The role of topical N-acetylcysteine in ocular therapeutics

Eghtedari, Yas; Oh, Lawrence; Girolamo, Nick Di; Watson, Stephanie

doi:10.1016/j.survophthal.2021.07.008

Cited by 25 publications

(21 citation statements)

References 87 publications

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“… Note : Data from these studies 15 , 19 , 20 , 23 , 30 , 36–39 , 41 , 42 , 47 , 61 , 62 . Abbreviations : CF, cystic fibrosis; CFTR-RD, cystic fibrosis transmembrane conductance regulator-related disorder; DED, dry eye disease; pRNFL, peripapillary retinal nerve fiber layer; SPEED, Standard Patient Evaluation of Eye Dryness; OSDI, Ocular Surface Disease Index; TBUT, tear break-up time; MMP-9, matrix metalloproteinase-9; ELISA, enzyme-linked immunosorbent assay; IL-8, interleukin-8; IFN-γ, interferon-γ; MIP-1α, macrophage inflammatory protein-1α; MIP-1β, macrophage inflammatory protein-1β.…”

Section: Discussionmentioning

confidence: 99%

“…Squibb & Sons, LLC, New Brunswick, NJ), are indicated for controlling pulmonary mucus obstructions, topical N-acetylcysteine medications, which were utilized in patient #1, can also be used to manage inflammatory CF/CFTR-RD ocular manifestations by inhibiting MMP-9 and nuclear factor kappa B (NF-κB). 23 , 46 , 47 Doxycycline also inhibits MMP-9, providing a similar protective effect for the cornea, and may be used preoperatively to treat bacterial blepharitis. 37 , 48 , 49 Mainstream treatments for various ocular surface disorders should be implemented as first-line treatment in these patients, including artificial tears, topical steroids, cyclosporin A 0.05% (Restasis ® ), lifitegrast 5% (Novartis Pharmaceuticals Corporation, Xiidra ® , East Hanover, NJ)), punctal plugs, and warm compresses.…”

Section: Discussionmentioning

confidence: 99%

“…[50][51][52][53][54][55][56] AMEED and Regener-Eyes ® are not currently FDA approved but have promising therapeutic potential as they leverage their anti-inflammatory, anti-angiogenic, and nonimmunogenic properties to promote limbal stem cell proliferation, facilitate corneal epithelial healing, and treat DED. [54][55][56] Note: Data from these studies 15,19,20,23,30,[36][37][38][39]41,42,47,61,62…”

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confidence: 99%

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Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders

Moshirfar¹,

Brown²,

Sulit³

et al. 2022

IMCRJ

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This article discusses common ocular manifestations of cystic fibrosis (CF) and cystic fibrosis transmembrane conductance regulator-related disorders (CFTR-RD). A structured approach for assessing and treating patients with CF/CFTR-RD seeking corneal refractive surgery is proposed, as well as a novel surgical risk scoring system. We also report two patients with various manifestations of CFTR dysfunction who presented for refractive surgery and the outcomes of the procedures. Surgeons seeking to perform refractive surgery on patients with CF/CFTR-RD should be aware of mild to severe clinical manifestations of CFTR dysfunction. Specific systemic and ocular manifestations of CF include chronic obstructive pulmonary disease (COPD), bronchiectasis, recurrent pulmonary infections, CF-related diabetes and liver disease, pancreatic insufficiency, conjunctival xerosis, night blindness, meibomian gland dysfunction (MGD), and blepharitis. Corneal manifestations include dry eye disease (DED), punctate keratitis (PK), filamentary keratitis (FK), xerophthalmia, and decreased endothelial cell density and central corneal thickness. Utilization of the appropriate review of systems (ROS) and screening tests will assist in determining if the patient is a suitable candidate for refractive surgery, as CF/CFTR-RD can impact the health of the cornea. Collaboration with other medical professionals who care for these patients is encouraged to ensure that their CF/CFTR-RD symptoms are best controlled via systemic and other treatment options. This will assist in reducing the severity of their ocular manifestations before and after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders

Moshirfar¹,

Brown²,

Sulit³

et al. 2022

IMCRJ

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“…Natural antioxidant therapy has been widely reported for various ophthalmic diseases, such as dry eye, cataracts, glaucoma, and AMD [205][206][207][208]. The National Eye Institute (NEI) in the United States conducted a large-scale clinical trial (the Age-Related Eye Disease Study; AREDS) in the late 1990s.…”

Section: Natural Antioxidant Therapy For Oxidative Stress-related Eye...mentioning

confidence: 99%

The Pathomechanism, Antioxidant Biomarkers, and Treatment of Oxidative Stress-Related Eye Diseases

Hsueh

Chen

Tsao

et al. 2022

IJMS

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Oxidative stress is an important pathomechanism found in numerous ocular degenerative diseases. To provide a better understanding of the mechanism and treatment of oxidant/antioxidant imbalance-induced ocular diseases, this article summarizes and provides updates on the relevant research. We review the oxidative damage (e.g., lipid peroxidation, DNA lesions, autophagy, and apoptosis) that occurs in different areas of the eye (e.g., cornea, anterior chamber, lens, retina, and optic nerve). We then introduce the antioxidant mechanisms present in the eye, as well as the ocular diseases that occur as a result of antioxidant imbalances (e.g., keratoconus, cataracts, age-related macular degeneration, and glaucoma), the relevant antioxidant biomarkers, and the potential of predictive diagnostics. Finally, we discuss natural antioxidant therapies for oxidative stress-related ocular diseases.

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“…N-acetylcysteine (NAC) is an acetylated form of the amino acid L-cysteine and an active precursor for the antioxidant glutathione [ 36 ]. For decades, NAC has been widely used in medicine for a variety of different indications.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Antimicrobial Activity of N-Acetylcysteine against Pathogens Most Commonly Associated with Infectious Keratitis in Dogs and Cats

et al. 2023

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To determine the in vitro antimicrobial activity of N-acetylcysteine (NAC) against common pathogens associated with infectious keratitis in dogs and cats, clinical isolates of Staphylococcus (S.) pseudintermedius (n = 20), Streptococcus (St.) canis (n = 10) and Pseudomonas (P.) aeruginosa (n = 7) of canine and feline infectious ulcerative keratitis and a quality control strain (P. aeruginosa DSM 19880) were tested. The minimal inhibitory concentration (MIC) of NAC concentrations was determined using microdilution methodology. For S. pseudintermedius and P. aeruginosa, NAC concentrations in the range of 1.56 mg/mL (0.156%) to 100 mg/mL (10%), and for St. canis, concentrations ranging from 0.195 mg/mL (0.0195%) to 6.25 mg/mL (0.625%) were tested. For S. pseudintermedius, the MIC was 3.12 mg/mL (0.312%) for all tested isolates. For P. aeruginosa isolates and the quality control strain, the MIC ranged from 3.12 mg/mL (0.312%) to 6.25 mg/mL (0.625%). For St. canis, the MIC ranged from 1.56 mg/mL (0.156%) to 3.12 mg/mL (0.312%). NAC has an in vitro antimicrobial activity against three bacterial species commonly found in infectious keratitis in dogs and cats and therefore may be a promising alternative or adjuvant to topical antibiotics. The results warrant a clinical pilot study to assess the potential of NAC to reduce or replace the use of topical antibiotics in line with the One Health approach.

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The role of topical N-acetylcysteine in ocular therapeutics

Cited by 25 publications

References 87 publications

Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders

Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders

The Pathomechanism, Antioxidant Biomarkers, and Treatment of Oxidative Stress-Related Eye Diseases

In Vitro Antimicrobial Activity of N-Acetylcysteine against Pathogens Most Commonly Associated with Infectious Keratitis in Dogs and Cats

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