Coassin Marco, Lambiase Alessandro, Costa Nicola, De Gregorio Alessandra, Sgrulletta Roberto, Sacchetti Marta, Aloe Luigi, Bonini Stefano
Laboratory of Ophthalmology, Interdisciplinary Center for Biomedical Research (CIR), University "Campus Bio-Medico" of Rome, Rome, Italy.
Graefes Arch Clin Exp Ophthalmol. 2005 Feb;243(2):151-5. doi: 10.1007/s00417-004-0955-2. Epub 2005 Jan 14.
Preliminary data show that nerve growth factor (NGF) may improve tear production in humans. We evaluated the efficacy of topical NGF treatment in dogs who developed dry eye after the excision of the third eyelid lacrimal gland.
English Bulldogs (2- to 6-year-old males and females) that had undergone the surgical removal of the prolapsed lacrimal gland of the third eyelid in both eyes at the age of 3-6 months developed chronic keratoconjunctivitis sicca associated with a decrease of Schirmer tear test I values after at least 1 year. One eye, randomly selected, of each dog was treated twice daily with 100 microl of NGF ointment for 1 month, while the fellow eye was used as control and treated with the ointment vehicle only. At baseline and after 1 month of NGF treatment the following examinations were performed: corneal evaluation by slit lamp, fluorescein staining, Schirmer tear test I, tear ferning test, corneal esthesiometry by cotton swab and conjunctival impression cytology.
Topical application of NGF caused a significant improvement of all the evaluated parameters compared with baseline values. In contrast, in the control eyes there was no significant difference between the values measured before and after treatment. In particular, after NGF treatment superficial punctate keratopathy was resolved, corneal haze was reduced from stage 4 to stage 2 and Schirmer test values increased (17.2+/-1.7 mm/min vs 4.5+/-1.3 mm/min; p<0.05), as did the tear mucous component (as demonstrated by ferning test: 2.0+/-0.0 vs 4.0+/-0.0; p<0.05); conjunctival impression cytology evaluation demonstrated the presence of numerous mucous filaments and a significant increase in conjunctival goblet cell density (102.7+/-68.3 vs. 18.2+/-14.3 cell x field; p<0.05). Topical NGF treatment improved corneal sensitivity in two of three eyes.
This open study suggests that topical application of NGF may enhance the production and functional characteristics in tear film, with an improvement of ocular surface signs in dogs with surgically induced dry eye. These results suggest the possibility of performing further, larger, controlled studies.
初步数据显示神经生长因子(NGF)可能改善人类泪液分泌。我们评估了局部应用NGF治疗双眼切除第三眼睑泪腺后发生干眼症的犬的疗效。
3至6个月龄时双眼接受手术切除脱垂的第三眼睑泪腺的英国斗牛犬(2至6岁雌雄犬),至少1年后出现慢性干燥性角结膜炎并伴有泪液分泌试验I值降低。每只犬随机选择一只眼,每天两次局部应用100微升NGF眼膏,持续1个月,而对侧眼作为对照,仅用眼膏基质治疗。在基线时和NGF治疗1个月后进行以下检查:裂隙灯角膜评估、荧光素染色、泪液分泌试验I、泪液蕨样变试验、棉签角膜感觉测定和结膜印迹细胞学检查。
与基线值相比,局部应用NGF使所有评估参数均有显著改善。相比之下,对照眼中治疗前后测量值无显著差异。特别是,NGF治疗后浅层点状角膜病变消退,角膜混浊从4期降至2期,泪液分泌试验值增加(17.2±1.7毫米/分钟对4.5±1.3毫米/分钟;p<0.05),泪液黏液成分也增加(通过蕨样变试验证明:2.0±0.0对4.0±0.0;p<0.05);结膜印迹细胞学评估显示存在大量黏液丝,结膜杯状细胞密度显著增加(102.7±68.3对18.2±14.3个细胞/视野;p<0.05)。局部应用NGF治疗使三只眼中的两只角膜敏感性提高。
这项开放性研究表明,局部应用NGF可能增强泪膜的分泌和功能特性,改善手术诱发干眼症犬的眼表体征。这些结果提示有必要进行进一步的、更大规模的对照研究。