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Singh S, Trakos N, Ali MJ. Effect of Topical 5-Fluorouracil on Lacrimal Drainage System: Histopathological Evidence From Animal Experiments and Potential Clinical Implications. Ophthalmic Plast Reconstr Surg 2023; 39:288-292. [PMID: 36356188 DOI: 10.1097/iop.0000000000002289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The purpose of this study is to investigate the histopathological changes in the lacrimal drainage system of rabbits following the application of 1% topical 5-fluorouracil (5-FU) for 4 weeks. METHODS Ten eyes of 10 healthy New Zealand white rabbits were subjected to topical instillation of 1% (10 mg/mL) 5-FU, 1 drop 4 times a day for 4 weeks. Rabbits underwent a detailed ocular examination including eyelids, ocular surface, punctal, peri-punctal changes, and nasolacrimal duct patency at baseline and after 4 weeks of 5-FU. The rabbits were then sacrificed, and the eyelid, conjunctiva, lacrimal gland, and the entire lacrimal drainage system were retrieved for histopathological analysis as per standard protocols. RESULTS Clinically demonstrable peripunctal changes and canalicular stenosis were noted in 6 (60%, 6/10) rabbits. Two of these (20%, 2/10) had additional complete regurgitation of clear fluid, indicating a nasolacrimal duct obstruction. The remaining 4 (40%, 4/10) clinically did not demonstrate lacrimal drainage changes and were patent on irrigation. The conjunctiva showed focal loss of goblet cells in several areas. Significant changes were noted in the canalicular, lacrimal sac, and the nasolacrimal duct tissues in the form of epithelial hyperplasia, subepithelial inflammation, edema, dilated and congested vessels, and fibrosis. The lacrimal gland, eyelid tissue (excluding tarsal conjunctiva), and cornea showed no significant histopathological changes. CONCLUSIONS Clinical and histopathological changes were noted in the lacrimal drainage system of rabbits subjected to topical 5-FU application. These findings can have potential clinical implications for patients receiving 5-FU therapy.
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Affiliation(s)
- Swati Singh
- Ophthalmic Plastics Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India
- Institute of Clinical and Functional Anatomy, Friedrich-Alexander University, Erlangen, Germany
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
| | | | - Mohammad Javed Ali
- Institute of Clinical and Functional Anatomy, Friedrich-Alexander University, Erlangen, Germany
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
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Zhao YM, Sun RS, Duan F, Wang FY, Li YJ, Qian XB, Zeng JT, Yang Y, Lin XF. Intravitreal slow-release dexamethasone alleviates traumatic proliferative vitreoretinopathy by inhibiting persistent inflammation and Müller cell gliosis in rabbits. Int J Ophthalmol 2023; 16:22-32. [PMID: 36659954 PMCID: PMC9815969 DOI: 10.18240/ijo.2023.01.04] [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: 10/08/2022] [Accepted: 10/31/2022] [Indexed: 12/31/2022] Open
Abstract
AIM To evaluate the effects of intravitreal slow-release dexamethasone on traumatic proliferative vitreoretinopathy (PVR) and Müller cell gliosis and preliminarily explored the possible inflammatory mechanism in a rabbit model induced by penetrating ocular trauma. METHODS Traumatic PVR was induced in the right eyes of pigmented rabbits by performing an 8-mm circumferential scleral incision placed 2.5 mm behind the limbus, followed by treatment with a slow-release dexamethasone implant (Ozurdex) or sham injection. Left eyes were used as normal controls. The intraocular pressure (IOP) was monitored using an iCare tonometer. PVR severity was evaluated via anatomical and histopathological examinations every week for 6wk; specific inflammatory cytokine and proliferative marker levels were measured by quantitative real-time polymerase chain reaction, Western blot, protein chip analysis, or immunofluorescence staining. RESULTS During the observation period, PVR severity gradually increased. Intense Müller cell gliosis was observed in the peripheral retina near the wound and in the whole retina of PVR group. Ozurdex significantly alleviated PVR development and Müller cell gliosis. Post-traumatic inflammation fluctuated and was persistent. The interleukin-1β (IL-1β) mRNA level was significantly upregulated, peaking on day 3 and increasing again on day 21 after injury. The expression of nod-like receptor family pyrin domain containing 3 (NLRP3) showed a similar trend that began earlier than that of IL-1β expression. Ozurdex suppressed the expression of IL-1β, NLRP3, and phosphorylated nuclear factor-kappa B (NF-κB). The average IOP after treatment was within normal limits. CONCLUSION The present study demonstrates chronic and fluctuating inflammation in a traumatic PVR rabbit model over 6wk. Ozurdex treatment significantly inhibites inflammatory cytokines expression and Müller cell gliosis, and thus alleviates PVR severity. This study highlights the important role of IL-1β, and Ozurdex inhibites inflammation presumably via the NF-κB/NLRP3/IL-1β inflammatory axis. In summary, Ozurdex provides a potential therapeutic option for traumatic PVR.
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Affiliation(s)
- Yi-Ming Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Rong-Sha Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Fang Duan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Fang-Yu Wang
- Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Xi'an 710004, Shaanxi Province, China
| | - Yu-Jie Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Bing Qian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Jie-Ting Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Yao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Feng Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, Guangdong Province, China
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Alqahtani AA, Aslam H, Shukrullah S, Fatima H, Naz MY, Rahman S, Mahnashi MH, Irfan M. Nanocarriers for Smart Therapeutic Strategies to Treat Drug-Resistant Tumors: A Review. Assay Drug Dev Technol 2022; 20:191-210. [DOI: 10.1089/adt.2022.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Hira Aslam
- Department of Physics, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Shazia Shukrullah
- Department of Physics, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Hareem Fatima
- Department of Physics, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Muhammad Yasin Naz
- Department of Physics, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Saifur Rahman
- Electrical Engineering Department, College of Engineering, Najran University, Najran, Saudi Arabia
| | - Mater H. Mahnashi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Muhammad Irfan
- Electrical Engineering Department, College of Engineering, Najran University, Najran, Saudi Arabia
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Xiao Y, Choi KS, Warther D, Huffman K, Landeros S, Freeman WR, Sailor MJ, Cheng L. A sustained dual drug delivery system for proliferative vitreoretinopathy. Drug Deliv 2021; 27:1461-1473. [PMID: 33100053 PMCID: PMC7594716 DOI: 10.1080/10717544.2020.1833382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) is a significant threat for vision recovery from retinal detachment or ocular trauma. Currently, no approved pharmacological intervention to prevent PVR. Daunorubicin (DNR) and dexamethasone (DEX) were sequentially loaded into oxidized porous silicon (pSiO2) particles by covalent conjugation. The DNR + DEX-loaded particles, and control particles loaded with DNR only and DEX only were incubated with RPE-populated collagen for daily gel surface quantitation. Toxicity was monitored by ophthalmic examinations and histological evaluation 21 days after injection. At 3rd week following intravitreal injection, a localized retinal detachment (RD) was created by subretinal injection of Healon in all pretreated eyes in addition to 3 non-interventional control eyes. 10 µg of bromodeoxyuridine (BrdU) was injected into the vitreous 4 h before sacrifice on day 3 after RD induction. Retinal sections were stained for glial fibrillary green protein (GFAP) and BrdU to identify activated glial cells and retinal cell proliferation. The studies demonstrated that all three pSiO2 particle types were well tolerated in vivo. DNR alone and DNR + DEX combination formulations demonstrated equally strong suppression on gel contraction (least square mean area of the gel: control = 1.71 vs. 30DNR = 1.85 or 30/40Dual = 1.83, p < .05). Eyes pretreated with pSiO2−DNR + DEX exhibited the least GFAP activation (least square mean intensity mm−2: Dual = 4.03, DNR = 7.76, Dex = 16.23, control = 29.11, p < .05) and BrdU expression (Mean number of BrdU positive cells per mm of retina: Dual = 2.77, DNR = 4.58, Dex = 4.01, control = 6.16, p < .05). The synergistic effect of a sustained release pSiO2−DNR/DEX showed promise for the prevention of PVR development while reducing the necessary therapeutic concentration of each drug.
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Affiliation(s)
- Ying Xiao
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Kyung Seek Choi
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - David Warther
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA, USA
| | - Kristyn Huffman
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Stephanie Landeros
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - William R Freeman
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Michael J Sailor
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA, USA
| | - Lingyun Cheng
- Department of Ophthalmology, Jacobs Retina Center at Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
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Wu S, Bian C, Li X, Chen M, Yang J, Jin Y, Shen Y, Cheng L. Controlled release of triamcinolone from an episcleral micro film delivery system for open-globe eye injuries and proliferative vitreoretinopathy. J Control Release 2021; 333:76-90. [PMID: 33771623 DOI: 10.1016/j.jconrel.2021.03.023] [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: 10/14/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
Open globe trauma is the major cause for single eye blindness that stem from subsequent proliferative vitreoretinopathy (PVR). Though biomaterials and tissue engineering have significantly advanced drug delivery and management of human diseases, currently there is no effective drug formulation or device to pharmacologically mitigate PVR formation after open-globe eye trauma. This highlighted the challenge we are facing to bring the technology from bench to bedside. The current study reported an engineered episcleral drug film using biodegradable material, Poly(L-lactide)-co-poly(ɛ-caprolactone), and triamcinolone acetonide (TA) as a model drug. The film can be conveniently sized into any shape to fit the configuration of the eye globe trauma and easily installed onto the ruptured sclera during primary trauma repair surgery. The film allows therapeutic TA to slow release for at least 6 months without toxicity and demonstrated a significant benefit to reduce the odds of developing severe PVR by 5.7 times when compared with a no-drug film control on a rabbit trauma PVR model. Our results suggested this micro episcleral drug film as promising drug delivery carrier for the targeted treatment of various unwanted retinal proliferation diseases.
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Affiliation(s)
- Shaoqun Wu
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Chengying Bian
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Xiaoli Li
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Miao Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Jie Yang
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Yuanhui Jin
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Yu Shen
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China
| | - Lingyun Cheng
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325027, China.
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Ueda S, Nunn BM, Chauhan R, McDonald K, Kaplan HJ, O'Toole MG, Tamiya S. Sustained dasatinib treatment prevents early fibrotic changes following ocular trauma. Graefes Arch Clin Exp Ophthalmol 2021; 259:1103-1111. [PMID: 33417094 PMCID: PMC8102289 DOI: 10.1007/s00417-020-05037-4] [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: 09/02/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 01/12/2023] Open
Abstract
Purpose Posterior ocular trauma and the subsequent fibrotic retinal complication termed proliferative vitreoretinopathy (PVR) are leading causes of blindness in children and young adults. A previous study suggested that changes occurring within the first month post-trauma can lead to development of PVR later. The aim of this study was to examine the effect of dasatinib, a tyrosine kinase inhibitor clinically used to treat chronic myeloid leukemia, on fibrotic changes occurring within the first month following ocular trauma. Methods A previously established swine ocular trauma model that mimics both contusion and penetrating injuries was used. Dasatinib was administered on days 4 and 18 post-trauma via intravitreal injection of either bolus solution or suspension of a sustained release system incorporated in biodegradable poly (lactic-co-glycolic acid) (PLGA) nanoparticles. Animals were followed up to day 32, and the development of traction full-thickness fold in the posterior retina was assessed. Results A full-thickness retinal fold extending from the wound site developed in 3 out of 4 control eyes injected with PLGA nanoparticles alone at 1 month. Administration of dasatinib solution had little preventative effect with 6 out of 7 eyes developing a fold. In contrast, dasatinib-incorporated PLGA nanoparticle injection significantly reduced the incidence of fold to 1 out of 10 eyes. Conclusions Injection of dasatinib-incorporated PLGA significantly reduced early fibrotic retinal changes which eventually lead to PVR following posterior ocular trauma. Thus, our sustained dasatinib release system can potentially be used to both prevent and/or broaden the surgical treatment window for PVR.
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Affiliation(s)
- Shunichiro Ueda
- Department of Ophthalmology and Visual Sciences, University of Louisville, 301 E Muhammad Ali Blvd, Louisville, KY, 40202, USA.,Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Betty M Nunn
- Department of Bioengineering, University of Louisville, 2301 S. Third St, Louisville, KY, 40292, USA
| | - Rajat Chauhan
- Department of Bioengineering, University of Louisville, 2301 S. Third St, Louisville, KY, 40292, USA
| | - Kevin McDonald
- Department of Ophthalmology and Visual Sciences, University of Louisville, 301 E Muhammad Ali Blvd, Louisville, KY, 40202, USA
| | - Henry J Kaplan
- Department of Ophthalmology and Visual Sciences, University of Louisville, 301 E Muhammad Ali Blvd, Louisville, KY, 40202, USA.,Department of Ophthalmology, Saint Louis University, St. Louis, USA
| | - Martin G O'Toole
- Department of Bioengineering, University of Louisville, 2301 S. Third St, Louisville, KY, 40292, USA.
| | - Shigeo Tamiya
- Department of Ophthalmology and Visual Sciences, University of Louisville, 301 E Muhammad Ali Blvd, Louisville, KY, 40202, USA.
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The Vitrectomy Timing Individualization System for Ocular Trauma (VTISOT). Sci Rep 2019; 9:12612. [PMID: 31471555 PMCID: PMC6717195 DOI: 10.1038/s41598-019-48862-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/14/2019] [Indexed: 01/16/2023] Open
Abstract
Ocular trauma is a major cause of monocular blindness worldwide. Vitrectomy at correct timing can significantly improve the efficacy and prognosis, but the timing of vitrectomy has remained highly controversial for decades. Trauma cases are different from each other, thus, a flexible timing system based on the details of each individual case is recommended. Unfortunately, no such a timing system is available for clinical application up to now. To establish the vitrectomy timing individualization system for ocular trauma (VTISOT), we first identified 6 independent tPVR risk factors (including Zone 3 Injury, Zone 3 retinal Laceration, Massive Vitreous Hemorrhage, Retinal Disorder, Timing of Vitrectomy and Type of Injury) by retrospective study. Then, the tPVR score was established by binary logistic regression analysis. Most importantly and critically, the vitrectomy timing individualization system for ocular trauma was established based on the identified tPVR risk factors and the tPVR score. The following evaluation of the VTISOT showed that the patients consistent with the VTISOT principles exhibited reduced tPVR incidence and better surgical results. In short, the VTISOT principles were established, which may provide a new approach to individualize the timing of vitrectomy and improve the prognosis after trauma.
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Abstract
Platinum has been a widely used metal for a variety of implanted medical devices, because of its inertness, low corrosion rate, high biocompatibility, high electric conductivity, and good mechanical stability. A highly desirable property still in need to be addressed is the tailoring of drug-delivery ability to that metal. This is needed in order to treat infections due to the process of implanting, to treat postoperation pain, and to prevent blood clotting. Can Pt itself serve as a delivery matrix? A review on metallic implants (Lyndon, J. A.; Boyd, B. J.; Birbilis, N. Metallic implant drug/device combinations for controlled drug release in orthopaedic applications. J. Control. Release 2014, 179, 63-75) proposes that "Metals themselves can be used for delivering pharmaceutics" but adds that "there has been no current research into [that] possibility" despite its advantages. Here we present a solution to that challenge and show a new method of using an inert metal as a 3D matrix from within which entrapped drug molecules are released. This new type of drug-delivery system is fabricated by the methodolodgy of entrapment of molecules within metals, resulting in various drugs@Pt. Specifically the following drugs have been entrapped and released: the pain-killer and platelet-inhibitor nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen and naproxen, the antibiotic ciprofloxacin, and the antiseptic chlorhexidine. The delivery profiles of all biocomposites were studied in two forms, powders and pressed discs, showing, in general, fast followed by slow first order release profiles. It is shown that the delivery kinetics can be tailored by changing the entrapment process, by applying different pressures in the disc preparation, and by changing the delivery temperature. The latter was also used to determine the activation energy for the release. Full characterization of the metallic biomaterials is provided, including X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray (EDAX), thermogravimetric analysis (TGA), and surface area/porosity analysis.
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Affiliation(s)
- Barak Menagen
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem, 9190401, Israel
| | - David Avnir
- Institute of Chemistry and the Center for Nanoscience and Nanotechnology, The Hebrew University of Jerusalem, Jerusalem, 9190401, Israel
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Hou H, Nudleman E, Weinreb R. Animal Models of Proliferative Vitreoretinopathy and Their Use in Pharmaceutical Investigations. Ophthalmic Res 2018; 60:195-204. [DOI: 10.1159/000488492] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 03/14/2018] [Indexed: 12/16/2022]
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Chen M, Hou J, Tan G, Xie P, Freeman WR, Beadle JR, Hostetler KY, Cheng L. A novel lipid prodrug strategy for sustained delivery of hexadecyloxypropyl 9-[2-(phosphonomethoxy)ethyl]guanine (HDP-PMEG) on unwanted ocular proliferation. Drug Deliv 2017; 24:1703-1712. [PMID: 29115885 PMCID: PMC8241053 DOI: 10.1080/10717544.2017.1399303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) is a blinding eye disease and there is no effective pharmacological measure to prevent PVR development. The difficulty comes from lack of potent antiproliferative agent and lack of sustained delivery to cover high-risk time window for PVR to develop. Lipid prodrug of PMEG, hexadecyloxypropyl 9-[(2-phosphonomethoxy)ethyl]guanine (HDP-PMEG), was prepared and was evaluated as a pharmacological adjuvant to surgical management of PVR. A dose-escalation study determined that the highest nontoxic dose for intravitreal use in pigmented rabbits was 3 µg per eye. The genotoxicity of HDP-PMEG was harnessed as a perioperative preventative measure against PVR in a rabbit eye model while the sustained intravitreal pharmacological effect was evaluated on a laser-induced fibrovascular model in rat eye. After intravitreal 3 µg, HDP-PMEG particles in the rabbit vitreous was visible for at least 6 weeks. A single 50-min intravitreal infusion of HDP-PMEG demonstrated significant inhibition of PVR formation when compared with the eyes infused with only BSS (BSS vs. HDP-PMEG: estimate = 1.14, OR = 3.1, p = .027). A single intravitreal 104 ng (equivalent to 3 µg for rabbit eye) of HDP-PMEG significantly inhibit laser-induced fibrovascular proliferation in rat eye by 55% (least square mean pixel, BSS = 4763569.5 vs. HDP-PMEG = 2148129.7, p < .0001, generalized estimating equation [GEE]). Retinal fluorescein angiography showed the odds for BSS intervened eyes to have higher-rated FA leaking grades were 38.5 times compared with HDP-PMEG treated eyes (p < .0001, GEE). Our study results indicate that single intravitreal HDP-PMEG may be a promising ocular drug delivery as a perioperative intervention to prevent PVR reoccurrence following primary surgical management.
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Affiliation(s)
- Mei Chen
- a Institute of Ocular Pharmacology , School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou , Zhejiang , China.,b Department of Ophthalmology, Dazhou Central Hospital , Dazhou , Sichuan , China
| | - Jiangping Hou
- a Institute of Ocular Pharmacology , School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou , Zhejiang , China.,c Department of Ophthalmology, Provincial Hospital Affiliated to Shandong University , Jinan City , Shandong , China
| | - Guilin Tan
- a Institute of Ocular Pharmacology , School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - Peng Xie
- a Institute of Ocular Pharmacology , School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou , Zhejiang , China
| | - William R Freeman
- d Jacobs Retina Center at Shiley Eye Center, Department of Ophthalmology , University of California San Diego , La Jolla , CA , USA
| | - James R Beadle
- e Department of Medicine , University of California, San Diego and the San Diego Veterans Medical Research Foundation , La Jolla , CA , USA
| | - Karl Y Hostetler
- e Department of Medicine , University of California, San Diego and the San Diego Veterans Medical Research Foundation , La Jolla , CA , USA
| | - Lingyun Cheng
- a Institute of Ocular Pharmacology , School of Ophthalmology and Optometry, Wenzhou Medical University , Wenzhou , Zhejiang , China.,d Jacobs Retina Center at Shiley Eye Center, Department of Ophthalmology , University of California San Diego , La Jolla , CA , USA
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Taskar P, Tatke A, Majumdar S. Advances in the use of prodrugs for drug delivery to the eye. Expert Opin Drug Deliv 2016; 14:49-63. [PMID: 27441817 DOI: 10.1080/17425247.2016.1208649] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Ocular drug delivery is presented with many challenges, taking into account the distinctive structure of the eye. The prodrug approach has been, and is being, employed to overcome such barriers for some drug molecules, utilizing a chemical modification approach rather than a formulation-based approach. A prodrug strategy involves modification of the active moiety into various derivatives in a fashion that imparts some advantage, such as membrane permeability, site specificity, transporter targeting and improved aqueous solubility, over the parent compound. Areas covered: The following review is a comprehensive summary of various novel methodologies and strategies reported over the past few years in the area of ocular drug delivery. Some of the strategies discussed involve polymer and lipid conjugation with the drug moiety to impart hydrophilicity or lipophilicity, or to target nutrient transporters by conjugation with transporter-specific moieties and retrometabolic drug design. Expert opinion: The application of prodrug strategies provides an option for enhancing drug penetration into the ocular tissues, and overall ocular bioavailability, with minimum disruption of the ocular diffusion barriers. Although success of the prodrug strategy is contingent on various factors, such as the chemical structure of the parent molecule, aqueous solubility and solution stability, capacity of targeted transporters and bioreversion characteristics, this approach has been successfully utilized, commercially and therapeutically, in several cases.
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Affiliation(s)
- Pranjal Taskar
- a Department of Pharmaceutics and Drug Delivery , University of Mississippi , University , MS , USA.,b Research Institute of Pharmaceutical Sciences , University of Mississippi , University , MS , USA
| | - Akshaya Tatke
- a Department of Pharmaceutics and Drug Delivery , University of Mississippi , University , MS , USA.,b Research Institute of Pharmaceutical Sciences , University of Mississippi , University , MS , USA
| | - Soumyajit Majumdar
- a Department of Pharmaceutics and Drug Delivery , University of Mississippi , University , MS , USA.,b Research Institute of Pharmaceutical Sciences , University of Mississippi , University , MS , USA
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Aljuffali IA, Lin CF, Chen CH, Fang JY. The codrug approach for facilitating drug delivery and bioactivity. Expert Opin Drug Deliv 2016; 13:1311-25. [DOI: 10.1080/17425247.2016.1187598] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ibrahim A. Aljuffali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Chwan-Fwu Lin
- Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chun-Han Chen
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jia-You Fang
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Taoyuan, Taiwan
- Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Priglinger CS, Obermann J, Szober CM, Merl-Pham J, Ohmayer U, Behler J, Gruhn F, Kreutzer TC, Wertheimer C, Geerlof A, Priglinger SG, Hauck SM. Epithelial-to-Mesenchymal Transition of RPE Cells In Vitro Confers Increased β1,6-N-Glycosylation and Increased Susceptibility to Galectin-3 Binding. PLoS One 2016; 11:e0146887. [PMID: 26760037 PMCID: PMC4712018 DOI: 10.1371/journal.pone.0146887] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 12/24/2015] [Indexed: 12/03/2022] Open
Abstract
Epithelial-to-mesenchymal transition (EMT) of retinal pigment epithelial cells is a crucial event in the onset of proliferative vitreoretinopathy (PVR), the most common reason for treatment failure in retinal detachment surgery. We studied alterations in the cell surface glycan expression profile upon EMT of RPE cells and focused on its relevance for the interaction with galectin-3 (Gal-3), a carbohydrate binding protein, which can inhibit attachment and spreading of human RPE cells in a dose- and carbohydrate-dependent manner, and thus bares the potential to counteract PVR-associated cellular events. Lectin blot analysis revealed that EMT of RPE cells in vitro confers a glycomic shift towards an abundance of Thomsen-Friedenreich antigen, poly-N-acetyllactosamine chains, and complex-type branched N-glycans. Using inhibitors of glycosylation we found that both, binding of Gal-3 to the RPE cell surface and Gal-3-mediated inhibition of RPE attachment and spreading, strongly depend on the interaction of Gal-3 with tri- or tetra-antennary complex type N-glycans and sialylation of glycans but not on complex-type O-glycans. Importantly, we found that β1,6 N-acetylglucosaminyltransferase V (Mgat5), the key enzyme catalyzing the synthesis of tetra- or tri-antennary complex type N-glycans, is increased upon EMT of RPE cells. Silencing of Mgat5 by siRNA and CRISPR-Cas9 genome editing resulted in reduced Gal-3 binding. We conclude from these data that binding of recombinant Gal-3 to the RPE cell surface and inhibitory effects on RPE attachment and spreading largely dependent on interaction with Mgat5 modified N-glycans, which are more abundant on dedifferentiated than on the healthy, native RPE cells. Based on these findings we hypothesize that EMT of RPE cells in vitro confers glycomic changes, which account for high affinity binding of recombinant Gal-3, particularly to the cell surface of myofibroblastic RPE. From a future perspective recombinant Gal-3 may disclose a therapeutic option allowing for selectively targeting RPE cells with pathogenic relevance for development of PVR.
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Affiliation(s)
- Claudia S. Priglinger
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
- * E-mail:
| | - Jara Obermann
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | | | - Juliane Merl-Pham
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Uli Ohmayer
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Jennifer Behler
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Fabian Gruhn
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
| | - Thomas C. Kreutzer
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | | | - Arie Geerlof
- Protein Expression and Purification Facility, Institute of Structural Biology, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | | | - Stefanie M. Hauck
- Research Unit Protein Science, Helmholtz Zentrum Munich, German Research Center for Environmental Health (GmbH), Munich, Germany
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Nassar K, Lüke J, Lüke M, Kamal M, Soliman MM, Grisanti S, Grisanti S. Effect of different fixative solutions on eyes with experimental proliferative vitreoretinopathy. Int J Exp Pathol 2015; 96:103-10. [PMID: 25670226 DOI: 10.1111/iep.12119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/05/2015] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to evaluate the use of different fixatives on the reliability of histopathological changes in a rabbit model of proliferative vitreoretinopathy (PVR). Twenty eyes from 10 rabbits were divided into four groups. The right eyes were used in two experimental groups (each n = 5), and the left, in two control groups (each n = 5). Using a newly developed scleral incision marker, an oblique scleral incision was standardized in the experimental groups, followed by intravitreal injection of 0.4 ml autologous blood and the left for wound repair for four weeks. Eyes were enucleated at four weeks. The groups differed in the type of used fixative solution (formaldehyde 4% vs. 1% buffered formaldehyde and 1.25% glutaraldehyde). The eyes were evaluated for the development of fibrosis, retinal detachment (RD), and processed for histopathology. Fibrous ingrowth of a variable degree was present in the experimental groups originating from the trauma site. Experimental eyes fixed with formaldehyde 4% had RD extension that was greater than that fixed in formaldehyde/glutaraldehyde mixture; however, the difference did not reach statistical significance (P = 0.15). This difference was not fully explained by the fibrosis which developed. In addition, in control groups, formaldehyde 4% induced a fixative-dependent retinal separation that was absent in eyes fixed with formaldehyde/glutaraldehyde mixture (P = 0.03). In conclusion, a mixture of buffered formaldehyde 1% and glutaraldehyde 1.25% combined with standardized scleral incision resulted in consistent pathological changes. A reliable PVR model is a condition sine qua non to evaluate antifibrotic treatment strategies.
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Affiliation(s)
- Khaled Nassar
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany.,Department of Ophthalmology, Fayoum University, Fayoum, Egypt
| | - Julia Lüke
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | - Matthias Lüke
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
| | - Mahmoud Kamal
- Department of Ophthalmology, Fayoum University, Fayoum, Egypt
| | | | | | - Swaantje Grisanti
- Department of Ophthalmology, University of Luebeck, Luebeck, Germany
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Yasin MN, Svirskis D, Seyfoddin A, Rupenthal ID. Implants for drug delivery to the posterior segment of the eye: A focus on stimuli-responsive and tunable release systems. J Control Release 2014; 196:208-21. [DOI: 10.1016/j.jconrel.2014.09.030] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 09/28/2014] [Accepted: 09/30/2014] [Indexed: 12/21/2022]
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Chiquet C, Rouberol F. Prolifération vitréo-rétinienne : traitement préventif. J Fr Ophtalmol 2014; 37:737-43. [DOI: 10.1016/j.jfo.2014.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
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Nassar K, Grisanti S, Tura A, Lüke J, Lüke M, Soliman M, Grisanti S. A TGF-β receptor 1 inhibitor for prevention of proliferative vitreoretinopathy. Exp Eye Res 2014; 123:72-86. [PMID: 24742493 DOI: 10.1016/j.exer.2014.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 03/01/2014] [Accepted: 04/03/2014] [Indexed: 02/06/2023]
Abstract
This study evaluates the use of the TGF-β receptor 1 inhibitor LY-364947 (LY) to prevent proliferative vitreoretinopathy (PVR). For the in vitro experiments Human Tenon's Fibroblasts (HTFs) and retinal pigment epithelial (RPE) cells were treated with different concentrations of LY to determine HTF proliferation and RPE transdifferentiation. For in vivo testing 30 rabbits underwent a PVR trauma model. The animals received different concentrations of intravitreally injected LY, with or without vitrectomy. LY treatment reduced HTF proliferation and RPE transdifferentiation in vitro. In vivo intravitreal injection of LY prevented PVR development significantly. This positive effect was also present when LY injection was combined with vitrectomy. Intravitreal injection of LY prevented tractional retinal detachment in 14 out of 15 animals. In conclusion, treatment with the TGF-β receptor 1 inhibitor LY reduces HTF proliferation and RPE transdifferentiation in vitro and prevents proliferative vitreoretinopathy and subsequent tractional retinal detachment in vivo.
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Affiliation(s)
- Khaled Nassar
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany; Fayoum University, Department of Ophthalmology, 63514 Fayoum, Egypt.
| | - Swaantje Grisanti
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - Aysegul Tura
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - Julia Lüke
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - Matthias Lüke
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany
| | - Mahmoud Soliman
- Cairo University, Department of Ophthalmology, 11956 Cairo, Egypt
| | - Salvatore Grisanti
- University of Luebeck, Department of Ophthalmology, Ratzeburger Allee 160, D-23538 Luebeck, Germany
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Barot M, Bagui M, Gokulgandhi MR, Mitra AK. Prodrug strategies in ocular drug delivery. Med Chem 2012; 8:753-68. [PMID: 22530907 DOI: 10.2174/157340612801216283] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 03/07/2012] [Accepted: 03/22/2012] [Indexed: 11/22/2022]
Abstract
Poor bioavailability of topically instilled drug is the major concern in the field of ocular drug delivery. Efflux transporters, static and dynamic ocular barriers often possess rate limiting factors for ocular drug therapy. Different formulation strategies like suspension, ointment, gels, nanoparticles, implants, dendrimers and liposomes have been employed in order to improve drug permeation and retention by evading rate limiting factors at the site of absorption. Chemical modification such as prodrug targeting various nutrient transporters (amino acids, peptide and vitamin) has evolved a great deal of interest to improve ocular drug delivery. In this review, we have discussed various prodrug strategies which have been widely applied for enhancing therapeutic efficacy of ophthalmic drugs. The purpose of this review is to provide an update on the utilization of prodrug concept in ocular drug delivery. In addition, this review will highlight ongoing academic and industrial research and development in terms of ocular prodrug design and delivery.
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Affiliation(s)
- Megha Barot
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA
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Zhou Q, Xu G, Zhang X, Cao C, Zhou Z. Proteomics of Post-Traumatic Proliferative Vitreoretinopathy in Rabbit Retina Reveals Alterations to a Variety of Functional Proteins. Curr Eye Res 2012; 37:318-26. [DOI: 10.3109/02713683.2011.635397] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Evaluation of 5-fluorouracil released from a foldable capsular vitreous body in vitro and in vivo. Graefes Arch Clin Exp Ophthalmol 2011; 250:751-9. [DOI: 10.1007/s00417-011-1862-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 10/20/2011] [Accepted: 11/08/2011] [Indexed: 10/15/2022] Open
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The novel use of decorin in prevention of the development of proliferative vitreoretinopathy (PVR). Graefes Arch Clin Exp Ophthalmol 2011; 249:1649-60. [PMID: 21735240 DOI: 10.1007/s00417-011-1730-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 04/21/2011] [Accepted: 04/24/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The cytokine transforming growth factor-ß (TGF-ß) is a pivotal contributor to tissue fibrosis and a key cytokine in the pathogenesis of cellular transdifferentiation, epithelial-mesenchymal transition (EMT), and cell adhesion. This study evaluates the effect of decorin, a naturally occurring TGF-ß inhibitor, in an experimental rabbit model for proliferative vitreoretinopathy (PVR). METHODS Traumatic PVR was induced in 50 rabbits divided into ten groups (n = 5). One group (GI) reveals a control with no treatment after trauma. Groups (GII-GIV) consisted of subgroups receiving phacovitrectomy at three different time points; (a) at the time of trauma, (b) 1 week following trauma, and (c) 2 weeks following trauma. GIII and GIV received 100 μg or 200 μg decorin, respectively. PVR severity was scored from 0 to 4. The amount of fibrosis was quantified using JMicroVision© software. RESULTS The control group GI developed severe PVR with tractional retinal detachment (TRD); (PVR score ≥2) in four rabbits out of five. Vitrectomy had a positive effect (p < 0.05) on PVR development when preformed immediately, however the developed fibrosis was high. The best results were obtained when surgery was used in conjunction with decorin that reduced both the PVR score and fibrosis development significantly (p < 0.05). Depending on dosage and time of vitrectomy, PVR could be completely avoided (PVR score = 0) in 16 rabbits out of 30. TRD was prevented in 13 rabbits out of 15 in GIII to 14 rabbits out of 15 in GIV. In decorin-treated eyes, vitrectomy outcome was best when preformed at 1 week after trauma. There were no drug-related toxic effects evident on clinical and histopathological examination. CONCLUSIONS In conclusion, in this rabbit model of PVR, adjuvant decorin application during vitrectomy effectively reduces fibrosis and TRD development. In conjunction with no obvious histopathological toxicity signs, decorin represents a promising substance to inhibit PVR reactions.
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Das N, Dhanawat M, Dash B, Nagarwal R, Shrivastava S. Codrug: An efficient approach for drug optimization. Eur J Pharm Sci 2010; 41:571-88. [DOI: 10.1016/j.ejps.2010.09.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 09/20/2010] [Accepted: 09/23/2010] [Indexed: 02/06/2023]
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Yin H, Gong C, Shi S, Liu X, Wei Y, Qian Z. Toxicity evaluation of biodegradable and thermosensitive PEG-PCL-PEG hydrogel as a potential in situ sustained ophthalmic drug delivery system. J Biomed Mater Res B Appl Biomater 2010; 92:129-37. [PMID: 19802831 DOI: 10.1002/jbm.b.31498] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this work, a biodegradable poly(ethylene glycol)-poly(epsilon-caprolactone)-poly (ethylene glycol) (PEG-PCL-PEG, PECE) triblock copolymer was successfully synthesized, which was flowing sol at low temperature and turned to nonflowing gel at body temperature. The toxicity evaluation of PECE hydrogel as a potential in situ sustained opthalmic drug delivery system was performed, including the biodegradability of PECE hydrogel in the eye, its effect on cultured human lens epithelia, intraocular pressure, and ocular tissues. The results indicated that the prepared PECE hydrogel was biocompatible and biodegradable despite of temporary elevated intraocular pressure and slight corneal endothelial damage at specific concentration. Therefore, PECE hydrogel may be a safe candidate for sustained ophthalmic drug delivery system.
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Affiliation(s)
- HongBo Yin
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Abstract
BACKGROUND Intravitreal injection (IVI) with administration of various pharmacological agents is a mainstay of treatment in ophthalmology for endopthalmitis, viral retinitis, age-related macular degeneration, cystoid macular edema, diabetic retinopathy, uveitis, vascular occlusions, and retinal detachment. The indications and therapeutic agents are reviewed in this study. METHODS A search of the English, German, and Spanish language MEDLINE database was conducted. A total of 654 references spanning the period through early 2008 were individually evaluated. RESULTS The advantage of the IVI technique is the ability to maximize intraocular levels of medications and to avoid the toxicities associated with systemic treatment. Intravitreal injection has been used to deliver several types of pharmacological agents into the vitreous cavity: antiinfective and antiinflammatory medications, immunomodulators, anticancer agents, gas, antivascular endothelial growth factor, and several others. The goal of this review is to provide a detailed description of the properties of numerous therapeutic agents that can be delivered through IVI, potential complications of the technique, and recommendations to avoid side effects. CONCLUSION The IVI technique is a valuable tool that can be tailored to the disease process of interest based on the pharmacological agent selected. This review provides the reader with a comprehensive summary of the IVI technique and its multitude of uses.
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Affiliation(s)
- Gholam A Peyman
- Department of Ophthalmology and Vision Science, College of Medicine, University of Arizona, Tucson, Arizona 85351, USA.
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Cheng L, Hostetler K, Valiaeva N, Tammewar A, Freeman WR, Beadle J, Bartsch DU, Aldern K, Falkenstein I. Intravitreal crystalline drug delivery for intraocular proliferation diseases. Invest Ophthalmol Vis Sci 2009; 51:474-81. [PMID: 19696179 DOI: 10.1167/iovs.09-3672] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE A long-lasting, slow-release, crystalline antiviral drug delivery system was initially reported using ganciclovir and cyclic cidofovir as the prototype compounds. The present study was undertaken to investigate the feasibility of applying this system to antiproliferative small molecules. METHODS The crystalline lipid prodrugs of hexadecyloxypropyl-arabinofuranosylguanine 5'-monophosphate (HDP-P-AraG), hexadecyloxypropyl 5-fluoro-2'-deoxyuridine cyclic 3',5'-monophosphate (HDP-cP-5-F-2dUrd), and hexadecyloxypropyl 5-fluoro-2'-deoxyuridine 5'-monophosphate (HDP-P-5-F-2dUrd) were synthesized from their parent compounds arabinofuranosylguanine (AraG) and 5-fluoro-2'-deoxyuridine (5-F-2dUrd). All three compounds were tested at escalating doses in rabbit eyes. Only one eye of each animal was injected with test compound, and the fellow eye was injected with 5% dextrose as the control. The injected eyes were monitored by slit lamp, a handheld tonometer, indirect ophthalmoscopy, electroretinography (ERG), and histology. The selected doses were used for efficacy study with the rat CNV model or the rabbit PVR model. RESULTS The highest nontoxic dose for HDP-P-AraG was 75 microg/eye, and was 70 and 210 microg/eye for HDP-P-5-F-2dUrd and HDP-cP-5-F-2dUrd, respectively. All compounds demonstrated a localized depot of crystalline aggregate in the vitreous with a clear view of vitreous and retina elsewhere. The drug depot of HDP-P-AraG was visible for 4 to 5 weeks; HDP-P-5-F-2dUrd, 8 to 10 weeks; and HDP-cP-5-F-2dUrd longer than 14 weeks. The treatment study showed HDP-P-AraG led to 33% reduction in CNV in the rat (P = 0.015), and HDP-cP-5-F-2dUrd provided 100% prevention of trauma-induced PVR in the rabbit (P = 0.046). The pretreatment study demonstrated a significant protection against intraocular proliferation compared with the 5-FU in a parallel study (P = 0.014). CONCLUSIONS The intravitreous injectable lipid prodrugs of AraG and 5-fluoro-2'-deoxyuridine could be long-lasting, slow-release, antiproliferative compounds to treat unwanted intraocular proliferation.
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Affiliation(s)
- Lingyun Cheng
- Jacobs Retina Center at Shiley Eye Center, University of California, San Diego, La Jolla, California, USA.
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Hashemi N, Shomali S, Heyrani-Moghaddam H, Amini S, Izadi S. Sub-tenon atracurium injection in rabbit eyes;a histopathologic study. J Ophthalmic Vis Res 2009; 4:35-9. [PMID: 23056672 PMCID: PMC3448381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 08/20/2008] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate early and late histopathologic changes following posterior sub-Tenon injection of atracurium in the rabbit eye. METHODS This study was performed on 39 healthy white New Zealand rabbits which received sub-Tenon injection of 0.05-0.08 mg/kg atracurium diluted in 0.5 ml normal saline (N/S) in the left and 0.5 ml N/S in the right eyes. Bilateral enuclation was performed one hour after the injection to evaluate early changes in 19 rabbits and one week later to determine late changes in the remaining 20 animals. After enucleation, the rabbits were euthanized. Enucleated eyes were sent in 10% formalin solution for histopathologic examination. After processing, the specimens were evaluated by light microscopy following staining with hematoxylin and eosin, and trichrome. RESULTS Congestion was more common in the control group 1 hour after injection.Liquifaction necrosis was seen in both groups but was significantly increased one week after the injection in the atracurium group. CONCLUSION Congestion is a transient complication related to injection which disappears after one week, but necrosis seems to be an important late complication of atracurium injection.
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Affiliation(s)
- Nafiseh Hashemi
- Correspondence to:Nafiseh Hashemi, MD. Assistant Professor of Ophthalmology; Department of Ophthalmology,Alzahra Eye Hospital, Zahedan University of Medical Sciences, Zahedan, Iran; Tel: +98 912 1776585, Fax: +98 5413233550; e-mail:
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Howard-Sparks M, Al-Ghananeem AM, Crooks PA, Pearson AP. A Novel Chemical Delivery System Comprising an Ocular Sustained Release Formulation of a 3α, 17α, 21-trihydroxy-5β-pregnan-20-one-BIS-5-Flourouracil Codrug. Drug Dev Ind Pharm 2008; 33:677-82. [PMID: 17613031 DOI: 10.1080/03639040601134108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Directly compressed sustained release pellets were prepared from material consisting of a molecule of 3alpha, 17alpha, 21-trihydroxy-5beta-pregnan-20-one (trihydroxy steroid, THS) covalently linked via carbonate moieties to two molecules of 5-flourouracil (5FU) to form a novel THS-BIS-5FU codrug for the treatment of angiogenesis. Dissolution and drug release was tested in vitro in 0.1M phosphate buffer (pH 7.4), human serum, and vitreous humor. The results suggest that neat THS-BIS-5FU codrug pellets are useful for sustained release ocular delivery of the parent compounds, and that the unique physicochemical properties of the codrug allow slow dissolution and rapid release of the two parent drugs. This codrug formulation is regarded as a "chemical delivery" system that involves dissolution of the codrug as the rate-limiting step followed by rapid hydrolysis of the carbonate ester linkages to release the parent drugs via sustained delivery.
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Affiliation(s)
- Michelle Howard-Sparks
- College of Pharmacy, Chandler Medical Center, University of Kentucky, Lexington, Kentucky 40536-0082, USA
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Al-Ghananeem AM, Crooks PA. Phase I and phase II ocular metabolic activities and the role of metabolism in ophthalmic prodrug and codrug design and delivery. Molecules 2007; 12:373-88. [PMID: 17851396 PMCID: PMC6149453 DOI: 10.3390/12030373] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Revised: 02/05/2007] [Accepted: 02/05/2007] [Indexed: 11/16/2022] Open
Abstract
While the mammalian eye is seldom considered an organ of drug metabolism, the capacity for biotransformation is present. Compared to the liver, the metabolic capabilities of the eye are minuscule; however, phase I and phase II metabolic activities have been detected in various ocular structures. The careful consideration of ocular tissue metabolic processes within the eye has important implications for controlling the detoxification of therapeutic agents and for providing the potential for site-specific bio-activation of certain drug molecules, thus enabling significant improvements in drug efficacy and the minimization of side-effect from either local or systemic drug delivery to the eye. Knowledge of these processes is important to prodrug and codrug development and to researchers involved in the design, delivery and metabolism of ophthalmic drugs. This present article reviews the progress in ocular prodrug and codrug design and delivery in light of ocular metabolic activities.
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Affiliation(s)
- Abeer M. Al-Ghananeem
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, USA; e-mail:
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Abstract
Fluorouracil (5-fluorouracil, 5-FU) is a pyrimidine analogue that was originally known for its widespread use as an anticancer drug. The ability of 5-FU to reduce fibroblastic proliferation and subsequent scarring has made it an important adjunct in ocular and periorbital surgeries. It is used in primary glaucoma filtering surgeries and in reviving failing filtering blebs, in dacryocystorhinostomy, pterygium surgery, and in vitreoretinal surgery to prevent proliferative vitreoretinopathy. In addition, 5-FU is also gaining recognition in the treatment and surgical management of ocular surface malignancies like ocular surface squamous neoplasia; however, the specific action of the drug on highly proliferating cells limits its use in primary acquired melanosis of the conjunctiva. When applied topically, this drug has a low rate of sight-threatening adverse effects, is inexpensive, and is easy to administer, making it an important tool in enhancing the success rate in ophthalmic surgery and in reducing the recurrence of ocular surface neoplasia.
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Affiliation(s)
- Lekha M Abraham
- Glaucoma Services, South Australian Institute of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, Australia
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