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1.
Edward J. Holland Walter O. Whitley Kenneth Sall Stephen S. Lane Aparna Raychaudhuri Steven Y. Zhang 《Current medical research and opinion》2016,32(10):1759-1765
Objective: Report efficacy findings from three clinical trials (one phase 2 and two phase 3 [OPUS-1, OPUS-2]) of lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease (DED).Research design and methods: Three 84-day, randomized, double-masked, placebo-controlled trials. Adults (≥18 years) with DED were randomized (1:1) to lifitegrast 5.0% or matching placebo. Changes from baseline to day 84 in signs and symptoms of DED were analyzed.Main outcome measures: Phase 2, pre-specified endpoint: inferior corneal staining score (ICSS; 0–4); OPUS-1, coprimary endpoints: ICSS and visual-related function subscale (0–4 scale); OPUS-2, coprimary endpoints: ICSS and eye dryness score (EDS, VAS; 0–100).Results: Fifty-eight participants were randomized to lifitegrast 5.0% and 58 to placebo in the phase 2 trial; 293 to lifitegrast and 295 to placebo in OPUS-1; 358 to lifitegrast and 360 to placebo in OPUS-2. In participants with mild-to-moderate baseline DED symptomatology, lifitegrast improved ICSS versus placebo in the phase 2 study (treatment effect, 0.35; 95% CI, 0.05–0.65; p?=?0.0209) and OPUS-1 (effect, 0.24; 95% CI, 0.10–0.38; p?=?0.0007). Among more symptomatic participants (baseline EDS ≥40, recent artificial tear use), lifitegrast improved EDS versus placebo in a post hoc analysis of OPUS-1 (effect, 13.34; 95% CI, 2.35–24.33; nominal p?=?0.0178) and in OPUS-2 (effect, 12.61; 95% CI, 8.51–16.70; p?<?0.0001).Limitations: Trials were conducted over 12 weeks; efficacy beyond this period was not assessed.Conclusions: Across three trials, lifitegrast improved ICSS in participants with mild-to-moderate baseline symptomatology in two studies, and EDS in participants with moderate-to-severe baseline symptomatology in two studies. Based on the overall findings from these trials, lifitegrast shows promise as a new treatment option for signs and symptoms of DED. 相似文献
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Rosario Gulias-Cañizo Anell Lagunes-Guillén Arturo González-Robles Erika Sánchez-Guzmán Federico Castro-Muñozledo 《Burns : journal of the International Society for Burn Injuries》2019,45(2):398-412
Background
Since recent reports have shown that (-)-Epigallocatechin-3-gallate (EGCG) could be used for treating proliferative and inflammatory disorders, we explored its use for the management of corneal chemical burns.Materials and methods
Initially, EGCG was assayed on the rabbit corneal epithelial cell line RCE1(5T5) to establish the best testing conditions, and to avoid unwanted outcomes in the experimental animals. Then, we studied its effects on cell proliferation, cell cycle progression and cell differentiation. Afterwards, we instilled EGCG in experimental grade II corneal alkali burns in mice, three times a day up to 21 days, and evaluated by slit lamp examination and histological sections of corneal epithelial, corneal endothelial and stromal edema, as well as the presence of inflammatory cells and neovascularization.Results
EGCG reduced cell growth and led to a decline in the proportion of proliferative cells in a concentration dependent manner. At 10 μM, EGCG promoted cell differentiation, an effect not related with apoptosis or cytotoxicity. When 10 μM EGCG was instilled in corneal alkali burns in mice three times a day up to 21 days, EGCG significantly reduced corneal opacity and neovascularization. The improved clinical appearance of the cornea was associated to a controlled epithelial growth; epithelial morphology was similar to that observed in normal epithelium and contrasted with the hyperproliferative, desquamating epithelium observed in control burn wounds. EGCG reduced corneal, stromal and endothelial edema, and wound inflammation.Conclusion
This work constitutes the first evidence for the use of EGCG in the acute phase of a corneal alkali burn, representing a possible novel alternative to improve patient outcomes as an add-on therapy. 相似文献4.
Bacterial keratitis continues to be one of the leading causes of corneal blindness in the developed as well as the developing world, despite swift progress since the dawn of the “anti-biotic era”. Although, we have expeditiously developed our understanding about the different causative organisms and associated pathology leading to keratitis, extensive gaps in knowledge continue to dampen the efforts required for early and accurate diagnosis, and management in these patients, resulting in poor clinical outcomes. The ability of the causative bacteria to subdue the therapeutic challenge stems from their large genome encoding complex regulatory networks, variety of unique virulence factors, and rapid secretion of tissue damaging proteases and toxins.In this review article, we provide an overview of the established diagnostic techniques and therapeutics for keratitis caused by various bacteria. We extensively report the recent in-roads through novel tools for accurately diagnosing mono- and poly-bacterial corneal infections. Furthermore, we outline the recent progress by our groups and others in understanding the sub-cellular genomic changes that lead to antibiotic resistance in these organisms. Finally, we discuss in detail, the novel therapies and drug delivery systems in development for the efficacious management of bacterial keratitis. 相似文献
5.
103例角膜溃疡的病因和病原及药物敏感试验的统计分析 总被引:7,自引:0,他引:7
对1995年1—12月间我院门诊103例角膜溃疡的病因、病原和药物敏感试验进行统计分析。病因:外伤59例(57.28%),继发感染34例(33.01%),原因不明8例(7.77%),戴接触镜2例(1.94%)。病原:真菌35例(33.98%),绿脓杆菌18例(17.48%),金黄色葡萄球菌15例(14.56%),表皮葡萄球菌9例(8.74%),淋球菌2例(1.94%)。对19例真菌性角膜溃疡同时进行细菌培养,有7例为混合感染,占36.84%。对几种主要检出菌的药物敏感试验表明:它们对普通抗菌素均可产生一定的耐药性 相似文献
6.
真皮-脂肪颗粒混合液注射移植修复面部凹陷性组织缺损 总被引:2,自引:0,他引:2
目的探索一种新的面部凹陷性组织缺损的修复方法。方法将真皮颗粒和脂肪颗粒混合制成真皮-脂肪颗粒混合液,用2mm脂肪抽吸针注射移植修复面部凹陷性组织缺损。结果本组18例,17例1次填充成功,仅1例因缺损面积过大而补充填充1次,全部病例伤口均Ⅰ期愈合,无感染,外形明显改善。结论真皮-脂肪颗粒混合移植修复面部凹陷性组织缺损,手术简单易行,术后吸收少,效果较好,值得推广。 相似文献
7.
聚合酶链反应检测铜绿假单胞菌感染性角膜溃疡的实验研究及临床应用 总被引:1,自引:0,他引:1
目的:探索聚合酶链反应(PCR)技术对铜绿假单胞菌感染性角膜溃疡快速诊断的可行性。优越性及其在临床应用中的价值。方法:建立PCR检测标准铜绿假单胞菌方法,对兔铜绿假单胞菌感染性角膜溃疡模型研究并应用于临床,并与细菌培养做比较。结果:铜绿假单胞菌扩增出一条长504bp的阳性条带,其他常见细菌,人和兔正常角膜组织均为阴性,动物模型PCR敏感性为93.8%。特异性为100.0%;细菌培养敏感性为68.7%。特异性为93.7%。临床标本PCR阳性率为66.7%;细菌培养阳性率为38.1%。结论:PCR技术对快速检测实验室和临床标本中的铜绿假单胞菌具有重要的应用价值。 相似文献
8.
本文报告胰岛细胞脑内移植治疗I型糖尿病共3例,分别经过3个月、4个月、6个月的临床观察,其临床症状明显改善或消失,空腹血糖由移植前平均12.38mmol/L下降至7.77mmol/L;3例患者普通胰岛素用量平均每日62.3~u,移植后第21~30天均完全停用胰岛素,其中1例已持续撤离胰岛素治疗达5个月。观察结果提示:胰岛移植物在患者的脑内成活,并具有良好的内分泌功能。 相似文献
9.
激光上皮下角膜磨镶术后角膜上皮瓣临床观察 总被引:1,自引:0,他引:1
目的 观察及探讨准分子激光上皮下角膜磨镶术(Laser subepithel ialkeratomileusis,LASEK)后,角膜上皮瓣的成活率及其影响因素。方法 对行LASEK治疗的42例(80眼)于术后1、2、3天,1、2、3、4周在裂隙灯显微镜下进行角膜上皮瓣的观察。结果 34例(68眼),角膜上皮瓣成活,成活占85%(68/80);未成活8例(12眼),未成活占15%(12/80)。结论 LASEK术后角膜上皮瓣成活率的高低,决定着LASEK的临床疗效,影响其成活的因素是多方面的。其中角膜上皮瓣边缘不整齐、破裂、对位不良、操作时间过长可能是其主要原因。 相似文献
10.
本文统计分析1985-1990年间我院眼科481例(569只眼)住院角膜病患者的病种分布和致盲原因。调查结果表明,发病性别男多于女(2:1),发病年龄以21-50岁为多,53.6%,最常见及致盲率高的为角膜炎症和外伤,其中病毒性角膜炎最多(33.9%),细菌性角膜溃疡致盲率最高(42.2%),角膜外伤居第二。分析表明,今后工作的重点是预防和治疗角膜炎症和外伤。 相似文献