Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110059, P.R. China.
Mol Med Rep. 2020 Sep;22(3):2433-2441. doi: 10.3892/mmr.2020.11311. Epub 2020 Jul 8.
Cataract is a blinding‑caused disease and affects millions of individuals worldwide. Although conventional phacoemulsification (CPCS) has been widely used for treatment of cataract, the incidence of cataract‑caused blindness still increased year by year. Recently, femtosecond laser technology has been expanded to variety of clinical applications, including cataract surgery. The present study evaluated the curative effect of bromfenac sodium (BS) after femtosecond laser‑assisted cataract surgery (FLACS) and analyzed the mechanism of action. A total of 90 patients were randomly divided into five groups: Group I, conventional phacoemulsification treatment (CPCS) + dexamethasone (DEX)/tobramycin (TOB); group II, CPCS + bromfenac sodium (BS); group III, Femtosecond laser‑assisted cataract surgery (FLACS) + DEX/TOB; group IV, FLACS + BS; and group V, FLACS + pranoprofen. Aqueous humor was collected from these patients post‑surgery. For in vitro studies, SRA01/04 cells were irradiated using UV, followed by the collection of culture media and cell lysate. Prostaglandin E2 (PGE2) levels, an indicator of inflammation, were measured using ELISA both in vivo and in vitro. In addition, cyclooxygenase (COX) and cleaved caspase‑1 p20 expression levels were analyzed using western blotting. The findings suggested that BS was more effective and safer compared with glucocorticoids (GCs) after cataract surgery. BS can protect against post‑operative inflammation by inhibiting PGE2 production. Under in vitro conditions BS prevented the SRA01/04 cells from undergoing apoptosis after UV treatment and also suppressed PGE2 release from UV‑irradiated SRA01/04 cells by modulating COX‑2 expression. Furthermore, BS may have an inhibitory effect on the inflammatory form of cell death. Overall, these results indicated that BS could replace existing GCs as a reliable drug for a perioperative period of cataract surgery. It was also identified that the inhibitory effect of BS on PGE2 production was mediated via the regulation of COX‑2.
白内障是一种致盲性疾病，影响着全球数百万人。尽管传统的超声乳化白内障吸除术（CPCS）已广泛用于白内障的治疗，但白内障致盲的发病率仍逐年上升。最近，飞秒激光技术已扩展到多种临床应用，包括白内障手术。本研究评估了溴芬酸钠（BS）在飞秒激光辅助白内障手术（FLACS）后的疗效，并分析了其作用机制。90 例患者随机分为五组：I 组，常规超声乳化白内障吸除术（CPCS）+地塞米松（DEX）/妥布霉素（TOB）；II 组，CPCS+溴芬酸钠（BS）；III 组，飞秒激光辅助白内障手术（FLACS）+DEX/TOB；IV 组，FLACS+BS；V 组，FLACS+普拉洛芬。术后采集这些患者的房水。对于体外研究，用紫外线照射 SRA01/04 细胞，然后收集培养基和细胞裂解物。用 ELISA 法测量前列腺素 E2（PGE2）水平，这是炎症的一个指标，分别在体内和体外进行研究。此外，用 Western blot 分析环氧化酶（COX）和裂解的 caspase-1 p20 表达水平。结果表明，与糖皮质激素（GCs）相比，BS 对白内障手术后的炎症更有效、更安全。BS 可以通过抑制 PGE2 的产生来防止术后炎症。在体外条件下，BS 可防止 SRA01/04 细胞在紫外线照射后发生凋亡，并通过调节 COX-2 的表达来抑制紫外线照射的 SRA01/04 细胞中 PGE2 的释放。此外，BS 可能对细胞死亡的炎症形式有抑制作用。总的来说，这些结果表明，BS 可以替代现有的 GCs，作为白内障手术围手术期的一种可靠药物。还发现 BS 抑制 PGE2 产生的作用是通过调节 COX-2 介导的。
