Summary: Copyright 2022 Wolters Kluwer Health, Inc. All rights reserved. Unauthorized use of these marks is strictly prohibited. Pharmacological therapy has emerged as a potential approach to. Moreover, we underscore the importance of combining GCS with immunosuppressive drugs and biological agents to minimize adverse reactions and optimize therapeutic outcomes. Upon reaching a dose of 30mg/d, it should be gradually reduced by 2.55mg every 12weeks. Prednisone, a commonly employed GCS medication for treating BU, is typically administered at an initial dose of 12mg/(kgd) in the morning for a duration of 12weeks [38, 49]. 2958, Obenberger, Corneal damage following intracorneal injection of N-acetyl-L-cysteine, Albrecht Von Graefes Arch Klin Exp Ophthalmol, 185, . Topical eye drops are generally the preferred route of drug administration because they are noninvasive and can be administered by the patient. And several anti-cataract drugs have been applied in the clinic, while the effect is still unsatisfied. Epub 2015 Jul 22. Most of these delivery systems, except for OHR1031 (Ohr Pharmaceutical) and Durasite ISV-215 (Insite Vision), however, have an undesirable initial burst effect. 2023 Feb 18:2023.02.17.528811. doi: 10.1101/2023.02.17.528811. 358, Bloemendal, Ageing and vision: structure, stability and function of lens crystallins, Prog Biophys Mol Biol, 86, . Western-blotting and size-exclusion chromatography (SEC) were used to explore the mechanism. Drug delivery to the lens for the management of cataracts. Curr Opin Ophthalmol 2017;28:98-103. 61, Wang, Biosynthesis, characterization and cytotoxicity of gold nanoparticles and their loading with N-acetylcarnosine for cataract treatment, J Photochem Photobiol B, 187, . Therefore, pharmacological treatment for cataracts is a cheaper and more readily available option for patients, which is also a hot topic for years. See this image and copyright information in PMC. It is administered as an outpatient clinic procedure. It is thus imperative to consider factors such as affordability, availability, accessibility, adequacy, and acceptability for new models of drug delivery. Correspondence to In 2021, the seven-year outcomes of the Multicenter Uveitis Steroid Treatment (MUST) trial, comprising 248 eyes from 177 participants with uveitic macular edema (ME), revealed a preference for systemic treatment over Fluocinolone acetonide implants. N-acetylcysteine amide and N-acetylcarnosine are two compounds that have increased bioavailability over their precursors, alleviating the challenges that have come with topical administration. Since the last major review of medical treatment of cataract the search for an anti-cataract agent has advanced on many fronts. Am J Ophthalmol 152:10591066, Pathanapitoon K, Kunavisarut P, Saravuttikul FA, Rothova A (2019) Ocular Manifestations and Visual Outcomes of Behcets Uveitis in a Thai population. Int J Nanomedicine. 1, Babizhayev, N-Acetylcarnosine, a natural histidine-containing dipeptide, as a potent ophthalmic drug in treatment of human cataracts, Peptides, 22, . 372, Cotgreave, N-acetylcysteine: pharmacological considerations and experimental and clinical applications, Adv Pharmacol, 38, . In this article, we will review the development and application of anti-cataract drugs based on Medical treatment of cataract is therefore a highly desired alternative. 345-356. Am J Ophthalmol 152:441448. This review summarizes recent findings in pharmacological treatment and delivery, focusing on drugs that target oxidative stress and the aggregation of crystallins. BS typically affects young adults between the ages of 25 and 35 [8], with ocular involvement commonly presenting 24years after disease onset, and is the leading cause of non-infectious uveitis in referral centers in Italy [9] and Turkey [10]. This enhanced penetration into the posterior segment allows for smaller doses with increased efficacy and minimal systemic side effects. PMC Behet's uveitis (BU) is a debilitating manifestation of Behet's disease, often requiring prompt and aggressive treatment to prevent vision loss. Curr Clin Pharmacol. Emerging potential of stimulus-responsive nanosized anticancer drug delivery systems for systemic applications. Makley and Zhao recently identified two kinds of novel pharmacological substances (25-hydroxycholesterol, lanosterol) that can reverse lens opacity by dissolving the aggregation of crystallin proteins, indicating that protein aggregation is not an endpoint and could be reversed with specific small-molecule drugs, significantly boosting the development of the cataract pharmacopeia and being regarded as a new dawn for cataract treatment. Meeting: 2020 Virtual Annual Meeting. A 2017 prospective study by Fabiani et al. In this review, we first recapitulate the first-line therapy and clinical challenges in the current treatment of GBM. Pharmacological therapy has emerged as a potential approach to combat the global shortage of surgery due to a lack of access and resources. Ruttala HB, Ramasamy T, Madeshwaran T, Hiep TT, Kandasamy U, Oh KT, Choi HG, Yong CS, Kim JO. Ther Adv Ophthalmol. The primary endpoint in the phase 3 study of OTX-TP was not met. Metabolic model predictions enable targeted microbiome manipulation through precision prebiotics. Aquaporin protein drug target helps treat cataracts. The target of the treatment was the A- and B-crystallin mutations that often cause cataracts in aging. Google Scholar [106] eCollection 2019. 2022 Dec 21;17:6527-6550. doi: 10.2147/IJN.S388604. Further research is warranted to elucidate the ideal combination therapy for BU patients, aiming to attain long-term remission of uveitis and improve visual outcomes. Epub 2009 May 14. 31, Dubois, N-acetylcarnosine (NAC) drops for age-related cataract, Cochrane Database Syst Rev, 2, . CD009493, Lian, The quest for homeopathic and nonsurgical cataract treatment, Curr Opin Ophthalmol, 31, . Epub 2016 Sep 20. It would be helpful if metrics and innovations were developed to measure compliance and accurate dosage, such as might be possible with eye drop bottle sensors.5. 34(4):354-360, July 2023. https://doi.org/10.1016/j.ophtha.2009.11.027, Ahmad ZM, Hughes BA, Abrams GW, Mahmoud TH (2012) Combined posterior chamber intraocular lens, vitrectomy, Retisert, and pars plana tube in noninfectious uveitis. Patients and ophthalmologists, however, may be deterred from using these devices because of foreign body sensation or patients inability to confirm that the punctal plugs are still in place. Clin Ophthalmol 10:19832020. -, Goodman DF, Stark WJ, Gottsch JD. The https:// ensures that you are connecting to the Some error has occurred while processing your request. During the chronic inflammation phase, the standard maintenance dose is 1520mg/d. Intravitreal and sustained-release GCS formulations have emerged as valuable additions to the therapeutic armamentarium, reducing systemic exposure and adverse effects. In 40.8% of patients, intraocular pressure exceeded 21mmHg. In cases of BU involving the anterior segment of the eye, 0.1% dexamethasone eye drops are routinely administered 46 times daily. OTX-TP (Ocular Therapeutix) and Evolute (Mati Therapeutics) deliver travoprost and latanoprost, respectively, for 3 months via drug-eluting punctal plugs. 2019 Sep 21;9(23):6885-6900. doi: 10.7150/thno.36510. Delivery has improved with the use of nanotechnology, but further research is needed to solidify these compounds' therapeutic effects on cataracts and improve delivery methods to the lens. Tugal-Tutkun I, Gupta V, Cunningham ET (2013) Differential diagnosis of Behet uveitis. 2018;13(2):110-119. doi: 10.2174/1574884713666180412150153. Ophthalmology 117:567575. Topical drug delivery is the most popular noninvasive method for the treatment of ocular diseases , though it must be able to reach the treatment area, provide adequate doses of drug ingredients, and maintain them in the eye continuously. Pharmacological therapy has emerged as a potential approach to combat the global shortage of surgery due to a lack of access and resources. Thanks for visiting CRSToday. All data generated or analyzed during this study are included in this published article. Structural and functional properties, chaperone activity and posttranslational modifications of alpha-crystallin and its related subunits in the crystalline lens: N-acetylcarnosine, carnosine and carcinine act as alpha- crystallin/small heat shock protein enhancers in prevention and dissolution of cataract in ocular drug delivery formulations of novel therapeutic agents. 5-cholesten-3b; 407, Brennan, Mechanisms of organelle elimination for lens development and differentiation, Exp Eye Res, 209, . eCollection 2022 Sep. Hsu CC, Chuang HK, Hsiao YJ, Teng YC, Chiang PH, Wang YJ, Lin TY, Tsai PH, Weng CC, Lin TC, Hwang DK, Hsieh AR. Systemic GCS usage may result in various side effects, including gastrointestinal ulcers, hypertension, diabetes, Cushing's syndrome, and osteoporosis [49, 57]. Ophthalmic Surg 1989;20:132-40. However, there was no significant therapeutic distinction between ITA and IDI, and their intraocular pressure risk profiles were comparable [42]. Studies demonstrate intravitreal GCS injections' efficacy in controlling acute-phase inflammation and improving best-corrected visual acuity. Babizhayev MA, Deyev AI, Yermakova VN, Brikman IV, Bours J. Pharmaceuticals (Basel). In instances of BU involving intermediate uveitis, posterior uveitis, and macular edema, systemic glucocorticoid therapy ought to be contemplated, particularly for severe retinal vasculitis and retinal vasculitis induced by BS. The management of BU poses a significant challenge for clinicians due to its recurrent and sight-threatening nature. The site is secure. BS occurs worldwide, with higher prevalence in regions along the ancient Silk Route, particularly in the Middle East, the Mediterranean basin, and the Far East [4]. Introduction One of the most common types of the primary tumor, hepatocellular carcinoma (HCC), has risen to become the world's fourth-biggest cause of cancer mortality [ 1, 2 ]. Age-related cataract and drug therapy: opportunities and challenges for topical antioxidant delivery to the lens . Subsequently, Ahmad et al. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Smart Resources in Ophthalmology: Applications and Social Networking. 1520, Zhang, Inhibitory effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system, Precis Clin Med, 5, . pbac021, Makley, Pharmacological chaperone for -crystallin partially restores transparency in cataract models, Science, 350, . 1122, Amer, N-acetylcysteine amide (AD4) attenuates oxidative stress in beta-thalassemia blood cells, Biochim Biophys Acta, 1780, . Epub 2015 Mar 23. Federal government websites often end in .gov or .mil. Age-related or senile cataract is one of the main causes of visual impairment in the elderly; given the lack of access to surgical treatment in many parts of the world, cataract remains a major cause of sight loss. Please refer to our, https://doi.org/10.1097/ICU.0000000000000910. Bethesda, MD 20894, Web Policies Anderson DF, Dhariwal M, Bouchet C, et al. J Clin Med. The standard routes of eye drops, ointments, and intravitreal injections are the backbone of ocular drug delivery in India. Pressing the buy now button more than once may result in multiple purchases. A novel high-throughput drug-screening platform, A novel high-throughput drug-screening platform for anti-cataract drugs. Please try after some time. The https:// ensures that you are connecting to the Targeting caveolae to pump bispecific antibody to TGF- into diseased lungs enables ultra-low dose therapeutic efficacy. The finding opens up the field for drug-based therapy rather . In 2015, Coskun et al. 1. Clin Pharmacokinet 44:6198. Am J Ophthalmol 138:289291. Furthermore, lanosterol, and more recently 5-cholesten-3b,25-diol (VP1-001), have been reported to combat the aggregation of crystallins in vivo and ex vivo . Effect of a fluocinolone acetonide insert on recurrence rates in noninfectious intermediate, posterior, or panuveitis: three-year results. Recent findings Antioxidants and oxysterols have been shown to improve or reverse lens opacity in cataract models. 2: Targeted communication during consultation. Functionalized resorcinarenes effectively disrupt the aggregation of A66-80 crystallin peptide related to cataracts. FOIA Inhibitory effect of lanosterol on cataractous lens of cynomolgus monkeys using a subconjunctival drug release system. Ocul Immunol Inflamm 18:18, Article Clin Exp Rheumatol 33:S145-151, Gao N, Han W, Ci WP, Liao H, Du J (2016) Clinical data analysis of cardiovascular involvement in Behcets disease. 2009 Jan;4(1):4-37. doi: 10.2174/157488409787236074. Published by Elsevier B.V. A revolutionary new treatment for cataracts has shown extremely positive results in laboratory tests, giving hope that the condition, which currently can only be cured with surgery, could soon. Lanosterol and 25-hydroxycholesterol dissociate crystallin aggregates isolated from cataractous human lens via different mechanisms. In 2013, Lightman et al. -. Bethesda, MD 20894, Web Policies The primary treatment objective encompasses achieving and sustaining remission by attenuating the immune response, controlling inflammation, and averting severe complications such as vision loss. PubMed
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