Corneal Epithelium in Diabetic Patients

Tsubota, Kazuo; Chiba, Keizo; Shimazaki, Jun

doi:10.1097/00003226-199103000-00011

Cited by 60 publications

(30 citation statements)

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“…These findings are in agreement with some reports involving diabetic patients (27). Nevertheless, other investigators have reported changes in one or the other of these parameters (10).…”

Section: Discussionsupporting

confidence: 93%

Insulin Treatment Ameliorates Impaired Corneal Reepithelialization in Diabetic Rats

Zagon

Sassani²,

McLaughlin

2006

Diabetes

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Patients with diabetes are at an increased risk for developing corneal disorders, often as a result of surgical and nonsurgical trauma. This study investigated whether intensive treatment of diabetes with the goal of maintaining blood glucose concentrations close to the normal range could ameliorate the delayed corneal wound healing found in animals with uncontrolled diabetes. Diabetes was induced with streptozotocin, and rats were divided into groups based on the degree of blood glucose control: 1) not treated with insulin implants (DB group), 2) receiving insulin implants and determined to be normoglycemic (DB-IN group), and 3) normal, nondiabetic animals serving as controls. Immediately before wounding at 9 or 11 weeks after the induction of the diabetic state, corneal thickness and corneal sensitivity of the DB and DB-IN groups were comparable with controls. DB, but not DB-IN, rats exhibited subnormal intraocular pressure. At 9 and 11 weeks after the onset of diabetes, the corneas of the right and left eyes, respectively, were abraded by mechanical scraping. The DB rats had residual corneal epithelial defects that ranged from 23% to 5.6-fold larger compared with the control group and a rate of healing that was 19% slower than control animals. The DB-IN group had healing characteristics similar to the control group. DNA synthesis in the peripheral cornea and conjunctiva, but not the limbus, of DB animals was reduced 50 and 91%, respectively, from control levels. Cell proliferation in the DB-IN group was comparable with the control group, with the exception of a 72% increase in the peripheral cornea in the DB-IN group. These results indicate that intensive therapy with insulin, which establishes normoglycemia in rats with diabetes, prevents the delay in wound healing of ocular surface epithelium observed in poorly controlled diabetic animals.

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“…These findings are in agreement with some reports involving diabetic patients (27). Nevertheless, other investigators have reported changes in one or the other of these parameters (10).…”

Section: Discussionsupporting

confidence: 93%

Insulin Treatment Ameliorates Impaired Corneal Reepithelialization in Diabetic Rats

Zagon

Sassani²,

McLaughlin

2006

Diabetes

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“…Histologically, it involves a thickening of the corneal epithelial basement membrane and morphologic changes in the corneal epithelium and endothelium. [6][7][8][9][10][11] Clinically, the damage to the corneal epithelium during vitreous surgery and retinal photocoagulation sometimes induces vision-threatening corneal complications, such as persistent epithelial defects in diabetic patients. 12) It has been reported that such diabetic keratopathy is experienced by 50% or more of diabetic patients.…”

mentioning

confidence: 99%

Enhancing Effects of Sericin on Corneal Wound Healing in Otsuka Long-Evans Tokushima Fatty Rats as a Model of Human Type 2 Diabetes

Nagai

Murao

Ito

et al. 2009

Biological & Pharmaceutical Bulletin

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Diabetes mellitus is a common metabolic disorder that affects more than 190 million people worldwide.1,2) The prevalence of type 2 diabetes mellitus is increasing rapidly, and currently affects the health of millions of humans now, and will continue to do so in the near future. Among the factors that are responsible for the increasing prevalence of this disease are obesity, the consumption of energy-dense diets and low levels of physical activity.3) Type 2 diabetes results from the failure of pancreatic beta cells to adequately compensate for obesity and insulin resistance. 4)Ocular complications secondary to type 2 diabetes mellitus are a well-known cause of diabetic keratopathy. 5) Diabetic keratopathy is an entity that includes slow healing or loose adhesion of the corneal epithelium after wounding in diabetic patients. Histologically, it involves a thickening of the corneal epithelial basement membrane and morphologic changes in the corneal epithelium and endothelium. [6][7][8][9][10][11] Clinically, the damage to the corneal epithelium during vitreous surgery and retinal photocoagulation sometimes induces vision-threatening corneal complications, such as persistent epithelial defects in diabetic patients.12) It has been reported that such diabetic keratopathy is experienced by 50% or more of diabetic patients. 13)The corneal wound repair process involves cell adhesion, migration, proliferation, matrix deposition and tissue remodeling.14) Many of these biological processes are mediated by growth factors, cytokines and other mediators released in injured tissues or cells.15) These growth factors have been recognized as important mediators of proper wound repair, 16) and treatment with growth factors such as platelet-derived growth factor-BB, and recombinant human epidermal growth factor has been shown to be beneficial for patients with chronic pressure ulcers or non-healing diabetic ulcers. [17][18][19][20] However, for reasons of effectiveness, safety and stable supply, a potent wound-healing agent for human corneal wounds has not yet been introduced, and the development of effective and safe corneal wound-healing drugs is highly anticipated.Proteins such as fibroin and sericin are the main constituents of silk, with fibroin contributing 70 to 80% and sericin 20 to 30% of the total cocoon weight.21) When cocoons or raw silk are used for textiles, the sericin is mostly removed from the cocoon and disposed of unused. However, sericin has recently been investigated for its activities in biotechnological fields. 22,23) We reported that sericin instillation has a potent effect in promoting wound healing and wound-size reduction in rats.24) Therefore, it is possible that sericin may be applied as eye drops for corneal wound repair in diabetic patients. In this study, we investigated the enhancing effects of sericin on corneal wound healing in the debrided corneal epithelium of Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model for human type 2 diabetes. MATERIALS AND METHODS Animals and Reagents Male Long-Eva...

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“…Type 2 diabetes mellitus results from the failure of pancreatic beta cells to compensate adequately for obesity and insulin re-athy is a pathology that includes slow healing or loose adhesion of the corneal epithelium after wounding in diabetic patients. Histologically, it involves a thickening of the corneal epithelial basement membrane and morphologic changes in the corneal epithelium and endothelium [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Kinetic Analysis of the Rate of Corneal Wound Healing in Otsuka Long-Evans Tokushima Fatty Rats, a Model of Type 2 Diabetes Mellitus

et al. 2010

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Diabetic keratopathy is a well-known ocular complication secondary to type 2 diabetes mellitus. In this study, we performed a kinetic analysis of corneal wound healing in Long-Evans rats (normal rat) and Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of type 2 diabetes mellitus. Corneal wound healing in 7-week-old normal rats was mostly complete 24 h after corneal epithelial abrasion, and the process of corneal wound healing took place according to an equation with a fi rst-order rate constant. The rate of corneal wound healing in normal rats decreased with aging. The process of corneal wound healing in 38-and 60-week-old normal and OLETF rats occurred in two phases with rate constants for the fi rst and second phases represented as α and β, respectively. The α and β values in 38-and 60-week-old OLETF rats were lower than those in normal rats of the corresponding age. Furthermore, a close relationship was observed between the corneal wound healing rate constant and plasma glucose levels in OLETF rats. The present studies suggest the sequence of events that occur following damage to the corneal surface in OLETF rats as a model animal for a human type 2 diabetes mellitus.

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Corneal Epithelium in Diabetic Patients

Cited by 60 publications

References 0 publications

Insulin Treatment Ameliorates Impaired Corneal Reepithelialization in Diabetic Rats

Insulin Treatment Ameliorates Impaired Corneal Reepithelialization in Diabetic Rats

Enhancing Effects of Sericin on Corneal Wound Healing in Otsuka Long-Evans Tokushima Fatty Rats as a Model of Human Type 2 Diabetes

Kinetic Analysis of the Rate of Corneal Wound Healing in Otsuka Long-Evans Tokushima Fatty Rats, a Model of Type 2 Diabetes Mellitus

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