Inserm UMR_S 1138, Team 17: From Physiopathology of Retinal Diseases to Clinical Advances, Centre de Recherche des Cordeliers, Paris, France; Sorbonne University, University of Pierre et Marie Curie, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France; Paris Descartes University, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France.
Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain; PharmaceuticalInnovation in Ophthalmology (Research Group), Fundación para la Investigación-HCSC, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Madrid, Spain.
J Control Release. 2017 Nov 28;266:187-197. doi: 10.1016/j.jconrel.2017.09.029. Epub 2017 Sep 22.
Mineralocorticoid receptor (MR) contributes to retinal/choroidal homeostasis. Excess MR activation has been shown to be involved in pathogenesis of central serous chorioretinopathy (CSCR). Systemic administration of MR antagonist (MRA) reduces subretinal fluid and choroidal vasodilation, and improves the visual acuity in CSCR patients. To achieve long term beneficial effects in the eye while avoiding systemic side-effects, we propose the use of biodegradable spironolactone-loaded poly-lactic-co-glycolic acid (PLGA) microspheres (MSs). In this work we have evaluated the ocular tolerance of MSs containing spironolactone in rat' eyes. As previous step, we have also studied the tolerance of the commercial solution of canrenoate salt, active metabolite of spironolactone. PLGA MSs allowed in vitro sustained release of spironolactone for 30days. Rat eyes injected with high intravitreous concentration of PLGA MSs (10mg/mL) unloaded and loaded with spironolactone maintained intact retinal lamination at 1month. However enhanced glial fibrillary acidic protein immunostaining and activated microglia/macrophages witness retinal stress were observed. ERG also showed impaired photoreceptor function. Intravitreous PLGA MSs concentration of 2mg/mL unloaded and loaded with spironolactone resulted well tolerated. We observed reduced microglial/macrophage activation in rat retina compared to high concentration of MSs with normal retinal function according to ERG. Spironolactone released from low concentration of MSs was active in the rat retina. Low concentration of spironolactone-loaded PLGA MSs could be a safe therapeutic choice for chorioretinal disorders in which illicit MR activation could be pathogenic.
醛固酮受体(MR)有助于视网膜/脉络膜的稳态。过量的 MR 激活已被证明与中心性浆液性脉络膜视网膜病变(CSCR)的发病机制有关。系统给予 MR 拮抗剂(MRA)可减少视网膜下液和脉络膜扩张,并改善 CSCR 患者的视力。为了在避免全身副作用的情况下在眼部获得长期的有益效果,我们提出使用可生物降解的螺内酯负载聚乳酸-共-羟基乙酸(PLGA)微球(MS)。在这项工作中,我们评估了含有螺内酯的 MS 在大鼠眼中的眼部耐受性。作为先前的步骤,我们还研究了螺内酯的商业溶液坎利酸盐的耐受性,坎利酸盐是螺内酯的活性代谢物。PLGA MS 允许螺内酯在体外持续释放 30 天。用高玻璃体内浓度(10mg/mL)负载和未负载螺内酯的 PLGA MS 注射的大鼠眼在 1 个月时保持完整的视网膜分层。然而,观察到增强的神经胶质纤维酸性蛋白免疫染色和激活的小胶质细胞/巨噬细胞见证了视网膜应激。ERG 还显示出光感受器功能受损。未负载和负载螺内酯的 PLGA MS 的玻璃体内浓度为 2mg/mL 时具有良好的耐受性。与 MS 高浓度相比,我们观察到大鼠视网膜中的小胶质细胞/巨噬细胞激活减少,并且根据 ERG 视网膜功能正常。从 MS 的低浓度释放的螺内酯在大鼠视网膜中具有活性。低浓度的螺内酯负载的 PLGA MS 可能是非法 MR 激活可能具有致病性的脉络膜视网膜疾病的安全治疗选择。