Rationale for anti-inflammatory therapy in dry eye syndrome

Paiva, Cintia S. de; Pflugfelder, Stephen C.

doi:10.1590/s0004-27492008000700017

Cited by 79 publications

(59 citation statements)

References 84 publications

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“…39 Regardless of the initiating cause, a vicious cycle of inflammation resulting from activation of an inflammatory cascade on the ocular surface may lead to eye damage. 40 In light of research findings suggesting that inflammatory mediators are involved in DES, the use of anti-inflammatory therapy has been gaining popularity. 41 The major anti-inflammatory agents currently in use include topical corticosteroids and immunomodulatory agents.…”

Section: Discussionmentioning

confidence: 99%

“…Such side effects limit the use or corticosteroids in the chronic treatment of DES. 40 Meanwhile, some topical immunomodulatory agents have been approved by the FDA for use on the ocular surface, such as Restasis, which is based on CsA. However, the controversial adverse effects, such as burning and stinging eyes, conjunctival hyperemia, cataracts, and eye pain, have led to the discontinuation of treatments based on CsA.…”

mentioning

confidence: 99%

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Anti-inflammatory effects of hinokitiol on human corneal epithelial cells: an in vitro study

et al. 2015

Eye

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Anti-inflammatory effects of hinokitiol on human corneal epithelial cells: an in vitro study

et al. 2015

Eye

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“…8 Inflammation can simultaneously be both a triggering and an exacerbating factor of the disease. 9,10,34 Cyclosporin and steroids are the main classes of anti-inflammatory compounds found in prescription medicines routinely used for the treatment of signs and/or symptoms of dry eye. [35][36][37] Cyclosporin, as compounded hospital preparations or Restasis Ò (0.05%…”

Section: Discussionmentioning

confidence: 99%

“…However, DED seems to be invariably associated with chronic inflammation of the ocular surface, although it is not known whether the local inflammation is causative 8 or simply occurs as a consequence of ocular dryness. 9,10 Regardless of the level of DED severity, frequent applications of artificial tears (ATs) remain a widely accepted and first-line treatment strategy for close to 80% of patients. 11,12 These supplements, depending on their formulation and active ingredients, are intended to (i) expand tear volume in aqueous tear deficiency; (ii) improve symptoms of dry eye in meibomian gland dysfunction patients 13 ; and (iii) enhance the tear film (TF) lipid layer of the TF and therefore improve TF stability and reduce tear evaporation.…”

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confidence: 99%

Comparison of the anti‐inflammatory effects of artificial tears in a rat model of corneal scraping

Daull¹,

Feraille²,

Elena³

et al. 2012

Acta Ophthalmologica

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Purpose: Artificial tears (ATs) are used routinely to alleviate the symptoms of mild to moderate dry eye. Preservative-free cationic emulsions (eg, Cationorm Ò ) are an innovative approach for the management of signs and symptoms of dry eye. The aim of the present exploratory experiment was to evaluate the efficacy of this cetalkonium chloride (CKC)-containing cationic emulsion on debrided cornea and to characterize its effects on scraping-induced inflammation. Methods: Four ATs were assessed in a rat model of corneal scraping. The upper part of the corneal epithelium was scraped before a 5-day treatment, followed by clinical evaluations and fluorescein staining to evaluate cornea recovery. The anti-inflammatory efficacy of the ATs was assessed in vivo and in vitro. Results: In vivo confocal microscopy (IVCM) revealed a trend toward better corneal clinical signs (lower IVCM scores) for the animals treated with the unpreserved ATs. Benzalkonium chloride treatment decreased goblet cell count by 37.5%. While the soft-preserved Systane Balance Ò and Optive Ò and the preservative-free Vismed Ò had no effect on the goblet cell count, Cationorm increased this count by almost 40%. Interestingly, inflammatory cell infiltration in the stroma was at its lowest following treatment with the preservative-free Cationorm. Cationorm is also the only AT decreasing IL6-and IL8-stimulated secretion by 59% and 74%, respectively. Conclusion: By restoring an adequately hydrated ocular surface environment, the different ATs promote corneal epithelium healing. These data position Cationorm as a promising AT for the management of signs and symptoms of dry eye in patients with mild to moderate dry eye disease presenting chronic subclinical levels of ocular inflammation.

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“…Its aetiology is varied and is associated with immunological, genetic, therapeutic, hormonal, and environmental factors (4) . The treatment of KCS depends on its severity; mild KCS is treated with artificial tears, while therapy with immunosuppressive drugs such as topical cyclosporin A (CsA) is recommended in moderate and severe forms (5,6) . CsA is a potent immunosuppressive agent isolated from the fungus Tolypocladium inflatum gams, which acts by inhibiting T-cell activity and suppressing inflammatory cytokines in the conjunctiva and lacrimal gland (7,8) .…”

mentioning

confidence: 99%

Sistema de liberação contendo ciclosporina para o tratamento de ceratoconjuntivite seca: estudo preliminar

Fulgêncio¹,

Saliba²,

Júnior³

2013

Rev. bras.oftalmol.

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RESUMOObjetivo: Este trabalho objetivou o desenvolvimento de um sistema mucoadesivo de liberação de ciclosporina A (CsA) para o tratamento de ceratoconjuntivite seca (CCS). Métodos: O sistema mucoadesivo foi preparado na forma de filme utilizando o polímero quitosana e CsA (25%p/v). Foram administrados no saco conjuntival do olho direito de coelhos normais (n=6) e a aferição da produção de lágrimas foi realizada diariamente antes e após a aplicação, de forma bilateral, durante sete dias, por meio do teste lacrimal de Schirmer. Avaliação oftalmológica foi realizada diariamente durante todo o estudo e seguido da análise histológica. Resultados: Os valores médios de produção de lágrimas foram alterados de 9,88 ± 0,37 mm/min para 16,02 ± 0,38 mm/min antes e após a administração do sistema respectivamente, significando um aumento de aproximadamente 60%. Todos os coelhos apresentaram hiperemia da conjuntiva palpebral e lacrimejamento. A hiperemia permaneceu durante 48 h após administração dos sistemas com resolução espontânea e o lacrimejamento foi diagnosticado até o final do experimento. Não foram observados outros sinais de reações indesejáveis. Nenhuma alteração histológica foi observada na mucosa conjuntival bulbar e palpebral à histopatologia. Conclusão: Os sistemas desenvolvidos são aparentemente seguros e eficientes criando expectativa para o tratamento da CCS. Novos estudos são necessários para avaliar a concentração de CsA liberada, assim como aceitabilidade e toxicidade dos sistemas em tratamentos mais prolongados.Descritores: Ceratoconjuntivite seca/terapia; Ciclosporina/uso terapêutico; Sistemas de liberação de medicamentos

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Rationale for anti-inflammatory therapy in dry eye syndrome

Cited by 79 publications

References 84 publications

Anti-inflammatory effects of hinokitiol on human corneal epithelial cells: an in vitro study

Anti-inflammatory effects of hinokitiol on human corneal epithelial cells: an in vitro study

Comparison of the anti‐inflammatory effects of artificial tears in a rat model of corneal scraping

Sistema de liberação contendo ciclosporina para o tratamento de ceratoconjuntivite seca: estudo preliminar

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