Department of Diagnostics and Microsurgery of Glaucoma, Medical University of Lublin, Ul. Chmielna 1, 20-079, Lublin, Poland.
Independent Unit of Tissue Engineering and Regenerative Medicine, Medical University of Lublin, Lublin, Poland.
Sci Rep. 2023 Sep 28;13(1):16353. doi: 10.1038/s41598-023-43246-z.
The aim of the study was to assess the influence of different regimes of patient's preparation before trabeculectomy on the markers of healing process in Tenon's fibroblast cultures.The studied group consisted of 66 patients with open angle glaucoma undergoing primary trabeculectomy. The patients were divided into 5 groups with different regimes of preparation before the surgery based on application or withdrawal of topical antiglaucoma medications and steroids (G1-patients using antiglaucoma drops until the day of the surgery; G2-patients using antiglaucoma drops until the day of the surgery and additionally dexamethasone for 4 weeks before surgery; G3-patients who stopped using antiglaucoma drops 4 weeks before the surgery and introduced dexamethasone for 4 weeks before surgery; G4-patients who stopped using antiglaucoma drops 4 weeks before the surgery; G5-control group, patients with newly diagnosed glaucoma in whom trabeculectomy was the first treatment option without medical treatment). During trabeculectomy the samples of Tenon's capsule were obtained. Tenon fibroblasts were isolated directly from the explants to test their proliferation ability and the level of released healing markers. Following factors typical of healing process were evaluated using commercially available ELISA kits: IL 1-β, IL-6, IL-8, VEGF-A, TGF-β1 and MMP-9. Concentrations of IL-1β, IL-6 and TGF-β1 were significantly higher in the group obtaining antiglaucoma drops. Additionally, in this group the fibroblasts revealed the highest proliferation potential, indicating the active healing process. The levels of IL-8, VEGF-A and MMP-9 were similar between the groups. Our study shows that for the best conjunctival anti-inflammatory control, the most influential factor is the withdrawal of antiglaucoma medications.
本研究旨在评估术前不同患者准备方案对小梁切除术患者成纤维细胞培养过程中愈合标志物的影响。该研究纳入了 66 例原发性小梁切除术的开角型青光眼患者。根据术前是否使用或停用局部降眼压药物和皮质类固醇，将患者分为 5 组（G1 组：患者持续使用降眼压眼药水至手术当天；G2 组：患者持续使用降眼压眼药水，并在术前 4 周加用地塞米松；G3 组：患者于术前 4 周停止使用降眼压眼药水，同时加用地塞米松；G4 组：患者于术前 4 周停止使用降眼压眼药水；G5 组：对照组，新诊断为青光眼的患者，首次治疗方案为小梁切除术，未进行药物治疗）。在小梁切除术中，获取了眼筋膜囊组织标本。直接从组织块中分离眼筋膜囊成纤维细胞，以测试其增殖能力和释放的愈合标志物水平。使用商业上可获得的 ELISA 试剂盒评估以下愈合过程中的典型因子：IL-1β、IL-6、IL-8、VEGF-A、TGF-β1 和 MMP-9。结果显示，持续使用降眼压眼药水的患者中，IL-1β、IL-6 和 TGF-β1 的浓度明显更高。此外，在该组中，成纤维细胞表现出最高的增殖潜能，表明存在活跃的愈合过程。各组间 IL-8、VEGF-A 和 MMP-9 的水平相似。本研究表明，为了获得最佳的结膜抗炎效果，最重要的影响因素是停用降眼压药物。
