Gehlbach P L, Purple R L, Hallaway P E, Hedlund B E
Department of Physiology, University of Minnesota Medical School, Minneapolis 55455.
Invest Ophthalmol Vis Sci. 1993 Sep;34(10):2871-7.
The iron chelating agent deferoxamine mesylate USP (Desferal, Ciba, Summit, NJ) is commonly used in the treatment of acute iron intoxication and chronic iron overload (associated with the transfusion-dependent anemias). When used for prolonged periods of time or in high doses deferoxamine is attended by a range of ocular toxicities. The visual symptoms associated with deferoxamine administration often limit effective iron chelation therapy and can result in permanent vision loss. Deferoxamine has recently been conjugated to certain high molecular weight biocompatible polymers without altering its iron-binding properties. Here the effect of conjugation of deferoxamine to hydroxyethyl starch on retinal toxicity is examined.
An albino rat model of electroretinographically determined, deferoxamine-induced retinal toxicity has been previously described. We use this model to evaluate and compare both native deferoxamine and hydroxyethyl starch conjugated deferoxamine.
Our data show that retinal function, as assessed by the electroretinogram b-wave, is significantly depressed 1 day after a single dose of native deferoxamine, while the b-waves of rats receiving a single dose of hydroxyethyl starch-deferoxamine, are not significantly depressed at any time during the study. In addition, the administered dose of hydroxyethyl starch-deferoxamine resulted in plasma deferoxamine concentrations up to five times greater than those achieved with native deferoxamine.
These results suggest that hydroxyethyl starch conjugated deferoxamine is associated with less retinal toxicity than native deferoxamine and that it may be a safer alternative for iron chelation therapy.
甲磺酸去铁胺(去铁敏,西巴公司,新泽西州萨米特)是一种铁螯合剂,常用于治疗急性铁中毒和慢性铁过载(与依赖输血的贫血症相关)。长时间大剂量使用去铁胺会引发一系列眼部毒性。与去铁胺给药相关的视觉症状常常限制了有效的铁螯合治疗,并可能导致永久性视力丧失。最近,去铁胺已与某些高分子量生物相容性聚合物结合,而不改变其铁结合特性。在此研究中,检测了去铁胺与羟乙基淀粉结合对视网膜毒性的影响。
先前已描述了一种通过视网膜电图测定的去铁胺诱导的白化大鼠视网膜毒性模型。我们使用该模型来评估和比较天然去铁胺和羟乙基淀粉结合的去铁胺。
我们的数据表明,单次给予天然去铁胺后1天,通过视网膜电图b波评估的视网膜功能显著降低,而在研究期间,接受单次剂量羟乙基淀粉 - 去铁胺的大鼠的b波在任何时候均未显著降低。此外,羟乙基淀粉 - 去铁胺的给药剂量导致血浆去铁胺浓度比天然去铁胺高出多达五倍。
这些结果表明,羟乙基淀粉结合的去铁胺比天然去铁胺的视网膜毒性更小,它可能是铁螯合治疗的更安全替代品。