Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Bone Marrow Transplant. 2010 Mar;45(3):565-9. doi: 10.1038/bmt.2009.173. Epub 2009 Jul 27.
Fibrosis and excessive extracellular matrix production are characteristic features of lacrimal gland chronic GVHD (cGVHD). Tranilast (n-[3,4-anthoranilic acid]), used for fibrotic skin disease, inhibits transforming growth factor-beta-induced matrix production. We conducted a non-randomized study comparing 8 patients (five men, three women; median age, 47 years) given topical tranilast with 10 patients (three men, seven women; median age, 37 years) receiving therapy with topical artificial tears, sodium hyaluronate and vitamin A for mild ocular cGVHD. The tranilast group instilled topical tranilast and artificial tears q.i.d., beginning the day of dry eye diagnosis. The ocular surface and tear dynamics of each patient were evaluated before hematopoietic stem cell transplant, at the onset of dry eye and after 3 months of treatment. At 3 months, the scores of the Rose Bengal test and Schirmer test with nasal stimulation had significantly improved in the tranilast group compared with that in the control group (P<0.05). Furthermore, although five control patients (50%) developed severe dry eye within the treatment period, only one tranilast-treated patient (12.5%) did; the rest still had mild dry eye (P<0.05). These results suggest the hypothesis that topical tranilast may effectively retard the progression of mild dry eye associated with cGVHD.
纤维变性和细胞外基质过度产生是泪腺慢性移植物抗宿主病（cGVHD）的特征。曲尼司特（n-[3,4-蒽酸]）用于治疗纤维化皮肤病，可抑制转化生长因子-β诱导的基质产生。我们进行了一项非随机研究，比较了 8 例（5 男 3 女；中位年龄 47 岁）接受局部曲尼司特治疗和 10 例（3 男 7 女；中位年龄 37 岁）接受局部人工泪液、玻璃酸钠和维生素 A 治疗的轻度眼 cGVHD 患者。曲尼司特组在出现干眼的当天开始每天滴注曲尼司特和人工泪液 4 次。在造血干细胞移植前、干眼发生时和治疗 3 个月后，评估每位患者的眼表和泪液动力学。在 3 个月时，与对照组相比，曲尼司特组的 Rose Bengal 试验和鼻刺激 Schirmer 试验评分显著改善（P<0.05）。此外，虽然 5 例对照组患者（50%）在治疗期间出现严重干眼，但仅 1 例曲尼司特治疗患者（12.5%）出现；其余患者仍有轻度干眼（P<0.05）。这些结果提示局部曲尼司特可能有效延缓与 cGVHD 相关的轻度干眼的进展。
