Candia Oscar A, Gerometta Rosana, Millar J Cameron, Podos Steven M
Departments of Structural and Chemical Biology, Mount Sinai School of Medicine, New York, New York, USA.
Arch Ophthalmol. 2010 Mar;128(3):338-43. doi: 10.1001/archophthalmol.2009.387.
To confirm the ocular hypotensive effects of anecortave acetate on an ovine model for steroid-induced ocular hypertension. Eyes of normal sheep exhibit a robust steroid-induced ocular hypertensive response. Recent observations in an uncontrolled, interventional case series indicated that anecortave elicited hypotensive effects when administered as a sub-Tenon depot in the eyes of a small sample of patients with glaucoma.
Intraocular pressure (IOP) was monitored by Perkins applanation tonometry in 16 normal sheep receiving topically administered prednisolone acetate, 0.5%, in both eyes, 3 times daily, a protocol that doubled IOP within 12 days. Half of the sheep had received a unilateral sub-Tenon injection of anecortave in 1 eye prior to the initiation of the bilateral prednisolone instillations, while the 8 remaining sheep received the unilateral anecortave sub-Tenon depot after the IOP was maximally elevated by the prednisolone instillations.
In these 2 sets of experiments, the presence of the anecortave depot suppressed the steroid-induced IOP elevation and reverted the elevated IOP to baseline levels. Measurements of aqueous outflow facility indicated that eyes treated with prednisolone plus anecortave exhibited a 5.8-fold higher outflow facility than the fellow eyes solely exposed to prednisolone, indicating that anecortave prevented the increase in outflow resistance produced by the corticosteroid.
Elucidation of the mechanisms of action of anecortave in animal models may prove relevant to the design of novel interventions for the management of primary open-angle glaucoma.
在类固醇诱导的高眼压绵羊模型中证实醋酸阿奈可他的降眼压作用。正常绵羊的眼睛对类固醇诱导呈现强烈的高眼压反应。最近在一个非对照的介入性病例系列中的观察表明,在一小部分青光眼患者眼中,当以球结膜下注射方式给药时,阿奈可他可产生降压作用。
通过帕金斯压平眼压计监测16只正常绵羊的眼压,这些绵羊双眼每日3次局部应用0.5%的醋酸泼尼松龙,该方案可使眼压在12天内翻倍。其中一半绵羊在双侧开始滴注泼尼松龙之前,一只眼睛接受了单侧球结膜下注射阿奈可他,而其余8只绵羊在泼尼松龙使眼压升至最高后接受单侧球结膜下注射阿奈可他。
在这两组实验中,阿奈可他注射剂的存在抑制了类固醇诱导的眼压升高,并使升高的眼压恢复到基线水平。房水流畅系数测量表明,用泼尼松龙加阿奈可他治疗的眼睛比仅暴露于泼尼松龙的对侧眼睛房水流畅系数高5.8倍,这表明阿奈可他可防止皮质类固醇引起的房水流出阻力增加。
在动物模型中阐明阿奈可他的作用机制可能对设计原发性开角型青光眼的新型干预措施具有重要意义。