Department of Ophthalmology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.
Department of Ophthalmology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.
Exp Eye Res. 2024 Oct;247:110044. doi: 10.1016/j.exer.2024.110044. Epub 2024 Aug 14.
Our objective was to determine the effect of a semi-synthetic sodium alginate hydrogel and its combination with platelet-rich plasma (PRP) on histopathological, biochemical, clinical, and anterior segment optical coherence tomography (AS-OCT) data. Alkali chemical burn of the cornea was induced. Injured rats were randomly divided into five equal groups and topically treated with phosphate-buffered saline (sham), platelet-rich plasma (PRP), 0.5% sodium citrate, a semi-synthetic sodium alginate hydrogel, or a combination of PRP and hydrogel (combined group) three times daily. The degree of corneal opacity (CO), corneal epithelial staining (CES), percentage of corneal epithelial defects (CEDP), degree of ciliary hyperemia (CH), neovascularization size (NVS), and extent of neovascularization (NVE) were evaluated. AS-OCT was performed at nine days, and then rats were sacrificed. Histological examination and enzyme-linked immunosorbent assays were performed to detect the concentrations of IL-1β and MMP-9 in the cornea. There were no significant differences between the groups regarding CEDP, CO, CES, CH, NVS, or NVE on the first day after corneal alkali burn injury (p > 0,05). At the last examination, CO was significantly lower in the PRP group than in the sham group (p = 0,044), while the CO concentrations were similar in terms of NVS (p > 0,05). Similarly, in terms of tissue MMP-9 levels, there were no significant differences between groups (p > 0,05). However, there was a significant difference in tissue IL-1β levels between the groups (p < 0,001). In the PRP and combined groups, the level of IL-1β was significantly lower than that in the sham group (p = 0,043 and p = 0,036, respectively). There was a significant difference in epithelial necrosis between the PRP, and it was the lowest in the combined group (p = 0,003). Epithelial thickness was highest in the combined group (p = 0,002). CEDP was significantly different at the last visit between the groups (p = 0.042). The fastest epithelial closing rate was observed for the combined group (p = 0,026). There was a significant negative correlation between tissue MMP-9 levels and corneal solidity and between tissue MMP-9 levels and the corneal area according to the AS-OCT measurements (p = 0,012 and p = 0,027, respectively). When used alone, topical hydrogel application did not significantly enhance the healing of corneal wounds. However, when combined with PRP, it leads to an increased rate of epithelial closure and neovascularization. This combination did not exacerbate inflammation or corneal opacity compared to PRP alone. The anticoagulant citrate solution in the PRP tube did not prove effective. The synergistic use of PRP and hydrogel could enhance epithelial thickness and reduce epithelial necrosis. The use of new parameters for corneal wound healing assessment was facilitated through AS-OCT image processing.
我们的目的是确定半合成海藻酸钠水凝胶及其与富血小板血浆（PRP）组合对组织病理学、生化、临床和眼前段光学相干断层扫描（AS-OCT）数据的影响。诱导角膜碱烧伤。受伤的大鼠被随机分为五组，每天三次分别用磷酸盐缓冲盐水（假手术）、富血小板血浆（PRP）、0.5%柠檬酸钠、半合成海藻酸钠水凝胶或 PRP 和水凝胶的组合（联合组）治疗。评估角膜混浊度（CO）、角膜上皮染色（CES）、角膜上皮缺损百分比（CEDP）、睫状充血程度（CH）、新生血管大小（NVS）和新生血管程度（NVE）。在第 9 天进行 AS-OCT 检查，然后处死大鼠。进行组织学检查和酶联免疫吸附试验，以检测角膜中白细胞介素-1β（IL-1β）和基质金属蛋白酶-9（MMP-9）的浓度。角膜碱烧伤后第一天，各组之间的 CEDP、CO、CES、CH、NVS 或 NVE 无显著差异（p>0.05）。在最后一次检查中，PRP 组的 CO 明显低于假手术组（p=0.044），而 NVS 方面的 CO 浓度相似（p>0.05）。同样，组织中 MMP-9 水平在各组之间无显著差异（p>0.05）。然而，各组之间的组织 IL-1β 水平存在显著差异（p<0.001）。在 PRP 和联合组中，IL-1β 水平明显低于假手术组（p=0.043 和 p=0.036）。PRP 组的上皮坏死程度有显著差异，联合组最低（p=0.003）。上皮厚度在联合组最高（p=0.002）。CEDP 在最后一次就诊时在组间有显著差异（p=0.042）。联合组上皮闭合速度最快（p=0.026）。组织 MMP-9 水平与角膜硬度和组织 MMP-9 水平与角膜面积之间存在显著负相关（p=0.012 和 p=0.027）。单独使用局部水凝胶应用并不能显著促进角膜伤口愈合。然而，当与 PRP 联合使用时，它会导致上皮闭合和新生血管的速度增加。与单独使用 PRP 相比，这种组合并没有加重炎症或角膜混浊。PRP 管中的抗凝柠檬酸盐溶液并不有效。PRP 和水凝胶的协同使用可以增加上皮厚度并减少上皮坏死。通过 AS-OCT 图像处理促进了角膜伤口愈合评估的新参数的使用。
