
| | - Carmel M O'Brien
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Research Way, Clayton, Victoria 3168, Australia; Australian Regenerative Medicine Institute, Science, Technology, Research and innovation Precinct (STRIP), Monash University, Wellington Road, Clayton, Victoria 3800, Australia
| | - Andrew E Rodda
- Department of Materials Science and Engineering, Monash University, 22 Alliance Lane, Clayton, Victoria 3800, Australia
| | - Neil R Cameron
- Department of Materials Science and Engineering, Monash University, 22 Alliance Lane, Clayton, Victoria 3800, Australia; School of Engineering, University of Warwick, Coventry CV4 7AL, United Kingdom.
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Pérez ML, Barreales S, Sabater-Cruz N, Martinez-Conesa EM, Vilarrodona A, Casaroli-Marano RP. Amniotic membrane extract eye drops: a new approach to severe ocular surface pathologies. Cell Tissue Bank 2021; 23:473-481. [PMID: 34549352 DOI: 10.1007/s10561-021-09962-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
A protocol for processing amniotic membrane as an extract to be re-hydrated and administered topically as eye drops (amniotic membrane extract eye drops, AMEED) has been developed. Safety and efficacy of AMEED was assessed in patients with severe ocular surface pathologies. prospective clinical follow-up of ocular surface symptoms before and after regular application of the AMEED for at least 4 weeks on patients with severe ocular surface disorders as chronic dry eye disease, limbal stem cell deficiency, neurotrophic ulcer and permanent and disabling symptomatology that were refractory to conventional treatment. Efficacy and tolerability were assessed based on patient-reported symptoms, objective measurements, and reports of adverse events. Thirty-six eyes from 25 patients were included. Although the visual quality function score, by means of a VQF25 questionnaire, was not statistically different after the treatment (p = 0.4657), there was a clear trend, statistically significant, towards the improvement in ocular symptoms like foreign body sensation, itching and stinging (p < 0.05) and clinical presentation of the pathology. All patients with corneal ulcer showed complete epithelization. Topically applied AMEED proved to be safe, well tolerated and effective in reducing the symptoms and clinical signs of severe ocular disease. Further studies are needed to confirm the best indications for AMEED use.
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Affiliation(s)
- Maria Luisa Pérez
- Barcelona Tissue Bank- Banc de Sang i Teixits (BTB), Barcelona, Spain. .,Institute of Biomedical Research (IIB-Sant Pau; SGR1113), Barcelona, Spain.
| | - Saúl Barreales
- Barcelona Tissue Bank- Banc de Sang i Teixits (BTB), Barcelona, Spain
| | - Noelia Sabater-Cruz
- Institut Clinic d'Oftalmologia (ICOF), Hospital Clinic de Barcelona, Barcelona, Spain
| | - Eva Maria Martinez-Conesa
- Barcelona Tissue Bank- Banc de Sang i Teixits (BTB), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - Anna Vilarrodona
- Barcelona Tissue Bank- Banc de Sang i Teixits (BTB), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau; SGR1113), Barcelona, Spain
| | - Ricardo P Casaroli-Marano
- Barcelona Tissue Bank- Banc de Sang i Teixits (BTB), Barcelona, Spain.,Department of Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Abstract
Ocular graft versus host disease (GVHD) is a common manifestation in patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT). Ocular GVHD affects approximately 10% of patients with acute GVHD and more than 50% of patients with chronic GVHD. Symptoms of dry eye disease are one of the clinical hallmarks of ocular GVHD, and inflammatory changes to the ocular surface, cornea, conjunctiva, eyelids and lacrimal glands have been observed. Less commonly, the posterior segment of the eye is involved in the form of microvascular retinopathy, scleritis or intraretinal and vitreous haemorrhage. Although ocular GVHD does not usually result in permanent visual loss, it often impairs the patient's quality of life and activities of daily living. Regular and more consistent ocular assessment of allo-HSCT patients, including screening prior to transplantation will allow for the earlier detection and treatment of ocular complications associated with GVHD and potentially prevent more severe outcomes. The implementation of additional screening including corneal endothelial cell density assessment and non-invasive analysis of tear biomarkers may be valuable additions to current clinical testing and assist in better detection and clinical intervention in patients with GVHD. This review describes the clinical features, diagnostic criteria and clinical scoring of ocular GVHD, as well as current treatment strategies and potential ophthalmic screening tools for common ocular complications. Further, we describe the clinical and histopathological features of ocular GVHD in preclinical mouse models.
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Affiliation(s)
- Jelena Marie Kezic
- Centre for Experimental Immunology, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Steven Wiffen
- Lions Eye Bank of Western Australia, Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Mariapia Degli-Esposti
- Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University, Victoria, Australia
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Wang M, Yennam S, McMillin J, Chen HH, de la Sen-Corcuera B, Hemmati R, Pflugfelder S. Combined therapy of ocular surface disease with plasma rich in growth factors and scleral contact lenses. Ocul Surf 2021; 23:162-168. [PMID: 34537416 DOI: 10.1016/j.jtos.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/05/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To review safety and efficacy of combined plasma rich in growth factors (PRGF) eye drops and scleral contact lens (SCL) therapy in patients with ocular surface disease. METHODS Patients with ocular surface disease of various etiologies were screened for at least 3 months of concurrent treatment with PRGF and SCL. Retrospective pre- and post-treatment measurements were collected, including patient satisfaction, severity and frequency of dry eye symptoms measured by a modified Symptom Assessment in Dry Eye (SANDE) questionnaire, visual acuity, and number of concurrent treatments. RESULTS 26 patients with ocular surface disease were included in the study with 20 patients answering the questionnaire (77% response rate). There were no adverse events reported. Most patients thought the combined therapy was better than previous treatments and would recommend to others (80%, 90% respectively). SANDE scores significantly decreased after use of concurrent therapy. There was a small but significant decrease in the number of other concurrent treatments. Visual acuity was unchanged. CONCLUSIONS This retrospective cohort study found PRGF used in combination with SCL is safe and significantly decreases symptoms in patients with recalcitrant ocular surface disease.
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Affiliation(s)
- Margaret Wang
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Sowmya Yennam
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Jake McMillin
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Hongan Hannah Chen
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Borja de la Sen-Corcuera
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain; Biotechnology Institute (BTI), Vitoria, Spain
| | - Roxana Hemmati
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Stephen Pflugfelder
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States.
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Mini Cleanroom for the Manufacture of Advanced Therapy Medicinal Products (ATMP): Bioengineered Corneal Epithelium. Pharmaceutics 2021; 13:pharmaceutics13081282. [PMID: 34452243 PMCID: PMC8401053 DOI: 10.3390/pharmaceutics13081282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/06/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Among several requirements for the manufacture of Advanced Therapy Medicinal Products (ATMP) are: following the guidelines of a pharmaceutical quality system, complying with Good Manufacturing Practice (GMP) and access to a cleanroom fulfilling strict environmental conditions (Class A work area and Class B environment). This makes ATMP expensive. Moreover, the production of many of these therapeutic products may also be unprofitable, as in most cases their use is limited to a few patients and to a single batch per manufacturing unit. To reduce costs, ATMP may be produced in a scaled-down system isolated from the external environment (isolator), allowing for placement of this facility in a Class D environment, which is much more permissive and less costly. In this work, we confirm that it is possible to manufacture bioengineered corneal epithelium inside an isolator while fulfilling all the safety assurance standards at an affordable cost for patients. This small-scale ultra-clean working environment complies with GMP guidelines and could be a solution for the high costs associated with conventional cleanroom ATMP production.
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Anitua E, de la Sen-Corcuera B, Orive G, Sánchez-Ávila RM, Heredia P, Muruzabal F, Merayo-Lloves J. Progress in the use of plasma rich in growth factors in ophthalmology: from ocular surface to ocular fundus. Expert Opin Biol Ther 2021; 22:31-45. [PMID: 34275392 DOI: 10.1080/14712598.2021.1945030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: The use of blood derivatives and especially Plasma rich in growth factors (PRGF), for regenerative purposes has been a common trend along the last decades in the field of oral surgery, dermatology, orthopedics, and more recently in ophthalmology.Areas covered: PRGF is a type of platelet-rich plasma that is being explored for the treatment of ocular injuries. The present review article highlights 50 ophthalmology-related publications about the application of PRGF in the treatment of acute and chronic pathologies in ophthalmology as well as most relevant challenges and future prospects.Expert opinion: PRGF technology provides a wide range of formulations that can be used therapeutically in many different acute and chronic ocular pathologies. In addition to eye drops enriched with autologous growth factors, PRGF enables the preparation of both immunologically safe and fibrin-based formulations. Recent advances in the field have promoted PRGF storage for 12 months under freezing conditions, its daily use for 7 days at room temperature and the freeze-dried formulation. The thermally treated immunosafe formulation has shown promising clinical results for the treatment of several diseases such as Sjögren syndrome, graft versus host disease or cicatrizing conjunctivitis. In addition, several fibrin formulations have been preclinically evaluated and clinically incorporated as an adjuvant to ocular surface or glaucoma surgeries, dermal fat graft procedures, limbal stem cell expansion and retinal surgeries. The present review explores the latest scientific and clinical data, current challenges, and main prospects of this technology for the treatment of several ocular injuries.
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Affiliation(s)
- E Anitua
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain.,Regenerative medicine, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - B de la Sen-Corcuera
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain.,Regenerative medicine, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - G Orive
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain.,Regenerative medicine, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.,NanoBioCel Group, School of Pharmacy, University of the Basque Country (UPV/EHU), Oviedo, Vitoria-Gasteiz, Spain
| | - R M Sánchez-Ávila
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain
| | - P Heredia
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain.,Regenerative medicine, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - F Muruzabal
- Regenerative medicine, Biotechnology Institute (BTI), Vitoria, Spain.,Regenerative medicine, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - J Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Spain
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Anitua E, Muñoz V, Aspe L, Tierno R, García-Salvador A, Goñi-de-Cerio F, Pino A. In vitro and in vivo Effect of Platelet-Rich Plasma-Based Autologous Topical Serum on Cutaneous Wound Healing. Skin Pharmacol Physiol 2021; 35:51-64. [PMID: 34247175 DOI: 10.1159/000517195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 05/01/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Skin injury and wound healing is an inevitable event during lifetime. However, several complications may hamper the regeneration of the cutaneous tissue and lead to a chronic profile that prolongs patient recovery. Platelet-rich plasma is rising as an effective and safe alternative to the management of wounds. However, this technology presents some limitations such as the need for repeated blood extractions and health-care interventions. OBJECTIVE The aim of this study was to assess the use of an endogenous and storable topical serum (ES) derived from plasma rich in growth factors promoting wound healing, and to obtain preliminary data regarding its clinical and experimental effect over ulcerated skin models and patient care. METHODS Human dermal fibroblast and 3D organotypic ulcerated skin models were used to assess ES over the main mechanisms of wound healing including cell migration, edge contraction, collagen synthesis, tissue damage, extracellular matrix remodeling, cell death, metabolic activity, and histomorphometry analysis. Additionally, 4 patients suffering from skin wounds were treated and clinically assessed. RESULTS ES promoted dermal fibroblast migration, wound edge contraction, and collagen synthesis. When topically applied, ES increased collagen and elastin deposition and reduced tissue damage. The interstitial edema, structural integrity, and cell activity were also maintained, and apoptotic levels were reduced. Patients suffering from hard-to-heal wounds of different etiologies were treated with ES, and the ulcers healed completely within few weeks with no reported adverse events. CONCLUSION This preliminary study suggests that ES might promote cutaneous wound healing and may be useful for accelerating the re-epithelization of skin ulcers.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.,BTI Biotechnology Institute, Vitoria, Spain
| | | | - Libe Aspe
- University Hospital of Araba (HUA), Vitoria, Spain
| | - Roberto Tierno
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.,BTI Biotechnology Institute, Vitoria, Spain
| | - Adrian García-Salvador
- GAIKER Technology Centre, Basque Research and Technology Alliance (BRTA), Zamudio, Spain
| | - Felipe Goñi-de-Cerio
- GAIKER Technology Centre, Basque Research and Technology Alliance (BRTA), Zamudio, Spain
| | - Ander Pino
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain, .,BTI Biotechnology Institute, Vitoria, Spain,
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45
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Sánchez-Ávila RM, Vázquez N, Chacón M, Persinal-Medina M, Brea-Pastor A, Berisa-Prado S, Fernández-Vega-Cueto L, Anitua E, Meana Á, Merayo-Lloves J. Fibrin-Plasma Rich in Growth Factors Membrane for the Treatment of a Rabbit Alkali-Burn Lesion. Int J Mol Sci 2021; 22:ijms22115564. [PMID: 34070266 PMCID: PMC8197415 DOI: 10.3390/ijms22115564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this work is to describe the use of Fibrin-Plasma Rich in Growth Factors (PRGF) membranes for the treatment of a rabbit alkali-burn lesion. For this purpose, an alkali-burn lesion was induced in 15 rabbits. A week later, clinical events were evaluated and rabbits were divided into five treatment groups: rabbits treated with medical treatment, with a fibrin-PRGF membrane cultured with autologous or heterologous rabbit Limbal Epithelial Progenitor Cells (LEPCs), with a fibrin-PRGF membrane in a Simple Limbal Epithelial Transplantation and with a fibrin-PRGF membrane without cultured LEPCs. After 40 days of follow-up, corneas were subjected to histochemical examination and immunostaining against corneal or conjunctival markers. Seven days after alkali-burn lesion, it was observed that rabbits showed opaque cornea, new blood vessels across the limbus penetrating the cornea and epithelial defects. At the end of the follow-up period, an improvement of the clinical parameters analyzed was observed in transplanted rabbits. However, only rabbits transplanted with cultured LEPCs were positive for corneal markers. Otherwise, rabbits in the other three groups showed positive staining against conjunctival markers. In conclusion, fibrin-PRGF membrane improved the chemically induced lesions. Nonetheless, only fibrin-PRGF membranes cultured with rabbit LEPCs were able to restore the corneal surface.
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Affiliation(s)
- Ronald M. Sánchez-Ávila
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Biotechnology Institute (BTI), 01007 Vitoria, Spain;
| | - Natalia Vázquez
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
| | - Manuel Chacón
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
| | - Mairobi Persinal-Medina
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
| | - Agustín Brea-Pastor
- Unidad de Bioterio e imagen Preclínica, Universidad de Oviedo, 33071 Oviedo, Spain;
| | - Silvia Berisa-Prado
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
| | - Luis Fernández-Vega-Cueto
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
| | - Eduardo Anitua
- Biotechnology Institute (BTI), 01007 Vitoria, Spain;
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria, Spain
| | - Álvaro Meana
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER) (U714), ISCII, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-985-240-141; Fax: +34-985-233-288
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, 33071 Oviedo, Spain; (R.M.S.-Á.); (N.V.); (M.C.); (M.P.-M.); (S.B.-P.); (L.F.-V.-C.); (J.M.-L.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33071 Oviedo, Spain
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Soifer M, Mousa HM, Levy RB, Perez VL. Understanding Immune Responses to Surgical Transplant Procedures in Stevens Johnsons Syndrome Patients. Front Med (Lausanne) 2021; 8:656998. [PMID: 34095169 PMCID: PMC8175970 DOI: 10.3389/fmed.2021.656998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/23/2021] [Indexed: 02/03/2023] Open
Abstract
Stevens Johnsons syndrome (SJS) is a mucocutaneous disorder caused by an autoimmune response most commonly to medications. Unless it is properly managed in the acute setting, this entity can affect the ocular surface causing chronic cicatrizing conjunctivitis with limbal stem cell deficiency and lid anomalies which ultimately result in corneal opacities that may limit patients' visual acuity. When this stage is reached, some patients might need to undergo some form of corneal and/or limbal stem cell transplantation that exposes an already sensitized immune system to a new alloantigen. While the innate immunity plays a role in corneal graft survival, adaptive immune responses play a major part in corneal graft rejection and failure, namely through CD4+ T cell lymphocytes. Hence, the management of the immune response to surgical transplant procedures in SJS patients, involves a dual approach that modulates the inflammatory response to a new alloantigen in the context of an autoimmune sensitized patient. This review will explore and discuss current perspectives and future directions in the field of ocular immunology on how to manage SJS immune responses to ocular surgical procedures, reviewing systemic and local immunosuppressive therapies and protocols to adequately manage this debilitating condition.
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Affiliation(s)
- Matias Soifer
- Foster Center for Ocular Immunology, Duke Eye Institute, Durham, NC, United States,Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
| | - Hazem M. Mousa
- Foster Center for Ocular Immunology, Duke Eye Institute, Durham, NC, United States,Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
| | - Robert B. Levy
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Victor L. Perez
- Foster Center for Ocular Immunology, Duke Eye Institute, Durham, NC, United States,Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States,*Correspondence: Victor L. Perez
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47
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Gandolfi M, Brandão C, Pellizon C, Hirota I, Barros R, Hussein A, Merlini N, Takahira R, Mesquita L. Allogenic platelet-rich plasma in induced ulcers in rat’s cornea. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The objective in this study was to evaluate the clinic effect of applying allogenic platelet-rich plasma (PRP) heated or not, for treating cornea ulcers, including the dosage of PDGF-BB in the cornea. The ulcers were induced, standardizing the left eye from 81 rats (Ratus norvegicus, albinus variety), assigned randomly into three groups (N=27): control group (CG) which did not receive any topic treatment; heated PRP group (GA) and PRP group (GP), which received topical treatment every eight hours for five days. Each group underwent evaluation at 24 hours (M1), three days (M3) and five days (M5). The clinical exam evaluated the opacity, vascularization and corneal repair. The corneal PDGF-BB was dosed through the ELISA method. The corneal opacity was decreased in PRP-treated animals (GA and GP) and corneal repair time reduced when compared to CG at M1 and M5. Furthermore, GP showed greater vascularization at M3 compared to M1. Applied allogenic PRP eye drops, heated or not, speed up corneal healing, and reduce corneal repair time. However, the corneal PDGF concentration was not altered in any of the treatments.
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Affiliation(s)
| | | | | | | | - R. Barros
- Universidade Estadual Paulista, Brazil
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48
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Sahli E, Arslan U, Özmert E, İdil A. Evaluation of the effect of subtenon autologous platelet-rich plasma injections on visual functions in patients with retinitis pigmentosa. Regen Med 2021; 16:131-143. [PMID: 33754798 DOI: 10.2217/rme-2020-0075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The photoreceptors in retinitis pigmentosa (RP) remain in dormant status for a while with a decrease in the growth factors in their microenvironment before apoptosis. Growth factors reduce retinal degeneration and apoptosis in animal models. Materials & methods: The data of 188 eyes of 94 patients who were injected with autologous platelet-rich plasma (PRP) into the subtenon space three-times every 2 weeks were evaluated retrospectively. Results: Statistically significant improvements in visual acuity, visual field and fixation stability were detected after treatment. When the treatment response of the patients' better-seeing eye compared with the response of the other eye, there was no statistically significant difference. Conclusion: The PRP treatment has a favorable effect on visual functions in patients with RP. This approach is promising as it is safe and easy.
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Affiliation(s)
- Esra Sahli
- Department of Ophthalmology, Ankara University, School of Medicine, Ankara 06620, Turkey
| | - Umut Arslan
- Ankara University, Technopolis, Ankara 06830, Turkey.,Bioretina Eye Clinic, Ankara 06560, Turkey
| | - Emin Özmert
- Department of Ophthalmology, Ankara University, School of Medicine, Ankara 06620, Turkey
| | - Aysun İdil
- Department of Ophthalmology, Ankara University, School of Medicine, Ankara 06620, Turkey
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Sabater AL, Mousa HM, Quinones X, Valenzuela F, Sanchez Avila RM, Orive G, Anitua E, Merayo J, Perez VL. Use of autologous plasma rich in growth factors fibrin membrane in the surgical management of ocular surface diseases. Int Ophthalmol 2021; 41:2347-2358. [PMID: 33745034 DOI: 10.1007/s10792-021-01788-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of the surgical use of autologous plasma rich in growth factors fibrin membrane (mPRGF) in improving corneal wound healing and regeneration in a variety of complex ocular surface defects. METHODS Chart review on 15 eyes of 14 included patients undergoing ocular surface intervention using intraoperative mPRGF at the Bascom Palmer Eye Institute and at the Instituto Oftalmológico Fernández-Vega was performed. Patients were grouped based on type of intervention or condition (penetrating keratoplasty, superficial keratectomy, neurotrophic or persistent corneal ulcers, and corneal perforation). Patients were followed for an average of 11 ± 5 months. Main outcomes measured were mPRGF dissolving time, best-corrected visual acuity, and evidence of any persistent epithelial defects, rejections, or complications. RESULTS All 15 eyes underwent successful placement of mPRGF. Average dissolving time for fibrin membrane was 21 ± 3 days. mPRGF resulted in total healing of the corneal defects in 13/15 (86.7%) of the treated eyes and partial healing in 2/15 (13.3%) eyes in which persistent epithelial defects were noted on follow-up. Visual acuity improvement was seen in 9/15 (60%) of the cases. CONCLUSION The use of autologous mPRGF in the healing and regeneration of the ocular surface is a secure and efficacious surgical option. Our data demonstrate that PRGF fibrin membrane should be contemplated as an important tool to optimize ocular surface regeneration in complex cases.
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Affiliation(s)
- Alfonso L Sabater
- Department of Ophthalmology, Bascom Palmer Eye Institute, Ocular Surface Center, University of Miami Miller School of Medicine, Miami, USA
| | - Hazem M Mousa
- Steven and Frances Foster Distinguished Chair in Ocular Immunology, Duke Eye Center for Ocular Immunology, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Xavier Quinones
- Department of Ophthalmology, Bascom Palmer Eye Institute, Ocular Surface Center, University of Miami Miller School of Medicine, Miami, USA
| | - Felipe Valenzuela
- Department of Ophthalmology, Bascom Palmer Eye Institute, Ocular Surface Center, University of Miami Miller School of Medicine, Miami, USA
| | | | - Gorka Orive
- Foundation Eduardo Anitua, Victoria, Spain.,Biotechnology Institute (BTI), Victoria, Spain.,NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006, Vitoria-Gasteiz, Spain.,Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain
| | - Eduardo Anitua
- Foundation Eduardo Anitua, Victoria, Spain.,Biotechnology Institute (BTI), Victoria, Spain
| | - Jesús Merayo
- Fernández-Vega University Institute, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
| | - Victor L Perez
- Department of Ophthalmology, Bascom Palmer Eye Institute, Ocular Surface Center, University of Miami Miller School of Medicine, Miami, USA. .,Steven and Frances Foster Distinguished Chair in Ocular Immunology, Duke Eye Center for Ocular Immunology, Duke University School of Medicine, Durham, NC, 27705, USA.
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50
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The Impact of Various Culture Conditions on Human Mesenchymal Stromal Cells Metabolism. Stem Cells Int 2021; 2021:6659244. [PMID: 33727935 PMCID: PMC7939743 DOI: 10.1155/2021/6659244] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/01/2021] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
In vitro and in vivo analyses are closely connected, and the reciprocal relationship between the two comprises a key assumption with concern to the conducting of meaningful research. The primary purpose of in vitro analysis is to provide a solid background for in vivo and clinical study purposes. The fields of cell therapy, tissue engineering, and regenerative medicine depend upon the high quality and appropriate degree of the expansion of mesenchymal stromal cells (MSCs) under low-risk and well-defined conditions. Hence, it is necessary to determine suitable alternatives to fetal bovine serum (FBS—the laboratory gold standard) that comply with all the relevant clinical requirements and that provide the appropriate quantity of high-quality cells while preserving the required properties. Human serum (autologous and allogeneic) and blood platelet lysates and releasates are currently considered to offer promising and relatively well-accessible MSC cultivation alternatives. Our study compared the effect of heat-inactivated FBS on MSC metabolism as compared to its native form (both are used as the standard in laboratory practice) and to potential alternatives with concern to clinical application—human serum (allogeneic and autologous) or platelet releasate (PR-SRGF). The influence of the origin of the serum (fetal versus adult) was also determined. The results revealed the key impact of the heat inactivation of FBS on MSCs and the effectiveness of human sera and platelet releasates with respect to MSC behaviour (metabolic activity, proliferation, morphology, and cytokine production).
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