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Salvetat ML, Pellegrini F, Spadea L, Salati C, Zeppieri M. Pharmaceutical Approaches to Normal Tension Glaucoma. Pharmaceuticals (Basel) 2023; 16:1172. [PMID: 37631087 PMCID: PMC10458083 DOI: 10.3390/ph16081172] [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: 07/05/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Normal tension glaucoma (NTG) is defined as a subtype of primary open-angle glaucoma (POAG) in which the intraocular pressure (IOP) values are constantly within the statistically normal range without treatment and represents approximately the 30-40% of all glaucomatous cases. The pathophysiology of this condition is multifactorial and is still not completely well known. Several theories have been proposed to explain the onset and progression of this disease, which can be divided into IOP-dependent and IOP-independent factors, suggesting different therapeutic strategies. The current literature strongly supports the fundamental role of IOP in NTG. The gold standard treatment for NTG tends to be based on the lowering IOP even if "statistically normal". Numerous studies have shown, however, that the IOP reduction alone is not enough to slow down or stop the disease progression in all cases, suggesting that other IOP-independent risk factors may contribute to the NTG pathogenesis. In addition to IOP-lowering strategies, several different therapeutic approaches for NTG have been proposed, based on vaso-active, antioxidant, anti-inflammatory and/or neuroprotective substances. To date, unfortunately, there are no standardized or proven treatment alternatives for NTG when compared to traditional IOP reduction treatment regimes. The efficacy of the IOP-independent strategies in decreasing the risk or treating NTG still remains inconclusive. The aim of this review is to highlight strategies reported in the current literature to treat NTG. The paper also describes the challenges in finding appropriate and pertinent treatments for this potentially vision-threatening disease. Further comprehension of NTG pathophysiology can help clinicians determine when to use IOP-lowering treatments alone and when to consider additional or alternatively individualized therapies focused on particular risk factors, on a case-by-case basis.
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Affiliation(s)
- Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Francesco Pellegrini
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, 00142 Rome, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Mastropasqua L, Agnifili L, Ferrante C, Sacchi M, Figus M, Rossi GCM, Brescia L, Aloia R, Orlando G. Citicoline/Coenzyme Q10/Vitamin B3 Fixed Combination Exerts Synergistic Protective Effects on Neuronal Cells Exposed to Oxidative Stress. Nutrients 2022; 14:nu14142963. [PMID: 35889920 PMCID: PMC9316190 DOI: 10.3390/nu14142963] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The present study aimed to investigate the rationale and efficacy of using a citicoline, coenzyme Q10 (CAVAQ10) and vitamin B3 fixed combination in combating inflammation and oxidation in neuronal cells exposed to oxidative stress. Methods: HypoE22 cells and isolated hypothalamic specimens were selected as in vitro models to conduct the experiments. The efficacy of citicoline, CAVAQ10, and vitamin B3, with their fixed combination, were assayed after the exposure of hypothalamic cells to hydrogen peroxide (concentration range 1 nM–10 µM), in order to evaluate the biocompatibility of treatments. The activity of neuroprotective and pro-inflammatory factors, namely, brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), and tumor necrosis factor-α (TNFα), involved in the neuronal cell damage in neurodegenerative diseases, were assayed in isolated hypothalamus. Results: Neither citicoline, CAVAQ10, nor vitamin B3 significantly altered hypothalamic cell viability, thus suggesting the biocompatibility of single ingredients and fixed combination in the concentration range considered for the study. In the same condition, citicoline and CAVAQ10 were also effective in reducing the gene expression of monoaminoxidase-B, involved in dopamine degradation. However, only citicoline demonstrated an ability to reduce dopamine levels. Conversely, all compounds were effective in reducing the gene expression of IL-6, and TNFα, and in inducing the gene expression of BDNF, with the co-administration of citicoline/CAVAQ10/vitamin B3 being generally more effective than single ingredients. Conclusions: The present findings support the beneficial and synergistic effects of citicoline, CAVAQ10, and vitamin B3 in fixed combination in reducing inflammation and oxidation, and in stimulating neurotrophin production in neuronal cells.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
| | - Luca Agnifili
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
- Correspondence: (L.A.); (L.B.); Tel.: +39-0871-358489 (L.A. & L.B.); Fax: +39-0871-358794 (L.A. & L.B.)
| | - Claudio Ferrante
- Department of Pharmacy, G. d’Annunzio University, 66013 Chieti, Italy; (C.F.); (G.O.)
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, IRCCS Multimedica, 20900 Milan, Italy;
| | - Michele Figus
- Ophthalmology Unit, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, 56124 Pisa, Italy;
| | | | - Lorenza Brescia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
- Correspondence: (L.A.); (L.B.); Tel.: +39-0871-358489 (L.A. & L.B.); Fax: +39-0871-358794 (L.A. & L.B.)
| | - Raffaella Aloia
- Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (R.A.)
| | - Giustino Orlando
- Department of Pharmacy, G. d’Annunzio University, 66013 Chieti, Italy; (C.F.); (G.O.)
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Młynarczyk M, Falkowska M, Micun Z, Obuchowska I, Kochanowicz J, Socha K, Konopińska J. Diet, Oxidative Stress, and Blood Serum Nutrients in Various Types of Glaucoma: A Systematic Review. Nutrients 2022; 14:nu14071421. [PMID: 35406033 PMCID: PMC9002851 DOI: 10.3390/nu14071421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/11/2022] Open
Abstract
Glaucoma is one of the most common causes of irreversible vision loss worldwide. It is an insidious disease with a multifactorial pathogenesis. Despite progress in treatment methods, prevention and lifestyle modifications may be useful in slowing the progression of this disease. This systematic review aimed to evaluate the influence of diet, oxidative stress, and disturbances in blood serum levels of nutrients on the incidence and severity of glaucoma based on scientific reports on the role of nutrition in the pathogenesis and course of glaucoma. This paper presents an analysis of the above issues; however, further research is required to develop this topic. Future clinical trials are needed to assess the influence of nutrition and to develop nutritional management strategies for patients with glaucoma.
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Affiliation(s)
- Maryla Młynarczyk
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Martyna Falkowska
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Białystok, Poland; (M.F.); (K.S.)
| | - Zuzanna Micun
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Iwona Obuchowska
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
| | - Jan Kochanowicz
- Department of Neurology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland;
| | - Katarzyna Socha
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D, 15-222 Białystok, Poland; (M.F.); (K.S.)
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Białystok, M. Skłodowskiej-Curie 24a, 15-276 Białystok, Poland; (M.M.); (Z.M.); (I.O.)
- Correspondence: ; Tel.: +48-600471666
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Healthy Lifestyle Score and Incidence of Glaucoma: The Sun Project. Nutrients 2022; 14:nu14040779. [PMID: 35215429 PMCID: PMC8879768 DOI: 10.3390/nu14040779] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The relationship between modifiable risk factors, such as diet and lifestyle, and glaucoma remains controversial. We analyse the effect of the Mediterranean lifestyle (ML) on glaucoma incidence in the “Seguimiento Universidad de Navarra” (SUN) Project. Methods: The SUN Healthy Lifestyle Score (SHLS) includes 10 healthy habits: never having smoked, moderate to high physical activity, Mediterranean diet adherence, moderate alcohol consumption, low television exposure, no binge drinking, short afternoon napping, meeting up with friends, working at least 40 h/wk, and low body mass index. The information was collected biennially through self-reported questionnaires. The relationship between new glaucoma cases and the SHLS was assessed by Cox regression using hazard ratios. Crude, multi-adjusted, and sensitivity analyses were performed. Results: During a median of 12 years of follow-up, 261 (1.42%) new cases of glaucoma were identified among 18,420 participants. After adjusting for potential confounders, participants in the healthiest SHLS category showed a significantly reduced risk of glaucoma compared to those in the lowest SHLS category (adjusted HR = 0.51, 95% CI = 0.28–0.93). For each point added to the SHLS, the risk of glaucoma relatively dropped 5%. Conclusions: Higher adherence to a ML, measured by the SHLS, was significantly associated with a lower risk of developing glaucoma. Based on our study, the ML is a protective factor for glaucoma incidence.
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de Souza Guedes L, Martinez RM, Bou-Chacra NA, Velasco MVR, Rosado C, Baby AR. An Overview on Topical Administration of Carotenoids and Coenzyme Q10 Loaded in Lipid Nanoparticles. Antioxidants (Basel) 2021; 10:1034. [PMID: 34206935 PMCID: PMC8300771 DOI: 10.3390/antiox10071034] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
Carotenoids and coenzyme Q10 are naturally occurring antioxidant compounds that are also found in human skin. These bioactive compounds have been the focus of considerable research due to their antioxidant, anti-inflammatory, and photoprotective properties. In this review, the current state of the art in the encapsulation of carotenoids and coenzyme Q10 in lipid nanoparticles to improve their bioavailability, chemical stability, and skin absorption is discussed. Additionally, the main findings are highlighted on the cytotoxic and photoprotective effects of these systems in the skin.
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Affiliation(s)
- Luciana de Souza Guedes
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (L.d.S.G.); (R.M.M.); (N.A.B.-C.); (M.V.R.V.)
| | - Renata Miliani Martinez
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (L.d.S.G.); (R.M.M.); (N.A.B.-C.); (M.V.R.V.)
| | - Nádia A. Bou-Chacra
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (L.d.S.G.); (R.M.M.); (N.A.B.-C.); (M.V.R.V.)
| | - Maria Valéria Robles Velasco
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (L.d.S.G.); (R.M.M.); (N.A.B.-C.); (M.V.R.V.)
| | - Catarina Rosado
- CBIOS, Universidade Lusófona’s Research Center for Biosciences & Health Technologies, 1749-024 Lisbon, Portugal;
| | - André Rolim Baby
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil; (L.d.S.G.); (R.M.M.); (N.A.B.-C.); (M.V.R.V.)
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