Boston University School of Medicine, Department of Ophthalmology, Boston, Massachusetts, United States.
Aerie Pharmaceuticals, Inc., Durham, North Carolina, United States.
Invest Ophthalmol Vis Sci. 2023 Feb 1;64(2):7. doi: 10.1167/iovs.64.2.7.
We investigated mechanisms of reduction of intraocular pressure (IOP) by Rho kinase inhibitor AR-12286 in steroid-induced ocular hypertension (SIOH).
C57BL/6 mice (N = 56) were randomly divided into Saline, dexamethasone (DEX), DEX + AR-12286, and DEX-discontinuation (DEX-DC) groups. IOP was measured weekly during the first four weeks in all groups. Beginning at week 5, the DEX-DC group was followed without treatment until IOP returned to normal, and the other groups were treated as assigned with IOP measured every other day for another week. Fluorescent tracer was injected into the anterior chamber to visualize the outflow pattern in the trabecular meshwork (TM) and TM effective filtration area (EFA) was determined. Radial sections from both high- and low-tracer regions were processed for electron microscopy.
AR-12286 reduced IOP in SIOH mouse eyes in one day (P < 0.01). At the end of week 5, mean IOP in the DEX + AR-12286 group was ∼4 mm Hg lower than DEX group (P < 0.001) and ∼2 mm Hg lower than DEX-DC group (P < 0.05). After one-week AR-12286 treatment (P < 0.05) or five-week DC of DEX (P < 0.01), DEX-induced reduction of EFA was rescued and DEX-induced morphological changes in the TM were partially reversed.
AR-12286 reversed steroid-induced morphological changes in the TM and reduced EFA, which correlated with reduced IOP in SIOH eyes. AR-12286 reduced IOP elevation in SIOH eyes more effectively than discontinuing DEX treatment even when accompanied by continuous DEX treatment. Therefore Rho kinase inhibitors may lower SIOH in patients who rely on steroid treatment.
研究 Rho 激酶抑制剂 AR-12286 降低类固醇诱导性高眼压(SIOH)眼内压(IOP)的机制。
将 56 只 C57BL/6 小鼠(N=56)随机分为盐水、地塞米松(DEX)、DEX+AR-12286 和 DEX 停药(DEX-DC)组。所有组在第一四周每周测量一次 IOP。从第 5 周开始,DEX-DC 组未进行治疗,直到 IOP 恢复正常,其他组按分配进行治疗,每隔一天测量一次 IOP,再持续一周。在前房内注射荧光示踪剂以可视化小梁网(TM)的流出模式,并确定 TM 有效滤过面积(EFA)。从高和低示踪剂区域的径向切片进行电子显微镜处理。
AR-12286 可在一天内降低 SIOH 小鼠眼内压(P<0.01)。在第 5 周末,DEX+AR-12286 组的平均 IOP 比 DEX 组低约 4mmHg(P<0.001),比 DEX-DC 组低约 2mmHg(P<0.05)。在接受一周的 AR-12286 治疗(P<0.05)或五周 DEX 停药(P<0.01)后,DEX 诱导的 EFA 减少得到挽救,DEX 诱导的 TM 形态变化部分逆转。
AR-12286 逆转了 TM 中的类固醇诱导的形态变化,并减少了 EFA,这与 SIOH 眼中的 IOP 降低相关。AR-12286 降低 SIOH 眼内压升高的效果比停药 DEX 治疗更有效,即使同时伴有持续的 DEX 治疗。因此,Rho 激酶抑制剂可能会降低依赖类固醇治疗的 SIOH 患者的眼压。