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局部用纳曲酮治疗糖尿病性干眼逆转及角膜感觉恢复

Dry eye reversal and corneal sensation restoration with topical naltrexone in diabetes mellitus.

作者信息

Zagon Ian S, Klocek Matthew S, Sassani Joseph W, McLaughlin Patricia J

机构信息

Department of Neural and Behavioral Sciences, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA 17033, USA.

出版信息

Arch Ophthalmol. 2009 Nov;127(11):1468-73. doi: 10.1001/archophthalmol.2009.270.

DOI:10.1001/archophthalmol.2009.270
PMID:19901212
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2840396/
Abstract

OBJECTIVE

To determine if topical application of naltrexone hydrochloride (NTX), an opioid antagonist, restores tear production and corneal sensation in rats with diabetes mellitus.

METHODS

Type 1 diabetes was induced with streptozotocin in rats. Tear production was measured by the Schirmer test, and corneal sensitivity, by an esthesiometer. Eye drops of 10(-5)M NTX or sterile vehicle were administered either once only or 4 times a day for 1 or 5 days; a single drop of insulin (1 U) was given once only.

RESULTS

Dry eye and corneal insensitivity were detected in the diabetic rats beginning 5 weeks after streptozotocin injection. One drop of NTX or 4 times a day for 1 or 5 days reestablished tear production and corneal sensitivity within 1 hour of administration. The reversal of dry eye lasted for up to 2 to 3 days depending on drug regimen, but restitution of corneal sensation lasted for 4 to 7 days. Topical application of 1 eye drop of insulin restored corneal sensitivity within 1 hour and lasted for at least 2 days. In contrast, 1 eye drop of insulin did not increase tear production at 1, 24, or 48 hours compared with diabetic animals receiving sterile vehicle.

CONCLUSION

Topical treatment with NTX normalizes tear production and corneal sensitivity in type 1 diabetic rats.

CLINICAL RELEVANCE

Topical application of NTX to the ocular surface may serve as an important strategy for treating dry eye and corneal anesthesia in diabetes. Its effect, if any, in other forms of decreased corneal sensitivity and/or dry eye should be investigated.

摘要

目的

确定阿片类拮抗剂盐酸纳曲酮（NTX）局部应用是否能恢复糖尿病大鼠的泪液分泌和角膜感觉。

方法

用链脲佐菌素诱导大鼠患1型糖尿病。通过泪液分泌试验测量泪液分泌，用感觉计测量角膜敏感性。给予10(-5)M NTX滴眼液或无菌赋形剂，给药方式为仅一次或每天4次，持续1天或5天；仅一次性给予一滴胰岛素（1 U）。

结果

链脲佐菌素注射后5周开始在糖尿病大鼠中检测到干眼和角膜感觉减退。一滴NTX或每天4次，持续1天或5天，在给药后1小时内恢复了泪液分泌和角膜感觉。干眼的逆转持续长达2至3天，具体取决于给药方案，但角膜感觉恢复持续4至7天。局部应用一滴胰岛素在1小时内恢复了角膜感觉，且持续至少2天。相比之下，与接受无菌赋形剂的糖尿病动物相比，一滴胰岛素在1、24或48小时时并未增加泪液分泌。

结论

NTX局部治疗可使1型糖尿病大鼠的泪液分泌和角膜感觉恢复正常。

临床意义

NTX局部应用于眼表可能是治疗糖尿病性干眼和角膜麻醉的重要策略。应研究其在其他形式的角膜感觉减退和/或干眼中的作用（若有）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/841b9073e197/nihms179032f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/e5df74afe2fe/nihms179032f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/e1fdf8c3b38a/nihms179032f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/bd3af8c5fa0c/nihms179032f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/17a1900b2796/nihms179032f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/841b9073e197/nihms179032f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/e5df74afe2fe/nihms179032f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/9b7e135b5a4f/nihms179032f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/e1fdf8c3b38a/nihms179032f3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/17a1900b2796/nihms179032f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/2840396/841b9073e197/nihms179032f6.jpg

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