Mu Changhua, Shi Meng, Liu Ping, Chen Lu, Marriott Gerard
Department of Bioengineering, Tsinghua-Berkeley Shenzhen Institute, and Center for Eye Disease and Development, Vision Science Graduate Program and School of Optometry, University of California-Berkeley, Berkeley, California 94720, United States.
ACS Cent Sci. 2018 Dec 26;4(12):1677-1687. doi: 10.1021/acscentsci.8b00641. Epub 2018 Nov 29.
Timolol, a potent inhibitor of β-adrenergic receptors (βARs), is a first-line drug for decreasing the intraocular pressure (IOP) of patients with glaucoma. Timolol is administered using 0.5% eye-drop solutions at >3 × 10 times the inhibitory concentration ( ) for βARs. This high dose is wasteful and triggers off-target effects that increase medication noncompliance. Here, we introduce contact lenses that release timolol to the eye throughout the day during passive exposures to natural daylight at a more therapeutically relevant concentration (>3000 ). Timolol is coupled to the polymer of the contact lens via a photocleavable caged cross-linker and is released exclusively to the surrounding fluid after the 400-430 nm mediated cleavage of the cross-linking group. Studies conducted in a preclinical mouse model of glaucoma show photoreleased timolol is effective as authentic timolol in reducing IOP. Our studies highlight several advantages of daylight-mediated release of timolol from lenses compared to eye-drops. First, fitted contact lenses exposed to natural daylight release sufficient timolol to sustain the inhibition of βARs over a 10 h period. Second, the contact lenses inhibit βARs in the eye using only 5.7% of the timolol within a single eye-drop. Third, the lenses allow the patient to passively control the amount of timolol released from the lens-for example, early morning exposure to outdoor sunlight would release enough timolol to maximally reduce the IOP, whereas subsequent periodic exposures to indoor daylight would release sufficient timolol to overcome the effects of its spontaneous dissociation from βARs. Fourth, our lenses are disposable, designed for single day use, and manufactured at a low cost.
噻吗洛尔是一种强效β-肾上腺素能受体(βARs)抑制剂,是降低青光眼患者眼压的一线药物。噻吗洛尔通过0.5%的滴眼液给药,其浓度是βARs抑制浓度的3×10倍以上。如此高的剂量既浪费,又会引发脱靶效应,增加用药的不依从性。在此,我们介绍一种隐形眼镜,在被动暴露于自然日光下时,能以更具治疗相关性的浓度(>3000 )全天向眼睛释放噻吗洛尔。噻吗洛尔通过可光裂解的笼形交联剂与隐形眼镜的聚合物相连,在400 - 430 nm介导的交联基团裂解后,仅释放到周围液体中。在青光眼临床前小鼠模型中进行的研究表明,光释放的噻吗洛尔在降低眼压方面与纯噻吗洛尔一样有效。我们的研究突出了与滴眼液相比,日光介导的噻吗洛尔从隐形眼镜释放的几个优点。首先,暴露于自然日光下的定制隐形眼镜释放的噻吗洛尔足以在10小时内持续抑制βARs。其次,隐形眼镜抑制眼睛中的βARs仅使用单滴眼药水所含噻吗洛尔的5.7%。第三,这种隐形眼镜使患者能够被动控制从镜片释放的噻吗洛尔量——例如,清晨暴露于户外阳光下会释放足够的噻吗洛尔以最大程度降低眼压,而随后定期暴露于室内日光下会释放足够的噻吗洛尔以克服其从βARs自发解离的影响。第四,我们的隐形眼镜是一次性的,设计为单日使用,且制造成本低。