Department of Ophthalmology & Visual Sciences, William H. Havener Eye Institute, 915 Olentangy River Rd, Suite 5000, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Biomedical Engineering, 140 W. 19th Ave., Fontana Labs the Ohio State University, Columbus, OH, USA.
Exp Eye Res. 2021 May;206:108542. doi: 10.1016/j.exer.2021.108542. Epub 2021 Mar 17.
The aim of the study was to investigate the effectiveness of exogenous recombinant human decoron and an accompanying penetration-enhancing solution in stiffening ex-vivo porcine corneas both transepithelially and after de-epithelialization. Eight porcine paired eyes were treated transepithelially: one eye with a pre-treatment solution (Pre-Tx), penetration enhancing solution (PE), and decoron while the fellow eye was treated by the same protocol but without decoron. A second group included 4 de-epithelialized pairs treated identically. The final group included 4 de-epithelialized pairs with one eye treated with Pre-Tx, PE, and decoron while the fellow eye was treated without PE. Uniaxial tensile testing was used to compare the corneal stiffness between the different treatment conditions. Residual tissue underwent immunohistochemistry analysis to evaluate the depth of penetration of decoron into the corneal stroma. There was no stiffening effect exhibited among corneas treated transepithelially with decoron compared to control (P > 0.05) and poor stromal penetration was exhibited on tissue analysis. Among de-epithelialized corneas, there was a significant stiffening effect seen in those treated with decoron at 3%, 4%, 5%, & 6% strain (P < 0.05) compared to control. Among de-epithelialized corneas there was also a significant stiffening effect seen in those treated with the PE and decoron at 4%, 5%, & 6% strain (P < 0.05) with improved stromal penetration confirmed by immunohistochemistry, versus without PE. De-epithelialization is necessary for effective stromal penetration of decoron. Depth of penetration and subsequent corneal stiffening may be improved with a penetration enhancing solution. Compared to riboflavin, decoron requires shorter treatment time and spares UV light exposure.
本研究旨在探讨外源性重组人脱冠素（decoron）及其伴随的渗透增强溶液在使离体猪角膜变硬方面的有效性，既包括经上皮途径，也包括去上皮后。8 对离体猪眼进行经上皮处理：一只眼用预处理溶液（Pre-Tx）、渗透增强溶液（PE）和 decoron 处理，而对侧眼则用相同的方案处理，但不含 decoron。第二组包括 4 对去上皮的配对眼，处理方式相同。最后一组包括 4 对去上皮的配对眼，其中一只眼用 Pre-Tx、PE 和 decoron 处理，而对侧眼则不用 PE 处理。单轴拉伸试验用于比较不同处理条件下角膜的硬度。残留组织进行免疫组织化学分析，以评估 decoron 渗透到角膜基质的深度。与对照组相比，经上皮途径用 decoron 处理的角膜没有表现出僵硬效应（P>0.05），组织分析显示渗透深度较差。在去上皮的角膜中，用 3%、4%、5%和 6%应变处理的角膜用 decoron 处理有明显的僵硬效应（P<0.05），与对照组相比。在去上皮的角膜中，用 PE 和 decoron 处理的角膜在 4%、5%和 6%应变时也有明显的僵硬效应（P<0.05），免疫组织化学证实渗透增强，而没有 PE 时则没有。去上皮化是 decoron 有效渗透到基质所必需的。渗透深度和随后的角膜变硬可能会通过渗透增强溶液得到改善。与核黄素相比，decoron 所需的治疗时间更短，且避免了紫外线照射。
