Gordon Y J, Araullo-Cruz T, Romanowski E G
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pa., USA.
Arch Ophthalmol. 1998 Jul;116(7):900-5. doi: 10.1001/archopht.116.7.900.
To evaluate the antiviral activity of topical diclofenac sodium (Voltaren Ophthalmic) and ketorolac tromethamine (Acular) (2 nonsteroidal anti-inflammatory drugs [NSAIDs]) on adenoviral replication in vitro and in the adenovirus (Ad) 5 McEwen-New Zealand rabbit ocular model.
The 50% inhibitory concentration of ketorolac and diclofenac and their respective preservative components were determined for common ocular adenoviral serotypes (Ad8, Ad19, Ad1, and Ad5). In a series of experiments, Ad5 McEwen-inoculated New Zealand rabbit eyes were treated topically 4 times daily for 18 days with either ketorolac, diclofenac, prednisolone acetate (Pred Forte), or control vehicle (Comfort Tears).
Outcome measures included serial ocular tear film titers and the formation of subepithelial immune corneal infiltrates.
In vitro, neither ketorolac nor diclofenac demonstrated significant inhibitory activity against Ad1, Ad5, Ad8, or Ad19. In the rabbit model, there were no statistically significant differences among ketorolac, diclofenac, and the control vehicle with respect to viral replication or the formation of subepithelial immune infiltrates. In contrast, 1% prednisolone prolonged viral shedding and inhibited immune infiltrates (P < .001 for both).
Our experimental study suggests that treatment of epidemic keratoconjunctivitis with topical NSAIDs may be a safer alternative than topical steroids. Only controlled clinical trials can determine whether topical NSAIDs can provide symptomatic relief and not interfere with normal viral clearance.
评估局部用双氯芬酸钠（Voltaren Ophthalmic）和酮咯酸氨丁三醇（Acular）（两种非甾体抗炎药[NSAIDs]）对腺病毒在体外及腺病毒（Ad）5 McEwen - 新西兰兔眼部模型中复制的抗病毒活性。
测定酮咯酸和双氯芬酸及其各自防腐剂成分对常见眼部腺病毒血清型（Ad8、Ad19、Ad1和Ad5）的50%抑制浓度。在一系列实验中，对接种Ad5 McEwen的新西兰兔眼，每日局部给药4次，持续18天，分别给予酮咯酸、双氯芬酸、醋酸泼尼松龙（Pred Forte）或对照赋形剂（Comfort Tears）。
观察指标包括连续的眼泪膜滴度以及角膜上皮下免疫浸润的形成。
在体外，酮咯酸和双氯芬酸对Ad1、Ad5、Ad8或Ad19均未表现出显著的抑制活性。在兔模型中，酮咯酸、双氯芬酸和对照赋形剂在病毒复制或角膜上皮下免疫浸润形成方面无统计学显著差异。相比之下，1%的泼尼松龙延长了病毒排出时间并抑制了免疫浸润（两者P均<0.001）。
我们的实验研究表明，用局部NSAIDs治疗流行性角结膜炎可能比局部用类固醇更安全。只有对照临床试验才能确定局部NSAIDs是否能提供症状缓解且不干扰正常的病毒清除。
