Lekhanont Kaevalin, Park Choul Yong, Smith Janine A, Combs Juan Castro, Preechawat Pisit, Suwan-Apichon Olan, Rangsin Ram, Chuck Roy S
Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, MD 21286-9278, USA.
J Ocul Pharmacol Ther. 2007 Feb;23(1):27-34. doi: 10.1089/jop.2006.0071.
The aim of this study was to compare the effects of topical nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid, doxycycline, and artificial tears for the treatment of ocular surface damage in the Botulinum toxin B (BTX-B)-induced mouse model of dry eye.
CBA/J mice were randomized into 2 experimental groups of 35 animals each. The control group received a transconjunctival injection of 0.05 mL of saline into the left lacrimal gland, and another group was injected with 0.05 mL of 20 milliunits BTX-B solution (SPSS, Inc., Chicago, IL). Three (3) days after intralacrimal gland injections, each group was equally randomized into 7 subgroups (n=5 each) to receive treatment unilaterally into their left eyes with topical artificial tears (0.5% carboxymethylcellulose sodium), 0.1% fluorometholone, 0.1% nepafenac, 0.4% ketorolac, 0.09% bromfenac, 0.1% diclofenac, or 0.025% doxycycline. Tear volume, ocular surface changes, and spontaneous blink rate were evaluated in each of the 14 experimental subgroups.
Topical fluorometholone, nepafenac, and doxycycline significantly improved corneal surface staining in the BTX-B-injected mice within 2 weeks of treatment. Topical ketorolac, diclofenac, and bromfenac, applied twice-daily, partially reduce corneal staining, and did so more slowly by the 4-week time point. In comparison, topical artificial tear-treated mice did not demonstrate significant improvement of the corneal surface at any time point. Aqueous tear production in the BTX-B-injected fluorometholone-treated group started to return to baseline level within 2 weeks, although not significantly. Meanwhile, BTX-B-injected mice treated with artificial tears, topical NSAIDs, and doxycycline still exhibited a reduction in tear production up to 4 weeks. No significant differences in blink rate between the control and study groups undergoing the various treatments were noted at all time points.
This study suggests the potential usefulness of topical NSAIDs, corticosteroid, and doxycycline for the clinical treatment of ocular surface epithelial disorders associated with dry eye.
本研究旨在比较局部使用非甾体抗炎药(NSAIDs)、皮质类固醇、多西环素和人工泪液对肉毒杆菌毒素B(BTX-B)诱导的干眼小鼠模型眼表损伤的治疗效果。
将CBA/J小鼠随机分为2个实验组,每组35只动物。对照组经结膜向左侧泪腺注射0.05 mL生理盐水,另一组注射0.05 mL含20毫单位BTX-B的溶液(SPSS公司,伊利诺伊州芝加哥)。泪腺注射后3天,每组再平均随机分为7个亚组(每组n = 5),分别用局部人工泪液(0.5%羧甲基纤维素钠)、0.1%氟米龙、0.1%萘非那酮、0.4%酮咯酸、0.09%溴芬酸、0.1%双氯芬酸或0.025%多西环素对左眼进行单侧治疗。对14个实验亚组中的每一组进行泪液量、眼表变化和自发眨眼率评估。
局部使用氟米龙、萘非那酮和多西环素在治疗2周内显著改善了BTX-B注射小鼠的角膜表面染色。每天应用2次的局部酮咯酸、双氯芬酸和溴芬酸部分减轻了角膜染色,到4周时间点时减轻作用更缓慢。相比之下,局部使用人工泪液治疗的小鼠在任何时间点角膜表面均未显示出显著改善。BTX-B注射并经氟米龙治疗的组泪液分泌在2周内开始恢复到基线水平,尽管不显著。同时,用人工泪液、局部NSAIDs和多西环素治疗的BTX-B注射小鼠在4周内泪液分泌仍减少。在所有时间点,接受各种治疗的对照组和研究组之间眨眼率均无显著差异。
本研究提示局部NSAIDs、皮质类固醇和多西环素在临床上对与干眼相关的眼表上皮疾病具有潜在的治疗作用。