NZ735959B2 - Ophthalmic compositions and methods of use therefor - Google Patents
Ophthalmic compositions and methods of use therefor Download PDFInfo
- Publication number
- NZ735959B2 NZ735959B2 NZ735959A NZ73595916A NZ735959B2 NZ 735959 B2 NZ735959 B2 NZ 735959B2 NZ 735959 A NZ735959 A NZ 735959A NZ 73595916 A NZ73595916 A NZ 73595916A NZ 735959 B2 NZ735959 B2 NZ 735959B2
- Authority
- NZ
- New Zealand
- Prior art keywords
- corneal
- composition
- dexamethasone
- cornea
- eye
- Prior art date
Links
- 239000000203 mixture Substances 0.000 title claims abstract description 231
- 210000004087 Cornea Anatomy 0.000 claims abstract description 232
- UREBDLICKHMUKA-CXSFZGCWSA-N Dexamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-CXSFZGCWSA-N 0.000 claims abstract description 116
- 229960003957 Dexamethasone Drugs 0.000 claims abstract description 109
- 229920001184 polypeptide Polymers 0.000 claims abstract description 80
- 150000001413 amino acids Chemical class 0.000 claims abstract description 46
- 208000004870 Refractive Errors Diseases 0.000 claims abstract description 20
- 239000003814 drug Substances 0.000 claims abstract description 13
- 239000011780 sodium chloride Substances 0.000 claims abstract description 8
- 150000002148 esters Chemical class 0.000 claims abstract description 6
- 150000003839 salts Chemical class 0.000 claims abstract description 6
- 150000004678 hydrides Chemical class 0.000 claims abstract description 5
- 125000003275 alpha amino acid group Chemical group 0.000 claims abstract 10
- 210000001508 Eye Anatomy 0.000 claims description 120
- 239000003795 chemical substances by application Substances 0.000 claims description 79
- 229920001436 collagen Polymers 0.000 claims description 52
- 102000008186 Collagen Human genes 0.000 claims description 49
- 108010035532 Collagen Proteins 0.000 claims description 49
- 229960005188 collagen Drugs 0.000 claims description 49
- 239000007943 implant Substances 0.000 claims description 40
- 239000003889 eye drop Substances 0.000 claims description 38
- 201000002287 keratoconus Diseases 0.000 claims description 29
- 238000004132 cross linking Methods 0.000 claims description 22
- 208000001491 Myopia Diseases 0.000 claims description 18
- 230000004379 myopia Effects 0.000 claims description 18
- 230000002354 daily Effects 0.000 claims description 16
- 238000001356 surgical procedure Methods 0.000 claims description 16
- 150000002500 ions Chemical class 0.000 claims description 15
- 229920002148 Gellan gum Polymers 0.000 claims description 14
- 201000009310 astigmatism Diseases 0.000 claims description 13
- 239000000216 gellan gum Substances 0.000 claims description 13
- 235000010492 gellan gum Nutrition 0.000 claims description 13
- 229940116904 ANTIINFLAMMATORY THERAPEUTIC RADIOPHARMACEUTICALS Drugs 0.000 claims description 9
- 229940074726 OPHTHALMOLOGIC ANTIINFLAMMATORY AGENTS Drugs 0.000 claims description 9
- 239000002260 anti-inflammatory agent Substances 0.000 claims description 9
- 201000010041 presbyopia Diseases 0.000 claims description 9
- 239000000969 carrier Substances 0.000 claims description 8
- 239000000314 lubricant Substances 0.000 claims description 8
- 239000003193 general anesthetic agent Substances 0.000 claims description 7
- 229960004833 Dexamethasone phosphate Drugs 0.000 claims description 6
- 206010020675 Hypermetropia Diseases 0.000 claims description 6
- 239000004599 antimicrobial Substances 0.000 claims description 6
- 201000006318 hyperopia Diseases 0.000 claims description 6
- 230000004305 hyperopia Effects 0.000 claims description 6
- 229940035295 Ting Drugs 0.000 claims description 5
- VQODGRNSFPNSQE-CXSFZGCWSA-N dexamethasone phosphate Chemical group C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)COP(O)(O)=O)(O)[C@@]1(C)C[C@@H]2O VQODGRNSFPNSQE-CXSFZGCWSA-N 0.000 claims description 5
- 201000004181 stromal dystrophy Diseases 0.000 claims description 4
- NBIIXXVUZAFLBC-UHFFFAOYSA-K [O-]P([O-])([O-])=O Chemical compound [O-]P([O-])([O-])=O NBIIXXVUZAFLBC-UHFFFAOYSA-K 0.000 claims description 3
- 239000010452 phosphate Substances 0.000 claims description 3
- 210000004027 cells Anatomy 0.000 description 94
- 239000002609 media Substances 0.000 description 72
- 102000000503 Collagen Type II Human genes 0.000 description 70
- 108010041390 Collagen Type II Proteins 0.000 description 70
- 210000001519 tissues Anatomy 0.000 description 52
- 230000002648 chondrogenic Effects 0.000 description 44
- 230000004069 differentiation Effects 0.000 description 37
- 210000002744 Extracellular Matrix Anatomy 0.000 description 33
- 230000014509 gene expression Effects 0.000 description 33
- 230000003637 steroidlike Effects 0.000 description 32
- 238000000465 moulding Methods 0.000 description 29
- 241000700159 Rattus Species 0.000 description 28
- 230000000694 effects Effects 0.000 description 24
- 210000000845 Cartilage Anatomy 0.000 description 22
- 229940012356 Eye Drops Drugs 0.000 description 22
- 239000003102 growth factor Substances 0.000 description 22
- 239000000523 sample Substances 0.000 description 22
- 241000283898 Ovis Species 0.000 description 20
- 238000000034 method Methods 0.000 description 20
- 239000000243 solution Substances 0.000 description 19
- 210000002950 fibroblast Anatomy 0.000 description 18
- 238000002372 labelling Methods 0.000 description 18
- 238000005259 measurement Methods 0.000 description 18
- -1 thasone (Johnstone Chemical class 0.000 description 17
- 206010022114 Injury Diseases 0.000 description 15
- 230000001965 increased Effects 0.000 description 15
- 238000003384 imaging method Methods 0.000 description 14
- 238000000338 in vitro Methods 0.000 description 13
- 102000004169 proteins and genes Human genes 0.000 description 13
- 108090000623 proteins and genes Proteins 0.000 description 13
- 238000002474 experimental method Methods 0.000 description 12
- 239000001963 growth media Substances 0.000 description 12
- 102000012422 Collagen Type I Human genes 0.000 description 11
- 108010022452 Collagen Type I Proteins 0.000 description 11
- 206010023332 Keratitis Diseases 0.000 description 11
- 238000009472 formulation Methods 0.000 description 11
- 239000000499 gel Substances 0.000 description 11
- 210000003683 Corneal Stroma Anatomy 0.000 description 10
- 206010064996 Ulcerative keratitis Diseases 0.000 description 10
- 150000001875 compounds Chemical class 0.000 description 10
- 210000003239 corneal fibroblast Anatomy 0.000 description 10
- 230000001939 inductive effect Effects 0.000 description 10
- 238000011068 load Methods 0.000 description 10
- 102000004190 Enzymes Human genes 0.000 description 9
- 108090000790 Enzymes Proteins 0.000 description 9
- 230000001058 adult Effects 0.000 description 9
- 230000037390 scarring Effects 0.000 description 9
- 210000001612 Chondrocytes Anatomy 0.000 description 8
- 238000011065 in-situ storage Methods 0.000 description 8
- 239000008188 pellet Substances 0.000 description 8
- 230000035755 proliferation Effects 0.000 description 8
- 230000002829 reduced Effects 0.000 description 8
- 239000000126 substance Substances 0.000 description 8
- 241000237970 Conus <genus> Species 0.000 description 7
- CZMRCDWAGMRECN-UGDNZRGBSA-N D-sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 7
- 229940110715 ENZYMES FOR TREATMENT OF WOUNDS AND ULCERS Drugs 0.000 description 7
- 210000002966 Serum Anatomy 0.000 description 7
- CZMRCDWAGMRECN-GDQSFJPYSA-N Sucrose Natural products O([C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@H](CO)O1)[C@@]1(CO)[C@H](O)[C@@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-GDQSFJPYSA-N 0.000 description 7
- 102000004965 antibodies Human genes 0.000 description 7
- 108090001123 antibodies Proteins 0.000 description 7
- 239000006196 drop Substances 0.000 description 7
- 229940079593 drugs Drugs 0.000 description 7
- 229940020899 hematological Enzymes Drugs 0.000 description 7
- 230000008929 regeneration Effects 0.000 description 7
- 238000011069 regeneration method Methods 0.000 description 7
- 150000003431 steroids Chemical class 0.000 description 7
- 239000005720 sucrose Substances 0.000 description 7
- 241000283707 Capra Species 0.000 description 6
- 229940096422 Collagen Type I Drugs 0.000 description 6
- 241000283984 Rodentia Species 0.000 description 6
- 230000002776 aggregation Effects 0.000 description 6
- 230000003190 augmentative Effects 0.000 description 6
- 238000004166 bioassay Methods 0.000 description 6
- 229910002092 carbon dioxide Inorganic materials 0.000 description 6
- 238000004113 cell culture Methods 0.000 description 6
- 201000010099 disease Diseases 0.000 description 6
- IJGRMHOSHXDMSA-UHFFFAOYSA-N nitrogen Chemical compound N#N IJGRMHOSHXDMSA-UHFFFAOYSA-N 0.000 description 6
- 229920000642 polymer Polymers 0.000 description 6
- 210000000130 stem cell Anatomy 0.000 description 6
- 238000002560 therapeutic procedure Methods 0.000 description 6
- 229920000160 (ribonucleotides)n+m Polymers 0.000 description 5
- 102100015880 BMP6 Human genes 0.000 description 5
- 101700086945 BMP6 Proteins 0.000 description 5
- 208000006069 Corneal Opacity Diseases 0.000 description 5
- 206010011005 Corneal dystrophy Diseases 0.000 description 5
- 206010011024 Corneal injury Diseases 0.000 description 5
- 210000000981 Epithelium Anatomy 0.000 description 5
- 206010016654 Fibrosis Diseases 0.000 description 5
- 241001465754 Metazoa Species 0.000 description 5
- 206010068760 Ulcers Diseases 0.000 description 5
- 238000004220 aggregation Methods 0.000 description 5
- 230000004075 alteration Effects 0.000 description 5
- 238000004458 analytical method Methods 0.000 description 5
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 5
- 230000004438 eyesight Effects 0.000 description 5
- 230000004761 fibrosis Effects 0.000 description 5
- 238000003364 immunohistochemistry Methods 0.000 description 5
- 239000007788 liquid Substances 0.000 description 5
- 230000000051 modifying Effects 0.000 description 5
- 238000011160 research Methods 0.000 description 5
- 230000001225 therapeutic Effects 0.000 description 5
- 230000000699 topical Effects 0.000 description 5
- 231100000397 ulcer Toxicity 0.000 description 5
- 230000004304 visual acuity Effects 0.000 description 5
- CPKVUHPKYQGHMW-UHFFFAOYSA-N 1-ethenylpyrrolidin-2-one;molecular iodine Chemical compound II.C=CN1CCCC1=O CPKVUHPKYQGHMW-UHFFFAOYSA-N 0.000 description 4
- 241000220450 Cajanus cajan Species 0.000 description 4
- 102000001187 Collagen Type III Human genes 0.000 description 4
- 108010069502 Collagen Type III Proteins 0.000 description 4
- 229920002676 Complementary DNA Polymers 0.000 description 4
- 208000004587 Corneal Disease Diseases 0.000 description 4
- 206010051559 Corneal defect Diseases 0.000 description 4
- 206010054760 Corneal thinning Diseases 0.000 description 4
- JYGXADMDTFJGBT-VWUMJDOOSA-N Cortisol Chemical compound O=C1CC[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 JYGXADMDTFJGBT-VWUMJDOOSA-N 0.000 description 4
- 239000006144 Dulbecco’s modified Eagle's medium Substances 0.000 description 4
- FAOZLTXFLGPHNG-KNAQIMQKSA-N Fluorometholone Chemical compound C([C@@]12C)=CC(=O)C=C1[C@@H](C)C[C@@H]1[C@]2(F)[C@@H](O)C[C@]2(C)[C@@](O)(C(C)=O)CC[C@H]21 FAOZLTXFLGPHNG-KNAQIMQKSA-N 0.000 description 4
- 108010088225 Nestin Proteins 0.000 description 4
- 102000008730 Nestin Human genes 0.000 description 4
- 241000233805 Phoenix Species 0.000 description 4
- 241000700157 Rattus norvegicus Species 0.000 description 4
- 210000003786 Sclera Anatomy 0.000 description 4
- 210000002536 Stromal Cells Anatomy 0.000 description 4
- 210000001138 Tears Anatomy 0.000 description 4
- 102000013127 Vimentin Human genes 0.000 description 4
- 108010065472 Vimentin Proteins 0.000 description 4
- 238000010171 animal model Methods 0.000 description 4
- 230000003416 augmentation Effects 0.000 description 4
- 230000015572 biosynthetic process Effects 0.000 description 4
- 239000002299 complementary DNA Substances 0.000 description 4
- 201000007717 corneal ulcer Diseases 0.000 description 4
- 238000011161 development Methods 0.000 description 4
- 230000018109 developmental process Effects 0.000 description 4
- 230000029087 digestion Effects 0.000 description 4
- 238000006073 displacement reaction Methods 0.000 description 4
- 238000005755 formation reaction Methods 0.000 description 4
- 238000007710 freezing Methods 0.000 description 4
- 239000011521 glass Substances 0.000 description 4
- 230000012010 growth Effects 0.000 description 4
- 229960000890 hydrocortisone Drugs 0.000 description 4
- 238000007373 indentation Methods 0.000 description 4
- 229910052740 iodine Inorganic materials 0.000 description 4
- 239000000463 material Substances 0.000 description 4
- 239000011159 matrix material Substances 0.000 description 4
- 210000000651 myofibroblasts Anatomy 0.000 description 4
- 229940021182 non-steroidal anti-inflammatory drugs Drugs 0.000 description 4
- 230000003287 optical Effects 0.000 description 4
- 230000002265 prevention Effects 0.000 description 4
- 230000002062 proliferating Effects 0.000 description 4
- 230000001172 regenerating Effects 0.000 description 4
- 238000006467 substitution reaction Methods 0.000 description 4
- 238000002054 transplantation Methods 0.000 description 4
- RYFMWSXOAZQYPI-UHFFFAOYSA-K trisodium phosphate Chemical compound [Na+].[Na+].[Na+].[O-]P([O-])([O-])=O RYFMWSXOAZQYPI-UHFFFAOYSA-K 0.000 description 4
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 4
- 102000007469 Actins Human genes 0.000 description 3
- 108010085238 Actins Proteins 0.000 description 3
- 206010059512 Apoptosis Diseases 0.000 description 3
- 210000003560 Epithelium, Corneal Anatomy 0.000 description 3
- 206010049796 Excoriation Diseases 0.000 description 3
- 241000272184 Falconiformes Species 0.000 description 3
- 102000013373 Fibrillar Collagens Human genes 0.000 description 3
- 108060002894 Fibrillar Collagens Proteins 0.000 description 3
- 108020004999 Messenger RNA Proteins 0.000 description 3
- OIGNJSKKLXVSLS-VWUMJDOOSA-N Prednisolone Chemical compound O=C1C=C[C@]2(C)[C@H]3[C@@H](O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 OIGNJSKKLXVSLS-VWUMJDOOSA-N 0.000 description 3
- 210000001525 Retina Anatomy 0.000 description 3
- 229960002477 Riboflavin Drugs 0.000 description 3
- AUNGANRZJHBGPY-SCRDCRAPSA-N Riboflavin Chemical compound OC[C@@H](O)[C@@H](O)[C@@H](O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O AUNGANRZJHBGPY-SCRDCRAPSA-N 0.000 description 3
- AUNGANRZJHBGPY-OUCADQQQSA-N Riboflavin Natural products OC[C@@H](O)[C@H](O)[C@@H](O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O AUNGANRZJHBGPY-OUCADQQQSA-N 0.000 description 3
- 102000006382 Ribonucleases Human genes 0.000 description 3
- 108010083644 Ribonucleases Proteins 0.000 description 3
- 102100016771 TGFBI Human genes 0.000 description 3
- 238000005299 abrasion Methods 0.000 description 3
- 230000003444 anaesthetic Effects 0.000 description 3
- 230000006907 apoptotic process Effects 0.000 description 3
- 108010068396 betaIG-H3 protein Proteins 0.000 description 3
- UIIMBOGNXHQVGW-UHFFFAOYSA-M buffer Substances [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 3
- 230000022159 cartilage development Effects 0.000 description 3
- 230000015556 catabolic process Effects 0.000 description 3
- 239000006143 cell culture media Substances 0.000 description 3
- 231100000269 corneal opacity Toxicity 0.000 description 3
- 239000006071 cream Substances 0.000 description 3
- 230000003247 decreasing Effects 0.000 description 3
- 230000004059 degradation Effects 0.000 description 3
- 238000006731 degradation reaction Methods 0.000 description 3
- 238000009826 distribution Methods 0.000 description 3
- KCXVZYZYPLLWCC-UHFFFAOYSA-N edta Chemical compound OC(=O)CN(CC(O)=O)CCN(CC(O)=O)CC(O)=O KCXVZYZYPLLWCC-UHFFFAOYSA-N 0.000 description 3
- 239000000839 emulsion Substances 0.000 description 3
- 230000003176 fibrotic Effects 0.000 description 3
- 239000007789 gas Substances 0.000 description 3
- 230000002055 immunohistochemical Effects 0.000 description 3
- 230000001976 improved Effects 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 239000003550 marker Substances 0.000 description 3
- 238000002844 melting Methods 0.000 description 3
- 229920002106 messenger RNA Polymers 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 238000006011 modification reaction Methods 0.000 description 3
- 239000003068 molecular probe Substances 0.000 description 3
- 229910052757 nitrogen Inorganic materials 0.000 description 3
- 238000003752 polymerase chain reaction Methods 0.000 description 3
- 230000002335 preservative Effects 0.000 description 3
- 239000003755 preservative agent Substances 0.000 description 3
- 230000000750 progressive Effects 0.000 description 3
- 238000003753 real-time PCR Methods 0.000 description 3
- 230000004044 response Effects 0.000 description 3
- 230000002441 reversible Effects 0.000 description 3
- 235000019192 riboflavin Nutrition 0.000 description 3
- 239000002151 riboflavin Substances 0.000 description 3
- FAPWRFPIFSIZLT-UHFFFAOYSA-M sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 3
- 239000001488 sodium phosphate Substances 0.000 description 3
- 229910000162 sodium phosphate Inorganic materials 0.000 description 3
- 235000011008 sodium phosphates Nutrition 0.000 description 3
- 239000004094 surface-active agent Substances 0.000 description 3
- XSQUKJJJFZCRTK-UHFFFAOYSA-N urea Chemical compound NC(N)=O XSQUKJJJFZCRTK-UHFFFAOYSA-N 0.000 description 3
- 239000005526 vasoconstrictor agent Substances 0.000 description 3
- LNAZSHAWQACDHT-XIYTZBAFSA-N (2R,3R,4S,5R,6S)-4,5-dimethoxy-2-(methoxymethyl)-3-[(2S,3R,4S,5R,6R)-3,4,5-trimethoxy-6-(methoxymethyl)oxan-2-yl]oxy-6-[(2R,3R,4S,5R,6R)-4,5,6-trimethoxy-2-(methoxymethyl)oxan-3-yl]oxyoxane Chemical compound CO[C@@H]1[C@@H](OC)[C@H](OC)[C@@H](COC)O[C@H]1O[C@H]1[C@H](OC)[C@@H](OC)[C@H](O[C@H]2[C@@H]([C@@H](OC)[C@H](OC)O[C@@H]2COC)OC)O[C@@H]1COC LNAZSHAWQACDHT-XIYTZBAFSA-N 0.000 description 2
- CWSZBVAUYPTXTG-UHFFFAOYSA-N 5-[6-[[3,4-dihydroxy-6-(hydroxymethyl)-5-methoxyoxan-2-yl]oxymethyl]-3,4-dihydroxy-5-[4-hydroxy-3-(2-hydroxyethoxy)-6-(hydroxymethyl)-5-methoxyoxan-2-yl]oxyoxan-2-yl]oxy-6-(hydroxymethyl)-2-methyloxane-3,4-diol Chemical compound O1C(CO)C(OC)C(O)C(O)C1OCC1C(OC2C(C(O)C(OC)C(CO)O2)OCCO)C(O)C(O)C(OC2C(OC(C)C(O)C2O)CO)O1 CWSZBVAUYPTXTG-UHFFFAOYSA-N 0.000 description 2
- 206010002537 Anisometropia Diseases 0.000 description 2
- 208000003464 Asthenopia Diseases 0.000 description 2
- HSWPZIDYAHLZDD-UHFFFAOYSA-N Atipamezole Chemical compound C1C2=CC=CC=C2CC1(CC)C1=CN=CN1 HSWPZIDYAHLZDD-UHFFFAOYSA-N 0.000 description 2
- 229960000686 Benzalkonium Chloride Drugs 0.000 description 2
- 210000004204 Blood Vessels Anatomy 0.000 description 2
- 229920002134 Carboxymethyl cellulose Polymers 0.000 description 2
- 102000020504 Collagenase family Human genes 0.000 description 2
- 108060005980 Collagenase family Proteins 0.000 description 2
- 206010010984 Corneal abrasion Diseases 0.000 description 2
- FWBHETKCLVMNFS-UHFFFAOYSA-N DATI Chemical compound C1=CC(C(=N)N)=CC=C1C1=CC2=CC=C(C(N)=N)C=C2N1 FWBHETKCLVMNFS-UHFFFAOYSA-N 0.000 description 2
- GHVNFZFCNZKVNT-UHFFFAOYSA-N Decanoic acid Chemical compound CCCCCCCCCC(O)=O GHVNFZFCNZKVNT-UHFFFAOYSA-N 0.000 description 2
- 208000002197 Ehlers-Danlos Syndrome Diseases 0.000 description 2
- 229940088598 Enzyme Drugs 0.000 description 2
- 206010015150 Erythema Diseases 0.000 description 2
- 108010067306 Fibronectins Proteins 0.000 description 2
- 102000016359 Fibronectins Human genes 0.000 description 2
- 208000010412 Glaucoma Diseases 0.000 description 2
- 206010019233 Headache Diseases 0.000 description 2
- 229920000663 Hydroxyethyl cellulose Polymers 0.000 description 2
- 239000004354 Hydroxyethyl cellulose Substances 0.000 description 2
- CGIGDMFJXJATDK-UHFFFAOYSA-N Indometacin Chemical compound CC1=C(CC(O)=O)C2=CC(OC)=CC=C2N1C(=O)C1=CC=C(Cl)C=C1 CGIGDMFJXJATDK-UHFFFAOYSA-N 0.000 description 2
- 206010061218 Inflammation Diseases 0.000 description 2
- 241000229754 Iva xanthiifolia Species 0.000 description 2
- 102100005689 KERA Human genes 0.000 description 2
- 101700012242 KERA Proteins 0.000 description 2
- LXCFILQKKLGQFO-UHFFFAOYSA-N Methylparaben Chemical compound COC(=O)C1=CC=C(O)C=C1 LXCFILQKKLGQFO-UHFFFAOYSA-N 0.000 description 2
- 210000002464 Muscle, Smooth, Vascular Anatomy 0.000 description 2
- QTNZYVAMNRDUAD-UHFFFAOYSA-N N-[4-[(2-methylpropan-2-yl)oxy]phenyl]acetamide Chemical compound CC(=O)NC1=CC=C(OC(C)(C)C)C=C1 QTNZYVAMNRDUAD-UHFFFAOYSA-N 0.000 description 2
- CMWTZPSULFXXJA-VIFPVBQESA-N Naproxen Chemical compound C1=C([C@H](C)C(O)=O)C=CC2=CC(OC)=CC=C21 CMWTZPSULFXXJA-VIFPVBQESA-N 0.000 description 2
- 101700072884 POP4 Proteins 0.000 description 2
- WRMNZCZEMHIOCP-UHFFFAOYSA-N Phenethyl alcohol Chemical compound OCCC1=CC=CC=C1 WRMNZCZEMHIOCP-UHFFFAOYSA-N 0.000 description 2
- 229920001213 Polysorbate 20 Polymers 0.000 description 2
- 239000004372 Polyvinyl alcohol Substances 0.000 description 2
- 229920000153 Povidone-iodine Polymers 0.000 description 2
- XOFYZVNMUHMLCC-ZPOLXVRWSA-N Prednisone Chemical compound O=C1C=C[C@]2(C)[C@H]3C(=O)C[C@](C)([C@@](CC4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 XOFYZVNMUHMLCC-ZPOLXVRWSA-N 0.000 description 2
- AKHNMLFCWUSKQB-UHFFFAOYSA-L Sodium thiosulphate Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=S AKHNMLFCWUSKQB-UHFFFAOYSA-L 0.000 description 2
- 239000004133 Sodium thiosulphate Substances 0.000 description 2
- 229960004492 Suprofen Drugs 0.000 description 2
- MDKGKXOCJGEUJW-UHFFFAOYSA-N Suprofen Chemical compound C1=CC(C(C(O)=O)C)=CC=C1C(=O)C1=CC=CS1 MDKGKXOCJGEUJW-UHFFFAOYSA-N 0.000 description 2
- 241000282898 Sus scrofa Species 0.000 description 2
- 102100014320 TGFB1 Human genes 0.000 description 2
- 101700041213 TGFB1 Proteins 0.000 description 2
- 102100002458 TGFB3 Human genes 0.000 description 2
- 229960002372 Tetracaine Drugs 0.000 description 2
- GKCBAIGFKIBETG-UHFFFAOYSA-N Tetracaine Chemical compound CCCCNC1=CC=C(C(=O)OCCN(C)C)C=C1 GKCBAIGFKIBETG-UHFFFAOYSA-N 0.000 description 2
- 102000009618 Transforming Growth Factors Human genes 0.000 description 2
- 108010009583 Transforming Growth Factors Proteins 0.000 description 2
- GLNADSQYFUSGOU-GPTZEZBUSA-J Trypan blue Chemical compound [Na+].[Na+].[Na+].[Na+].C1=C(S([O-])(=O)=O)C=C2C=C(S([O-])(=O)=O)C(/N=N/C3=CC=C(C=C3C)C=3C=C(C(=CC=3)\N=N\C=3C(=CC4=CC(=CC(N)=C4C=3O)S([O-])(=O)=O)S([O-])(=O)=O)C)=C(O)C2=C1N GLNADSQYFUSGOU-GPTZEZBUSA-J 0.000 description 2
- MDYZKJNTKZIUSK-UHFFFAOYSA-N Tyloxapol Chemical compound O=C.C1CO1.CC(C)(C)CC(C)(C)C1=CC=C(O)C=C1 MDYZKJNTKZIUSK-UHFFFAOYSA-N 0.000 description 2
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Vitamin C Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 description 2
- NNJVILVZKWQKPM-UHFFFAOYSA-N Xylocaine Chemical compound CCN(CC)CC(=O)NC1=C(C)C=CC=C1C NNJVILVZKWQKPM-UHFFFAOYSA-N 0.000 description 2
- QTBSBXVTEAMEQO-UHFFFAOYSA-M acetate Chemical compound CC([O-])=O QTBSBXVTEAMEQO-UHFFFAOYSA-M 0.000 description 2
- 230000001154 acute Effects 0.000 description 2
- 238000007792 addition Methods 0.000 description 2
- 235000010323 ascorbic acid Nutrition 0.000 description 2
- 229960005070 ascorbic acid Drugs 0.000 description 2
- 239000011668 ascorbic acid Substances 0.000 description 2
- 230000001580 bacterial Effects 0.000 description 2
- 239000000227 bioadhesive Substances 0.000 description 2
- 238000001574 biopsy Methods 0.000 description 2
- 230000004397 blinking Effects 0.000 description 2
- 230000000903 blocking Effects 0.000 description 2
- 229960000539 carbamide Drugs 0.000 description 2
- 239000004202 carbamide Substances 0.000 description 2
- 235000013877 carbamide Nutrition 0.000 description 2
- CURLTUGMZLYLDI-UHFFFAOYSA-N carbon dioxide Chemical compound O=C=O CURLTUGMZLYLDI-UHFFFAOYSA-N 0.000 description 2
- 239000001569 carbon dioxide Substances 0.000 description 2
- 239000001768 carboxy methyl cellulose Substances 0.000 description 2
- 235000010948 carboxy methyl cellulose Nutrition 0.000 description 2
- 239000008112 carboxymethyl-cellulose Substances 0.000 description 2
- 230000001413 cellular Effects 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 2
- HEDRZPFGACZZDS-UHFFFAOYSA-N chloroform Chemical compound ClC(Cl)Cl HEDRZPFGACZZDS-UHFFFAOYSA-N 0.000 description 2
- 229960003920 cocaine Drugs 0.000 description 2
- ZPUCINDJVBIVPJ-LJISPDSOSA-N cocaine Chemical compound O([C@H]1C[C@@H]2CC[C@@H](N2C)[C@H]1C(=O)OC)C(=O)C1=CC=CC=C1 ZPUCINDJVBIVPJ-LJISPDSOSA-N 0.000 description 2
- ZPUCINDJVBIVPJ-BARDWOONSA-N cocaine Natural products O([C@@H]1C[C@H]2CC[C@H](N2C)[C@@H]1C(=O)OC)C(=O)C1=CC=CC=C1 ZPUCINDJVBIVPJ-BARDWOONSA-N 0.000 description 2
- 230000000052 comparative effect Effects 0.000 description 2
- 238000011109 contamination Methods 0.000 description 2
- 230000004453 corneal transparency Effects 0.000 description 2
- 230000000875 corresponding Effects 0.000 description 2
- 239000006184 cosolvent Substances 0.000 description 2
- 238000005520 cutting process Methods 0.000 description 2
- PLCQGRYPOISRTQ-FCJDYXGNSA-L dexamethasone sodium phosphate Chemical compound [Na+].[Na+].C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)COP([O-])([O-])=O)(O)[C@@]1(C)C[C@@H]2O PLCQGRYPOISRTQ-FCJDYXGNSA-L 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 238000010790 dilution Methods 0.000 description 2
- 201000009910 diseases by infectious agent Diseases 0.000 description 2
- 231100000673 dose–response relationship Toxicity 0.000 description 2
- 230000002708 enhancing Effects 0.000 description 2
- 238000011124 ex vivo culture Methods 0.000 description 2
- 238000010195 expression analysis Methods 0.000 description 2
- 230000037320 fibronectin Effects 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- GNBHRKFJIUUOQI-UHFFFAOYSA-N fluorescein Chemical compound O1C(=O)C2=CC=CC=C2C21C1=CC=C(O)C=C1OC1=CC(O)=CC=C21 GNBHRKFJIUUOQI-UHFFFAOYSA-N 0.000 description 2
- 150000004676 glycans Polymers 0.000 description 2
- 231100000869 headache Toxicity 0.000 description 2
- 235000019447 hydroxyethyl cellulose Nutrition 0.000 description 2
- 230000002458 infectious Effects 0.000 description 2
- 230000002757 inflammatory Effects 0.000 description 2
- 230000004054 inflammatory process Effects 0.000 description 2
- 230000002401 inhibitory effect Effects 0.000 description 2
- 238000003780 insertion Methods 0.000 description 2
- 201000000766 irregular astigmatism Diseases 0.000 description 2
- 229960004194 lidocaine Drugs 0.000 description 2
- 230000004301 light adaptation Effects 0.000 description 2
- 230000001050 lubricating Effects 0.000 description 2
- 238000010841 mRNA extraction Methods 0.000 description 2
- 229920000609 methyl cellulose Polymers 0.000 description 2
- 239000001923 methylcellulose Substances 0.000 description 2
- 235000010981 methylcellulose Nutrition 0.000 description 2
- 229960002009 naproxen Drugs 0.000 description 2
- 230000001537 neural Effects 0.000 description 2
- 235000015097 nutrients Nutrition 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
- 230000002093 peripheral Effects 0.000 description 2
- 230000035479 physiological effects, processes and functions Effects 0.000 description 2
- 229920003023 plastic Polymers 0.000 description 2
- 239000004033 plastic Substances 0.000 description 2
- 235000010486 polyoxyethylene sorbitan monolaurate Nutrition 0.000 description 2
- 229920001282 polysaccharide Polymers 0.000 description 2
- 239000005017 polysaccharide Substances 0.000 description 2
- 150000004804 polysaccharides Polymers 0.000 description 2
- 229920002451 polyvinyl alcohol Polymers 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 229960001621 povidone-iodine Drugs 0.000 description 2
- 229960005205 prednisolone Drugs 0.000 description 2
- 229960004618 prednisone Drugs 0.000 description 2
- 238000000746 purification Methods 0.000 description 2
- 239000011541 reaction mixture Substances 0.000 description 2
- 230000001603 reducing Effects 0.000 description 2
- WVYADZUPLLSGPU-UHFFFAOYSA-N salsalate Chemical compound OC(=O)C1=CC=CC=C1OC(=O)C1=CC=CC=C1O WVYADZUPLLSGPU-UHFFFAOYSA-N 0.000 description 2
- 229960000953 salsalate Drugs 0.000 description 2
- 150000007949 saponins Chemical class 0.000 description 2
- 235000017709 saponins Nutrition 0.000 description 2
- 238000004621 scanning probe microscopy Methods 0.000 description 2
- 238000002864 sequence alignment Methods 0.000 description 2
- KEAYESYHFKHZAL-UHFFFAOYSA-N sodium Chemical compound [Na] KEAYESYHFKHZAL-UHFFFAOYSA-N 0.000 description 2
- 239000011734 sodium Substances 0.000 description 2
- 229910052708 sodium Inorganic materials 0.000 description 2
- JAJWGJBVLPIOOH-IZYKLYLVSA-M sodium taurocholate Chemical compound [Na+].C([C@H]1C[C@H]2O)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC(=O)NCCS([O-])(=O)=O)C)[C@@]2(C)[C@@H](O)C1 JAJWGJBVLPIOOH-IZYKLYLVSA-M 0.000 description 2
- 235000019345 sodium thiosulphate Nutrition 0.000 description 2
- 238000003756 stirring Methods 0.000 description 2
- 235000000346 sugar Nutrition 0.000 description 2
- 230000017423 tissue regeneration Effects 0.000 description 2
- 229920001664 tyloxapol Polymers 0.000 description 2
- 229960004224 tyloxapol Drugs 0.000 description 2
- 239000003981 vehicle Substances 0.000 description 2
- 230000029663 wound healing Effects 0.000 description 2
- HCHKCACWOHOZIP-UHFFFAOYSA-N zinc Chemical compound [Zn] HCHKCACWOHOZIP-UHFFFAOYSA-N 0.000 description 2
- 239000011701 zinc Substances 0.000 description 2
- 229910052725 zinc Inorganic materials 0.000 description 2
- 235000016804 zinc Nutrition 0.000 description 2
- OQANPHBRHBJGNZ-FYJGNVAPSA-N (3E)-6-oxo-3-[[4-(pyridin-2-ylsulfamoyl)phenyl]hydrazinylidene]cyclohexa-1,4-diene-1-carboxylic acid Chemical compound C1=CC(=O)C(C(=O)O)=C\C1=N\NC1=CC=C(S(=O)(=O)NC=2N=CC=CC=2)C=C1 OQANPHBRHBJGNZ-FYJGNVAPSA-N 0.000 description 1
- DHPRQBPJLMKORJ-XRNKAMNCSA-N (4S,4aS,5aS,6S,12aR)-7-chloro-4-(dimethylamino)-1,6,10,11,12a-pentahydroxy-6-methyl-3,12-dioxo-4,4a,5,5a-tetrahydrotetracene-2-carboxamide Chemical compound C1=CC(Cl)=C2[C@](O)(C)[C@H]3C[C@H]4[C@H](N(C)C)C(=O)C(C(N)=O)=C(O)[C@@]4(O)C(=O)C3=C(O)C2=C1O DHPRQBPJLMKORJ-XRNKAMNCSA-N 0.000 description 1
- TWBNMYSKRDRHAT-RCWTXCDDSA-N (S)-timolol hemihydrate Chemical compound O.CC(C)(C)NC[C@H](O)COC1=NSN=C1N1CCOCC1.CC(C)(C)NC[C@H](O)COC1=NSN=C1N1CCOCC1 TWBNMYSKRDRHAT-RCWTXCDDSA-N 0.000 description 1
- MXDYUONTWJFUOK-UHFFFAOYSA-N 1-(azepan-1-yl)dodecan-1-one Chemical compound CCCCCCCCCCCC(=O)N1CCCCCC1 MXDYUONTWJFUOK-UHFFFAOYSA-N 0.000 description 1
- AHPMSOZQRIEVLQ-UHFFFAOYSA-N 1-(azepan-1-yl)octan-1-one Chemical compound CCCCCCCC(=O)N1CCCCCC1 AHPMSOZQRIEVLQ-UHFFFAOYSA-N 0.000 description 1
- AXTGDCSMTYGJND-UHFFFAOYSA-N 1-dodecylazepan-2-one Chemical compound CCCCCCCCCCCCN1CCCCCC1=O AXTGDCSMTYGJND-UHFFFAOYSA-N 0.000 description 1
- CNIIGCLFLJGOGP-UHFFFAOYSA-N 2-(naphthalen-1-ylmethyl)-4,5-dihydro-1H-imidazole Chemical compound C=1C=CC2=CC=CC=C2C=1CC1=NCCN1 CNIIGCLFLJGOGP-UHFFFAOYSA-N 0.000 description 1
- JKXYOQDLERSFPT-UHFFFAOYSA-N 2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-[2-(2-octadecoxyethoxy)ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethoxy]ethanol Chemical compound CCCCCCCCCCCCCCCCCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCOCCO JKXYOQDLERSFPT-UHFFFAOYSA-N 0.000 description 1
- VUKAUDKDFVSVFT-UHFFFAOYSA-N 2-[6-[4,5-bis(2-hydroxypropoxy)-2-(2-hydroxypropoxymethyl)-6-methoxyoxan-3-yl]oxy-4,5-dimethoxy-2-(methoxymethyl)oxan-3-yl]oxy-6-(hydroxymethyl)-5-methoxyoxane-3,4-diol Chemical compound COC1C(OC)C(OC2C(C(O)C(OC)C(CO)O2)O)C(COC)OC1OC1C(COCC(C)O)OC(OC)C(OCC(C)O)C1OCC(C)O VUKAUDKDFVSVFT-UHFFFAOYSA-N 0.000 description 1
- JJOFNSLZHKIJEV-UHFFFAOYSA-N 2-amino-2-(hydroxymethyl)propane-1,3-diol;2-[2-chloro-5-cyano-3-(oxaloamino)anilino]-2-oxoacetic acid Chemical compound OCC(N)(CO)CO.OCC(N)(CO)CO.OC(=O)C(=O)NC1=CC(C#N)=CC(NC(=O)C(O)=O)=C1Cl JJOFNSLZHKIJEV-UHFFFAOYSA-N 0.000 description 1
- KLLLJCACIRKBDT-UHFFFAOYSA-N 2-phenyl-1H-indole Chemical compound N1C2=CC=CC=C2C=C1C1=CC=CC=C1 KLLLJCACIRKBDT-UHFFFAOYSA-N 0.000 description 1
- GIKNHHRFLCDOEU-UHFFFAOYSA-N 4-Hydroxyamphetamine Chemical compound CC(N)CC1=CC=C(O)C=C1 GIKNHHRFLCDOEU-UHFFFAOYSA-N 0.000 description 1
- BHQCQFFYRZLCQQ-UMZBRFQRSA-N 4-[(3R,5S,7R,12S)-3,7,12-trihydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl]pentanoic acid Chemical class C([C@H]1C[C@H]2O)[C@H](O)CCC1(C)C1C2C2CCC(C(CCC(O)=O)C)C2(C)[C@@H](O)C1 BHQCQFFYRZLCQQ-UMZBRFQRSA-N 0.000 description 1
- 102100002944 ACAN Human genes 0.000 description 1
- WOIIIUDZSOLAIW-NSHDSACASA-N AZAPROPAZONE Chemical compound C1=C(C)C=C2N3C(=O)[C@H](CC=C)C(=O)N3C(N(C)C)=NC2=C1 WOIIIUDZSOLAIW-NSHDSACASA-N 0.000 description 1
- 229940022659 Acetaminophen Drugs 0.000 description 1
- 229940023040 Acyclovir Drugs 0.000 description 1
- 108010067219 Aggrecans Proteins 0.000 description 1
- 229940006546 Albon Drugs 0.000 description 1
- 239000012099 Alexa Fluor family Substances 0.000 description 1
- REYFJDPCWQRWAA-UHFFFAOYSA-N Antazoline Chemical compound N=1CCNC=1CN(C=1C=CC=CC=1)CC1=CC=CC=C1 REYFJDPCWQRWAA-UHFFFAOYSA-N 0.000 description 1
- 210000002159 Anterior Chamber Anatomy 0.000 description 1
- 229940109449 Antisedan Drugs 0.000 description 1
- 229940091143 Apazone Drugs 0.000 description 1
- IEJXVRYNEISIKR-UHFFFAOYSA-N Apraclonidine Chemical compound ClC1=CC(N)=CC(Cl)=C1NC1=NCCN1 IEJXVRYNEISIKR-UHFFFAOYSA-N 0.000 description 1
- 206010003246 Arthritis Diseases 0.000 description 1
- 241000182988 Assa Species 0.000 description 1
- 229960003002 Atipamezole Drugs 0.000 description 1
- 101700000123 BMP2 Proteins 0.000 description 1
- 102100005377 BMP2 Human genes 0.000 description 1
- APKFDSVGJQXUKY-INPOYWNPSA-N BRL-49594 Chemical compound O[C@H]1[C@@H](N)[C@H](O)[C@@H](C)O[C@H]1O[C@H]1/C=C/C=C/C=C/C=C/C=C/C=C/C=C/[C@H](C)[C@@H](O)[C@@H](C)[C@H](C)OC(=O)C[C@H](O)C[C@H](O)CC[C@@H](O)[C@H](O)C[C@H](O)C[C@](O)(C[C@H](O)[C@H]2C(O)=O)O[C@H]2C1 APKFDSVGJQXUKY-INPOYWNPSA-N 0.000 description 1
- 241000894006 Bacteria Species 0.000 description 1
- 229960005274 Benzocaine Drugs 0.000 description 1
- BLFLLBZGZJTVJG-UHFFFAOYSA-N Benzocaine Chemical compound CCOC(=O)C1=CC=C(N)C=C1 BLFLLBZGZJTVJG-UHFFFAOYSA-N 0.000 description 1
- UREBDLICKHMUKA-DVTGEIKXSA-N Betamethasone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@H](C)[C@@](C(=O)CO)(O)[C@@]1(C)C[C@@H]2O UREBDLICKHMUKA-DVTGEIKXSA-N 0.000 description 1
- NWIUTZDMDHAVTP-UHFFFAOYSA-N Betaxolol Chemical compound C1=CC(OCC(O)CNC(C)C)=CC=C1CCOCC1CC1 NWIUTZDMDHAVTP-UHFFFAOYSA-N 0.000 description 1
- 229940093761 Bile Salts Drugs 0.000 description 1
- 230000036912 Bioavailability Effects 0.000 description 1
- LEBVLXFERQHONN-UHFFFAOYSA-N Bupivacaine Chemical compound CCCCN1CCCCC1C(=O)NC1=C(C)C=CC=C1C LEBVLXFERQHONN-UHFFFAOYSA-N 0.000 description 1
- XZPUTNZHTQVTHG-UHFFFAOYSA-M CCCCCCCCC([O-])=S Chemical compound CCCCCCCCC([O-])=S XZPUTNZHTQVTHG-UHFFFAOYSA-M 0.000 description 1
- 102100002974 CDKN1A Human genes 0.000 description 1
- 108060001895 CRIPT Proteins 0.000 description 1
- YQEZLKZALYSWHR-UHFFFAOYSA-N Calypsol Chemical compound C=1C=CC=C(Cl)C=1C1(NC)CCCCC1=O YQEZLKZALYSWHR-UHFFFAOYSA-N 0.000 description 1
- 239000005632 Capric acid (CAS 334-48-5) Substances 0.000 description 1
- 229960001222 Carteolol Drugs 0.000 description 1
- LWAFSWPYPHEXKX-UHFFFAOYSA-N Carteolol Chemical compound N1C(=O)CCC2=C1C=CC=C2OCC(O)CNC(C)(C)C LWAFSWPYPHEXKX-UHFFFAOYSA-N 0.000 description 1
- RZEKVGVHFLEQIL-UHFFFAOYSA-N Celecoxib Chemical compound C1=CC(C)=CC=C1C1=CC(C(F)(F)F)=NN1C1=CC=C(S(N)(=O)=O)C=C1 RZEKVGVHFLEQIL-UHFFFAOYSA-N 0.000 description 1
- 229960001927 Cetylpyridinium Chloride Drugs 0.000 description 1
- YMKDRGPMQRFJGP-UHFFFAOYSA-M Cetylpyridinium chloride Chemical compound [Cl-].CCCCCCCCCCCCCCCC[N+]1=CC=CC=C1 YMKDRGPMQRFJGP-UHFFFAOYSA-M 0.000 description 1
- 229960001091 Chenodeoxycholic Acid Drugs 0.000 description 1
- RUDATBOHQWOJDD-BSWAIDMHSA-N Chenodeoxycholic acid Chemical compound C([C@H]1C[C@H]2O)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC(O)=O)C)[C@@]2(C)CC1 RUDATBOHQWOJDD-BSWAIDMHSA-N 0.000 description 1
- 210000003837 Chick Embryo Anatomy 0.000 description 1
- OSASVXMJTNOKOY-UHFFFAOYSA-N Chlorobutanol Chemical compound CC(C)(O)C(Cl)(Cl)Cl OSASVXMJTNOKOY-UHFFFAOYSA-N 0.000 description 1
- 229960004926 Chlorobutanol Drugs 0.000 description 1
- 229960002023 Chloroprocaine Drugs 0.000 description 1
- VDANGULDQQJODZ-UHFFFAOYSA-N Chloroprocaine Chemical compound CCN(CC)CCOC(=O)C1=CC=C(N)C=C1Cl VDANGULDQQJODZ-UHFFFAOYSA-N 0.000 description 1
- 241000579895 Chlorostilbon Species 0.000 description 1
- 102000036765 Chondroitin-sulfate-ABC endolyases Human genes 0.000 description 1
- 108090000819 Chondroitin-sulfate-ABC endolyases Proteins 0.000 description 1
- MYSWGUAQZAJSOK-UHFFFAOYSA-N Ciprofloxacin Chemical compound C12=CC(N3CCNCC3)=C(F)C=C2C(=O)C(C(=O)O)=CN1C1CC1 MYSWGUAQZAJSOK-UHFFFAOYSA-N 0.000 description 1
- 241000284156 Clerodendrum quadriloculare Species 0.000 description 1
- KDLRVYVGXIQJDK-AWPVFWJPSA-N Clindamycin Chemical compound CN1C[C@H](CCC)C[C@H]1C(=O)N[C@H]([C@H](C)Cl)[C@@H]1[C@H](O)[C@H](O)[C@@H](O)[C@@H](SC)O1 KDLRVYVGXIQJDK-AWPVFWJPSA-N 0.000 description 1
- 241001550206 Colla Species 0.000 description 1
- 235000008592 Colubrina texensis Nutrition 0.000 description 1
- 206010010071 Coma Diseases 0.000 description 1
- 208000001590 Congenital Abnormality Diseases 0.000 description 1
- 206010010741 Conjunctivitis Diseases 0.000 description 1
- 206010011013 Corneal erosion Diseases 0.000 description 1
- 206010011033 Corneal oedema Diseases 0.000 description 1
- 201000009343 Cornelia de Lange syndrome Diseases 0.000 description 1
- 235000004035 Cryptotaenia japonica Nutrition 0.000 description 1
- 108010016788 Cyclin-Dependent Kinase Inhibitor p21 Proteins 0.000 description 1
- 102000014005 Cyclin-dependent kinase inhibitor 1 Human genes 0.000 description 1
- 108050003898 Cyclin-dependent kinase inhibitor 1 Proteins 0.000 description 1
- 229920000858 Cyclodextrin Polymers 0.000 description 1
- 102000004127 Cytokines Human genes 0.000 description 1
- 108090000695 Cytokines Proteins 0.000 description 1
- 101710034658 DNASE1 Proteins 0.000 description 1
- RFWZESUMWJKKRN-UHFFFAOYSA-N Dapiprazole Chemical compound CC1=CC=CC=C1N1CCN(CCC=2N3CCCCC3=NN=2)CC1 RFWZESUMWJKKRN-UHFFFAOYSA-N 0.000 description 1
- 208000003471 De Lange Syndrome Diseases 0.000 description 1
- 206010052122 Dellen Diseases 0.000 description 1
- 210000002555 Descemet Membrane Anatomy 0.000 description 1
- 229950002874 Dexamethasone acefurate Drugs 0.000 description 1
- BQTXJHAJMDGOFI-NJLPOHDGSA-N Dexamethasone isonicotinate Chemical compound O=C([C@]1(O)[C@@]2(C)C[C@H](O)[C@]3(F)[C@@]4(C)C=CC(=O)C=C4CC[C@H]3[C@@H]2C[C@H]1C)COC(=O)C1=CC=NC=C1 BQTXJHAJMDGOFI-NJLPOHDGSA-N 0.000 description 1
- 229960002344 Dexamethasone sodium phosphate Drugs 0.000 description 1
- 229940087410 Dexasone Drugs 0.000 description 1
- 229920002307 Dextran Polymers 0.000 description 1
- HUPFGZXOMWLGNK-UHFFFAOYSA-N Diflunisal Chemical compound C1=C(O)C(C(=O)O)=CC(C=2C(=CC(F)=CC=2)F)=C1 HUPFGZXOMWLGNK-UHFFFAOYSA-N 0.000 description 1
- 229940016763 Dipivefrin Drugs 0.000 description 1
- OCUJLLGVOUDECM-UHFFFAOYSA-N Dipivefrine Chemical compound CNCC(O)C1=CC=C(OC(=O)C(C)(C)C)C(OC(=O)C(C)(C)C)=C1 OCUJLLGVOUDECM-UHFFFAOYSA-N 0.000 description 1
- 208000003164 Diplopia Diseases 0.000 description 1
- 206010013774 Dry eye Diseases 0.000 description 1
- 229960003913 Econazole Drugs 0.000 description 1
- LEZWWPYKPKIXLL-UHFFFAOYSA-N Econazole Chemical compound C1=CC(Cl)=CC=C1COC(C=1C(=CC(Cl)=CC=1)Cl)CN1C=NC=C1 LEZWWPYKPKIXLL-UHFFFAOYSA-N 0.000 description 1
- 210000001671 Embryonic Stem Cells Anatomy 0.000 description 1
- 241000196324 Embryophyta Species 0.000 description 1
- 206010014801 Endophthalmitis Diseases 0.000 description 1
- 210000002889 Endothelial Cells Anatomy 0.000 description 1
- 210000000871 Endothelium, Corneal Anatomy 0.000 description 1
- 241001635598 Enicostema Species 0.000 description 1
- 241000283073 Equus caballus Species 0.000 description 1
- 210000003743 Erythrocytes Anatomy 0.000 description 1
- 241000588724 Escherichia coli Species 0.000 description 1
- 229950009769 Etabonate Drugs 0.000 description 1
- 229960003976 Etidocaine Drugs 0.000 description 1
- VTUSIVBDOCDNHS-UHFFFAOYSA-N Etidocaine Chemical compound CCCN(CC)C(CC)C(=O)NC1=C(C)C=CC=C1C VTUSIVBDOCDNHS-UHFFFAOYSA-N 0.000 description 1
- 229960005293 Etodolac Drugs 0.000 description 1
- XFBVBWWRPKNWHW-UHFFFAOYSA-N Etodolac Chemical compound C1COC(CC)(CC(O)=O)C2=N[C]3C(CC)=CC=CC3=C21 XFBVBWWRPKNWHW-UHFFFAOYSA-N 0.000 description 1
- 206010016256 Fatigue Diseases 0.000 description 1
- 229960001419 Fenoprofen Drugs 0.000 description 1
- RDJGLLICXDHJDY-UHFFFAOYSA-N Fenoprofen Chemical compound OC(=O)C(C)C1=CC=CC(OC=2C=CC=CC=2)=C1 RDJGLLICXDHJDY-UHFFFAOYSA-N 0.000 description 1
- 208000005417 Fleck Corneal Dystrophy Diseases 0.000 description 1
- RFHAOTPXVQNOHP-UHFFFAOYSA-N Fluconazole Chemical compound C1=NC=NN1CC(C=1C(=CC(F)=CC=1)F)(O)CN1C=NC=N1 RFHAOTPXVQNOHP-UHFFFAOYSA-N 0.000 description 1
- XRECTZIEBJDKEO-UHFFFAOYSA-N Flucytosine Chemical compound NC1=NC(=O)NC=C1F XRECTZIEBJDKEO-UHFFFAOYSA-N 0.000 description 1
- 229960003973 Fluocortolone Drugs 0.000 description 1
- GAKMQHDJQHZUTJ-ULHLPKEOSA-N Fluocortolone Chemical compound C1([C@@H](F)C2)=CC(=O)C=C[C@]1(C)[C@@H]1[C@@H]2[C@@H]2C[C@@H](C)[C@H](C(=O)CO)[C@@]2(C)C[C@@H]1O GAKMQHDJQHZUTJ-ULHLPKEOSA-N 0.000 description 1
- SYTBZMRGLBWNTM-UHFFFAOYSA-N Flurbiprofen Chemical compound FC1=CC(C(C(O)=O)C)=CC=C1C1=CC=CC=C1 SYTBZMRGLBWNTM-UHFFFAOYSA-N 0.000 description 1
- 229960003898 Flurbiprofen sodium Drugs 0.000 description 1
- 206010016845 Foetal alcohol syndrome Diseases 0.000 description 1
- ZJAOAACCNHFJAH-UHFFFAOYSA-N Foscarnet Chemical compound OC(=O)P(O)(O)=O ZJAOAACCNHFJAH-UHFFFAOYSA-N 0.000 description 1
- 229960004675 Fusidic Acid Drugs 0.000 description 1
- IECPWNUMDGFDKC-MZJAQBGESA-N Fusidic acid Chemical compound O[C@@H]([C@@H]12)C[C@H]3\C(=C(/CCC=C(C)C)C(O)=O)[C@@H](OC(C)=O)C[C@]3(C)[C@@]2(C)CC[C@@H]2[C@]1(C)CC[C@@H](O)[C@H]2C IECPWNUMDGFDKC-MZJAQBGESA-N 0.000 description 1
- 229960002963 Ganciclovir Drugs 0.000 description 1
- IRSCQMHQWWYFCW-UHFFFAOYSA-N Ganciclovir Chemical compound O=C1NC(N)=NC2=C1N=CN2COC(CO)CO IRSCQMHQWWYFCW-UHFFFAOYSA-N 0.000 description 1
- 108010026132 Gelatinases Proteins 0.000 description 1
- 102000013382 Gelatinases Human genes 0.000 description 1
- CEAZRRDELHUEMR-URQXQFDESA-N Gentamicin Chemical compound O1[C@H](C(C)NC)CC[C@@H](N)[C@H]1O[C@H]1[C@H](O)[C@@H](O[C@@H]2[C@@H]([C@@H](NC)[C@@](C)(O)CO2)O)[C@H](N)C[C@@H]1N CEAZRRDELHUEMR-URQXQFDESA-N 0.000 description 1
- 229940065521 Glucocorticoid inhalants for obstructive airway disease Drugs 0.000 description 1
- 229960002743 Glutamine Drugs 0.000 description 1
- 206010072579 Granulomatosis with polyangiitis Diseases 0.000 description 1
- 102000001974 Hyaluronidase Human genes 0.000 description 1
- 108010074224 Hyaluronoglucosaminidase Proteins 0.000 description 1
- 229920002153 Hydroxypropyl cellulose Polymers 0.000 description 1
- 206010020751 Hypersensitivity Diseases 0.000 description 1
- XQFRJNBWHJMXHO-RRKCRQDMSA-N IDUR Chemical compound C1[C@H](O)[C@@H](CO)O[C@H]1N1C(=O)NC(=O)C(I)=C1 XQFRJNBWHJMXHO-RRKCRQDMSA-N 0.000 description 1
- HEFNNWSXXWATRW-UHFFFAOYSA-N Ibuprofen Chemical compound CC(C)CC1=CC=C(C(C)C(O)=O)C=C1 HEFNNWSXXWATRW-UHFFFAOYSA-N 0.000 description 1
- 229960004716 Idoxuridine Drugs 0.000 description 1
- 229960000905 Indomethacin Drugs 0.000 description 1
- 206010060833 Infectious crystalline keratopathy Diseases 0.000 description 1
- 108010002350 Interleukin-2 Proteins 0.000 description 1
- 102000004388 Interleukin-4 Human genes 0.000 description 1
- 108090000978 Interleukin-4 Proteins 0.000 description 1
- 210000000554 Iris Anatomy 0.000 description 1
- 206010022998 Irritability Diseases 0.000 description 1
- 206010023335 Keratitis interstitial Diseases 0.000 description 1
- XMAYWYJOQHXEEK-OZXSUGGESA-N Ketoconazole Chemical compound C1CN(C(=O)C)CCN1C(C=C1)=CC=C1OC[C@@H]1O[C@@](CN2C=NC=C2)(C=2C(=CC(Cl)=CC=2)Cl)OC1 XMAYWYJOQHXEEK-OZXSUGGESA-N 0.000 description 1
- DKYWVDODHFEZIM-UHFFFAOYSA-N Ketoprofen Chemical compound OC(=O)C(C)C1=CC=CC(C(=O)C=2C=CC=CC=2)=C1 DKYWVDODHFEZIM-UHFFFAOYSA-N 0.000 description 1
- OZWKMVRBQXNZKK-UHFFFAOYSA-N Ketorolac Chemical compound OC(=O)C1CCN2C1=CC=C2C(=O)C1=CC=CC=C1 OZWKMVRBQXNZKK-UHFFFAOYSA-N 0.000 description 1
- 229960003630 Ketotifen Fumarate Drugs 0.000 description 1
- ZCVMWBYGMWKGHF-UHFFFAOYSA-N Ketotifene Chemical compound C1CN(C)CCC1=C1C2=CC=CC=C2CC(=O)C2=C1C=CS2 ZCVMWBYGMWKGHF-UHFFFAOYSA-N 0.000 description 1
- ZDXPYRJPNDTMRX-VKHMYHEASA-N L-glutamine Chemical compound OC(=O)[C@@H](N)CCC(N)=O ZDXPYRJPNDTMRX-VKHMYHEASA-N 0.000 description 1
- BBMULGJBVDDDNI-OWKLGTHSSA-N Lasalocid Chemical compound C([C@@H]1[C@@]2(CC)O[C@@H]([C@H](C2)C)[C@@H](CC)C(=O)[C@@H](C)[C@@H](O)[C@H](C)CCC=2C(=C(O)C(C)=CC=2)C(O)=O)C[C@](O)(CC)[C@H](C)O1 BBMULGJBVDDDNI-OWKLGTHSSA-N 0.000 description 1
- 229960000320 Lasalocid Drugs 0.000 description 1
- 241000283986 Lepus Species 0.000 description 1
- IXHBTMCLRNMKHZ-LBPRGKRZSA-N Levobunolol Chemical compound O=C1CCCC2=C1C=CC=C2OC[C@@H](O)CNC(C)(C)C IXHBTMCLRNMKHZ-LBPRGKRZSA-N 0.000 description 1
- 229960000831 Levobunolol Drugs 0.000 description 1
- 210000000088 Lip Anatomy 0.000 description 1
- 229960004305 Lodoxamide Drugs 0.000 description 1
- RVGLGHVJXCETIO-UHFFFAOYSA-N Lodoxamide Chemical compound OC(=O)C(=O)NC1=CC(C#N)=CC(NC(=O)C(O)=O)=C1Cl RVGLGHVJXCETIO-UHFFFAOYSA-N 0.000 description 1
- 210000004072 Lung Anatomy 0.000 description 1
- 102100018200 MMP1 Human genes 0.000 description 1
- 101700019781 MMP1 Proteins 0.000 description 1
- 208000002780 Macular Degeneration Diseases 0.000 description 1
- 102000000424 Matrix Metalloproteinase 2 Human genes 0.000 description 1
- 108010016165 Matrix Metalloproteinase 2 Proteins 0.000 description 1
- 102000000422 Matrix Metalloproteinase 3 Human genes 0.000 description 1
- 229940087412 Maxidex Drugs 0.000 description 1
- SBDNJUWAMKYJOX-UHFFFAOYSA-N Meclofenamic Acid Chemical compound CC1=CC=C(Cl)C(NC=2C(=CC=CC=2)C(O)=O)=C1Cl SBDNJUWAMKYJOX-UHFFFAOYSA-N 0.000 description 1
- GZENKSODFLBBHQ-ILSZZQPISA-N Medrysone Chemical compound C([C@@]12C)CC(=O)C=C1[C@@H](C)C[C@@H]1[C@@H]2[C@@H](O)C[C@]2(C)[C@@H](C(C)=O)CC[C@H]21 GZENKSODFLBBHQ-ILSZZQPISA-N 0.000 description 1
- HYYBABOKPJLUIN-UHFFFAOYSA-N Mefenamic acid Chemical compound CC1=CC=CC(NC=2C(=CC=CC=2)C(O)=O)=C1C HYYBABOKPJLUIN-UHFFFAOYSA-N 0.000 description 1
- 210000002901 Mesenchymal Stem Cells Anatomy 0.000 description 1
- BQIPXWYNLPYNHW-UHFFFAOYSA-N Metipranolol Chemical compound CC(C)NCC(O)COC1=CC(C)=C(OC(C)=O)C(C)=C1C BQIPXWYNLPYNHW-UHFFFAOYSA-N 0.000 description 1
- 229960002704 Metipranolol Drugs 0.000 description 1
- BYBLEWFAAKGYCD-UHFFFAOYSA-N Miconazole Chemical compound ClC1=CC(Cl)=CC=C1COC(C=1C(=CC(Cl)=CC=1)Cl)CN1C=NC=C1 BYBLEWFAAKGYCD-UHFFFAOYSA-N 0.000 description 1
- 206010027626 Milia Diseases 0.000 description 1
- 201000009262 Mooren's ulcer Diseases 0.000 description 1
- 206010028334 Muscle spasms Diseases 0.000 description 1
- 210000003205 Muscles Anatomy 0.000 description 1
- 208000008621 Nance-Horan syndrome Diseases 0.000 description 1
- 229960003255 Natamycin Drugs 0.000 description 1
- NCXMLFZGDNKEPB-FFPOYIOWSA-N Natamycin Chemical compound O[C@H]1[C@@H](N)[C@H](O)[C@@H](C)O[C@H]1O[C@H]1/C=C/C=C/C=C/C=C/C[C@@H](C)OC(=O)/C=C/[C@H]2O[C@@H]2C[C@H](O)C[C@](O)(C[C@H](O)[C@H]2C(O)=O)O[C@H]2C1 NCXMLFZGDNKEPB-FFPOYIOWSA-N 0.000 description 1
- 206010028813 Nausea Diseases 0.000 description 1
- 241000772415 Neovison vison Species 0.000 description 1
- 241001182492 Nes Species 0.000 description 1
- 241000207746 Nicotiana benthamiana Species 0.000 description 1
- HYWYRSMBCFDLJT-UHFFFAOYSA-N Nimesulide Chemical compound CS(=O)(=O)NC1=CC=C([N+]([O-])=O)C=C1OC1=CC=CC=C1 HYWYRSMBCFDLJT-UHFFFAOYSA-N 0.000 description 1
- 229960001180 Norfloxacin Drugs 0.000 description 1
- OGJPXUAPXNRGGI-UHFFFAOYSA-N Norfloxacin Chemical compound C1=C2N(CC)C=C(C(O)=O)C(=O)C2=CC(F)=C1N1CCNCC1 OGJPXUAPXNRGGI-UHFFFAOYSA-N 0.000 description 1
- 210000004940 Nucleus Anatomy 0.000 description 1
- 206010030113 Oedema Diseases 0.000 description 1
- QQBDLJCYGRGAKP-FOCLMDBBSA-N Olsalazine Chemical compound C1=C(O)C(C(=O)O)=CC(\N=N\C=2C=C(C(O)=CC=2)C(O)=O)=C1 QQBDLJCYGRGAKP-FOCLMDBBSA-N 0.000 description 1
- 241000283973 Oryctolagus cuniculus Species 0.000 description 1
- XAPRFLSJBSXESP-UHFFFAOYSA-N Oxycinchophen Chemical compound N=1C2=CC=CC=C2C(C(=O)O)=C(O)C=1C1=CC=CC=C1 XAPRFLSJBSXESP-UHFFFAOYSA-N 0.000 description 1
- 229940005542 PARASYMPATHOMIMETICS Drugs 0.000 description 1
- 102100000685 POP4 Human genes 0.000 description 1
- 102100015381 PTGS2 Human genes 0.000 description 1
- 101710040930 PTGS2 Proteins 0.000 description 1
- 208000002193 Pain Diseases 0.000 description 1
- IJHNSHDBIRRJRN-UHFFFAOYSA-N Pheniramine Chemical compound C=1C=CC=NC=1C(CCN(C)C)C1=CC=CC=C1 IJHNSHDBIRRJRN-UHFFFAOYSA-N 0.000 description 1
- 229960001190 Pheniramine Drugs 0.000 description 1
- 229960002895 Phenylbutazone Drugs 0.000 description 1
- 229960001802 Phenylephrine Drugs 0.000 description 1
- SONNWYBIRXJNDC-VIFPVBQESA-N Phenylephrine Chemical compound CNC[C@H](O)C1=CC=CC(O)=C1 SONNWYBIRXJNDC-VIFPVBQESA-N 0.000 description 1
- 229940067107 Phenylethyl Alcohol Drugs 0.000 description 1
- 108091000081 Phosphotransferases Proteins 0.000 description 1
- 102000030951 Phosphotransferases Human genes 0.000 description 1
- 206010034960 Photophobia Diseases 0.000 description 1
- QYSPLQLAKJAUJT-UHFFFAOYSA-N Piroxicam Chemical compound OC=1C2=CC=CC=C2S(=O)(=O)N(C)C=1C(=O)NC1=CC=CC=N1 QYSPLQLAKJAUJT-UHFFFAOYSA-N 0.000 description 1
- 108010093965 Polymyxin B Proteins 0.000 description 1
- 229920001451 Polypropylene glycol Polymers 0.000 description 1
- 229940068977 Polysorbate 20 Drugs 0.000 description 1
- 229920001214 Polysorbate 60 Polymers 0.000 description 1
- 229940068968 Polysorbate 80 Drugs 0.000 description 1
- LRJOMUJRLNCICJ-JZYPGELDSA-N Prednisolone acetate Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@@](C(=O)COC(=O)C)(O)[C@@]1(C)C[C@@H]2O LRJOMUJRLNCICJ-JZYPGELDSA-N 0.000 description 1
- MFDFERRIHVXMIY-UHFFFAOYSA-N Procaine Chemical compound CCN(CC)CCOC(=O)C1=CC=C(N)C=C1 MFDFERRIHVXMIY-UHFFFAOYSA-N 0.000 description 1
- QELSKZZBTMNZEB-UHFFFAOYSA-N Propylparaben Chemical compound CCCOC(=O)C1=CC=C(O)C=C1 QELSKZZBTMNZEB-UHFFFAOYSA-N 0.000 description 1
- MWWATHDPGQKSAR-UHFFFAOYSA-N Propyne Chemical compound CC#C MWWATHDPGQKSAR-UHFFFAOYSA-N 0.000 description 1
- 102000016611 Proteoglycans Human genes 0.000 description 1
- 108010067787 Proteoglycans Proteins 0.000 description 1
- KCLANYCVBBTKTO-UHFFFAOYSA-N Proxymetacaine Chemical compound CCCOC1=CC=C(C(=O)OCCN(CC)CC)C=C1N KCLANYCVBBTKTO-UHFFFAOYSA-N 0.000 description 1
- 210000001747 Pupil Anatomy 0.000 description 1
- WKSAUQYGYAYLPV-UHFFFAOYSA-N Pyrimethamine Chemical compound CCC1=NC(N)=NC(N)=C1C1=CC=C(Cl)C=C1 WKSAUQYGYAYLPV-UHFFFAOYSA-N 0.000 description 1
- 229960001487 RIMEXOLONE Drugs 0.000 description 1
- 238000002123 RNA extraction Methods 0.000 description 1
- 206010038848 Retinal detachment Diseases 0.000 description 1
- 206010039073 Rheumatoid arthritis Diseases 0.000 description 1
- QTTRZHGPGKRAFB-OOKHYKNYSA-N Rimexolone Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@@H]2[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CC)(C)[C@@]1(C)C[C@@H]2O QTTRZHGPGKRAFB-OOKHYKNYSA-N 0.000 description 1
- RZJQGNCSTQAWON-UHFFFAOYSA-N Rofecoxib Chemical compound C1=CC(S(=O)(=O)C)=CC=C1C1=C(C=2C=CC=CC=2)C(=O)OC1 RZJQGNCSTQAWON-UHFFFAOYSA-N 0.000 description 1
- 241001303601 Rosacea Species 0.000 description 1
- YGSDEFSMJLZEOE-UHFFFAOYSA-N Salicylic acid Chemical compound OC(=O)C1=CC=CC=C1O YGSDEFSMJLZEOE-UHFFFAOYSA-N 0.000 description 1
- 102000011763 Serum Amyloid A Protein Human genes 0.000 description 1
- 108010076895 Serum Amyloid A Protein Proteins 0.000 description 1
- 229940045946 Sodium Taurodeoxycholate Drugs 0.000 description 1
- ABBQHOQBGMUPJH-UHFFFAOYSA-M Sodium salicylate Chemical compound [Na+].OC1=CC=CC=C1C([O-])=O ABBQHOQBGMUPJH-UHFFFAOYSA-M 0.000 description 1
- 229940075582 Sorbic Acid Drugs 0.000 description 1
- 208000005392 Spasm Diseases 0.000 description 1
- 241000790234 Sphingomonas elodea Species 0.000 description 1
- 210000000952 Spleen Anatomy 0.000 description 1
- 210000001562 Sternum Anatomy 0.000 description 1
- 229920000147 Styrene maleic anhydride Polymers 0.000 description 1
- SKIVFJLNDNKQPD-UHFFFAOYSA-N Sulfacetamide Chemical compound CC(=O)NS(=O)(=O)C1=CC=C(N)C=C1 SKIVFJLNDNKQPD-UHFFFAOYSA-N 0.000 description 1
- 229960002673 Sulfacetamide Drugs 0.000 description 1
- ZZORFUFYDOWNEF-UHFFFAOYSA-N Sulfadimethoxine Chemical compound COC1=NC(OC)=CC(NS(=O)(=O)C=2C=CC(N)=CC=2)=N1 ZZORFUFYDOWNEF-UHFFFAOYSA-N 0.000 description 1
- 229960001940 Sulfasalazine Drugs 0.000 description 1
- 229940032484 Sulfisoxazole Drugs 0.000 description 1
- NHUHCSRWZMLRLA-UHFFFAOYSA-N Sulfizole Chemical compound CC1=NOC(NS(=O)(=O)C=2C=CC(N)=CC=2)=C1C NHUHCSRWZMLRLA-UHFFFAOYSA-N 0.000 description 1
- MLKXDPUZXIRXEP-MFOYZWKCSA-N Sulindac Chemical compound CC1=C(CC(O)=O)C2=CC(F)=CC=C2\C1=C/C1=CC=C(S(C)=O)C=C1 MLKXDPUZXIRXEP-MFOYZWKCSA-N 0.000 description 1
- 229960000894 Sulindac Drugs 0.000 description 1
- 208000002847 Surgical Wound Diseases 0.000 description 1
- 239000000150 Sympathomimetic Substances 0.000 description 1
- 229940064707 Sympathomimetics Drugs 0.000 description 1
- 229940037128 Systemic Glucocorticoids Drugs 0.000 description 1
- 101700076745 TGFB3 Proteins 0.000 description 1
- 229960002180 Tetracycline Drugs 0.000 description 1
- OFVLGDICTFRJMM-WESIUVDSSA-N Tetracycline Chemical compound C1=CC=C2[C@](O)(C)[C@H]3C[C@H]4[C@H](N(C)C)C(O)=C(C(N)=O)C(=O)[C@@]4(O)C(O)=C3C(=O)C2=C1O OFVLGDICTFRJMM-WESIUVDSSA-N 0.000 description 1
- 239000004098 Tetracycline Substances 0.000 description 1
- BYJAVTDNIXVSPW-UHFFFAOYSA-N Tetrahydrozoline Chemical compound N1CCN=C1C1C2=CC=CC=C2CCC1 BYJAVTDNIXVSPW-UHFFFAOYSA-N 0.000 description 1
- 229940033663 Thimerosal Drugs 0.000 description 1
- RTKIYNMVFMVABJ-UHFFFAOYSA-L Thiomersal Chemical compound [Na+].CC[Hg]SC1=CC=CC=C1C([O-])=O RTKIYNMVFMVABJ-UHFFFAOYSA-L 0.000 description 1
- 229960000707 Tobramycin Drugs 0.000 description 1
- NLVFBUXFDBBNBW-PBSUHMDJSA-N Tobramycin Chemical compound N[C@@H]1C[C@H](O)[C@@H](CN)O[C@@H]1O[C@H]1[C@H](O)[C@@H](O[C@@H]2[C@@H]([C@@H](N)[C@H](O)[C@@H](CO)O2)O)[C@H](N)C[C@@H]1N NLVFBUXFDBBNBW-PBSUHMDJSA-N 0.000 description 1
- UPSPUYADGBWSHF-UHFFFAOYSA-N Tolmetin Chemical compound C1=CC(C)=CC=C1C(=O)C1=CC=C(CC(O)=O)N1C UPSPUYADGBWSHF-UHFFFAOYSA-N 0.000 description 1
- 108090001012 Transforming Growth Factor beta Proteins 0.000 description 1
- 102000004887 Transforming Growth Factor beta Human genes 0.000 description 1
- 108090000097 Transforming growth factor beta-3 Proteins 0.000 description 1
- VSQQQLOSPVPRAZ-RRKCRQDMSA-N Trifluridine Chemical compound C1[C@H](O)[C@@H](CO)O[C@H]1N1C(=O)NC(=O)C(C(F)(F)F)=C1 VSQQQLOSPVPRAZ-RRKCRQDMSA-N 0.000 description 1
- 229960003962 Trifluridine Drugs 0.000 description 1
- 235000015724 Trifolium pratense Nutrition 0.000 description 1
- 240000002913 Trifolium pratense Species 0.000 description 1
- 102000018594 Tumour necrosis factor Human genes 0.000 description 1
- 108050007852 Tumour necrosis factor Proteins 0.000 description 1
- 206010045181 Turner's syndrome Diseases 0.000 description 1
- RUDATBOHQWOJDD-UZVSRGJWSA-N Ursodeoxycholic acid Chemical compound C([C@H]1C[C@@H]2O)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC(O)=O)C)[C@@]2(C)CC1 RUDATBOHQWOJDD-UZVSRGJWSA-N 0.000 description 1
- 229960001661 Ursodiol Drugs 0.000 description 1
- 229940029983 VITAMINS Drugs 0.000 description 1
- 229960003636 Vidarabine Drugs 0.000 description 1
- 229940045997 Vitamin A Drugs 0.000 description 1
- FPIPGXGPPPQFEQ-BOOMUCAASA-N Vitamin A Natural products OC/C=C(/C)\C=C\C=C(\C)/C=C/C1=C(C)CCCC1(C)C FPIPGXGPPPQFEQ-BOOMUCAASA-N 0.000 description 1
- 229930003451 Vitamin B1 Natural products 0.000 description 1
- 229930003779 Vitamin B12 Natural products 0.000 description 1
- 229940011671 Vitamin B6 Drugs 0.000 description 1
- 229930003629 Vitamin B6 Natural products 0.000 description 1
- 229930003268 Vitamin C Natural products 0.000 description 1
- 229940046009 Vitamin E Drugs 0.000 description 1
- 229930003427 Vitamin E Natural products 0.000 description 1
- 229940021016 Vitamin IV solution additives Drugs 0.000 description 1
- 229940046010 Vitamin K Drugs 0.000 description 1
- 229930003448 Vitamin K Natural products 0.000 description 1
- 229940019697 Vitamin K containing hemostatics Drugs 0.000 description 1
- 201000011250 Waardenburg's syndrome Diseases 0.000 description 1
- 201000005928 Weill-Marchesani syndrome Diseases 0.000 description 1
- 210000002417 Xiphoid Bone Anatomy 0.000 description 1
- 229940046282 Zinc Drugs 0.000 description 1
- 229940091251 Zinc Supplements Drugs 0.000 description 1
- RKUNBYITZUJHSG-PJPHBNEVSA-N [(1R,5S)-8-methyl-8-azabicyclo[3.2.1]octan-3-yl] 3-hydroxy-2-phenylpropanoate Chemical compound C([C@H]1CC[C@@H](C2)N1C)C2OC(=O)C(CO)C1=CC=CC=C1 RKUNBYITZUJHSG-PJPHBNEVSA-N 0.000 description 1
- DDIWRLSEGOVQQD-BJRLRHTOSA-N [(8S,9R,10S,11S,13S,14S,16R,17R)-17-(2-acetyloxyacetyl)-9-fluoro-11-hydroxy-10,13,16-trimethyl-3-oxo-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-17-yl] furan-2-carboxylate Chemical compound O([C@]1([C@@]2(C)C[C@H](O)[C@]3(F)[C@@]4(C)C=CC(=O)C=C4CC[C@H]3[C@@H]2C[C@H]1C)C(=O)COC(C)=O)C(=O)C1=CC=CO1 DDIWRLSEGOVQQD-BJRLRHTOSA-N 0.000 description 1
- ITYMTTQVNYAJAA-OCUNRLNVSA-N [(8S,9R,10S,11S,13S,14S,16R,17R)-9-fluoro-11-hydroxy-17-(2-hydroxyacetyl)-10,13,16-trimethyl-3-oxo-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-17-yl] propanoate Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)CO)(OC(=O)CC)[C@@]1(C)C[C@@H]2O ITYMTTQVNYAJAA-OCUNRLNVSA-N 0.000 description 1
- WDPYZTKOEFDTCU-WDJQFAPHSA-N [2-[(8S,9R,10S,11S,13S,14S,16R,17R)-9-fluoro-11,17-dihydroxy-10,13,16-trimethyl-3-oxo-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthren-17-yl]-2-oxoethyl] hexadecanoate Chemical compound C1CC2=CC(=O)C=C[C@]2(C)[C@]2(F)[C@@H]1[C@@H]1C[C@@H](C)[C@@](C(=O)COC(=O)CCCCCCCCCCCCCCC)(O)[C@@]1(C)C[C@@H]2O WDPYZTKOEFDTCU-WDJQFAPHSA-N 0.000 description 1
- 230000001594 aberrant Effects 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 229960001138 acetylsalicylic acid Drugs 0.000 description 1
- 229960004150 aciclovir Drugs 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- NIXOWILDQLNWCW-UHFFFAOYSA-N acrylic acid Chemical compound OC(=O)C=C NIXOWILDQLNWCW-UHFFFAOYSA-N 0.000 description 1
- MKUXAQIIEYXACX-UHFFFAOYSA-N acyclovir Chemical compound N1C(N)=NC(=O)C2=C1N(COCCO)C=N2 MKUXAQIIEYXACX-UHFFFAOYSA-N 0.000 description 1
- 125000002252 acyl group Chemical group 0.000 description 1
- 230000002730 additional Effects 0.000 description 1
- 239000002313 adhesive film Substances 0.000 description 1
- 230000002293 adipogenic Effects 0.000 description 1
- 239000003470 adrenal cortex hormone Substances 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 229930002945 all-trans-retinaldehyde Natural products 0.000 description 1
- FPIPGXGPPPQFEQ-OVSJKPMPSA-N all-trans-retinol Chemical compound OC\C=C(/C)\C=C\C=C(/C)\C=C\C1=C(C)CCCC1(C)C FPIPGXGPPPQFEQ-OVSJKPMPSA-N 0.000 description 1
- 201000005794 allergic hypersensitivity disease Diseases 0.000 description 1
- 150000001408 amides Chemical class 0.000 description 1
- 229960003942 amphotericin B Drugs 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 125000000129 anionic group Chemical group 0.000 description 1
- 229960002469 antazoline Drugs 0.000 description 1
- 230000000844 anti-bacterial Effects 0.000 description 1
- 230000001387 anti-histamine Effects 0.000 description 1
- 230000003110 anti-inflammatory Effects 0.000 description 1
- 230000000845 anti-microbial Effects 0.000 description 1
- 230000000840 anti-viral Effects 0.000 description 1
- 239000003429 antifungal agent Substances 0.000 description 1
- 229940006131 antiglaucoma preparations and miotics Parasympathomimetics Drugs 0.000 description 1
- 239000000739 antihistaminic agent Substances 0.000 description 1
- 229940111133 antiinflammatory and antirheumatic drugs Oxicams Drugs 0.000 description 1
- 239000002543 antimycotic Substances 0.000 description 1
- 230000001640 apoptogenic Effects 0.000 description 1
- 229960002610 apraclonidine Drugs 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 201000006058 arrhythmogenic right ventricular cardiomyopathy Diseases 0.000 description 1
- BSYNRYMUTXBXSQ-UHFFFAOYSA-N aspirin Chemical compound CC(=O)OC1=CC=CC=C1C(O)=O BSYNRYMUTXBXSQ-UHFFFAOYSA-N 0.000 description 1
- 239000012298 atmosphere Substances 0.000 description 1
- 229960001671 azapropazone Drugs 0.000 description 1
- 239000003855 balanced salt solution Substances 0.000 description 1
- 239000007640 basal medium Substances 0.000 description 1
- 239000002876 beta blocker Substances 0.000 description 1
- 229960002537 betamethasone Drugs 0.000 description 1
- 229960004324 betaxolol Drugs 0.000 description 1
- 239000003613 bile acid Substances 0.000 description 1
- 239000003833 bile salt Substances 0.000 description 1
- 230000035514 bioavailability Effects 0.000 description 1
- 230000003851 biochemical process Effects 0.000 description 1
- 230000003115 biocidal Effects 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 239000012472 biological sample Substances 0.000 description 1
- 201000004569 blindness Diseases 0.000 description 1
- 239000008366 buffered solution Substances 0.000 description 1
- 229960003150 bupivacaine Drugs 0.000 description 1
- 229950011189 butacetin Drugs 0.000 description 1
- 238000010804 cDNA synthesis Methods 0.000 description 1
- 238000010805 cDNA synthesis kit Methods 0.000 description 1
- 238000004364 calculation method Methods 0.000 description 1
- 230000024881 catalytic activity Effects 0.000 description 1
- 150000001768 cations Chemical class 0.000 description 1
- 229960000590 celecoxib Drugs 0.000 description 1
- 230000030833 cell death Effects 0.000 description 1
- 239000006285 cell suspension Substances 0.000 description 1
- 230000003833 cell viability Effects 0.000 description 1
- 229920002678 cellulose Polymers 0.000 description 1
- 239000001913 cellulose Substances 0.000 description 1
- 238000005119 centrifugation Methods 0.000 description 1
- 238000003889 chemical engineering Methods 0.000 description 1
- 229950001904 chenodiol Drugs 0.000 description 1
- 239000000812 cholinergic antagonist Substances 0.000 description 1
- 230000001684 chronic Effects 0.000 description 1
- 201000006994 chronic ulcer of skin Diseases 0.000 description 1
- 230000001886 ciliary Effects 0.000 description 1
- 229960003405 ciprofloxacin Drugs 0.000 description 1
- 238000004140 cleaning Methods 0.000 description 1
- 238000003776 cleavage reaction Methods 0.000 description 1
- 229960002227 clindamycin Drugs 0.000 description 1
- 125000003346 cobalamin group Chemical group 0.000 description 1
- 229960002424 collagenase Drugs 0.000 description 1
- 238000004624 confocal microscopy Methods 0.000 description 1
- 201000004182 congenital stromal corneal dystrophy Diseases 0.000 description 1
- 239000000882 contact lens solution Substances 0.000 description 1
- RYGMFSIKBFXOCR-UHFFFAOYSA-N copper Chemical compound [Cu] RYGMFSIKBFXOCR-UHFFFAOYSA-N 0.000 description 1
- 229910052802 copper Inorganic materials 0.000 description 1
- 239000010949 copper Substances 0.000 description 1
- 201000003046 cornea plana Diseases 0.000 description 1
- 201000004573 corneal ectasia Diseases 0.000 description 1
- 201000004778 corneal edema Diseases 0.000 description 1
- 201000004889 corneal granular dystrophy Diseases 0.000 description 1
- 238000010192 crystallographic characterization Methods 0.000 description 1
- 101700043120 cslA Proteins 0.000 description 1
- 230000001351 cycling Effects 0.000 description 1
- 229960002947 dapiprazole Drugs 0.000 description 1
- 230000002950 deficient Effects 0.000 description 1
- 230000003412 degenerative Effects 0.000 description 1
- 230000003413 degradative Effects 0.000 description 1
- 230000002939 deleterious Effects 0.000 description 1
- 230000001809 detectable Effects 0.000 description 1
- 229950000250 dexamethasone dipropionate Drugs 0.000 description 1
- 229950000812 dexamethasone palmitate Drugs 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 229960001259 diclofenac Drugs 0.000 description 1
- DCOPUUMXTXDBNB-UHFFFAOYSA-N diclofenac Chemical compound OC(=O)CC1=CC=CC=C1NC1=C(Cl)C=CC=C1Cl DCOPUUMXTXDBNB-UHFFFAOYSA-N 0.000 description 1
- 238000009792 diffusion process Methods 0.000 description 1
- 229960000616 diflunisal Drugs 0.000 description 1
- 229960000966 dipivefrine Drugs 0.000 description 1
- 239000006185 dispersion Substances 0.000 description 1
- 239000012153 distilled water Substances 0.000 description 1
- 150000002019 disulfides Chemical class 0.000 description 1
- 238000001035 drying Methods 0.000 description 1
- 239000003792 electrolyte Substances 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- 229910052876 emerald Inorganic materials 0.000 description 1
- 239000010976 emerald Substances 0.000 description 1
- 230000003511 endothelial Effects 0.000 description 1
- 238000004146 energy storage Methods 0.000 description 1
- 230000002255 enzymatic Effects 0.000 description 1
- 239000002532 enzyme inhibitor Substances 0.000 description 1
- 239000000262 estrogen Substances 0.000 description 1
- QUSNBJAOOMFDIB-UHFFFAOYSA-N ethyl amine Chemical compound CCN QUSNBJAOOMFDIB-UHFFFAOYSA-N 0.000 description 1
- 201000009819 exposure keratitis Diseases 0.000 description 1
- 230000001605 fetal Effects 0.000 description 1
- 201000007794 fetal alcohol syndrome Diseases 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000003619 fibrillary Effects 0.000 description 1
- 230000003328 fibroblastic Effects 0.000 description 1
- 229960004884 fluconazole Drugs 0.000 description 1
- 229960004413 flucytosine Drugs 0.000 description 1
- 229960001048 fluorometholone Drugs 0.000 description 1
- 229960002390 flurbiprofen Drugs 0.000 description 1
- VVIAGPKUTFNRDU-ABLWVSNPSA-N folinic acid Chemical compound C1NC=2NC(N)=NC(=O)C=2N(C=O)C1CNC1=CC=C(C(=O)N[C@@H](CCC(O)=O)C(O)=O)C=C1 VVIAGPKUTFNRDU-ABLWVSNPSA-N 0.000 description 1
- 235000008191 folinic acid Nutrition 0.000 description 1
- 239000011672 folinic acid Substances 0.000 description 1
- WSFSSNUMVMOOMR-UHFFFAOYSA-N formaldehyde Chemical compound O=C WSFSSNUMVMOOMR-UHFFFAOYSA-N 0.000 description 1
- 125000002485 formyl group Chemical group [H]C(*)=O 0.000 description 1
- 229960005102 foscarnet Drugs 0.000 description 1
- 230000002538 fungal Effects 0.000 description 1
- 238000001879 gelation Methods 0.000 description 1
- 239000003349 gelling agent Substances 0.000 description 1
- 230000002068 genetic Effects 0.000 description 1
- 229960002518 gentamicin Drugs 0.000 description 1
- 230000004313 glare Effects 0.000 description 1
- 239000003862 glucocorticoid Substances 0.000 description 1
- 125000001475 halogen functional group Chemical group 0.000 description 1
- 238000003306 harvesting Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 230000001744 histochemical Effects 0.000 description 1
- 229960002773 hyaluronidase Drugs 0.000 description 1
- 230000036571 hydration Effects 0.000 description 1
- 238000006703 hydration reaction Methods 0.000 description 1
- 239000000416 hydrocolloid Substances 0.000 description 1
- 239000000017 hydrogel Substances 0.000 description 1
- 229950005360 hydroxyamfetamine Drugs 0.000 description 1
- 239000001863 hydroxypropyl cellulose Substances 0.000 description 1
- 235000010977 hydroxypropyl cellulose Nutrition 0.000 description 1
- 239000001866 hydroxypropyl methyl cellulose Substances 0.000 description 1
- 235000010979 hydroxypropyl methyl cellulose Nutrition 0.000 description 1
- 229920003088 hydroxypropyl methyl cellulose Polymers 0.000 description 1
- 229940071676 hydroxypropylcellulose Drugs 0.000 description 1
- 229960001680 ibuprofen Drugs 0.000 description 1
- 230000001771 impaired Effects 0.000 description 1
- 238000010348 incorporation Methods 0.000 description 1
- 239000000411 inducer Substances 0.000 description 1
- 200000000018 inflammatory disease Diseases 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 239000003112 inhibitor Substances 0.000 description 1
- 229910052500 inorganic mineral Inorganic materials 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 230000016507 interphase Effects 0.000 description 1
- 201000006904 interstitial keratitis Diseases 0.000 description 1
- 239000007928 intraperitoneal injection Substances 0.000 description 1
- 238000009114 investigational therapy Methods 0.000 description 1
- 239000002555 ionophore Substances 0.000 description 1
- 230000000236 ionophoric Effects 0.000 description 1
- 230000002427 irreversible Effects 0.000 description 1
- 230000003522 irritant Effects 0.000 description 1
- 239000002085 irritant Substances 0.000 description 1
- 231100000021 irritant Toxicity 0.000 description 1
- 238000002955 isolation Methods 0.000 description 1
- 229960003299 ketamine Drugs 0.000 description 1
- 229960004125 ketoconazole Drugs 0.000 description 1
- 229960000991 ketoprofen Drugs 0.000 description 1
- 229960004752 ketorolac Drugs 0.000 description 1
- 230000002147 killing Effects 0.000 description 1
- 201000003775 lattice corneal dystrophy Diseases 0.000 description 1
- 229960001691 leucovorin Drugs 0.000 description 1
- 230000000670 limiting Effects 0.000 description 1
- 239000002502 liposome Substances 0.000 description 1
- 230000004807 localization Effects 0.000 description 1
- 229960000558 lodoxamide tromethamine Drugs 0.000 description 1
- 239000011777 magnesium Substances 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 238000007734 materials engineering Methods 0.000 description 1
- 235000013372 meat Nutrition 0.000 description 1
- 229960003803 meclofenamic acid Drugs 0.000 description 1
- VPNGEIHDPSLNMU-UHFFFAOYSA-N medetomidine hydrochloride Chemical compound Cl.C=1C=CC(C)=C(C)C=1C(C)C1=CNC=N1 VPNGEIHDPSLNMU-UHFFFAOYSA-N 0.000 description 1
- 229960001011 medrysone Drugs 0.000 description 1
- 229960003464 mefenamic acid Drugs 0.000 description 1
- 229960002409 mepivacaine Drugs 0.000 description 1
- INWLQCZOYSRPNW-UHFFFAOYSA-N mepivacaine Chemical compound CN1CCCCC1C(=O)NC1=C(C)C=CC=C1C INWLQCZOYSRPNW-UHFFFAOYSA-N 0.000 description 1
- 239000004292 methyl p-hydroxybenzoate Substances 0.000 description 1
- 235000010270 methyl p-hydroxybenzoate Nutrition 0.000 description 1
- 229960002216 methylparaben Drugs 0.000 description 1
- 229960002509 miconazole Drugs 0.000 description 1
- 238000007431 microscopic evaluation Methods 0.000 description 1
- 238000000386 microscopy Methods 0.000 description 1
- 239000011707 mineral Substances 0.000 description 1
- 238000002156 mixing Methods 0.000 description 1
- 230000004342 moderate myopia Effects 0.000 description 1
- PMZURENOXWZQFD-UHFFFAOYSA-L na2so4 Chemical compound [Na+].[Na+].[O-]S([O-])(=O)=O PMZURENOXWZQFD-UHFFFAOYSA-L 0.000 description 1
- BLXXJMDCKKHMKV-UHFFFAOYSA-N nabumeton Chemical compound C1=C(CCC(C)=O)C=CC2=CC(OC)=CC=C21 BLXXJMDCKKHMKV-UHFFFAOYSA-N 0.000 description 1
- 229960004270 nabumetone Drugs 0.000 description 1
- 239000002105 nanoparticle Substances 0.000 description 1
- 229960005016 naphazoline Drugs 0.000 description 1
- 239000004311 natamycin Substances 0.000 description 1
- 235000010298 natamycin Nutrition 0.000 description 1
- 230000001272 neurogenic Effects 0.000 description 1
- 210000002569 neurons Anatomy 0.000 description 1
- 230000000508 neurotrotrophic Effects 0.000 description 1
- 230000004297 night vision Effects 0.000 description 1
- 229960000965 nimesulide Drugs 0.000 description 1
- 239000002353 niosome Substances 0.000 description 1
- 239000000041 non-steroidal anti-inflammatory agent Substances 0.000 description 1
- 230000000414 obstructive Effects 0.000 description 1
- 239000002674 ointment Substances 0.000 description 1
- 229960004110 olsalazine Drugs 0.000 description 1
- 239000002997 ophthalmic solution Substances 0.000 description 1
- 230000004792 oxidative damage Effects 0.000 description 1
- RZVAJINKPMORJF-UHFFFAOYSA-N p-acetaminophenol Chemical compound CC(=O)NC1=CC=C(O)C=C1 RZVAJINKPMORJF-UHFFFAOYSA-N 0.000 description 1
- 102000002574 p38 Mitogen-Activated Protein Kinases Human genes 0.000 description 1
- 108010068338 p38 Mitogen-Activated Protein Kinases Proteins 0.000 description 1
- 229960005489 paracetamol Drugs 0.000 description 1
- 229920002866 paraformaldehyde Polymers 0.000 description 1
- 230000002445 parasympatholytic Effects 0.000 description 1
- 230000001499 parasympathomimetic Effects 0.000 description 1
- 239000000734 parasympathomimetic agent Substances 0.000 description 1
- 239000002245 particle Substances 0.000 description 1
- 230000008506 pathogenesis Effects 0.000 description 1
- 230000000149 penetrating Effects 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 239000003961 penetration enhancing agent Substances 0.000 description 1
- 230000000737 periodic Effects 0.000 description 1
- 230000002085 persistent Effects 0.000 description 1
- 230000003285 pharmacodynamic Effects 0.000 description 1
- VYMDGNCVAMGZFE-UHFFFAOYSA-N phenylbutazonum Chemical compound O=C1C(CCCC)C(=O)N(C=2C=CC=CC=2)N1C1=CC=CC=C1 VYMDGNCVAMGZFE-UHFFFAOYSA-N 0.000 description 1
- 201000001757 phlyctenulosis Diseases 0.000 description 1
- 239000002953 phosphate buffered saline Substances 0.000 description 1
- 230000000704 physical effect Effects 0.000 description 1
- 230000004977 physiological function Effects 0.000 description 1
- 230000035790 physiological processes and functions Effects 0.000 description 1
- 229960002702 piroxicam Drugs 0.000 description 1
- 210000001778 pluripotent stem cell Anatomy 0.000 description 1
- 229920001993 poloxamer 188 Polymers 0.000 description 1
- 229920001888 polyacrylic acid Polymers 0.000 description 1
- 201000006292 polyarteritis nodosa Diseases 0.000 description 1
- 229960005266 polymyxin B Drugs 0.000 description 1
- 229920000024 polymyxin B Polymers 0.000 description 1
- 239000000256 polyoxyethylene sorbitan monolaurate Substances 0.000 description 1
- 239000000244 polyoxyethylene sorbitan monooleate Substances 0.000 description 1
- 235000010482 polyoxyethylene sorbitan monooleate Nutrition 0.000 description 1
- 239000001818 polyoxyethylene sorbitan monostearate Substances 0.000 description 1
- 235000010989 polyoxyethylene sorbitan monostearate Nutrition 0.000 description 1
- 229940113124 polysorbate 60 Drugs 0.000 description 1
- 229920000053 polysorbate 80 Polymers 0.000 description 1
- 229920002745 polystyrene-block- poly(ethylene /butylene) Polymers 0.000 description 1
- 235000019422 polyvinyl alcohol Nutrition 0.000 description 1
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 description 1
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 230000002980 postoperative Effects 0.000 description 1
- 230000003389 potentiating Effects 0.000 description 1
- 239000000843 powder Substances 0.000 description 1
- 238000001556 precipitation Methods 0.000 description 1
- OZAIFHULBGXAKX-UHFFFAOYSA-N precursor Substances N#CC(C)(C)N=NC(C)(C)C#N OZAIFHULBGXAKX-UHFFFAOYSA-N 0.000 description 1
- 229960002800 prednisolone acetate Drugs 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 229960004919 procaine Drugs 0.000 description 1
- 102000004196 processed proteins & peptides Human genes 0.000 description 1
- 108090000765 processed proteins & peptides Proteins 0.000 description 1
- 230000002250 progressing Effects 0.000 description 1
- 230000002035 prolonged Effects 0.000 description 1
- 229960003981 proparacaine Drugs 0.000 description 1
- 235000010232 propyl p-hydroxybenzoate Nutrition 0.000 description 1
- 239000004405 propyl p-hydroxybenzoate Substances 0.000 description 1
- 229960003415 propylparaben Drugs 0.000 description 1
- 230000002797 proteolythic Effects 0.000 description 1
- 201000002154 pterygium Diseases 0.000 description 1
- 230000005180 public health Effects 0.000 description 1
- CYMJPJKHCSDSRG-UHFFFAOYSA-N pyrazolidine-3,4-dione Chemical class O=C1CNNC1=O CYMJPJKHCSDSRG-UHFFFAOYSA-N 0.000 description 1
- 229960000611 pyrimethamine Drugs 0.000 description 1
- 239000003642 reactive oxygen metabolite Substances 0.000 description 1
- 238000003259 recombinant expression Methods 0.000 description 1
- 201000009308 regular astigmatism Diseases 0.000 description 1
- 230000002787 reinforcement Effects 0.000 description 1
- 230000002040 relaxant effect Effects 0.000 description 1
- 230000000246 remedial Effects 0.000 description 1
- 239000011347 resin Substances 0.000 description 1
- 229920005989 resin Polymers 0.000 description 1
- 230000002207 retinal Effects 0.000 description 1
- 235000020945 retinal Nutrition 0.000 description 1
- 239000011604 retinal Substances 0.000 description 1
- 230000004264 retinal detachment Effects 0.000 description 1
- 229960003471 retinol Drugs 0.000 description 1
- 229960000371 rofecoxib Drugs 0.000 description 1
- 201000004700 rosacea Diseases 0.000 description 1
- 231100000241 scar Toxicity 0.000 description 1
- 210000001423 scleral cell Anatomy 0.000 description 1
- 238000007790 scraping Methods 0.000 description 1
- 230000001624 sedative Effects 0.000 description 1
- 239000000932 sedative agent Substances 0.000 description 1
- 230000035807 sensation Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 230000011664 signaling Effects 0.000 description 1
- NRHMKIHPTBHXPF-TUJRSCDTSA-M sodium cholate Chemical compound [Na+].C([C@H]1C[C@H]2O)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC([O-])=O)C)[C@@]2(C)[C@@H](O)C1 NRHMKIHPTBHXPF-TUJRSCDTSA-M 0.000 description 1
- 229960004025 sodium salicylate Drugs 0.000 description 1
- 159000000000 sodium salts Chemical class 0.000 description 1
- 229910052938 sodium sulfate Inorganic materials 0.000 description 1
- 235000011152 sodium sulphate Nutrition 0.000 description 1
- AUAGTGKMTMVIKN-UHFFFAOYSA-M sodium;2-(3-fluoro-4-phenylphenyl)propanoate Chemical compound [Na+].FC1=CC(C(C([O-])=O)C)=CC=C1C1=CC=CC=C1 AUAGTGKMTMVIKN-UHFFFAOYSA-M 0.000 description 1
- YXHRQQJFKOHLAP-FVCKGWAHSA-M sodium;2-[[(4R)-4-[(3R,5R,8R,9S,10S,12S,13R,14S,17R)-3,12-dihydroxy-10,13-dimethyl-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl]pentanoyl]amino]ethanesulfonate Chemical compound [Na+].C([C@H]1CC2)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC(=O)NCCS([O-])(=O)=O)C)[C@@]2(C)[C@@H](O)C1 YXHRQQJFKOHLAP-FVCKGWAHSA-M 0.000 description 1
- NAFSTSRULRIERK-UHFFFAOYSA-M sodium;7,9-dihydro-3H-purin-1-ide-2,6,8-trione Chemical compound [Na+].N1C([O-])=NC(=O)C2=C1NC(=O)N2 NAFSTSRULRIERK-UHFFFAOYSA-M 0.000 description 1
- 239000007779 soft material Substances 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- WSWCOQWTEOXDQX-UHFFFAOYSA-N sorbic acid Chemical compound CC=CC=CC(O)=O WSWCOQWTEOXDQX-UHFFFAOYSA-N 0.000 description 1
- 235000010199 sorbic acid Nutrition 0.000 description 1
- 239000004334 sorbic acid Substances 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 238000003892 spreading Methods 0.000 description 1
- 230000003019 stabilising Effects 0.000 description 1
- 238000010186 staining Methods 0.000 description 1
- 238000010561 standard procedure Methods 0.000 description 1
- 108091007018 stromelysin Proteins 0.000 description 1
- 150000008163 sugars Chemical class 0.000 description 1
- 229960004306 sulfadiazine Drugs 0.000 description 1
- SEEPANYCNGTZFQ-UHFFFAOYSA-N sulfadiazine Chemical compound C1=CC(N)=CC=C1S(=O)(=O)NC1=NC=CC=N1 SEEPANYCNGTZFQ-UHFFFAOYSA-N 0.000 description 1
- 229960000654 sulfafurazole Drugs 0.000 description 1
- 229960005404 sulfamethoxazole Drugs 0.000 description 1
- QAOWNCQODCNURD-UHFFFAOYSA-L sulfate Chemical compound [O-]S([O-])(=O)=O QAOWNCQODCNURD-UHFFFAOYSA-L 0.000 description 1
- 150000003462 sulfoxides Chemical class 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
- 230000001975 sympathomimetic Effects 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 201000000596 systemic lupus erythematosus Diseases 0.000 description 1
- 229960002871 tenoxicam Drugs 0.000 description 1
- WZWYJBNHTWCXIM-UHFFFAOYSA-N tenoxicam Chemical compound O=C1C=2SC=CC=2S(=O)(=O)N(C)C1=C(O)NC1=CC=CC=N1 WZWYJBNHTWCXIM-UHFFFAOYSA-N 0.000 description 1
- 235000019364 tetracycline Nutrition 0.000 description 1
- 229940016284 tetrahydrozoline Drugs 0.000 description 1
- 229960000337 tetryzoline Drugs 0.000 description 1
- 229960003495 thiamine Drugs 0.000 description 1
- KYMBYSLLVAOCFI-UHFFFAOYSA-N thiamine Chemical compound CC1=C(CCO)SCN1CC1=CN=C(C)N=C1N KYMBYSLLVAOCFI-UHFFFAOYSA-N 0.000 description 1
- 229960004605 timolol Drugs 0.000 description 1
- 238000011099 tissue engineering Methods 0.000 description 1
- 229960001017 tolmetin Drugs 0.000 description 1
- 238000003325 tomography Methods 0.000 description 1
- 239000006163 transport media Substances 0.000 description 1
- 230000001960 triggered Effects 0.000 description 1
- 230000001228 trophic Effects 0.000 description 1
- 230000036269 ulceration Effects 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
- 229940115889 ursodeoxycholic acid Drugs 0.000 description 1
- NQPDZGIKBAWPEJ-UHFFFAOYSA-M valerate Chemical compound CCCCC([O-])=O NQPDZGIKBAWPEJ-UHFFFAOYSA-M 0.000 description 1
- 229940070710 valerate Drugs 0.000 description 1
- ZTHWFVSEMLMLKT-CAMOTBBTSA-N vidarabine monohydrate Chemical compound O.C1=NC=2C(N)=NC=NC=2N1[C@@H]1O[C@H](CO)[C@@H](O)[C@@H]1O ZTHWFVSEMLMLKT-CAMOTBBTSA-N 0.000 description 1
- 230000003612 virological Effects 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 235000013343 vitamin Nutrition 0.000 description 1
- 239000011782 vitamin Substances 0.000 description 1
- 235000019155 vitamin A Nutrition 0.000 description 1
- 239000011719 vitamin A Substances 0.000 description 1
- 235000010374 vitamin B1 Nutrition 0.000 description 1
- 239000011691 vitamin B1 Substances 0.000 description 1
- 235000019163 vitamin B12 Nutrition 0.000 description 1
- 239000011715 vitamin B12 Substances 0.000 description 1
- 235000019158 vitamin B6 Nutrition 0.000 description 1
- 239000011726 vitamin B6 Substances 0.000 description 1
- 150000003697 vitamin B6 derivatives Chemical class 0.000 description 1
- 235000019154 vitamin C Nutrition 0.000 description 1
- 239000011718 vitamin C Substances 0.000 description 1
- 150000003700 vitamin C derivatives Chemical class 0.000 description 1
- 235000019165 vitamin E Nutrition 0.000 description 1
- 239000011709 vitamin E Substances 0.000 description 1
- 150000003712 vitamin E derivatives Chemical class 0.000 description 1
- 235000019168 vitamin K Nutrition 0.000 description 1
- 239000011712 vitamin K Substances 0.000 description 1
- 150000003721 vitamin K derivatives Chemical class 0.000 description 1
- 229930003231 vitamins Natural products 0.000 description 1
- 230000003313 weakening Effects 0.000 description 1
- 230000003442 weekly Effects 0.000 description 1
- 238000001262 western blot Methods 0.000 description 1
- 229960005332 zileuton Drugs 0.000 description 1
- MWLSOWXNZPKENC-SSDOTTSWSA-N zileuton Chemical compound C1=CC=C2SC([C@H](N(O)C(N)=O)C)=CC2=C1 MWLSOWXNZPKENC-SSDOTTSWSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
- A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
- A61K31/573—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone substituted in position 21, e.g. cortisone, dexamethasone, prednisone or aldosterone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/18—Growth factors; Growth regulators
- A61K38/1841—Transforming growth factor [TGF]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
- A61P27/10—Ophthalmic agents for accommodation disorders, e.g. myopia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07K—PEPTIDES
- C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- C07K14/435—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- C07K14/475—Growth factors; Growth regulators
- C07K14/495—Transforming growth factor [TGF]
Abstract
The present disclosure encompasses use of a composition for preparing a medicament for treating or preventing a condition associated with a thinning or irregularity of a cornea; or treating or preventing a refractive error associated with a defect of a cornea, the composition comprising: a TGFfi3 polypeptide, and dexamethasone or any salts, esters, or hydrides thereof, and the TGFfi3 polypeptide comprising SEQ ID NO:1, or at least 100 amino acids of the amino acid sequence of SEQ ID NO:1, or sharing at least 90% sequence identity to the amino acid sequence of SEQ ID NO:1. lypeptide, and dexamethasone or any salts, esters, or hydrides thereof, and the TGFfi3 polypeptide comprising SEQ ID NO:1, or at least 100 amino acids of the amino acid sequence of SEQ ID NO:1, or sharing at least 90% sequence identity to the amino acid sequence of SEQ ID NO:1.
Description
OPHTHALMIC COMPOSITIONS AND METHODS OF USE THEREFOR
RELATED APPLICATION
This application claims the benefit of New Zealand provisional patent
application number NZ 705727, filed 5 March 2015, the contents of which are hereby
incorporated herein in their ty.
FIELD OF THE INVENTION
The present disclosure relates to compositions and methods useful for the
treatment and/or prevention of conditions of the eye. In particular, the disclosure relates
to compositions and methods that can be used in augmenting and regenerating the cornea,
and in correcting refractive errors of the eye.
OUND OF THE ION
It was previously believed that differentiated cells relinquished their ability
to regress to an r state. However, this View has been challenged by the induction of
pluripotent stem cells (cell reprogramming) and evidence showing that differentiated
cells can switch to another phenotype (Takahashi & ka 2006; Wemig et a1. 2007;
Yarnanaka & Blau 2010; Gurdon & Melton 2008; Peran et a1. 2011). In addition, it is
now believed that the microenvironment for cells, which includes the surrounding cells,
extracellular matrix, and growth and differentiation factors, plays an important role in
bringing about the redirection of cellular differentiation (Hakelien and Collas 2002).
With this information, researchers have begun to p therapeutics that utilise cell
reprogramming and stem cell technologies.
The cornea of the eye accounts for more than two-thirds of the eye’s total
refractive power ing power). Even small changes in corneal shape can have a
dramatic effect on the clarity with which an image is brought to focus on the retina. The
stromal layer of the cornea (the clear front surface of the eye) comprises the majority of
the corneal tissue and is composed of highly organised lamellae which are made up of
y packed collagen fibrils, mostly of collagen types I and V (Marshall et al. 1993).
The unique structure of the stromal layer as a result of the uniform alignment of the
collagen fibrils confers the properties of ess and transparency on the cornea
(Funderburgh 2000).
When stromal cells (the l keratocytes) are removed from the cornea
and cultured in a monolayer they exhibit the logical teristics of fibroblasts
W0 2016/140581
and switch from a stellate shaped cell to a multinucleate, fiJsiform shaped cell
rburgh et al. 2001). Another commonly observed phenotype of cytes is the
myofibroblast form that is seen in the cornea after injury (Jester et al. 1987). Changes in
exogenous growth factors and nes are thought to bring about these phenotypic
changes (Funderburgh et a1. 2001).
TGFB family of growth factors are known to be the most potent inducers of
chondrogenic (cartilage) entiation (Heng, Cao, & Lee 2004; Johnstone et a1. 1998;
Menetrey et al. 2000). TGFBI stimulates the sis of ens and fibronectin by
chick embryo fibroblasts (Ignotz and Massague 1986). For keratocytes, TGFBl and
TGFBZ are known to cause ECM deposition associated with scarring, possibly due to
conversion of keratocytes into the myofibroblast phenotype (Funderburgh, Mann,
Funderburgh, Corpuz, & Roth 2001). In contrast, TGFB3 has been shown to induce
corneal fibroblasts to produce ECM depositions made up of collagen type 1 t
fibrosis or scarring (Karamichos, Hutcheon, & Zieske 2011). Certain non—proteinaceous
al compounds such as thasone (Johnstone, Hering, Caplan, Goldberg, &
Yoo 1998), ascorbic acid (Farquharson, Berry, Barbara Mawer, Seawright, & Whitehead
1998), and ethanol (Kulyk & n 1996) are also known to promote chondrogenic
differentiation in vitro.
There are a number of conditions affecting the cornea, including various
defects, injuries, diseases, and degenerative conditions. Myopia results from excessive
curvature of the cornea so that light entering the eye focuses in front of the retina. It is
the most prevalent Vision impairment worldwide affecting the vision of 70 to 90% of
people in some Asian countries and 30 to 40% in Europe and the United States (Frederick
2002). In most cases, myopia first occurs in school-age children and progresses until
about the age of 20. It is also associated with increased prevalence of macular
degeneration, retinal detachment, and glaucoma in adulthood (Ebenstein & Pruitt 2006).
Myopia is most commonly corrected by the use of prescription eye glasses
or contact lenses. However, these s do not provide permanent treatment for the
condition, and they are unsuitable for use during certain activities. Contact lenses are also
ated with ophthalmic infections and more s ions, including corneal
abrasions and ulcers. In certain circumstances, refractive surgery or orthokeratology is
indicated for myopia. Still, these treatments provide only a temporarily correction for
W0 2016/140581
mild to moderate myopia; they are not permanent treatments, and they are unsuitable for
SCVCI‘C cases.
conus is an ecstatic corneal dystrophy associated with stromal thinning
and disruption of the portion of the cornea known as Bowman’s layer. The progressive
thinning of the corneal stroma typically occurs over decades and s in the cornea
developing a l shape. This results in an impairment of vision due to irregular
astigmatism and . The pathogenesis of keratoconus is still unknown but has been
associated with factors such as constant eye g and contact lens wear afiachmer,
Feder, & Belin 1984; Sherwin & Brookes 2004). It can appear as early as puberty and
continues to progress until the third or fourth decade of life.
The incidence of keratoconus has been estimated at approximately 1 in 2000
in the general population worldwide (Rabinowitz 1998), with no predilection for either
gender. Since the onset of keratoconus is typically in early adulthood with continuation
into prime earning and child-rearing years, the loss of quality of life and the economic
burden of the treatment of keratoconus represent a significant public health n.
Keratoconus is a major indication for cornea transplantation in the Western world,
determined by chers to constitute 28.8% of corneal transplantation in France
(Legeais et a1. 2001) and from 11.4% to 15.4% in the United States (Cosar et a1. 2002;
s et a1. 2000). There is an unusually high prevalence of keratoconus in New
Zealand, with a disproportionately high incidence in Pasifika and Maori tions
(Patel et a1. 2005; Patel & McGhee 2013). In New Zealand, approximately 50% of all
corneal transplants performed are for keratoconus (Edwards et a1. 2002).
Despite several studies on keratoconus, the underlying biochemical process
s poorly understood. The familial occurrence of conus suggests that one of
the aetiological s is genetic (Ihalainen 1985). The condition has also been linked to
certain biochemical and biomechanical factors. For example, it has been determined that
the corneal thinning of keratoconus is a result of the loss of extracellular matrix (ECM)
components. r, this could be due to their destruction, their defective formation,
or a combination of these (Klintworth & Damms 1995; Klintworth 1999; Jhanji et a1.
2011). In the l stroma, changes associated with keratoconus include a decrease in
the number of lamellae and keratocytes (Ku, Niederer, Patel, Sherwin, & McGhee 2008;
Sherwin & Brookes 2004), and changes in organisation of the lamellae and distribution
of collagen fibrillary mass (Meek et a1. 2005).
W0 2016/140581
It is thought that the degradation ofthe stromal layer might be due to aberrant
proteolytic enzyme activity hi, Yue, Sugar, & Lam 1994). conus corneas
are known to have decreased levels of enzyme inhibitors and an increased level of
degradative enzymes (Kenney & Brown 2003). Biomechanical factors include thinning
and decreased rigidity of the cornea due to oxidative damage caused by ultraviolet
radiation and mechanical trauma (Kenney & Brown 2003). Biomechanical investigation
of keratoconic corneas has revealed a decrease in elasticity and ess; r the
reasons for this remain unknown (Edmund 1988). It has been suggested that a reduction
in collagen cross—links could be a cause (Wollensak & Buddecke 1990). Currently there
is no satisfactory animal model for keratoconus and investigations have been largely
limited to an ex vivo setting.
Depending on the severity of the condition, attempts to slow progression of
conus e the use of special spectacles and contact lens. In severe cases,
corneal implants, intrastromal rings, or corneal transplants are ary (Jhanj i, Sharma,
& Vajpayee 2011). Penetrating keratoplasty, a procedure in which the entire thickness of
the cornea is removed and ed by donor corneal tissue, is the most commonly used
surgical procedure used to treat advanced cases of conus (Rabinowitz 1998).
Keratoconus is the leading tion for corneal transplantation surgery worldwide, with
about 12-20% ofthose affected by conus requiring a corneal transplant (Pramanik,
Musch, n, & Farjo 2006).
Early treatment options for keratoconus, such as customised gas permeable
lenses known as Rose K lenses, have been focussed on improving visual . Newer
treatments aim to slow the progression of the disease. A ent known as corneal
collagen cross-linking (CXL) looks at increasing corneal rigidity and biomechanical
stability. In this procedure, the epithelium is debrided, topical riboflavin drops are
administered, and the s are exposed to ultraviolet—A light at 370 nm for
approximately 30 minutes (Ashwin & McDonnell 2010; G. Wollensak, Spoerl, & Seiler
2003). It is believed that the UV—A light activates the riboflavin thereby producing
reactive oxygen species that induce the formation ofcovalent bonds between the collagen
molecules in the corneal stroma (Spoerl, Huhle, & Seiler 1998; G. Wollensak et a1. 2003).
This ure, however, is not recommended for the treatment of corneas thinner than
400 um due to the possibility of endothelial cell damage. Although this treatment leads
to a stiffer cornea, it does not address the problem of corneal thinning.
W0 2016/140581
Therefore, there is an ongoing need for therapeutic compositions and
methods for addressing conditions of the eye, including conditions ing the cornea.
There is a particular need for therapies that are relatively non-invasive and readily
administered.
SUMMARY OF THE INVENTION
The inventors have ped compositions and methodsfor modulating
corneal cells, to alter collagen expression and extracellular matrix formation in l
tissue. These compositions and methods are useful for regenerating and/or augmenting
the cornea, and thereby treating and/or preventing various conditions of the cornea and
refractive errors of the eye.
In one aspect, the ion comprises a method of treating or preventing a
ion associated with a thinning or irregularity of a cornea, comprising: contacting
the cornea with a ition comprising a TGFB3 polypeptide or a variant or fragment
thereof, and dexamethasone or derivative thereof or related dal agent, thereby
treating or preventing the condition.
In s aspects:
The TGFB3 polypeptide consists of the amino acid sequence of SEQ ID
NO:1.
The dexamethasone is thasone phosphate.
The composition comprises 10 to 100 ng/ml of the TGFB3 polypeptide.
The composition comprises 40 to 4000 ng/ml dexamethasone.
The composition is formulated as an eye drop.
The composition is formulated with gellan gum.
The composition is administered once daily or twice daily.
The composition is co-administered with one or more additional agents for
the eye.
The one or more additional agents for the eye are selected from the group
consisting of: anaesthetic agents, anti-inflammatory agents, anti-microbial agents, and
lubricants.
The composition is administered in conjunction with use of a t lens,
corneal , corneal implant, or intrastromal ring.
W0 2016/140581
The contact lens, corneal insert, corneal t, or intrastromal ring is
adapted for moulding or g corneal shape during and/or following treatment with
the ition.
The contact lens, corneal insert, corneal implant, or intrastromal ring is
adapted to act as a carrier for the composition or as a composition eluting device.
The composition is administered in conjunction with corneal collagen
crosslinking.
The administration of the composition is prior to and/or subsequent to
crosslinking.
The condition is selected from the group consisting of: keratoconus, myopia,
and astigmatism.
In an alternative aspect, the method comprises co-administration of a
composition comprising the TGFB3 polypeptide or a variant or fragment thereof, and a
ition comprising the dexamethasone or derivative thereof or related steroidal
agent.
In one r aspect, the invention comprises a method of treating or
preventing damage or injury of a cornea, comprising: contacting the cornea with a
ition comprising a TGFB3 polypeptide or a variant or fragment thereof, and
dexamethasone or tive thereof or related steroidal agent, thereby treating or
preventing the damage or injury of the cornea.
In various aspects:
The TGFB3 polypeptide consists of the amino acid
ce of SEQ ID
N021.
The dexamethasone is dexamethasone phosphate.
The ition comprises 10 to 100 ng/ml of the TGFB3 polypeptide.
The composition comprises 40 to 4000 ng/ml dexamethasone.
The composition is formulated as an eye drop.
The composition is formulated with gellan gum.
The composition is administered once daily or twice daily-
The composition is co—administered with one or more additional agents for
the eye.
W0 2016/140581
The one or more additional agents for the eye are selected from the group
consisting of: anaesthetic agents, anti-inflammatory agents, anti-microbial agents, and
lubricants.
The composition is administered in conjunction with use of a contact lens
corneal insert, corneal implant, or intrastromal ring.
The t lens, l , corneal implant, or intrastromal ring is
adapted for moulding or holding corneal shape during and/or following treatment with
the composition.
The contact lens, l insert, corneal implant, or intrastromal ring is
adapted to act a carrier for the composition or as a composition eluting device.
The damage or injury of the cornea is associated with one or more of: an
abrasion, tear, ulcer, burn, puncture, and surgery.
In an alternative aspect, the method comprises co-administration of a
composition comprising the TGFB3 polypeptide or a variant or fragment thereof, and a
composition sing the dexamethasone or derivative thereof or related steroidal
agent.
In yet a fithher aspect, the invention comprises a method of ng or
preventing a refractive error of the eye, comprising: ting they eye with a
composition sing a TGFB3 polypeptide or a variant or fragment thereof, and
dexamethasone or derivative f or related steroidal agent, thereby treating or
preventing the refractive error of the eye.
In various aspects:
The TGFB3 polypeptide consists of the amino acid sequence of SEQ ID
N021.
The dexamethasone is dexamethasone phosphate.
The ition comprises 10 to 100 ng/ml ofthe TGF[33 ptide.
The composition comprises 40 to 4000 ng/ml dexamethasone.
The composition is formulated as an eye drop.
The composition is formulated with gellan
gum.
The composition is administered once daily or twice daily.
W0 2016/140581
The composition is co-administered with one or more onal agents for
the eye.
The one or more additional agents for the eye are selected from the group
consisting of: anaesthetic agents, anti-inflammatory agents, icrobial agents, and
lubricants.
The composition is administered for use in conjunction with a contact lens,
corneal insert, corneal implant, or intrastromal ring.
The contact lens, corneal insert, corneal implant, or intrastromal ring is
d for moulding or holding corneal shape during and/or following treatment with
the composition.
The contact lens, corneal insert, corneal implant, or intrastromal ring is
adapted to act as a carrier for the composition or as a composition eluting device.
The method is performed preceding or following refractive
surgery.
The refractive error of the eye is associated with one or more of: myopia,
hyperopia, astigmatism, and presbyopia.
In an alternative aspect, the method comprises co-administration of a
composition comprising the TGFB3 ptide or a variant or fragment f, and a
composition comprising the dexamethasone or derivative f or related steroidal
agent.
In still a timber aspect, the invention encompasses a kit comprising:
a composition comprising a TGFB3 ptide or a variant or nt thereof,
and dexamethasone or derivative thereof or related steroidal agent; and
one or more contact lenses.
In various aspects:
The contact lens, corneal , corneal implant, or intrastromal ring is
adapted for moulding or holding corneal shape during and/or following treatment with
the composition.
The contact lens, l insert, corneal implant, or intrastromal ring act
as a
carrier for the ition or as a composition eluting device.
The TGFB3 polypeptide ts of the amino acid
sequence of SEQ ID
NO:1.
W0 40581
The dexamethasone is dexamethasone phosphate.
The composition comprises 10 to 100 ng/ml ofthe TGFB3 polypeptide.
The composition comprises 40 to 4000 ng/ml dexamethasone.
The composition is formulated as an eye drop.
The composition is formulated with gellan gum.
The composition is ated for administration once daily or twice daily.
The composition is co-formulated with one or more additional agents for the
eye.
The kit includes one or more additional agents for the eye.
The one or more additional agents for the eye are selected from the
group
consisting of: anaesthetic agents, nflammatory agents, icrobial agents, and
lubricants.
The kit es a contact lens solution.
The kit includes instructions for use.
The kit is used for the treatment or prevention of a refractive error of the
eye.
The kit is used for the treatment or prevention of a corneal condition selected
from the group ting of: keratoconus, myopia, hyperopia, astigmatism, presbyopia,
and stromal dystrophies.
The kit is used for the treatment of a l condition selected from the
group consisting of: an abrasion, tear, ulcer, burn, puncture, corneal melt, and surgical
injury.
In an alternative aspect, the kit ses as separate components a
composition comprising the TGFB3 polypeptide or a variant or fragment thereof, and a
composition comprising the dexamethasone or derivative thereof or related steroidal
agent.
In even a r aspect, the invention comprises a method of inducing
en type II expression in a keratocyte, comprising: contacting the keratocyte with a
composition comprising a TGFB3 polypeptide or a variant or nt thereof, and
dexarnethasone or derivative thereof or related steroidal agent, thereby inducing collagen
type II expression in the keratocyte.
In various aspects:
W0 2016/140581
The TGFB3 polypeptide consists of the amino acid sequence of SEQ ID
NO:1.
The dexamethasone is dexamethasone phosphate.
The composition comprises 10 to 100 ng/ml of the TGFl33 polypeptide.
The composition comprises 40 to 4000 ng/ml dexamethasone.
The composition is formulated for administration via a contact lens, a corneal
insert, a corneal implant, or an intrastromal ring.
The composition is formulated for administration as a solution, gel, cream,
or emulsion.
The method is performed in viva.
The method is med ex vivo.
In an alternative aspect, the method comprises co-administration of a
composition comprising the TGFB3 polypeptide or a variant or nt thereof, and a
composition comprising the dexamethasone or derivative f or related steroidal
agent.
The ing brief summary broadly describes the features and technical
advantages ofcertain embodiments ofthe present invention. Further technical advantages
will be described in the detailed description of the invention and examples that follows.
Novel features that are believed to be characteristic of the invention will be
better understood from the detailed description of the invention when considered in
connection with any accompanying figures and es. However, the figures and
examples provided herein are intended to help illustrate the invention or assist with
developing an tandingiofthe invention, and are not intended to limit the invention's
scope.
BRIEF DESCRIPTION OF THE GS
Figure 1A: Schematic showing myopia caused by an increased curvature of
the cornea such that light entering the eye is not focussed onto the retina.
Figure 1B: View of a normal (A) and keratoconic (B) cornea, respectively.
(C): Scheimpflug image in severe keratoconus. cant corneal ng is
appreciated in the l cornea.
Figure 2: Organotypic slice culture set up.
W0 40581
Figure 3: Growth factor eye drops led in the eye of adult male Wistar
rat.
Figure 4: Phoenix Micron IV in vivo eye imaging system set up specific for
imaging rat eyes.
Figure 5: tic of (A): a nanoindenter , (B): a typical load-
displacement curve obtained during the indentation s which is used to calculate
corneal elasticity and hysteresis. Pmax = maximum load d; hmax = penetration depth;
he = contact depth (the height of the contact between the tip and the sample); hf = final
depth; S = unloading stiffness.
Figure 6: Nanoindentation rigs designed to hold the human corneal button
(A) and the rat globe (B). The central section of the cornea is located by using the
microscope, (C), and once located the indenter probe is used, (D).
Figure 7: Corneal keratocytes seeded in chondrogenic differentiation
medium. cytes cultured for 3 weeks in ogenic entiation medium
containing TGF|33 and dexamethasone formed spheres, which were labelled with: (A)
nestin around the periphery of the spheres; (B) collagen type II within the core. The
culture medium was then switched to serum containing fibroblast proliferation medium
for 1 week, causing cells from the spheres to spread out and populate the dish, (C). Cells
in monolayer were negative for type II collagen whereas the cell clusters remained
positive for collagen type II, (D).
Figure 8: Corneal keratocytes seeded in serum containing fibroblast
proliferating medium. Keratocytes cultured in control fibroblast proliferation medium for
3 weeks were ve for nestin (A), and collagen Type II (B). Confluent asts
were then cultured in chondrogenic differentiation medium containing TGFB3 and
dexamethasone for 3 weeks, (C). The cells remained negative for collagen type II, (D).
(E): pellet culture of confluent fibroblasts in chondrogenic differentiation . After
3 weeks in culture the cell pellet was sectioned and labelled positive for the keratocyte
marker keratocan, (F), and negative for the chondrocyte specific type II collagen, (G).
Figure 9: Human corneal slices cultured for 2 weeks in control medium (A)
and (D) were negative for type II collagen and positive for type I collagen, respectively.
Human corneal slices cultured for 1 week, (B) and (E), and 2 weeks, (C) and (F), in
chondrogenic differentiation medium and ed for collagen type II, (B) and (C), and
type I, (E) and (F). Strong labelling for type II collagen was seen in corneal slices treated
W0 40581
for 2 weeks whereas slices treated for only 1 week were negative for type II collagen.
Slices ed in chondrogenic differentiation medium for both the time periods,
although less strongly labelled when compared to the control treated slices, were positive
for the native corneal collagen type I.
Figure 10: Human corneal slices cultured for 2 weeks in: (A) control medium
and (B) chondrogenic differentiation medium and labelled for collagen type 11. Similar
results were obtained as shown by Figure 9. In vivo experiments showing (C): untreated
corneas; (D) and (E): treated corneas with a Widespread labelling of type II en in
the TGFB3 and dexamethasone treated corneas of rats. er labelling was seen in the
anterior ) part of the cornea, (D). Type II collagen appeared fibrillar and was
evenly distributed throughout the ECM.
Figure 11: Keratoconic corneal button cultured in vitro in control medium,
(A), (C) and (E), and chondrogenic differentiation medium, (B), (D) and (F), for 2 weeks
and labelled for collagen type II (A) and (B), and vimentin (C)-(F), respectively.
Compared to the labelling in normal human corneas the labelling of type II en in
treated conic corneas (B) was weaker. However, the deposition of type II collagen
had a similar pattern to that previously Seen after in vitro and in vivo treatment of normal
human and rat corneas. The fibroblast population in the treated half of the keratoconic
button (D) and (F) increased in number and the keratocytes appeared healthier and intact
with multiple, long cell processes (F), when compared to the untreated half of the
keratoconic cornea, (C) and (E).
Figure 12: Ex vivo cultured human keratoconic cornea cultured for 3 weeks
in control medium, (A) and (C), and chondrogenic differentiation media, (B) and (D),
and ed for alpha smooth muscle actin (OLSMA), (A) and (B), and type III collagen,
(C) and (D). There was stronger labelling for aSMA in stromal layer of corneas cultured
in l medium (A), when compared to corneas cultured in ogenic
entiation medium. Comeas cultured in either of the two media did not label
positively for type III collagen.
Figure 13: Corneal arency of in viva treated comeas. Treated, (A) and
(C), and untreated, (B) and (D), corneas. After 3 weeks the treated and ted corneas
were indistinguishable from each other. The front view of the corneas (A) and (B) reveal
a clear comea through which light easily passes to reveal the blood vessels of the back
of the eye very clearly. At 8 weeks the in vivo imaging of the cross section of the cornea
W0 2016/140581
reveals a clear, transparent cornea through which light easily passes. There were no signs
of corneal opacity or scarring.
Figure 14: Quantitative gene expression of en type II (A), and collagen
type I (B), in in viva treated corneas. There was an l se in type II collagen
expression upon after 1 week of treatment. Upon withdrawal of the treatment there was
a marked se in type II collagen expression, (A). Native corneal collagen type I
sion was also initially upregulated, however upon long term treatment (up to 7
weeks) its expression was able to the control untreated , (B).
Figure 15: Comparison of 1 week in viva treated and untreated corneas does
not reveal a significant difference in hardness (H) and reduced elastic modulus (Er).
Figure 16: Load deformation curves obtained for 3 week in viva d and
untreated corneas from two rats. The corresponding graphs with the d values clearly
show an increase in elastic modulus (Er) and hardness (H) in the treated corneas.
Figure 17: Comparison of elastic modulus and hardness of 8 week treated
and control human keratoconic cornea reveals a marked increase in both parameters in
the d cornea.
Figure 18: Reshaping of the cornea in the sheep eye by combining in viva
cell reprogramming with a rigid contact lens to hold the desired corneal shape during
treatment.
Figure 19: (A) The Phoenix Micron IV in viva eye imaging system. The
imaging system enables measurement of corneal thickness, curvature, and transparency.
(B) An OCT attachment enables Visualisation of the anterior eye and measurement of
corneal ess and integrity, similar to the image seen here. (C) A nanoindenter and
(D) schematic representation of the set-up which will be used to assess l
biomechanics ex viva in sheep. Output is shown as a load-displacement curve which can
be analysed to obtain Young’s modulus of elasticity, and a measure ofhardness. In large
animals such as sheep, corneal thickness (E) is indicated in microns and corneal curvature
measurements (F) are obtained using a portable Pentacam®. For corneal curvature (F),
widely spaced colour contours indicate a large radius of curvature; narrower contours
te areas of r curvature. Numbers indicate the radius of curvature at each
point.
Figure 20: Only TGFB3 combined with dexamethasone produces collagen
type II deposition. Sheep corneal tissue were cultured in (A) BMP6, (B) BMP6 +
W0 2016/140581
hydrocortisone, (C) TGFB3 + ortisone, (D) BMP6 + dexarnethasone, (E) TGFBS
+ prednisone, (F) TGFfi3 + Triesense®, (G) and (H) TGFB3 + thasone at 20X
and 60X magnification, respectively, and labelled for cartilage specific collagen type II.
Figure 21: Dose response study for combinations of TGFB3 and
dexamethasone. Sheep corneas were cultured for 3 weeks and labelled for collagen
type II.
DETAILED DESCRIPTION OF THE INVENTION
The following description sets forth numerous exemplary configurations,
parameters, and the like. It should be recognised, however, that such description is not
intended as a limitation on the scope of the present invention, but is instead provided as
a description of exemplary embodiments.
Definitions
In each instance herein, in descriptions, s, embodiments, and examples
of the t invention, the terms “comprising’3 LC
, including”, etc., are to be read
expansively, without limitation. Thus, unless the context clearly requires otherwise,
throughout the description and the claims, the words “comprise”, “comprising”, and the
like are to be construed in an ive sense as to opposed to an exclusive
sense, that is
to say in the sense of “including but not limited to”.
As used herein, “augmenting” refers to s of increasing one or more of
the thickness, hardness, elastic modulus, tensile strength, and regularity of the
cornea,
ing the corneal tissue (e.g., the stromal layer). Augmentation may be used to
impose a particular shape to the , i.e., corneal curvature. Augmentation methods
may be performed in the presence or absence of a particular condition of the eye, or of
the cornea. Augmentation may involve the increase in components in the extracellular
matrix of the cornea (e.g., collagen type II). tation
may also involve increasing
the number of cells (e.g., keratocytes) in the cornea. The number of cells may be
increased, for example, by altering the proliferative state of such cells from quiescent to
“Co-administration” or “co-administering” refers to the ed use of
agents, for example, eutic agents for the eye, and includes the administration of co-
formulations (i.e., combination formulations), as well as the simultaneous or sequential
administration of te formulations. Similarly, “in conjunction” refers to the
combined use ofa therapeutic composition and a therapeutic device/procedure.
This can
W0 2016/140581
include use of the composition preceding use of the device/procedure, simultaneously
with the device/procedure, and/or following use ofthe device/procedure.
A “condition” of the cornea refers to a state of disease, defect, damage,
injury, degeneration, or ction of the cornea. The condition may affect the corneal
tissue (e.g., the stromal layer) or corneal cells (e. g., keratocytes). The condition
may be
' an acute condition, for example,
an abrasion or ulceration, or may be a c condition,
for e, keratoconus or myopia.
The “cornea” as used herein refers to the transparent front part ofthe
eye that
covers the iris, pupil, and anterior chamber of the eye. It includes the corneal epithelium,
Bowman’s layer, corneal stroma, Descemet’s membrane, and the corneal epithelium. Of
particular interest is the stromal layer (also called the substantia propria) ofthe cornea,
which comprises an extracellular matrix of regularly ed collagen fibres along with
keratocytes,
A “derivative”, as relating to a chemical derivative, refers to a nd that
has been chemically modified. The present sure
encompasses each of the chemical
compounds bed herein as well as any derivatives thereof, including chemically
modified forms such as salts, hydrides, esters, and other modifications of the original
compound.
“Isolated” as used herein, with particular nce to ptides, refers to
a molecule that is separated from its natural environment. An isolated le may be
obtained by any method or ation of methods as known and used in the art,
including biochemical, recombinant, and synthetic ques. To obtain isolated
components, the polypeptides may be prepared by at least one purification or enrichment
step. Of particular interest are polypeptides and peptides obtained by artificial means,
i.e., non-natural, means. This includes but is not d to, synthetic chemistry,
recombinant logy, purification ols, etc. Included are polypeptides isolated
from natural, recombinant, or synthetic sources. Also included are polypeptides produced
by chemical synthesis, or by plasmids, vectors, or other expression constructs that may
be introduced into a cell or cell-free translation system. Such polypeptides
are clearly
distinguished fiom polypeptides as they naturally occur, without human intervention.
The terms “protein” or “polypeptide” (e.g., SEQ ID N021), and other such
terms, for simplicity, refer to the molecules described herein. Such terms
are not meant
to provide the complete characterization of these molecules. Thus, a protein or
W0 2016/140581
polypeptide may be characterised herein as having a particular amino acid sequence, a
particular 2—dimensiona1 representation of the ure, but it is understood that the
actual le claimed has other features, including 3—dimensional structure, mobility
about certain bonds and other properties of the molecule as a whole. It is the les
themselves and their properties as a whole that are encompassed by this sure. The
terms “protein” and “polypeptide” are used interchangeably herein.
A TGFB3 “polypeptide” refers to ptides obtained from any source,
and synthetic
e.g., isolated naturally ing polypeptides, recombinant polypeptides,
polypeptides, and to include polypeptides having the naturally occurring amino acid
and fragments of
sequence as well as polypeptides having variant amino acid sequences,
such sequences, as described in detail herein. TGFB3 may also be referred to in the art as
transforming growth factor-beta3, TGFB3, ARVD, and FL]16571.
Amino acid “sequence identity” refers to the amino acid to amino acid
comparison oftwo or more polypeptides. A test sequence may be identical to a reference
(i.e., share 100% identity), or may include one or more amino acid
sequence
substitutions. In preferred aspects, amino acid substitutions may possess r chemical
and/or physical properties such as charge or hydrophobicity, as compared to the reference
amino acid. Sequence identity may be typically determined by sequence alignments at
the regions of highest homology. Sequence alignment algorithms, for example BLAST®
in the art. Based on the
ce alignment programs, are well known and widely used
sequence alignment, the percent identity can be determined between the compared
polypeptide sequences.
A ctive error” as used herein, refers to error in the focusing of light by
the eye. Refractive errors may e spherical errors and cylindrical errors. Both lower
order aberrations and higher order tions are included. Specifically included as
refractive errors are the conditions of the eye noted as myopia, hyperopia, astigmatism,
anisometropia, and presbyopia.
“Regeneration”, in relation to the cornea, refers to the restoration of one or
more of the shape, thickness, regularity, hardness, elastic modulus, and tensile strength
of the cornea, including that of the corneal tissue (e.g., the stromal layer). Methods of
regeneration may be used to impose a particular shape to the cornea, i.e., l
curvature. Regeneration methods may be med in the treatment of a ular
ion of the eye, or of the cornea. Regeneration may involve the increase in
W0 40581
components in the extracellular matrix ofthe cornea (e.g., collagen type II). Regeneration
may also involve increasing the number of cells (e.g., keratocytes) in the cornea. The
number of cells may be increased, for example, by altering the proliferative state of such
cells from quiescent to active.
“Reprogramming” of cells, for example, for corneal cells (e. g., keratocytes)
refers to changes in the state of differentiation. Reprogramming is associated with one or
more s in cell morphology, ar gene expression (e.g., collagen expression,
ing collagen type I and/or type II expression), or the cells erative state (e.g.,
quiescent or active).
The term “subject” refers to a human or non-human animal.
“Preventing” refers to stopping or delaying the onset of a condition, for
example an eye condition, or particularly a corneal condition, such as a disorder or other
defect of the cornea. A preventative measure will result in the stoppage or delay of one
or more symptoms of the condition, or a lessening of ms if such do arise.
Prevention of a corneal condition may involve augmenting the cornea, as described in
detail herein.
“Treating” refers to reducing, ameliorating, or resolving a condition, for
example an eye condition, or particularly a corneal ion, such as a disorder or other
defect of the cornea. A treatment will result in the ion, amelioration, or elimination
of one or more symptoms of the condition. Treatment of a corneal condition may involve
regeneration of the cornea, as detailed herein. The compositions and methods of the
invention may be used for treating various conditions, for ting various conditions,
or for both treating and preventing various conditions, as described in detail herein.
Cell and tissue regeneration
Cell and tissue regeneration technologies hold considerable promise in
eutic treatments. As disclosed herein, the inventors have developed compositions and
methods for modulating cells using in situ cell reprogramming in order to affect collagen
type II expression and extracellular matrix (ECM) deposition in l . This, in turn,
is used to strengthen andfor augment the cornea of the eye. The inventors thereby provide a
unique approach for the in situ / in vivo regeneration and augmentation ofthe corneal stromal
Accordingly, the disclosed methods may be utilised in in vivo tissue engineering
therapy for various conditions of the cornea, including myopia and keratoconus. As noted
W0 2016/140581
above, myopia is characterised by the excessive curvature of the cornea (Figure 1A),
while keratoconus is a progressive ectatic corneal dystrophy leading to a characteristic
n of corneal thinning (Figure 1B; image adapted from Romero-Jimenez,
Santodomingo-Rubido, & Wolffsohn 2010).
l keratocytes are relatively ent and normally only produce large
amounts of extracellular matrix (ECM) when they switch to a fibroblast or myofibroblast
ype. ECM deposition associated with those ypes y leads to corneal
fibrosis and loss of transparency (Kadler, Baldock, Bella, & andford 2007).
Chondrocytes, the cells that make up cartilage, secrete type II collagen which is a fibrillar
collagen similar to type I found in the cornea. Type II collagen is also expressed by
keratocytes during development ofthe chick cornea and it is only later replaced by type I
in the mature chick stroma (Linsenmayer et a1. 1990).
The inventors have previously shown that stromal cells from adult human
and rat corneas can be reprogrammed to e neuron specific proteins when treated
with al lineage ying growth factors (Greene et a1. 2013). This data
demonstrates that an adult cell population can be rarmned simply by the
modulation of the growth factor environment both in vitro and in viva.
Now, as demonstrated herein, the inventors show that corneal stromal cells
can be d in vitro and ex vivo to produce cartilage specific fibrillar collagen,
collagen type II, by treating the cells with transforming growth factor B3 (TGFB3) and
dexamethasone (Examples 8 and 9). In particular, the inventors have demonstrated that
keratocytes in human keratoconic corneal biopsies express collagen type II when treated
with these two compounds (Example 8). In addition, with animal studies, the inventors
have demonstrated that the two compounds of TGFB3 and dexamethasone can be
delivered in viva using eye drops to stimulate collagen II deposition le 9).
Notably, the deposition of collagen type II was uniform, improving the biomechanics of
the cornea, with no fibrosis or scarring, and no effect on corneal transparency (Examples
11 and 13).
Without wishing to be bound by theory, it is esised that the collagen
deposition is brought about by the reprogramming of cells within the stroma to a
chondrocyte phenotype. It is known that chondrocytes secrete type II collagen which is
not only a fibrillar collagen similar to type I found in the cornea, but is also expressed
W0 2016/140581
during development of the chick cornea (Linsenmayer et al. 1990). It is only later
replaced by collagen type I in the mature stroma (Linsenmayer et al. 1990).
In the results described herein, an initial se in collagen type I
expression was observed upon ent of corneal keratocytes with TGFB3 and
dexamethasone (Example 12). However, the inventors er that the observed level
of en type I deposition would be insufficient to stiffen/reshape a cornea.
Furthermore, the tion of collagen type II is deemed more feasible as a treatment
gy. It is noted that collagen type II is less susceptible to enzymatic degradation, for
example, by enzymes present in a keratoconic cornea.
In accordance with the inventors’ s, it is le to use the
reprogramming ofkeratocytes to e new ECM molecules as an effective treatment
to improve the biomechanical characteristics of the cornea. This approach is ered
advantageous, as it reduces susceptibility to degradation by corneal enzymes, as noted
above. The disclosed treatment module aims not only to stabilise the
cornea, but also to
provide remedial aid for conditions of the eye, including various corneal conditions and
refractive errors ofthe eye. Thus, the methods ofthe invention
may be used, for example,
for the treatment of keratoconic keratocytes in the ectatic cornea. Additionally, the
methods of the invention may be used for the treatment of myopia and various other
conditions of the cornea, as described in detail .
Conditions affecting the eye and cornea
The itions described herein find particular use in regenerating
augmenting the cornea (e.g., the stromal layer), as well as corneal cells (e.g., keratocytes).
The compositions may be used to address corneal thinning, weakening, cell loss, tissue
loss, matrix loss, collagen loss, and/or irregularity. In this way, the compositions
described herein may be utilised for various conditions affecting the eye, including
ions involving corneal defects, disease, damage, injury, and/or degeneration,
well as refractive errors of the eye.
In specific aspects, the invention
encompasses s for treating defects
of the cornea. In certain situations, the methods of the ion
may also be used to
prevent corneal defects. The defects may be associated with a particular ion of the
cornea. ary conditions include keratoconus, as described in detail herein, and
related conditions, which include corneal ectasias such as keratoglobus, pellucid
marginal degeneration, and posterior keratoconus (see, e.g., Arffa 1997; Krachmer et al.
W0 2016/140581
1984; Rabonitz 2004; Jinabhai et a1. 2010). Specifically included as defects are ,
presbyopia, and also astigmatisms, which encompass regular and irregular astigmatisms.
Congenital defects of the cornea are also included. Amongst these are cornea plana and
microcomea, the latter of which may be associated with fetal alcohol syndrome, Turner
syndrome, Ehlers-Danlos syndrome, Weill-Marchesani syndrome, Waardenburg's
syndrome, Nance—Horan syndrome, and Cornelia de Lange's syndrome. Included also is
globus (mentioned above) that may be associated with Ehlers-Danlos syndrome
type IV.
In further aspects, the invention
encompasses methods for treating damage
or degeneration of the cornea. In certain situations, the methods of the invention
may be
used to t l damage. Damage or degeneration
may be associated with a
particular condition of the cornea. Specifically included is corneal melt, for example,
corneal melt associated with an inflammatory disorder, such as rheumatoid arthritis.
Other exemplary conditions include keratitis, such
as marginal keratitis, stromal keratitis,
exposure keratitis, neurotrophic keratitis, tary keratitis, rosacea keratitis, Viral
keratifis including herpes keratitis, fiingal keratitis, protozoal keratitis, and other
infectious keratitis, such as luetic interstitial keratitis, microsporidial tis,
Thygeson's keratitis, and infectious crystalline keratopathy. Included also is ulcerative
keratitis, also called peripheral ulcerative keratitis (PUK), which includes ulcerative
keratitis that is ated with a systemic disease, such
as toid arthritis Wegener's
granulomatosis, systemic lupus erythematosus, relapsing ondritis, and
polyarteritis nodosa. Endophthalmitis is also ed. Included as well are chronic
corneal edema, Mooren's ulcer, dellen, phlyctenulosis, Terrien's ration,
Salzman's
degeneration, spheroidal degeneration, and Fuch’s phy. Such conditions
are well
known and well characterised in the art. See,
e.g., Jackson 2008; Denniston 2009; and
Willshaw et al. 2000. Additionally included are stromal dystrophies, for
example, lattice
corneal dystrophy (e.g., type I and type 2), granular corneal dystrophy (e.g.,
type 1 and
type 2), macular l dystrophy, Schnyder l dystrophy, congenital stromal
corneal dystrophy, and fleck corneal dystrophy.
] In still fiirther aspects, the invention
encompasses methods for treating injury
to the cornea. Included are injuries due to physical damage, chemical
damage, radiation
damage, and/or damage from particular medication. Injury may be associated with
corneal abrasion, corneal erosion, corneal
puncture, ne rupture, corneal scarring,
W0 2016/140581
or l ulcers, including melting ulcers, indolent ulcers, and superficial ulcers.
Included also are injuries and other damage associated with eye surgery, including
surgical wounds, corneal damage following radial keratectomy, and acute problems
following plasty, which include persistent lial defects. Additionally included
are injuries associated with corneal melt, for example, corneal melt ing surgery or
other treatments of the eye (e.g., topical NSAID administration). l melting may
be attributable to infectious, inflammatory, or trophic causes. Included also are injuries
and damage of the cornea associated with aging.
In even further aspects, the invention asses methods for treating or
preventing refractive errors of the eye. Such refractive errors may be associated with
particular conditions, including myopia, hyperopia, presbyopia, anisometropia, higher
order aberrations, and various astigmatisms. Higher order aberrations include, but are not
limited to, comas, trefoils, quadrafoils, spherical aberrations, and aberrations identified
by mathematical expressions (e.g., Zemike polynomials).
Conditions of the cornea may be diagnosed by s methods, including
fluorescein staining, which may include a Seidel's test, specular microscopy, corneal
topography, isometric tomography, pachymetry, ultrasound, slit lamps, corneal scrapes,
and biopsies. Diagnosis may also e assessments for visual acuity and/or
opacification. l conditions may be associated with one or more symptoms of:
pain, photophobia, foreign body ion, reduced Visual acuity, oedema, white cell
infiltrate, fluorescein uptake, vascularisation, redness, and systemic symptoms such as
headaches, nausea, and fatigue. rly, symptoms of refractive errors may include but
are not d to: reduced visual acuity as well as blurry , double vision, haziness
of vision, visual fatigue, foreign body sensation, problematic glare or halos, starburst
patterns, ghost images, impaired night Vision, ing, excessive staring, excessive
blinking, headaches, eye rubbing, eye strain, eye surface dessication, eye tion,
redness, and spasms of the eye.
Therapeutic compositions
As noted above, the itions described herein may be ed for
treating and/or preventing various conditions of the eye, ing conditions affecting
the cornea and refractive errors of the eye. The compositions may include a TGFBS
polypeptide, or variants or fragments thereof, along with dexamethasone, or derivatives
thereof or related steroidal agents.
W0 2016/140581
In various aspects, the composition may be formulated to include the noted
combination ofcomponents (a TGFB3 polypeptide (or variants or fragments thereof) plus
dexamethasone (or derivatives for related steroidal agents)), or may be formulated
to include a first component (a TGFB3 polypeptide (or ts or fragments thereof) or
alternatively dexamethasone (or derivatives thereof or related steroidal agents)) with the
second component to be added in prior to administration. atively, the ition
may be formulated to include a first component (a TGFB3 polypeptide (or variants or
nts thereof) or atively dexamethasone (or derivatives thereof or related
steroidal agents)), which is used in simultaneous or sequential administration with a
formulation that includes the second component.
In one aspect, the TGFB3 polypeptide may e at least the following
amino acid sequence: ALDTNYCFRN LEENCCVRPL YIDFRQDLGW
KWVHEPKGYY ANFCSGPCPY LRSADTTHST VLGLYNTLNP EASASPCCVP
QDLEPLTILY YVGRTPKVEQ KSCK CS (SEQ ID NO:1) (GenBank
Reference CAR70088.1). The TGFB3 polypeptide may include at least 112 amino acids
shown above, and may have a molecular mass of 25.5 kDa. Alternatively, the TGFBS
polypeptide may be derived from amino acids 644—850 (207 amino acids) ofthe precursor
polypeptide sequence identified in k Reference CAA33024.1; GenBank
Accession No. CAA33024; or NCBI Reference Sequence 230.1.
In other aspects, a TGFB3 variant or fragment may be utilised. For e,
the variant or fragment may exhibit at least 75% sequence identity to SEQ ID NO:1,
preferably at least 80% identity, more preferably at least 85%, most preferably at least
90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at
least 97%, at least 98%, at least 99% or about 100% sequence ty to SEQ ID N021,
as described herein. It is ofparticular interest where the TGFB3 variant exhibits biological
activity, for example, activity that is similar or improved compared to the non—variant
polypeptide
In further s, a particular fragment may be utilised. For example, the
TGFB3 fragment may comprise at least 80 amino acids, at least 85 amino acids of SEQ
ID NO:1, more ably at least 90 amino acids, at least 91 amino acids, at least 92
amino acids, at least 93 amino acids, at least 94 amino acids, at least 95 amino acids, at
least 96 amino acids, at least 97 amino acids, at least 98 amino acids, at least 99 amino
acids, most preferably at least 100 amino acids, at least 101 amino acids, at least 102
W0 40581
amino acids, at least 103 amino acids, at least 104 amino acids, at least 105 amino acids,
at least 106 amino acids, 107 amino acids, 108 amino acids, 109 amino acids, 110 amino
acids, or 1 11 amino acids ofSEQ ID NO:1. Ofparticular interest are functional fragments
of TGFB3, for example, fragments that exhibit biological ty, for example, activity
that is similar or improved compared to the reference polypeptide.
In a particular aspect, the TGFB3 polypeptide or the variant or fragment
thereof may be provided as a recombinant ptide. For example, the polypeptide
may be expressed in cell or cell-free expression systems as widely known and used in the
art. Included amongst these are bacterial, fungal, plant, and mammalian expression
systems. sion systems using E. coli cells, CHO cells, HEK cells, and Nicotiana
benthamiana cells are specifically included. The TGFB3 polypeptide or the variant or
fragment thereof may be provided as a human recombinant polypeptide expressed in
human or non-human expression systems. The TGFB3 polypeptide or the variant or
fragment thereof may be provided as a disulfide—linked homodimeric, non-glycosylated,
polypeptide chain, in accordance with known methods.
The TGFB3 polypeptide or the variant or fragment thereof
may be ed
from recombinant expression systems by standard methods, including well known
tographic techniques. The TGFB3 polypeptide or the variant or fragment thereof
may include a sequence tag to facilitate cleavage, isolation, and/or localisation of the
polypeptide. In accordance with the present invention, the TGFB3 polypeptide may be
ed from various commercial sources. For example, recombinant human TGFB3
may be obtained from R&D Systems (Catalogue Nos. 243-B3-002; 243-B3-010),
ion, Inc. ogue Nos. 4344-500; 4344-50; 4344-5), or c Protein
Specialists (Catalogue Nos. CYT-113; CYT-319).
The biological activity of the TGFB3 polypeptide or the variant
or fragment
thereof may be measured in accordance with widely known and used methods. For
example, biological activity may be measured in e by the polypeptides ability to
inhibit the mink lung lial (leLu) cells proliferation (see,
e.g., Premaraj et a1.
2006). Exemplary activity by this measurement is shown by an EDso of S 50 ng/ml.
Alternatively, biological activity may be ed by the dose-dependent inhibition of
IL—4 induced proliferation of mouse HT—2 cells (BALB/c spleen ted by sheep
erythrocytes in the presence of IL-2) (see, e.g., Tsang et al. . Exemplary activity by
this measurement is typically 0.1 to 0.5 ng/ml. Alternatively, the composition that
W0 2016/140581 2016/050033
includes the combination of agents described herein may be measured for biological
activity using the methods noted below. For example, induction of collagen type II (e.g.,
collagen type II, alpha 1) in keratocytes can be assessed by one or more of:
immunohistochemical assays, n assays, Western blot analysis, polymerase chain
reaction (PCR) analysis, and quantitative PCR technologies.
As described herein, the composition may also include dexamethasone, a
derivative f, and/or a related steroidal agent. Dexamethasone is characterised as
having the following chemical structure:
The trade names for dexamethasone include, for example, on®,
Dexasone®, ®, Hexadrol®, Maxidex®, and Minims®.
In various s, derivatives of dexamethasone may be used, including any
esters and salts thereof. Exemplary derivatives include but are not limited to:
dexamethasone-l7-acetate (CAS RN: 11773), dexamethasone disodium phosphate
(CAS RN: 2392—3 9—4), thasone valerate (CAS RN: 14899-3 6-6), dexamethasone-
21-isonicotinate (CAS RN: 22657), dexamethasone palmitate (CAS RN: 33755
3), dexamethasone propionate (CAS RN: 555415), dexamethasone acefurate (CAS
RN: 83 880—70-0), dexamethasone—21-galactoside (CAS RN: 92901—23—0),
thasone 21-thiopivalate, dexamethasone 21-thiopentan0ate, dexamethasone 21-
thiolmethyl-butanoate, thasone 21—thiolmethyl-butanoate, thasone
21—thiohexanoate, dexamethasone 2l—thiolmethyl—pentanoate, dexamethasone 21—
thiol-3,3 -dimethyl-butanoate, dexamethasone 21—thiolethy1—butanoate,
dexamethasone 2 l ctan0ate, dexamethasone 2 l -thiolethyl-hexan0ate,
dexamethasone 2 1 -thiononanoate, dexamethasone 2 l ecanoate, dexamethasone 2 1 -
p-fluorothiobenzoate or a combination thereof. Specifically included are dexamethasone
alcohol and dexamethasone sodium phosphate. Dexamethasone derivatives are also
included, as described in US 4177268.
W0 2016/140581
The composition may include related steroidal agents, in lieu ofor in on
to dexamethasone. For example, other corticoid steroids may be utilised, in replacement
ofor along with dexamethasone. Preferred for use as related steroids are Group C steroids
according to n classification, which includes thasone—type steroids, such
as dexamethasone, thasone sodium phosphate, betamethasone, thasone
sodium phosphate, and fluocortolone. Other related steroidal agents include but are not
d to: fluoromethalone, lotoprendol, medrysone, prednisolone, prednisone,
rimexolone, hydrocortisone, lodoxamide, or any tive or combination thereof.
Specifically included are fluoromethalone acetate, fluoromethalone alcohol,
prednisolone acetate, predrn'solone sodium phosphate, lotoprendol etabonate,
hydrocortisone e, and lodoxamide tromethamine. It is understood, for any of the
chemicals of this sure, that the chemicals may be in various modified forms such
as acetate forms, and sodium phosphate forms, sodium salts, and the like.
The composition may include, for example, 0.04 ng/ml to 4 ng/ml; or 0.04
ng/ml to 0.4 ng/ml; or 0.4 ng/ml to 4 ng/ml; or 4 to 40 ng/ml; or 40 ng/ml to 400 ng/ml,
or 40 ng/ml to 4000 ng/ml thasone, or derivative f or related steroidal agent;
or about 0.04 ng/ml, about 0.08 ng/ml, about 0.12 rig/ml, about 0.4 ng/ml, about 0.8
ng/ml, about 1.2 ng/ml, about 4 ng/ml, about 12 ng/ml, about 24 ng/ml, about 40 ng/ml,
about 80 ng/ml, about 120 ng/ml, about 240 ng/ml, about 400 ng/ml, about 800 ng/ml,
about 1000 ng/ml, about 1600 ng/ml, about 2000 ng/ml, about 2400 ng/ml, about 3200
ng/ml, or about 4000 ng/ml dexamethasone, or derivative thereof or related steroidal
agent.
As further examples, the composition may include 0.4 pg/ml to 40 ug/ml; or
0.4 ug/ml to 4 ug/ml; or 4 ug/ml to 40 ug/ml dexamethasone, or derivative thereof or
related steroidal agent; or about 0.4 ug/ml, about 0.8 ug/ml, about 1 ,
about 1-2 ug/ml, about 2 pig/ml, about 4 ug/ml, about 8 ug/ml, about 12 ug/ml, about 20
ug/rnl, or about 40 pg/ml dexamethasone, or derivative thereof or related steroidal agent.
As yet further examples, the composition may include 0.1 mg/ml to 1 mg/ml;
or 0.5 mg/ml to 5 mg/ml; or 1 mg/ml to 10 mg/ml; dexamethasone, or derivative thereof
or related steroidal agent; or about 0.1 mg/ml, about 0.5 mg/ml, about 1 mg/ml, about 2
mg/ml, about 5 mg/ml, or about 10 mg/ml dexamethasone, or derivative thereof or related
steroidal agent.
W0 2016/140581
The composition may include, for example, 1 ng/ml to 1 pig/ml; or 1 ng/ml
to 10 ng/ml; or 10 ng/ml to 100 ng/ml; or 100 ng/ml to l rig/ml TGFB3 ptide or
variants or fragments thereof, or about 1 ng/ml, about 5 ng/ml, about 10 ng/ml, about 20
ng/ml, about 50 ng/ml, about 100 ng/ml, about 200 ng/ml, about 500 ng/ml, about 800
ng/ml, or about 1 rig/ml TGFB3 polypeptide or variants or fragments thereof. In particular
s, the composition may include at least 40 ng/ml dexamethasone, or derivative
thereof or related steroidal agent, along with at least 4 ng/ml TGFB3 polypeptide, or
variants or fragments thereof.
The composition may also include one or more nflammatory agents.
Exemplary anti-inflammatory agents include, at least, ketotifen fumarate, enac
sodium, flurbiprofen sodium, ketorlac trometharnine, suprofen, celecoxib, naproxen,
rofecoxib, or any derivative or combination thereof. Particularly included are non-
steroidal anti-inflammatory drugs (NSAIDs). The composition may additionally include
one or more anaesthetic agents. Exemplary hetics include, at least, topical
anaesthetics such as proparacaine, lidocaine, and tetracaine, and any derivative or
combination thereof. Other agents for the eye may be selected for inclusion with the
ition; these may be chosen by the skilled artisan based on the ion and needs
of the subject under treatment.
The compositions as described herein may be formulated for topical
administration, as described herein and in accordance with known s. In certain
circumstances, intraocular administration may be desirable. The composition may be
provided in any form suitable for administration to the eye. Exemplary formulations
include, at least, solutions, sions, ons (dispersions), gels, creams, or
ointments in a suitable ophthalmic vehicle. For example, the composition may be
provided in the form of eye drops, a semisolid gel, or a spray. In certain aspects, moulding
contact lenses or other inserts/implants may be impregnated with the composition of the
invention. In this manner, the composition can be delivered to the cornea continuously
and in a time-release manner as the subject is wearing the contact .
For topical administration to the eye, the itions may be formulated
with a pH range of 5.0 to 8.0. This pH range may be achieved by the addition of buffers
to the solution. It is preferred that the formulations are stable in buffered solutions. That
is, there is no e ction between the buffer and the active agents that would
cause the composition to be le, e.g., by precipitation or aggregation. The
W0 2016/140581
be hypertonic (5% to 40%, preferably approximately
. composition may 10, 20, 30, or
40%) or hypotonic (0% to 5%, preferably approximately 1, 2, 3, or 4%) depending on
the needs of the subject (e.g., working needs, rest hours, sleeping, etc.) A hypertonic
composition (e.g., 40%) may be used when combined with moulding t lenses, as
described in detail herein.
The compositions may e one or more suitable preservatives as optional
ingredients. le preservatives may be added to t contamination, for example,
bacterial contamination. Such agents may include, but are not limited to, benzalkonium
chloride, thimerosal, chlorobutanol, methyl paraben, propyl paraben, phenylethyl
alcohol, EDTA, sorbic acid, Onamer® M, and other agents lmown to those skilled in the
art, or any combination thereof. such preservatives may be typically employed at a level
of 0.001% to 1.0% by weight of the composition.
] The itions may contain an optional co-solvent. The solubility of the
components of the present compositions may be enhanced by a surfactant or other
appropriate co—solvent in the composition. Such vents/surfactants include, for
example, polysorbate 20, 60, and 80, p0lyoxyethylene/polyoxypropylene surfactants
(e.g. Pluronic® F-68, F-84, and P-103), cyclodextrin, tyloxapol, and other agents known
to those skilled in the art, and any combination thereof. Such co-solvents may be typically
employed at a level of 0.01% to 2% by weight of the composition.
Penetration enhancing agents may be used to se uptake of the
composition into the eye. Exemplary agents include, at least, cetylpyridinium chloride,
ionophores such as lasalocid, benzalkonium chloride, Parabens, Tween 20, saponins, Brij
, Brij 78, Brij 98, ethylenediaminetetraacetic acid, bile salts, and bile acids (such as
sodium cholate, sodium taurocholate, sodium eoxycholate, sodium
taurodeoxycholate, taurocholic acid, chenodeoxycholic acid, and ursodeoxycholic acid),
capric acid, azone, fusidic acid, hexamethylene lauramide, saponins, hexamethylene
octanamide, and decylrnethyl sulfoxide.
In addition, bioadhesive polymers may be used to adhere to the mucin coat
covering the eye, to prolong contact of the ition with the eye. Bioadhesive
polymers may be macromolecular hydrocolloids with numerous hydrophilic functional
, such as carboxyl-, hydroxyl-, amide, and sulphate capable of establishing
electrostatic interactions. Exemplary agents include, at least, polyarylic acid (e.g.,
carbopol, hil, and rbophil) and carboxymethyl cellulose.
W0 2016/140581
Controlled release systems may also be used; such systems may involve in
situ gels, colloidal particles, nanoparticles, and/or niosomes. Other drug delivery s
include but are not limited to: non-erodible ocular inserts, erodible ocular inserts,
hydrogels, collagen shields, liposomes, drug-loaded films (e.g., NOD®), and
ionotophoresis.
The compositions may e, also, an al agent to increase viscosity.
Viscosity increased above that of simple aqueous solutions may be desirable to increase
ocular absorption of the active compounds, to decrease ility in dispensing the
formulation, to decrease physical separation of components of a suspension or emulsion
of the ation and/or to otherwise improve the ophthalmic formulation. Such
Viscosity builder agents e as examples polyvinyl alcohol, polyvinyl pyrrolidone,
methyl cellulose, hydroxy propyl methylcellulose, hydroxyethyl cellulose,
carboxymethyl cellulose, hydroxy propyl cellulose, other agents known to those skilled
in the art, or a combination thereof. Such agents may be typically employed at a level of
0.01% to 2% by weight of the composition.
In particular aspects, the compositions include a gelling agent, for example,
high molecular weight water-soluble polysaccharides such as gellan gum. Gellan gum
may be obtained from various commercial sources, for example, as sold under the trade
name Kelcogel®. In particular, Kelcogel® LT100 may be used as a fine mesh, high acyl
gellan, which forms soft, c, non-brittle gels. In specific aspects, the gellan gum
based composition is formulated as a 0.5% eye drop
] Other agents may be used to further ise or otherwise enhance the
composition. For example, one or more of EDTA, sodium chloride, tyloxapol, sodium
sulfate, and/or hydroxyethylcellulose may have additional beneficial effects of further
stabilising the composition.
Therapeutic methods
As noted above, the compositions bed herein find particular use in
regenerating or augmenting the cornea (e.g., the stromal layer), as well as corneal cells
(e.g., cytes). In ular, the compositions may be used to provide enhanced
shaping, thickness, regularity, hardness, elastic modulus, e th, or functionality
(e. g., refraction) of the cornea. Thus, the compositions described herein may be used to
address various conditions of the cornea and correct refractive errors ofthe
eye, and may
be used as adjunct therapy with other eye treatments.
W0 2016/140581
As previously noted, the composition may be formulated in any suitable
means for administration to the eye. Included as formulations are ophthalmic solutions,
creams, emulsions, nts, and gels. Specifically noted are formulations that are made
as eye drops. In a particular aspect, the composition may be administered as an eye drop
using any of the many types of eye drop dispensers on the market. As exemplifications,
the container for the compositions ofthe invention may be clear, translucent, and opaque
and may n other properties or combination of properties such as being glass lined,
tamper proof, packaged in single or few dose aliquots, and any combination thereof.
The composition may be stered in therapeutically effective amounts
to a subject to e a desired medical outcome. In particular, the composition may be
administered in amounts to address an ophthalmic condition described herein, or at least
te one or more symptoms of such condition. The precise dosage ofthe ition
(i.e., amount and scheduling) may be determined by a clinician, based on the subject and
the condition presented. Exemplary formulations (e. g., eye drops) may be administered
1 to 24 times per day, or 1 to 12 times per day, or 1 to 6 times per day, or 1 to 4 times per
day, or 1 to 3 times per day, or 1 to 2 times per day, or 1, 2, 3 4, 6, 8, 12, 18, or 24 times
per day. The composition may be topically applied as an eye drop by placing one drop in
each eye to be treated. Alternatively, 2 to 3 drops may be applied to each eye.
For the described composition, the dosage range may be, for example, 0.2 pg
to 2.4 ng; or 2 pg to 2.4 ng of dexamethasone, or tive f or related steroidal
agent; or about 0.2 pg, about 0.4 pg, about 0.6 pg, about 0.8 pg, about 1.2 pg, about 2.4
pg, about 2 pg, about 4 pg, about 6 pg, about 8 pg, about 12 pg, about 18 pg, about 24
pg, about 0.2 ng, about 0.26 ng, about 0.4 ng, about 0.6 ng, about 0.8 ng, about 1.2 ng,
about 1.8 mg, or about 2.4 ng of thasone, or derivative thereof or related steroidal
agent, per eye for one dose.
As other examples, the dosage range may be 12 ng to 1.3 ug; 0r 6 ng to
600 ng dexamethasone, or derivative thereof or related steroidal agent; or about 6 ng,
about 8 ng, about 12 ng, about 16 ng, about 18 ng, about 24 ng, about 26
ng, about 30 ng,
about 36 ng, about 40 ng, about 48 ng, about 52 ng, about 54 ng, about 60
ng, about 72
ng, about 78 ng, about 80 ng, about 90 ng, about 120 11g, about 130 ng, about 160 ng,
about 180 ng, about 240 ng, about 260 ng, about 300 ng, about 360
ng, about 400 ng,
about 480 ng, about 520 ng, about 540 ng, about 600
ng, about 720 ng, about 780 ng,
W0 2016/140581
about 900 ng, about 1.2 pg, about 1.3 pg of dexamethasone, or derivative thereof or
related dal agent, per eye for one dose.
As still other examples, the dosage range may be 1.5 pg to 150 pg; 2.6 pg to
260 pg; or 6.5 pg to 650 pg of dexamethasone, or derivative thereof or related dal
agent; or about 1.5 pg, about 2 pg, about 3 pg, about 4.5 pg, about 6 pg, about 6.5 pg,
about 7.5 pg, about 10 pg, about 15 pg, about 22.5 pg, about 32.5 pg, about 20 pg, about
26 pg, about 30 pg, about 40 pg, about 45 pg, about 60 pg, about 65 pg, about 75 pg,
about 80 pg, about 90 pg, about 100 pg, about 120 pg, about 130 pg, about 150 pg, about
180 pg, about 225 pg, about 240 pg, about 260 pg, about 200 pg, about 300 pg, about
325 pg, about 450 pg, about 600 pg, or about 650 pg dexamethasone, or derivative
thereof or related dal agent, per eye for one dose. It will be recognised that specific
formulations of dexamethasone are commercially available, and such may be utilised in
accordance with accepted dosage amounts and scheduling.
Any of the above noted dosages of dexamethasone may be co-administered
with a dosage range of, for example, 5 pg to 65 ng; or 0.5 ng to 65 ng of TGFB3
polypeptide, or variants or fragments thereof; or about 5 pg, about 10 pg, about 15 pg,
about 20 pg, about 30 pg, about 45 pg, about 60 pg, about 0.05 ng, about 0.1 ng, about
- 0.15 ng, about 0.2 ng, about 0.3 ng, about 0.45 ng, about 0.5 ng, about 0.6 ng, about 0.65
ng, about 1 ng, about 1.5 ng, about 2 ng, about 3 ng, about 4 ng, about 4.5 ng, about 6
ng, about 6.5 ng, about 7.5 ng, about 9 ng, about 10 ng, about 12 ng, about 13 ng, about
ng, about 16 ng, about 20 ng, about 22.5 ng, about 24 ng, about 30 ng, about 32.5 ng,
about 36 ng, about 40 ng, about 45 ng, about 48 ng, about 50 ng, about 52 ng, about 60
ng, or about 65 ng of TGFB3 polypeptide, or variants or fragments thereof, per eye for
one dose.
Dosage for one eye may be about one drop ofthe sed composition. One
drop of composition may be 10 pl to 200 pl, 20 pl'and 120 pl, or 50 pl to 80 pl or any
values in between. For example, dispensers such as pipettors can dispense drops from 1
pl to 300 p1 and any value in between. Preferably, the dispenser metes out about 15 pl,
about 20 pl, about 30 pl, about 45 p1, about 60 pl, or about 65 pl per drop ofthe disclosed
composition.
Where the composition is administered via a t lens or another
/implant , the contact lens or insert/implant may include, for example,
0.01 mg to 10 mg of dexamethasone, or derivative thereof or related steroidal agent; or
W0 2016/140581
about 0.01 mg, about 0.1 mg, about 0.5 mg, about 0.7 mg, about 1 mg, about 5 mg, or
about 10 mg of dexamethasone, or tive thereof or related steroidal agent.
Alternatively, the contact lens or insert/implant may include 10 ng to 100 ng of
thasone, or derivative thereof or related steroidal agent; or about 1 ng, about 5 ng,
about 10 ng, about 20 ng, about 50 ng, about 80 ng, or about 100 ng dexamethasone, or
derivative thereof or related steroidal agent. As further examples, the contact lens or
insert/implant may include about 10 ng to 1 ug of TGFB3 polypeptide, or variants or
fragments thereof; or about 10 ng, about 50 ng, about 100 ng, about 200 ng, about 500
ng, about 800 ng, or about 1 ug TGFB3 polypeptide, or variants or fragments thereof.
The compositions described herein may be used in conjunction with various
al procedures or other treatments. For e, the compositions can be used along
with surgical and non-surgical methods for the refractive correction of the eye.
Exemplary methods include but are not limited to: radial keratotomy (RK), including
mini asymmetric radial tomy (MARK), hexagonal keratotomy (HK),
photorefractive keratectomy (PRK), keratomilleusis, laser in situ keratomileusis
(LASIK), e.g., intraLASIK®, laser epithelial keratomileusis (LASEK), e.g., Epi-
LASEK, automated lamellar keratoplasty (ALK), laser thermal keratoplasty (LTK),
conductive keratoplasty (CK), limbal relaxing incisions (LRI), astigmatic keratotomy
(AK), epikeratophakia, anterior ciliary sclerotomy (ACS), scleral reinforcement surgery,
presbyopia reversal, laser reversal of presbyopia (LRP), omeal rings (ICR),
tromal corneal ring segments (e.g., INTACTS®), implantable contact lenses,
scleral expansion bands (SEB), and M . Also included are
thermokeratoplasty, orthokeratology, enzyme orthokeratology, and chemical
orthokeratology.
The compositions may be used in conjunction with surgical correction of
non—refractive conditions, for example, surgical correction of a corneal tear. In particular
aspects, the compositions described herein may be used in ction with specific
surgical methods performed on the cornea. ary methods include but are not
limited to: corneal transplant surgery, ating keratoplasty (PK), phototherapeutic
keratectomy (PTK), pterygium excision, corneal tattooing, keratoprosthesis insertion
(e.g., KPro or Dohlman-Doane), and osteo-odonto—keratoprosthesis insertion (OOKP).
The compositions may be used in conjunction with corneal collagen
crosslinking. Corneal crosslinking lly es the use of riboflavin solution
W0 2016/140581
activated by exposure to UV-A light. Noted inking methods include but are not
limited to: corneal inking with the epithelium removed (Dresden protocol, or epi-
oft), transepithelial crosslinking (epi-on), and accelerated inking. Crosslinking
procedures are generally available, and marketed as CXL, C3-R® CCL® and KXL®
l crosslinking, amongst . Administration of the composition may be prior to,
and/or subsequent to, the crosslinking procedure. It is proposed that the disclosed
compositions can be used to avoid or counter the deleterious effects of crosslinking
procedures, such as stromal haze and cell loss (described in more detail, below).
Moreover, corneal ration with the disclosed compositions can allow crosslinking
to be performed on subjects who were previously ineligible for such procedures, e.g.,
those with l ess less than 400 um. Furthermore, the disclosed compositions
can be used to slow or halt progressive corneal ng, which would not be addressed
by the use of inking on its own.
The compositions described herein may be co-administered with one or more
additional agents for the eye. In various aspects, co-administration may be by
simultaneous or subsequent administration with such agents, or by co-formulation with
such agents. Depending on the condition being treated or prevented, the compositions
bed herein may be co—administered with one or more agents, which include but are
not limited to: antihistamines, ‘sympathomimetics, beta receptor blockers,
parasympathomimetics, parasympatholytics, glandins, nutrients, vasoconstrictors,
lubricants, anti-microbials, and anaesthetics. Specifically included are various anti—
inflammatory agents, including non-steroidal nflammatory drugs (NSAIDs). The
compositions may also be co-administered with eye lubricating solutions and tearreplacing
solutions.
Non-limiting examples of hetics include: benzocaine, bupivacaine,
cocaine, etidocaine, lidocaine, mepivacaine, ine, prilocalne, chloroprocaine,
procaine, acaine, ropicaine, and tetracaine. miting examples of anti—
inflammatory agents include: aspirin, acetaminophen, indomethacin, sulfasalazine,
olsalazine, sodium salicylate, choline magnesium trisalicylate, salsalate, diflunisal,
salicylsalicylic acid, sulindac, etodolac, tolmetin, diclofenac, ketorolac, ibuprofen,
naproxen, flurbiprofen, ketoprofen, fenoprofen, suprofen, oxaproxin, mefenamic acid,
meclofenamic acid, oxicams, piroxicam, tenoxicam, pyrazolidinediones,
phenylbutazone, oxyphenthatrazone, pheniramine, antazoline, nabumetone, COX—2
W0 2016/140581
inhibitors rex®), apazone, nimesulide, and zileuton. Glucocorticoids such as
ortisone, prednisolone, fluorometholone, and dexamethasone may also be used as
anti-inflammatory agents.
Exemplary anti-microbial agents include but are not limited to: acin
zinc, mphenicol, chlorotetracycline, ciprofloxacin, omycin, gentamicin,
norfloxacin, sulfacetamide, sulfisoxazole, polymyxin B, tetracycline, tobramycin,
idoxuridine, trifluridine, vidarabine, acyclovir, foscarnet, ganciclovir, natamycin,
amphotericin B, mazole, econazole, fluconazole, ketoconazole, miconazole,
flucytosine, clindamycin, pyrimethamine, folinic acid, sulfadiazine, and hoprim—
sulfamethoxazole. Exemplary vasoconstrictors include but are net limited to: dipivefrin
(Propine®), hrine, phenylephrine, apraclonidine, cocaine, hydroxyamphetamine,
naphazoline, tetrahydrozoline, dapiprazole, betaxolol, carteolol, levobunolol,
metipranolol, and timolol. Nutrients include vitamins, minerals, and other beneficial
agents such as vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C (ascorbic acid),
vitamin E, vitamin K, and zinc.
] In specific s, the composition bed herein is formulated as eye
drops, and such eye drops are used in conjunction with other eye drop formulations. Such
other eye drops may include but are not limited to: rinse/lubricating eye drops, dry eye
treatments, steroid and antibiotic eye drops, glaucoma eye drops, allergy/anti—
inflammatory eye drops, and conjunctivitis eye drops.
The compositions may be used in conjunction with contact lenses, corneal
inserts, corneal implants, or intrastromal rings, to assist in supporting or reshaping the
subject’s cornea. Included amongst corneal inserts are l inlay and corneal onlay
devices. For example, contact lenses, intrastromal rings, or other inserts/implants may be
used for moulding or g corneal shape preceding, during, and/or ing
treatment with the composition. It is noted that a corneal ‘insert’ typically refers to a
temporary device inserted into the cornea, while a corneal ‘implant’ typically refers to a
more permanent device. However, many well known devices are described
interchangeably in the art as implants/inserts. Therefore, the terms insert/implant” as
used herein are not to be deemed as strictly limiting based on time of usage.
The contact lens, corneal insert, l implant, or intrastromal ring may be
used with the disclosed composition for treatment of corneal defects, diseases, damage,
injury, and/or degeneration, as well as refractive errors of the eye. In various aspects, the
W0 2016/140581
contact lens, corneal insert, corneal implant, or intrastromal ring may act as a carrier for
the composition or as a composition eluting device. In other s, the contact lens,
intrastromal ring, or other corneal insert/implant may be utilised with the composition
that is suitable for administration to the eye, e.g., eye drops, as described in detail herein.
In certain aspects, computer software may be used to determine the contact lenses,
corneal inserts, corneal implants, or intrastromal rings that are most suitable for the
subject and/or to determine the formulationof the composition. In particular aspects,
treatment utilising contact lenses, corneal inserts, corneal implants, or intrastromal rings
along with the composition described herein is used preceding or following eye surgery,
e.g., refractive or lant surgery.
The treatment may'involve assessing the subject (e.g., age, working needs of
the t, eye defect or e, etc.), prescribing the use of moulding t lenses,
corneal inserts, l implants, or intrastromal rings to assist with the needed changes
in the radius of curvature of the or surface of the cornea, and ibing the
composition described herein to be used in conjunction with the contact lenses or
implants/inserts. The contact lenses or implants/inserts which are prescribed and utilised
by the subject can be used exert a mechanical force on the cornea thereby inducing a
change in shape, i.e., the refractive power, of the cornea.
In certain preferred aspects, the cornea may be supported or shaped by use of
a corneal insert, corneal implant, or tromal ring in conjunction with the disclosed
composition. Examples of commercially available devices include INTACS® and
KeraRing intrastromal corneal rings. In another aspect, a moulding contact lens may be
used in conjunction with the disclosed ition. The contact lens
may be hard or
rigid, or it may be a soft lens. atively, the contact lens may se both hard and
soft portions. If a soft contact lens is used, more positive or negative curvature can be
induce in the cornea, and the discomfort in the subject's eyes will diminish as he or she
adapts to the contact lenses. If a hard contact lens is used, more mechanical pressure can
be exerted on the . The contact lenses may be gas permeable. Moulding contact
lenses may be ed from commercial s. Examples of commercially available
lenses include, at least, DreamLite, OK Lens, EyeDream, MiracLens, DreamLens, i-GO
OVC, GOV, Wake and See, CRT, Fargo/iSee, Emerald and Wave Contact Lens System
lenses.
W0 2016/140581
Once the contact lens, corneal insert, corneal implant, or intrastromal ring is
placed on/into the eye of the subject, the composition described herein (e.g., eye drops)
may be administered to the eye. In certain circumstances, it may be desirable to pre—
administer the composition prior to placement ofthe contact lens, l , corneal
t, or intrastromal ring. Advantageously, the contact , intrastromal rings, or
other inserts/implants and the composition may be used in ction to produce a
change in the shape, and thereby the refractive power, of the cornea. The composition
may be administered more frequently to allow the cornea to adopt the desired change in
shape. In certain s, the composition is administered at least every 24, 12, or 8 hours.
In other aspects, the composition is administered every 6 hours. In certain other aspects,
the composition is administered approximately every 3 hours. In yet other aspects, the
composition is administered approximately every 2 hours. In still other aspects, the
composition is administered every hour.
Without wishing to be bound by any particular theory, the combined use of
contact lenses, corneal inserts, corneal implants, or intrastromal rings and the
composition described herein may induce changes in the molecular structure of the
cornea and may induce changes in the cells and proteins such as collagen (e.g., collagen
type II) found in the corneal stroma. The surface of the cornea is thereby made more
uniform. By ng irregularities in the surface ofthe cornea, the quality and clearness
of all images (i.e., visual acuity) is improved.
For the calculation of the moulding contact lenses the flattest keratometry is
taken. One of skill in this art could also use the steeper keratometry or an average ofboth
and based on this corneal curvature make the necessary calculations to flatten or steepen
the radius of curvature ofthe anterior surface of the cornea and thus correct the refractive
defect of the eye. The base curve of the moulding contact lens may be calculated based
on the change in the refractive power for each eye separately. In ular aspects, the
base curve ofthe moulding contact lens may be calculated starting with one to four flatter
or steeper rs, more preferably one to three flatter or steeper diopters, even more
preferably one to two flatter or r diopters, ing on the tive error that is
required. The peripheral base curve depends on the tion of the moulding contact
lens and is calculated to be 0.5 mm of radius greater than the central zone, but can vary
depending on the design.
W0 2016/140581
The diameter of the moulding contact lens used in accordance with the
invention may be from 8.0 mm to 18.0 mm. Commercially available lenses are produced
with such diameters. In certain aspects, the moulding contact lens may be a hard contact
lens with a diameter ranging from 8.0 mm to 12.0 mm. In other aspects, the moulding
contact lens may be a soft contact lens with a diameter ranging from 13.0 mm to 15.0
mm. Soft contact lenses may cover the entire cemea and go from sclera to sclera. In still
other aspects, the moulding contact lens may be sed of hard and soft materials.
The contact lens may be hard in the , out to approximately 12.0 mm, 13.0 mm, 14.0
mm, or 15.0 mm, and then soft in the periphery out to 16.0 mm, 17.0 mm, and 18.0 mm.
A larger contact lens, preferably a soft contact lens, may be used at night as a moulding
contact lens.
The power of the moulding contact lenses can be determined to the nearest
possible tive power that the subject requires to see tably. During the
adaptation process 'with the moulding contact lenses, if the vision is not adequate for the
needs of the subject, the subject is prescribed sses while the subject is undergoing
treatment. As the cornea is being reshaped or has been reshaped, various optometric
measurements may be repeated to confirm that the treatment is progressing as planned
and is adequate. Such measurements may include assessment of visual acuity for near
and far vision, orthotypes, keratometry measurements, objective and subjective
retinoscopy, diagrams of the adaptation of the moulding contact lens, movement of the
moulding contact lens, and t of the moulding contact lens.
] After the measurements are taken, changes may be made to the ent
program based on these measurements. With each tion, a on may be made
whether to continue with the same moulding contact lens or whether a new contact lens
should be used. In addition, the same on can be made with regard to the composition
being used with the moulding contact lenses. Changes in the moulding contact lenses
and/or in the composition can be made to induce the desired ing of the cornea over
several weeks. In certain aspects, weekly periodic revisions are performed during the first
8 weeks after beginning ent.
The composition as described herein induces changes in the collagen content
of the cornea (e.g., collagen type II). Other aspects of the anatomy, histology, and
physiology of the cornea may also be affected by composition. In certain aspects, the
composition may be onic or hypotonic to induce changes in l hydration. In
W0 2016/140581
other aspects, the composition may be used to change the molecular structure of the
cornea (e.g., the extracellular ) and in this way augment or repair the cornea, or
reshape the cornea to the desired curvature.
When reshaping the cornea, it may be desirable to co-administer one or more
enzymes to soften the cornea. Exemplary enzymes include but are not limited to
hyaluronidase, chondroitinase ABC, chondroitinase AC, keratanse, and stromelysin,
which have been shown to work on various proteoglycan components of the cornea.
Included also are the enzyme collagenase, matrix metalloproteinase 1 (interstitial
collagenase), and matrix metalloproteinase 2 (gelatinase). Where the composition is co-
administered with any such s, it may be ble to include a vehicle such as a
polymer (e.g., methylcellulose, polyvinyl alcohol, cellulose, etc.) in the composition to
enhance the working of such enzymes. Additional agents may be included to activate
metalloproteinase s, e.g., interleukin-la, tumour necrosis factor u/B and any
subtypes thereof, monosodium urate drate, 4-amino mercuric acetate,
human serum amyloid A, human B2 microglobin, and copper de. Also included
may be carbamide (urea). Any combination of these agents may also be used.
The composition may also be co-administered with one or more enzymes that
degrade other sugars or proteins found in the cornea. The composition may be co—
administered with one or more anaesthetics used to reduce the irritation of the moulding
contact lens or any corneal /implant to the cornea. The ition
may be cc-
administered with one or more lubricants to improve the comfort of the subject during
the treatment. In other aspects, the composition may be co-administered with one or more
anti-microbial agents such as anti-bacterial, anti-viral, and/or anti-fungal agents. The
composition may also be co-administered with one or more vasoconstrictors. The person
of skill in the art can determine the appropriate agents for co—administration to the subject
based on the condition being treated.
In certain aspects, the composition may be provided in a kit. The kit
include one or more of: moulding contact lenses, ating
eye drops, cleaning or other
ons for the contact lenses, a contact lens ng case, an extra pair of contact
lenses, and instructions for wearing the contact lenses and using the ition. The
composition provided with the kit may be formulated to include the noted combination
of components (a TGFB3 polypeptide (or variants or nts thereof) plus
dexamethasone (or derivatives thereofor related steroidal agents», or the kit
may include
W0 2016/140581
the components as te formulations, to be mixed together prior to administration, or
to be administered together, i.e., by simultaneous or sequential stration.
EXAMPLES
The examples described herein are provided for the
purpose of illustrating
c embodiments and aspects of the invention and are not intended to limit the
invention in any way. Persons of ordinary skill can utilise the disclosures and teachings
herein to produce other embodiments, aspects, and variations without undue
experimentation. All such ments, aspects, and variations are considered to be part
of this invention.
Example 1: Overview of experiments
In previous experiments, the ors have shown that it is possible to direct
keratocytes to differentiate down a neuronal lineage. The experiments described herein have
aimed to investigate the potential of cytes to switch to
a chondrocyte-like cells that
secrete cartilage specific collagen type II. This type of cartilage is thought to be expressed
during development (Linsenmayer et a1. 1990). A further aim has been to establish whether
collagen type II deposition could be induced in vivo in the corneas of live rats and whether
this treatment positively affected the optical properties of the
corneas. A still further aim has
been to determine whether keratocytes in keratoconic tissue could be amenable to this
method of cell reprogramming and subsequent production of collagen
type II rich ECM.
Finally, the experiments have aimed to evaluate the effect of type II collagen deposition on
the biomechanical properties ofthe in vivo and ex vivo treated
corneas using nanoindentation
testing, a ineering approach that enables analysis of hardness and elastic s.
Example 2: Tissue samples
Human tissue
Cadaveric whole human corneas, keratoconic corneas ed at the time of
lant surgery, human limbal rims and surgeon cut DSEK caps (excess stromal tissue
from Descemet's stripping endothelial keratoplasty) were obtained from donors
sourced
h the New Zealand al Eye Bank (Auckland, New Zealand). Human limbal
rims were collected after the central corneal button had been removed for corneal
transplantation surgery leaving a 2 mm l margin from the limbal junction. Prior to
the use oftissue, research ethics approval and t
was obtained fiom the Northern X
Regional Human Ethics Committee. All , until use, was stored inNew Zealand Eye
Bank medium (2% FCS, 2 mM L-glutamine, 1 x Anti-Anti in Eagles MEM) and
W0 2016/140581
transported in New Zealand Eye Bank transport medium (Eye Bank medium
supplemented with 5% dextran).
Animal tissue
Ethics al for animal s was obtained from the University of
Auckland Animal Ethics Committee (application number R856). Eyes and cartilage from
6—8 week old adult male Wistar rats were obtained after euthanisation using a carbon
dioxide chamber. The Whole eye was removed from the animal and the cornea was
carefully dissected out using surgical scissors with the aid of a dissecting microscope.
The xiphoid process, which is part of the sternum that ns a thin, broad plate of
cartilage at its end, was dissected out using a scalpel blade. The animal tissue was washed
with povidone-iodine (PVP-I) and sodium thiosulphate. The excess fat and tissue
covering the cartilage was scraped away with a blade. Freshly ted eyes and
cartilage were stored for a minimal amount of time in phosphate ed saline solution
until use.
Example 3: Histological analysis
Tissue preparation and cryoseetioning
Corneal and cartilage pieces (2 mm x 2 mm) were ed in l
Cutting Temperature compound (OCT, Tissue-Tek, Sakura, The Netherlands) before
being snap frozen in liquid nitrogen. Sections 10-15 pm thick were cut using a Microm
HM550 Cryostat (Thermo-Scientific, USA) and mounted on SuperFrostTM Plus
electrostatic slides (Menzel-Glenser, Germany). Cryosections were stored at —20°C until
r use.
Cell and Tissue Culture
Tissue digestion and cell ation from human and rat corneas
Limbal rims were dissected to isolate stroma from sclera in a class II laminar
flow hood. Following this, the corneal epithelium and endothelium was gently scraped
off with a keratome and discarded. DSEK caps also received gentle scraping with a
keratome to remove the epithelium. Remaining stromal tissue was then digested in 0.4%
type II collagenase -Aldrich), in Hanks balanced salt solution ®, Life
Technologies) at 37°C with gentle mixing on an orbital shaker. A variety of digestion
times were used with 5 hours being the time required for optimal tissue digestion and cell
Viability.
W0 2016/140581
] Afier tissue digestion was complete the cells were ed by centrifiiging at
1200 rpm for seven minutes. The cells were then resuspended in a l amount ofan
appropriate cell culture medium and counted using a Leica DM IL bench top inverted
microscope and a Neubauer hemocytometer. A 1:1 ratio of cell suspension added to
trypan blue solution (0.04% trypan blue stock in PBS) was used with a minimum ofthree
counts per sample and the average value taken.
Cell culture of corneal keratocytes
All cell manipulations were performed in a class II laminar flow hood using
aseptic technique. Isolated keratocytes were cultured in either 12 or 24 well cluster plates
(Falcon) on plastic or glass coverslips in 2-3 ml of cell culture media. Cells were kept in
a humidified incubator at 37°C with 5% C02. Culture media was changed after 24 hours
then every two days subsequently or more frequently if required. Cultures were viewed
daily with a Leica DM IL bench top inverted microscope. For cell pellet culture, freshly
obtained cells after tissue were pelleted by centrifuging at 300 g for 7 minutes at 20°C in
a plastic conical tube. Appropriate culture media was added to the tubes. After 24 hours
of incubation at 37°C, the cells had contracted and formed a pellet which did not adhere
to the walls of the tube. The pellets were cultured in 2 m1 of media in a humidified
atmosphere of 5% C02 at 37°C for three weeks. Media was d every other day.
Organotypic slice culture
Human and rat corneal and cartilage tissue was thin-sliced (1-2 mm) in an
anteroposterior plane with a blade and the slices were placed in an organotypic air-liquid
hase culture system (Figure 2). , the explants ofhealthy tissue were ed
on 0.4 pm pore size cell culture inserts (Millicell, France) at the interface between culture
medium and a C02 rich environment. Corneal sections were placed epithelium side up
on cell e plate inserts with 3 m1 of culture medium. The culture media was changed
every other day.
Example 3: In vitro reprogramming
Culture media
Several custom made media were used as bed in the table below.
Table 1: Cell culture media used
W0 2016/140581
Fibroblast Dulbecco's Modified Eagle 10% PBS, 1% Anti-anti (1OOX stock), 1%
eration Medium (DMEM) (Life GlutaMAXTM (IOOX stock)
medium lo ies, GIBCO®
ogenic Advanced DMEM (Life 10 ng/ml TGF[33 (Abcam, ab52313), 10-7M
reprogramming Technologies, GIBCO®) dexamethasone (Abcam, 43),
medium 1% GlutaMAXTM (Life Technologies,
GIBCO®) (100X stock), 1% Anti-Anti
lOOX stock (Life Technolo ies, GIBCO®
Control medium Dulbecco's Modified Eagle 1% GlutaMAXTM (100X stock), 1% Anti-
Medium (DMEM) Anti lOOX stock
Chondrogenic reprogramming of cytes
Tissue slices were cultured in the chondrogenic differentiation medium for
varying time intervals to determine the m time required for the growth factor
treatment. Samples were collected for each time point (Table 2). For obtaining a
monolayer of cells, keratocytes were seeded on glass coverslips at a density of 15 x 104
per cmz. The cells were allowed to attach to the coverslips for 24 hours and culture media
was changed every other day. Cultures were maintained for up to 3 weeks.
Table 2: Experimental time points for l tissue slice culture
Time point 1 Time point 1 Time point 1
Week 1 Week 2 Week 3
Sample 1 chondrogenic control medium control medium
differentiation medium
Sample 2 ogenic chondrogenic control medium
differentiation medium differentiation medium
Sample 3 chondrogenic chondrogenic chondrogenic
differentiation medium differentiation medium differentiation medium
Sample 4 control medium control medium control medium
Example 4: In vivo ramming
Gel eye drop formulation for growth factor delivery
Eye drops were formulated using gellan gum which is a water soluble
polysaccharide produced by the bacterium, Pseudomonas elodea. The use of gel base
formulation allows a prolonged corneal residence time and increased ocular
bioavailability of the therapeutic agent. Since polymeric gellan gum is an anionic
polymer it undergoes in situ gelling in the presence of mono- and divalent cations such
as Ca”, Mg“, K”, and Na+ (Bakliwal, & Pawar 2010)
. The electrolytes present in the
tear fluid cause the gelation of the polymer when it is instilled in the
eye and this in turn
results in a longer residence time and increased ilability of the drug
(Ludwig
W0 2016/140581
2005). Based on previous formulation studies, the polymer formulation is a non-irritant
and safe for in vivo use (Rupenthal, Green, & Alany 2011).
A 0.5% solution was prepared by first heating distilled water to 80°C followed
by the addition of gellan gum (KelcogelTM USA) with nt stirring. Once the powder was
completely dissolved, the solution was cooled and stored at 4°C. The appropriate amounts of
growth factors were added to the runny gel with constant stirring. A ten times higher
concentration of growth factors than that used in the culture medium was used to make
for the drug lost through naso—lacrymal drainage and blinking. The eye drop gel included a
final concentration of 100 ng/ml TGFB3 and approximately 4 [Lg/ml dexamethasone.
ent with neurogenic and chondrogenic factors
The animals were manually restrained and approximately 15 uL ofthe eye drops
were led in the right eye (Figure 3). The contra lateral eye was used as the control eye.
Thrice daily eye drops were administered for up to 5 days for neuronal specification and for
up to 8 weeks for chondrogenic specification.
Example 5: histochemical (IHC) analysis
Tissue harvesting and treatment
At the end of the ent the animals were euthanised using a carbon
dioxide chamber. The eyes were ted and rinsed in phosphate buffered saline. The
corneas were then dissected out carefully and fixed in 4% paraforrnaldehyde (PFA) for
1 hour and treated with sucrose solution in order to cryoprotect the tissue before freezing
and ning. Sucrose as a cryoprotection is a ant that prevents the formation of
ice crystal artefact in frozen tissue sections. In the case of slow ng of the tissue
cryoprotection is particularly important.
Briefly, the corneas were inunersed in 20% sucrose on for 5 hours at
4°C and then moved to a 30% sucrose solution and kept at 4°C until the tissue sinks
(usually overnight). The corneas were then embedded in OCT nd and immersed
in liquid nitrogen to bring about rapid freezing. The frozen blocks of tissue were stored
at -80°C until further use. Approximately 10-15 pm thick cryostat sections were mounted
on SuperFrostTM Plus slides and the slides were stored at -80°C until needed. In the case
of cell cultures, the cells cultured on lips were rinsed with PBS and fixed with 4%
PFA for 15 minutes. Coverslips were immersed in PBS until further use.
Immunohistochemistry
W0 2016/140581
For tissue cryosections, before carrying out immunohistochemistry, the
slides were kept at room temperature for 15-20 minutes. The OCT
was washed offusing
PBS and the zone around the tissue demarcated using a wax
pen. The tissue slices were
first incubated with a blocking solution of 10% normal goat serum for 1 hour followed
by overnight incubation with the appropriate on of primary antibody at 4°C. The
slides were then rinsed three times in PBS before incubation with the appropriate dilution
of secondary antibody. The secondary antibody was left on for 2 hours at room
temperature. Slices were counterstained with the nuclear marker 4’, 6’—diamidino
phenylindol (DAPI) and d in Citifluor antifade agent (ProSciTech, Australia). An
s FlroiewTM FV-lOOO confocal laser ng microscope (405 nm, 473 nm,
and 559 nm wavelength ) and Leica DMRA fluorescence microscope
were used for
imaging.
Table 3: Antibodies used
Antibod Su lier/Cat. No. Dilution used
Prima antibodies
Abcam/ab63080 12000
Mouse anti Collaen T ell Milliore/MAB8887 1:200
Mouse anti Colla_en Tpe III Bio_enesis/2150-0081 1:100
Mouse anti Vimentin iima/V6630 1 : 1000
'2Mouse anti0L Smooth muscle actin ovocastra/NCL-SMA 1:100
a dies
Goat anti mouse Alexa 568 Molecular orobes®/A-11031 1:500
Goat anti rabbit Alexa 488 Molecular Probes®/A-11034 1:500
Goat anti mouse Alexa 488 Molecular Probes®/A-11001 1:500
e 6: Gene expression analysis
RNA isolation and cDNA synthesis
The mRNA extraction from samples was carried out using the PureLink®
RNA MicroKit (Invitrogen). In brief, tissue s were mixed with 0.75 ml TRIzol®
and carrier RNA and homogenised using a hand held homogeniser (PRO Scientific, Inc.).
The samples where then incubated with 0.2 ml of chloroform followed by centrifugation
at 12000 rpm and 4°C for 15 minutes. The
upper phase was separated and was mixed
with ethanol and then transferred to the collection column tube.
] The RNA was collected on the column by centrifuging at 12000 rpm for 1
minute. The flow-through was discarded and the extracted RNA treated with
deoxyribonuclease ). The column was washed several times with the buffers
W0 2016/140581
provided and the RNA was finally dispersed in ribonuclease (RNAse) free water. The
tration was determined using a NanoDrop® (Thermo Scientific) and the
mRNA
was stored at -80°C.
The cript® VILOTM cDNA Synthesis Kit (InvitrogenTM, Life
Technologies) was used to prepare cDNA. Briefly, 100 ng ofRNA was incubated at 25°C
for 10 minutes with VILOTM Reaction Mix, SuperScript® Enzyme
Mix, and RNAse free
water. The samples were then incubated at 42°C for 120 minutes followed by
85°C
incubation for 5 s. The cDNA was stored at -20°C.
Quantitative PCR using TaqMan® gene expression
assays
TaqMan® Gene Expression Assays for the genes of interest were ed.
In the PCR step, 10 uL of TaqMan® Universal Master Mix
II was combined with 1 nL
of the assay, approximately 25
ng of cDNA and 9 uL water to make up a volume of 20
uL. The tubes were vortexed and centrifuged briefly to spin down the contents. Each
cDNA sample was prepared in triplicate and pipetted into
a 3 84 well plate. 20 uL of each
reaction mixture was loaded into each well of a MicroAmp® Optical
3 84-Well Reaction
Plate (Applied Biosystems). The plate was then covered with
a mp® Optical
Adhesive Film (Applied Biosystems) and the plate
was centrifuged briefly to eliminate
air bubbles. The plate was transferred to the 7900HT Fast
Real—Time PCR System and
was run using the following l cycling parameters, 50°C for 2 min, 95°C for
minutes followed by 40 cycles of 95°C at 15
sec and 60°C at 1 minute. Results were
analysed as described in the previous section.
Table 4: TaqMan® gene
assays used for QPCR
Gene 5 mbol Gene name Assa 1])
Collal (Rat Collaen, me I, al-ha 1 Rn01463848 ml
C012a1 Rat Collaen, e H, al-hal Rn01637085 ml
C012a1 Rat Colla_en, eII, alhal Rn01637087 m1
Pop4 (Rat) Ribonuclease P protein subunit p29 Rn02347225_ml
housekeeuin _ene
en, ‘0611, al ha 1 H800264051 ml
CDKN1A (Human)
Cyclin—Dependent Kinase Inhibitor 1 H3003 55782_m1
kee in; _ene
Example 7: g of biomechanical and optical properties of
corneas following in
situ stromal ECM protein deposition
Examination of or segment (frontal structures) of the
rodent eye
W0 2016/140581
] Corneal biomechanics have been shown to be relevant in the diagnosis and
treatment of various corneal diseases and provide insight into the structure of the
cornea
and its relation to corneal physiological function. Comeas that have undergone treatment
to bring about the deposition ofECM protein also need to be tested for l opacity
as reduced arency would be undesirable.
The Phoenix Micron IV Rodent eye Imaging System (Phoenix Research
Labs) was used to examine the corneas of treated rats. Rats were first sedated using an
intra—peritoneal injection of ketamine and Domitor® (3:2). The slit-lamp attachment of
the Micron IV imaging system was used to examine the layers ofthe
cornea in detail and
check corneal integrity and arency. Retinal imaging was also done to check corneal
transparency. ing imaging, the rats were administered Antisedan® (atipamezole)
for reversal of the sedative.
Nanoindentation measurements of in vitro and in vivo treated
corneas
] Nanoindentation provides mechanical ements of materials of interest
through the application ofultra-small forces perpendicular to the sample plane of interest
and measurement of the ant sample indentation (Dias & Ziebarth 2013).
Nanoindentation has recently emerged as a powerful tool for measuring nano- and
microscale mechanical properties in tissues and other biomaterials (Ebenstein & Pruitt
2006). The more recent advancement of in situ scanning probe microscopy (SPM)
imaging, Where the nanoindenter tip is simultaneously used as a 3D imaging device
combined with nanoindentation has enabled a new wave of novel materials
research
(Dickinson & Schirer 2009). Force, displacement, and time are ed simultaneously
while a nanoindentation tip is pushed into the corneal tissue under
a controlled load. The
forces applied during nanoindentation can be as small
as a few nanoNewtons or as large
as several Newtons ng a range of size scales to be studied. Nanoindentation
tests
are output as a load-displacement curve which can be analysed using well defined
equations to calculate the mechanical properties relating to rigidity, integrity, and
city of the cornea.
Human conic corneas were put into organotypic culture either in
control medium or in medium containing the specific ECM protein inducing
reprogramming factors. Nanoindentation measurements were then taken at the end ofthe
ent time. For the in vivo study, the animals were ly restrained and
W0 2016/140581
approximately 15 uL of the gel eye drop formulation containing the ramming
used
factors were instilled in the right eye of each Wistar rat. The contra lateral eye was
for up to seven weeks.
as the control eye. Eye drops were administered thrice daily
Nanoindentation measurements were ed after week 1, week 3, or week 7 of the
treatment period on isolated eyes.
Nanoindentation testing was carried out at the Chemical and Materials
Engineering lab at the University of Auckland. In order to test the cornea in its natural
position was ed for nanoindentation. Previous studies have used
a mould
yrene and blue tack to hold the corneas in place. The effect ofthe mould deforming
under the load was a potential source of error so a hard mould was decided on for testing.
The first material that was used to create a mould was conventional play dough. This was
formed to the exact shape and curvature of human cornea s (Figure 6(A)). The
play dough was then left to harden over the next two days before being used in testing.
The testing of the rat eyes was slightly different as the entire globe was used. To hold the
globes in place a petri dish filled with a resin and having small indent to hold the globe
was used (Figure 6(B)). PBS was used to keep the s from drying out.
Because the s are very soft biological samples a conospherical fluid
tip was used for all nanoindentation testing. The indent load used for the human samples
was 50 uN. For the rat globes a range of loads between 3 and 5 uN were used. The fibre
optic light was switched on and the sample placed ly under the stream of light from
the microscope. The central section of the cornea was placed directly in the stream of
light as accurately as possible (Figure 6(C)). The sample was focused by adjusting the Z
slider until the surface of the cornea could be observed in good resolution. To ensure that
the focus was on the central highest point of the cornea sample, the View was moved in
the x and y directions to e how the focus changed.
] Once the data collection point was focused on the centre of the cornea, the
sample boundary was defined and a quick approach was performed. Before indenting the
load function had to be set up correctly. The actual indentation process is automated by
the Hysitron Triboindenter® (Figure 6(D)). The pre—defined load was placed on the
indenter tip which penetrates the sample until it reaches a defined limit. The tip was then
held for 10 seconds before the tip was unloaded from the sample. The hardness of the
sample is determined by the area of residual indentation (Ar) after the tip is unloaded.
W0 2016/140581
m Load (P)
Hardness =W
Where Pmax is the maximum ation load and Area is the contact area of
the conospherical tip with the sample. The reduced elastic modulus is a representation of
the elastic modulus in both the sample and the indenter tip as shown by the following
equation:
1 1 - vi2 1 - va
‘ +
Er Ei Em
Where 1' referrers to the er and m refers to the sample material. The
reduced elastic modulus tells us how elastic a sample is. Because the same indenter tip is
used for each test the reduced elastic modulus can be used to compare the city in
each sample being tested.
Example 8: Adult human corneal keratocytes produce cartilage specific collagen
type II upon treatment with exogenous TGFB3 and dexamethasone
It is known that one growth factor may act on several types of cells With
similar or varied effects whilst more than one growth factor
may share r biological
functions. When choosing growth factors, cytokines, and chemicals that might bring
about en deposition in the corneal stroma it was important to consider the known
effects of certain exogenous factors. In the present experiments, a combination treatment
of TGFB3 and dexamethasone was utilised.
] Most ofthe evidence for the effects of TGFB3 and dexamethasone has been
obtained by studies done on their effects on stem/progenitor cells (Schuldiner, Yanuka,
itz-Eldor, Melton, & Benvenisty 2000; Worster, Nixon, Brower-Toland, &
Williams 2000). A combination of TGFB and dexamethasone has been usly used
to induce progenitor cells to differentiate into chondrocytes in vitro (Diekman, Rowland,
Lennon, Caplan, & Guilak 2009; Johnstoner et al. 1998; Kolambkar, Peister, Soker, Atala,
& Guldberg 2007; Winter et a1. 2003). Furthermore, dexamethasone, a synthetic d
drug has been used to treat inflammatory eye conditions. Therefore a combination of
TGFB3 and dexamethasone was used in the chondrogenic differentiation medium to drive
the differentiation of keratocytes s a chondrocyte phenotype.
W0 2016/140581
In the present experiments, the expression of type I and type II en was
specifically noted. It is known that fibrillar types of collagen such as types I and II self—
assemble and crosslink to form highly crystalline fibres exhibit a very high stiffness, low
extensibility and a remarkable elastic energy storage capacity (Wells 2003). It is the
crosslinking which contributes towards the stiffness and tensile strength of the fibres.
The corneal stromal extracellular matrix (ECM) is composed of tightly packed
heterotypic collagen fibrils made up mostly of collagen types I and V. r to corneal
fibrils, cartilage fibrils are heterotypic (made up of types 11 and XI) and have a uniform
diameter of 25 nm (slightly smaller than corneal ) (Mendler, ender, n,
Winterhalter, & Bruckner 1989). Collagen II is the major fibril component of cartilage and
is similar to en I in that the molecule essentially ts of a single uninterrupted
helical domain 300 nm in length. Owing to their similarities, collagens II and XI are
considered to be the cartilage analogues of collagens I and V (corneal stroma collagens) in
other tissues.
In the present experiments, corneal keratocytes from adult corneas were
seeded in either the chondrogenic differentiation medium containing TGFB3 and
dexamethasone or a standard fibroblast proliferation medium. Within 2-3 days the
keratocytes seeded in the chondrogenic differentiation media formed cell
ations/spheres (Figure 7(A)) approximately 50—100 pm in diameter. The spheres
ed for the chondrocyte c en type II in the central portion and nestin
around the periphery (Figure 7(B)). Furthermore, once the s were placed in the
fibroblast proliferation media cells from the spheres started spreading outwards (Figure
7(C)) to populate the culture dish thereby forming a cell monolayer. The regions where
the cells had once been aggregated labelled for collagen type II whereas the cells in
yer did not (Figure 7(D)).
Keratocytes seeded in the fibroblast proliferating medium formed an even
monolayer of fibroblast-like cells (Figure 8(A)) which did not label for either nestin or
collagen type II (Figure 8(B)). When the media was changed to chondrogenic
differentiation medium there were no s in the appearance of the culture and cells
remained collagen type 11 negative. These results suggest that cell aggregation appears
to be important for cartilage-like ECM production. Keratocytes seeded into fibroblast
proliferation medium failed to form the necessary cell aggregations. Therefore, in order
to form fibroblast clusters, the confluent fibroblasts were dissociated from the culture
W0 2016/140581
dish, ed, and grown as a pellet culture in chondrogenic differentiation medium for
a further three weeks. Cell pellets labelled positive for the corneal stroma specific ECM
n keratocan but not the cartilage specific ECM protein type II en (Figure 8(F)
and (G)).
Example 9: Keratocytes in adult human corneas and adult rat corneas secrete
collagen type 11 containing ECM when treated with TGF|33 and dexamethasone
Slices of adult human cornea were placed in organotypic slice culture in
either control medium or chondrogenic entiation medium for two weeks. The tissue
slices were then ed for the ocyte specific ECM n collagen type II and
the native corneal collagen type 1. Positive labelling was seen only in the TGFB3 and
dexamethasone treated corneas (Figure 9(C) and 10(B)). It was found that a treatment
period of two weeks resulted in deposition of type II collagen within the stroma] ECM
of treated corneas (Figure 9(C)). Treatment for 1 week did not result in any e
deposition of type II collagen in the stromal ECM (Figure 9(B)).
The amount and pattern of the native en type I appeared to be slightly
altered in the treated corneas. In general, the intensity of the labelling was similar but the
distribution was more extensive and the amount of labelling was higher in the untreated
corneas (Figure 9(D)). Furthermore, the newly produced type II collagen was laid evenly
and in an ordered fashion in the ECM without g any large masses or aggregates.
The labelling was clearly seen along the pre—existing collagen framework of the l
stroma and was distributed across the entire thickness of the stroma] layer.
The in vitro human corneal tissue experiment was then extended to an in viva
rodent study wherein the right corneas of male Wistar rats were d for two weeks
with a thrice daily stration of 15 ul of a gellan gum based eye drop formulation of
TGFl33 and dexamethasone. After two weeks the rats were euthanised and the corneas
processed for immunohistochemistry. Only the treated corneas labelled positive for
collagen type II with a higher degree of deposition observed in the anterior part of the
cornea (Figure 10(D) and (E)). Thus, only corneal slices cultured in the chondrogenic
differentiation medium were positive for type II collagen. Furthermore, type II collagen
was laid down in uniform layers along the pre-existing collagen framework ofthe stroma.
W0 2016/140581
Example 10: Induction of collagen type II deposition in conic corneas
The inventors next looked to confirm that the in viva reprogramming
observed in their studies could be utilised in treatments for keratoconus. Experiments
were carried out to affirm that keratocytes in conic
corneas were amenable to the
induction of collagen type II tion. Keratoconic corneal buttons obtained after
corneal transplant surgery were placed into culture
as soon as they were obtained. Half
of each button was put into control medium and the other half
placed in chondrogenic
differentiation medium and maintained for 2 weeks. After 2 weeks the tissue was
processed for either immunohistochemistry or mRNA extraction. The stromal ECM of
only the d half of the cornea was ve for type II collagen (Figure 11(B)).
Although the intensity of the ing was lower in keratoconic tissue when compared
to normal corneal tissue, the labelling pattern was similar and-followed an ordered
arrangement along the backbone of isting collagen lamellae.
Vimentin ing revealed stark differences between keratocytes in the
untreated and treated keratoconic corneas. In general the cyte density
was lower in
the untreated corneas with a scarcity of cells in the posterior
part of the cornea (Figure
11(C)). Also, the cytes in treated corneas appeared more tous and complete
in logy when compared to keratocytes in untreated
corneas (Figure 11(E) and
(F)). Keratocytes in treated corneas were longer and had a larger number ofcell
processes
which labelled strongly for Vimentin when ed to the keratocytes
in the untreated
corneas.
Example 11: TGFB3 and dexamethasone treatment does not induce deposition of
fibrotic proteins or cause corneal opacity
Human corneas cultured in the chondrogenic differentiation medium
for up
to three weeks were labelled for collagen type III and aSMA which
are associated with
fibrosis and scarring (Gabbiam' 2003; Karamichos et a1. 2012).
There was no evidence of
any fibrotic matrix deposition, on the other hand there was a higher degree of aSMA
labelling in the l tissue (Figure 12). These results confirm previous findings that,
unlike TGFBI and TGFBZ, TGFl33 does not induce the differentiation of corneal
keratocytes into myofibroblasts.
Slit lamp examination was performed on the live
rats throughout the study
period. Upon examination, treated and untreated corneas
were indistinguishable with no
signs of scarring or opacity. Back of the
eye imaging to reveal the blood vessels showed
W0 2016/140581
clear corneas which did not obstruct the passage of light (Figure 13(A) and (B)) and in
vivo cross section imaging ofthe rat cornea using the Micron IV lens revealed transparent
corneas through which light easily passed (Figure 13(C) and (D)). There was no Sign of
any corneal y or cloudiness which would lead to the obstruction of light g
through the cornea.
Example 12: Change in mRNA expression of collagen type II and type I upon
treatment in vivo
Rat s which were treated in vivo for 1 week, 7 weeks, and 3 weeks
followed by a non-treatment period of 4 weeks were subjected to quantitative gene
expression analysis. The aim was to determine whether type II collagen expression
decreases again and/or permanently ceases after growth factor treatment is withdrawn.
The effect of the treatment on native corneal collagen type II was also investigated.
] When compared to the 7 weeks treated corneas, the 1 week d corneas
expressed very high levels of type II collagen. The expression levels dropped
considerably upon withdrawal of the treatment as indicated by the first graph in figure
. For type I collagen expression, the 1 week and 7 week d corneas were each
compared to their untreated corneas. It was found that there was an l spike in type I
Collagen sion after 1 week treatment but by week 7 type I Collagen expression
was significantly lower and comparable to its expression in the untreated cornea (Figure
14 (13)).
Example 13: Change in biomechanical properties of in vitro and in vivo treated
C0rneas
It was hypothesised that the laying down of type II en would affect the
stiffness and elasticity of the corneas. In order to evaluate these changes, the in viva rat
corneas and ex Vivo treated human corneas and their matching controls were subjected to
nanoindentation testing.
When compared to the untreated controls the 1 week in vivo d rat
corneas did not have a significant increase in either hardness or elasticity (Figure 15). In
the 3 week in vivo treated corneas, there was a clear difference between the treated and
control eye. Each of the corneas was tested up to eight times and the resulting load
ation graphs obtained showed good reproducibility e 16). In the right eye
exposed to the growth factor treatment, both the hardness and reduced elastic modulus
were markedly higher. A matched pair toglobus corneas that were cultured
ex vivo
W0 2016/140581
in either the control medium or the chondrogenic differentiation medium for 6 weeks
were also subjected to the same biomechanical testing. Once again, testing revealed a
significant increase in hardness and elastic modulus in the treated cornea (Figure 17).
Example 14: Comparative combinations of growth factors and steroids
An ex vivo study on sheep corneas was carried out in order to investigate the
efficacy of other growth factor-steroid combinations in chondrogenic entiation of
corneal keratocytes.
Fresh sheep eyes were obtained from Auckland Meat Processors. The
corneas were immediately excised and washed with povidone-iodine (PVP-I) and sodium
thiosulphate Solution. Then, 8 mm discs of sheep corneal tissue were cut using a trephine.
One sheep corneal disc was placed in each of the culture conditions (outlined in Table 5)
for 3 weeks. The corneal discs were then placed in an organotypic air-liquid interphase
culture system.
, the explants of healthy tissue were cultured on 0.4 pm pore size cell
culture inserts cell, France) at the interface between culture medium and a C02 rich
environment. Corneal sections were placed epithelium side up on cell culture plate s
with 3 ml of e . The culture media was changed every other day. The basal
medium used was co's Modified Eagle Medium (DMEM) supplemented with 1%
Anti-Anti (antibiotic-antimycotic solution) and 1% GlutaMAXTM (GIBCO®). At the end
of 3 weeks, each corneal disc was fixed in 4% paraformaldehyde (PFA) for 1 hour and
treated with sucrose solution in order to cryoprotect the tissue before freezing and
sectioning.
] In brief, the corneas were immersed in 20% sucrose solution for 5 hours at
4°C and then moved to a 30% sucrose solution and kept at 4°C until the tissue sank
(usually overnight). The corneas were then embedded in OCT (optimal cutting
temperature) compound and immersed in liquid nitrogen to bring about rapid freezing.
The frozen blocks oftissue were stored at -80 °C until further use. imately 4—6 40
um thick cryostat ns were mounted on rostTM Plus slides and the slides were
stored at —80 °C until needed. The corneal sections were then labelled for collagen type
For immunohistochemistry, the slides were kept at room temperature for 15-
s. The OCT was washed off using PBS and the zone around the tissue was
demarcated using a wax pen. The tissue slices were first incubated with a blocking
W0 2016/140581
solution of 10% normal goat serum for 1 hr followed by overnight tion with mouse
anti en II antibody (Millipore/MAB8887) at 4°C. The slides were then rinsed three
times in PBS before incubation with the appropriate on of goat anti mouse Alexa
Fluor® 488 secondary antibody (Molecular Probes®/A—1 1001). The secondary dy
was left on for 2 hours at room temperature. Slices were counterstained with the nuclear
marker 4’, 6’—diamidinophenylindol (DAPI) and mounted in Citifluor antifade agent
(ProSciTech, Australia). An Olympus FlroiewTM FV-1000 al laser scanning
microscope (405 nm, 473 nm and 559 nm ngth ) and Leica DMRA
fluorescence microscope were used to visualise labelling.
Table 5 s the findings from this study. Figure 20 shows representative
images of collagen type II labelling in corneal sections, in each of the conditions.
Table 5: Tested combinations of growth factors and steroids
Growth factor—steroid combination Collagen type II deposition (Y/N) Representative image
BMP6
BMP6 + h drocortisone
TGF33+ h drocortisone iii
BMP6 + dexamethasone 2
TGF 33 + rednisone 2
TGF £3 + Triesense®
TGF 33+ dexamethasone ii
The results confirmed that the combination of TGFBB and dexamethasone is
the only tested combination that ed the desired response from the target cells (Figure
, panels G—H). The other growth factor-steroid combinations failed to produce the
desired s in collagen type II in keratocytes (Figure 20, panels A—F). The results
also confirmed the reprogramming of keratocytes in sheep corneas (Figure 20, panels G-
Previous studies have shown other growth factors and other steroid
compounds to be unsuitable for corneal treatment and repair. TGFISI and TGFpZ both
e fibrotic scarring ngton, Albon et a1. 2006; Desmouliere, Chaponnier et al.
2005; Jester, Huang et a1. 2002; Cowin et a1. 2001; Shah et a1. 1995). EGF negatively
regulates chondrogenesis (Yoon 2000). Estrogen also negatively regulates
chondrogenesis (Kato & Gospodarowicz 1985). Hydrocortisone has been shown to
promote adipogenic rather than chondrogenic differentiation (Ghoniem et a1. 2015; Lee,
Kuo et al. 2004). These earlier studies show the significance of the present findings on
W0 2016/140581
TGFB3 and dexamethasone, which act together to promote chondrogenic entiation
of corneal keratocytes and scar free corneal healing.
Example 15: Comparative dosages for TGFB3 and dexamethasone
Prior to an in vivo study, experiments were performed to identify the various
ive dosages for ex vivo treatments. A dose range study was carried out for TGFB3
and dexamethasone by culturing sheep corneas in culture media ning these two
s in varying concentrations.
Fresh sheep eyes were obtained and corneas were excised and treated as
noted in Example 14. One sheep corneal disc was placed in each of the 16 culture
conditions (Figure 21) for 3 weeks. The corneal discs were cultured and then subjected
to immunohistochemjcal and microscopic analysis as noted in e 14. Figure 21
shows representative images of collagen type II labelling in corneal sections in each of
the conditions.
This study revealed that lower concentrations of TGFB3 (2—4 ng/mL) and
dexamethasone (1-10 nM) had lower efficacy ex vivo (Figure 21, first and second rows).
Higher doses, i.e., 8—10 ng/mL TGFB3 and 100-1000 nM thasone were efficient
in inducing collagen type II deposition (Figure 21, third and fourth rows).
These results confirmed the use of 100 nM thasone and 10 ng/mL
TGFB3 as effective concentrations (Figure 21, third row). Higher concentrations of
dexamethasone (1000 nM, i.e., 400 ng/mL) were also shown to be effective (Figure 21,
fourth row). It was noted that the dexamethasone trations tested in this study were
considerably lower than the concentrations used in cially ble eye drops
(i.e., 1 mg/mL dexamethasone).
Example 16: Overview of experimental observations and results
] A combination of TGFBl and dexamethasone has been previously used to
induce progenitor cells to differentiate into chondrocytes in vitro (Diekman et al. 2009;
Johnstone et a1. 1998; Kolarnbkar et a1. 2007; Winter et a1. 2003). In other studies, a side
population of l stromal cells has been shown to produce a matrix made up of the
cartilage specific collagen II under similar chondrogenic differentiation conditions (Du,
Funderburgh, Mann, SundarRaj, & Funderburgh 2005). It has also been reported that
sclcral cells after four weeks in a chondrogenic differentiation medium containing
TGFBI and BMP2 expressed cartilage specific markers including aggrecan, and collagen
W0 2016/140581
type 11. Furthermore, human scleral cells have been shown to retain their chondrogenic
potential in vivo after being transplanted into a rat cartilage defect (Seko et a1. 2008). It
is known that the fibroblastic cells of the sclera and the corneal stroma share a common
logical .
As shown , keratocytes seeded in e medium containing TGFB3
and dexamethasone and in the absence of serum spontaneously formed cell spheroids
within 2-3 days by cell aggregation and by three weeks these cell clusters labelled
positive for cartilage specific type II collagen. Initially upon treatment with TGFB3 and
dexamethasone, type I collagen expression was also increased. When the medium was
changed to a control medium containing fetal calf serum the cell clusters dispersed into
a monolayer of cells. Cells growing in the yer no longer expressed type II
en. These results suggest that cell aggregation or environment might be important
in collagen type II induction.
Notably, keratocytes which were first proliferated as fibroblasts in serum
ning medium did not secrete collagen type II when the medium was changed to the
TGFB3 and dexamethasone containing chondrogenic differentiation medium. This
suggests that once proliferated as fibroblasts the cells lose the ability to differentiate
along a chondrogenic pathway. Further to this, fibroblasts grown in three-dimensional
culture in chondrogenic differentiation medium as a pellet also failed to express cartilage
specific collagen type 11. These results suggest that the ent keratocyte phenotype
and cell aggregation are important to chondrogenic differentiation.
It is shown herein that ex vivo culture of normal and keratoconic corneas in
chondrOgenic entiation media revealed uniform tion oftype II collagen along
the stromal lamellae. Every keratocyte within the corneal stroma was associated with the
collagen type II labelling, once again suggesting that the reprogramming into a
chondrogenic ype is stochastic and confirming that results obtained from the in
vitro cell culture were not as a result of proliferation of a side population of progenitor
cells. Furthermore, in viva treatment of corneas in rats also caused the tion of type
II collagen in a manner similar to that seen in ex vivo culture. r, stronger
immunolabelling of type II collagen was seen in the anterior part of the cornea when
treated in vivo, most probably reflecting easier diffusion of growth factors into the
anterior layers of the stroma from the ocular surface.
W0 2016/140581
Studies looking at differences in keratocyte density in keratoconic corneas
have reported an overall decrease in cell density. The s here also confirm this.
However, unlike other studies which have reported a marked decrease in cell density in
the anterior part of the stroma (Hollingsworth, Efron, & Tullo 2005; Ku et a1. 2008;
ci et a1. 2010; Niederer et a1. 2008), the results here indicate a marked decrease
in cyte density in the posterior part of the stroma of the untreated keratoconic
cornea also. In keratoconus there is a general thinning of the cornea. It is not known,
however, whether this is due to the apoptosis of keratocytes and subsequent decreased
tion of ECM or whether keratocyte apoptosis is secondary to the process of
l thinning.
As shown herein, the treated half of the keratoconic cornea which was
cultured in the chondrogenic medium containing TGFB3 and dexamethasone had an
increased keratocyte density when compared to the control. Furthermore, the posterior
region of the stroma appeared to be repopulated by keratocytes. The cytes in the
treated half also appeared to look healthier with large prominent nuclei and several cell
processes. This indicates that the treatment with the two factors have possibly caused
keratocytes to proliferate and repopulate the stroma, in particular the ior part which
was devoid of keratocytes.
Collagen crosslinking, one of the current treatments for keratoconus, s
in an initial period of keratocyte apoptosis in the or part of the stroma. This is then
followed by a period of repopulation of the stroma by the keratocytes. Keratocyte cell
death is generally seen in response to an injury and in the case of inking is
understood to be as a result ofUVA-induced cellular damage. This apoptotic
se is
thought to have d in order to t the cornea from further inflammation n,
Netto, & Ambrosio 2003).
Stromal haze which can last up to several months is also observed after the
crosslinking ent. It has been attributed to the increase in collagen diameter and
spacing between the collagen fibrils which results in the modification of the corneal
microstructure. Most studies have reported a decrease in corneal haze between 6—12
months after the treatment (Greenstein, Fry, Bhatt, & Hersh 2010; Mazzotta et a1. 2008).
Although there have been several clinical observations of the corneas carried out after
the crosslinking treatment there is ambiguity regarding the cause ofthe corneal haze and
other possible downstream effects of the treatment. The fact that it takes several months
W0 2016/140581
for corneas to be repopulated and become clear suggests that the crosslinking might be
triggering a wound healing response within the stroma.
] In this study, even upon long term (up to 8 weeks) in vitro and in vivo
treatment there was no evidence of corneal opacity. This is probably due to the deposition
of the collagen II in uniform layers along the pre-existing collagen lamellae. Deposition
of collagen type III (associated with fibrosis) and alpha-smooth muscle actin (during
oblast ion) leads to opacity and scarring. Both these are seen during
corneal ng. Neither of these proteins was expressed in the treated corneas
suggesting that wound healing cascades which could bring about ng were not being
triggered.
As described herein, quantitative measurement of type II collagen mRNA
expression showed that its expression was significantly lowered upon withdrawal of
TGFB3 and dexamethasone. This suggests that the reprogramming of keratocytes is not
irreversible and the subsequent deposition oftype II collagen in the ECM can potentially
be controlled. This is important for the development of therapeutic methods,
as it would
not be desirable to induce irrepressible ECM deposition.
Nanoindentation has been employed in the assessment of postoperative
therapeutic methods such as crosslinking for keratoconus (a corneal dystrophy) and post—
LASIK ectasia in the eye. In one study done on human cadaver corneas it was found that
en crosslinking caused a two-fold increase in the c modulus in the anterior
corneal stroma while the posterior stroma was unaffected by the treatment (Dias,
Diakonis, Kankariya, Yoo, & th 2013). In this study, anterior corneal elasticity
was measured. In addition, the results in this study do te that posterior stroma
keratocyte density was altered in the TGF03 and dexamethasone treated corneas.
While nanoindentation does not measure the properties of the individual
collagen fibrils it can e the changes in the inherent elastic property of the cornea
which will be altered on collagen II deposition with a subsequent increase in collagen
crosslinking. Structural ences within the stroma are reflected in the corresponding
differences in biomechanical properties. The results here show that there
was almost a
three-fold increase in c modulus and hardness in the growth factor treated rat
s. These results te that the treatment results in a stiffer
cornea with higher
elasticity. The elastic modulus is a measure of a nce’s resistance to being deformed
W0 2016/140581
elastically and therefore a higher elastic modulus indicates that a material is more
ult to deform. In this study, a significant increase in hardness and c modulus
in 3 week treated corneas when compared to 1 week treated corneas is consistent with
the immunohistochemical labelling results that show at least 2-3 weeks of treatment is
required for the laying down of detectable layers of type II collagen.
The immunohistochemical labelling results coupled with the gene expression
studies and hanical testing show that keratocytes within an intact cornea are
amenable to reprogramming along a chondrogenic pathway by treatment with TGF[33
and dexamethasone. The ramming by combined TGFB3 and dexamethasone
treatment is stochastic and may be controlled via the modulation of the growth factor
treatment period to result in stiffer, more elastic corneas. y, administration of both
agents is ed; when TGFB3 and dexamethasone are tested separately, no collagen
type II production in keratocytes is observed. A novel treatment is therefore proposed for
conus and other eye conditions using in vivo tissue ering, by administration
of TGFB3 and dexamethasone, as described herein.
Example 17: Large animal model to investigate reshaping of the cornea
Reshaping the cornea whilst delivering the l regimen in a sheep model
Additional experiments are carried out to use a large animal model to
demonstrate reshaping ofthe cornea. For these experiments, a large animal model is used
to allow placement of prescription contact lenses. Sheep are used as a model animal, as
their eyes are comparable in size and physiology to that ofhumans. In addition, housing
facilities are available at Lincoln University, Christchurch. It is noted also that sheep
have a mild temperament, and are amenable to handling.
Sheep [are d in accordance with standard operating procedure in the
housing facility. The eye drop formulation with optimal TGFB3 and thasone
concentrations (volume scaled) based upon the rodent dose optimisation studies are
instilled in the right eye followed by the placing of corneal ® (or similar l
rings) to hold the desired curvature of the cornea during collagen deposition (Figure 18).
Eye drops are continued to be administered either once or twice daily (as determined in
rodent sation studies) for a period ofthree weeks. The INTACS® are then removed
and the animals are continued to be housed for a further three weeks or six months.
W0 2016/140581
] Before ent and at the end of the treatment (when the ® are
removed), corneal thickness and curvature measurements are taken. The le corneal
pachymeter is used to detect changes in corneal thickness of treated versus control
contralateral corneas in vivo. A portable Pentacam® is used to measure corneal curvature
as well as corneal thickness of the sheep eyes before and after treatment (Figures 19(E)
and (F)). Corneal measurements are repeated again at three weeks after lenses removal
with the final (most accurate) Pentacam® measurements. These are taken after killing
the animal but prior to eye removal for immunohistological and biomechanical analysis
as described above for rodent s. In the unlikely event that the sheep are unable to
tolerate a hard t lens (signs of infection, inflammation or irritability), the study is
continued without lenses, which allows completion of key parameters such as type II
en deposition and distribution, and hanical properties.
In view of the results, it is proposed to use in vivo tissue ering as
described in detail herein, in combination with of a rigid gas permeable OrthoK contact
lenses (or similar) to permanently reshape and stabilise the , providing treatment
for common corneal defects, including .
References
Ashwin, P. T., & McDonnell, P. J. (2010). Collagen cross-linkage: a
comprehensive review and directions for future research. British Journal of
Ophthalmology, 94(8), 965-970.
Cosar, C. B. et a1. (2002). Indications for penetrating keratoplasty and
associated procedures, 1996-2000. Cornea, 21(2), 148-151.
Cowin, A. J., Holmes, T. M., Brosnan, P., & Ferguson, M. W. (2001).
Expression of TGF-beta and its receptors in murine fetal and adult dermal wounds.
European Journal ofDermatology, 1 1(5), 424—3 1 .
Denniston A. K. 0., Murray P. I. (2009) Oxford Handbook of
Ophthalmology (0UP). Second edition. Oxford: New York. Oxford University Press.
Desmouliere, A., et al. (2005). Tissue repair, contraction, and the
myofibroblast. Wound Repair and Regeneration, 13(1), 7-12.
W0 2016/140581
Dias, J., Diakonis, V. F., Kankariya, V. P., Yoo, S. H., & Ziebarth, N. M.
(2013). Anterior and posterior corneal stroma city after corneal collagen
crosslinking treatment. mental Eye Research, 116, 58-62.
Dias, J. M., & Ziebarth, N. M. (2013). Anterior and posterior corneal stroma
elasticity assessed using nanoindentation. Experimental Eye Research, 115, 41-46.
son, M. E., & Schirer, J. P. (2009). Probing more than the surface.
Materials Today, 12(7), 46-50.
Diekman, B. 0., Rowland, C. R., , D. P., Caplan, A. 1., & Guilak, F.
(2009). Chondrogenesis of adult stem cells from adipose tissue and bone marrow:
induction by growth factors and cartilage—derived matrix. Tissue engineering Part A,
16(2), 523-533.
Dobbins, K. R., F. W. Price Jr., W. E. Whitson. (2000). Trends in the
indications for penetrating keratoplasty in the Midwestern United States. Cornea, 19(6),
813-816.
Ebenstein, D. M., & Pruitt, L. A. (2006). Nanoindentation of biological
materials. Nano Today, 1(3), 26—33.
Edmund, C. . l elasticity and ocular rigidity in normal and
keratoconic eyes. Acta lmologica, 66(2), 134-140.
Edwards, M. et a1. (2002). Indications for corneal transplantation in New
Zealand: 1991-1999. Cornea, 21(2), 152-155.
Farquharson, C., Berry, J. L., Barbara Mawer, E., ght, E., &
Whitehead, C. C.‘ (1998). Ascorbic acid-induced chondrocyte terminal entiation:
the role of the extracellular matrix and 1, 25-dihydroxyvitamin D. European Journal of
Cell Biology, 76(2),, 1 10—1 18.
Fredrick, D. R. (2002). Myopia. BMJ: British l Journal, 324(7347),
1195.
Fukuchi, T., Yue, B., Sugar, 1., & Lam, S. . Lysosomal enzyme
activities in conjunctiva] s of patients with keratoconus. Archives of
Ophthalmology, 112(10), 1368.
W0 40581
Funderburgh, J. L. (2000). Corneal proteoglycans. In: Proteoglycans:
Structure, y and Molecular Interactions, R. V. Lozzo, Editor. Marcel Dekker.
Funderburgh, J. L., Mann, M. M., Funderburgh, M. L., Corpuz, L., & Roth,
M. R. (2001). Proteoglycan expression during transforming growth factor-induced
keratocyte—myofibroblast transdifferentiation. Journal of Biological Chemistry, ),
44 1 73 .
Funderburgh, J. L., M. M. Mann, and M. L. Funderburgh (2003) Keratocyte
phenotype mediates proteoglycan structure. Journal of Biological Chemistry, 278(46):
45629.
Gabbiani, G. (2003). The myofibroblast in wound healing and
fibrocontractive diseases. The l of Pathology, 200(4), 500-503.
Ghoniem, A. A., Acil, Y., Wiltfang, J., & Gierloff, M. (2015). ed
adipogenic in vitro entiation: comparison of different adipogenic cell culture media
on human fat and bone stroma cells for fat tissue engineering. Anatomy & Cell Biology,
48(2), 85-94.
Greene, C. A. et al. (2013). Cells from the adult corneal stroma can be
reprogrammed to a neuron-like cell using exogenous growth s. Experimental Cell
ch, 322(1), 122-132.
Greenstein, S. A., Fry, K. L., Bhatt, J., & Hersh, P. S. (2010). Natural history
of corneal haze after collagen crosslinking for keratoconus and l ectasia:
Scheimpflug and biomicroscopic analysis. Journal of Cataract & Refractive y,
36(12), 2105—2114.
Gurdon, J. B., D. A. Melton. (2008). Nuclear reprogramming in cells.
Science, 322, 1811—1815.
Gordon, M. K., R. A. Hahn (2010). Collagens. Cell and Tissue Research,
339(1), 247—257.
Hakelien, A.M., P. . (2002). Novel approaches to transdifferentiation.
Cloning & Stem Cells, 4(4), 379-3 87.
Heng, B. C., Cao, T., & Lee, E. H. (2004). Directing stem cell differentiation
into the ogenic lineage in vitro. Stem Cells, 22(7), 1152-1167.
W0 2016/140581
Hollingsworth, J. G., Efron, N., & Tullo, A. B. (2005). In vivo corneal
confocal microscopy in keratoconus. Ophthalmic and Physiological Optics, 25(3), 254-
260.
] Ignotz, R. A. & Massague’, J. . Transforming growth factor-beta
stimulates the expression of fibronectin and collagen and their incorporation into the
ellular matrix. Journal of ical Chemistry, 261, 345.
Ignotz, R. A., Endo, T., & ue, J. (1987). Regulation offibronectin and
type I collagen mRNA levels by transforming growth factor-beta. Journal of Biological
Chemistry, 262(14), 6443-6446.
Jackson T. L. (2008) Moorfields Manual of Ophthalmology, Mosby,
Elsevier.
Jester, J. V., Rodrigues, M. M., & Herman, I. M. (1987). Characterization of
lar corneal wound healing fibroblasts. New insights into the myofibroblast. The
American Journal of Pathology, 127(1), 140.
Jester, J. V., et a1. (2002). TGFB induced myofibroblast differentiation of
rabbit keratocytes requires synergistic TGFB, PDGF and integrin signaling. Experimental
Eye Research 75(6), 645-657.
Jhanji, V., Shanna, N., & Vajpayee, R. B. (2011). Management of
conus: t scenario. British Journal of Ophthalmology, 95(8), 1044-1050.
Jinabhai, A., H. Radhakrishnan, C. O’Donnell. (2010). Pellucid corneal
marginal degeneration: a review. Contact Lens & or Eye, 34(2), 56-63.
Johnstone, B., Hering, T. M., Caplan, A. 1., Goldberg, V. M., & Yoo, J. U.
(1998). In Vitro Chondrogenesis of Bone Marrow-Derived Mesenchymal Progenitor
Cells. Experimental Cell Research, , 265-272.
Kadler, K. E., Baldock, C., Bella, J., & Boot-Handford, R. P. .
Collagens at a glance. Journal of Cell Science, 120(12), 1955—1958.
chos, D., Hutcheon, A., & , J. (2011). Transforming growth
factor-[33 regulates assembly of a non-fibrotic matrix in a 3D corneal model. Journal of
Tissue Engineering and Regenerative Medicine, 5(8), e228-e238.
W0 40581 2016/050033
Karamichos, D., Zareian, R., Guo, X., Hutcheon, A. E. K., Ruberti, J. W., &
, J. D. . Novel in vitro model for keratoconus disease. Journal of Functional
Biomaterials, 3(4), 760-775.
Kato, Y. and D. Gospodarowicz (1985). Stimulation by glucocorticoid of the
synthesis of cartilage-matrix proteoglycans produced by rabbit costal chondrocytes in
vitro. Journal of Biological Chemistry, 260(4), 2364-2373.
C. Kenney, M., & Brown, D. J. (2003). The cascade hypothesis of
keratoconus. Contact Lens and Anterior Eye, 26(3), 139-146.
Klintworth, G. K. (1999). Advances in the molecular genetics of corneal
dystrophies. American Journal of Ophthalmology, 128(6), 4.
Klintworth, G. K., & Damms, T. (1995). Corneal dystrophies and
keratoconus. Current Opinion in Ophthalmology, 6(4), 44-56.
] Kolambkar, Y. M., r, A., Soker, S., Atala, A., & Guldberg, R. E. .
Chondrogenic differentiation of amniotic fluid-derived stem cells. Journal of Molecular
Histology, 38(5), 405-413.
Krachmer, J. H., Peder, R. S., & Belin, M. W. (1984). conus and
related noninflammatory corneal thinning disorders. Survey of Ophthalmology, 28(4),
293-322.
Ku, J. Y., er, R. L., Patel, D. V., Sherwin, T., & McGhee, C. N. (2008).
Laser scanning in vivo confocal analysis of keratocyte density in keratoconus.
Ophthalmology, 115(5), 845-850.
Kulyk, W. M., & Hoffman, L. M. (1996). Ethanol re stimulates
cartilage differentiation by embryonic limb hyme cells. Experimental Cell
Research, 223(2), 290-300.
Lee, K. D., et a1. (2004). In vitro hepatic differentiation of human
mesenchymal cells. Hepatology, 40(6), 1275-1284.
Legeais, J.-M., et a1. (2001). Nineteen years ofpenetrating keratoplasty in the
Hotel-Dieu Hospital in Paris. , 20(6), 603-606.
W0 2016/140581
Linsenmayer, T. F., Fitch, J. M., & Birk, D. E. (1990). Heterotypic collagen
fibrils and stabilizing collagens. Annals of the New York Academy of es, ,
143-160.
Ludwig, A. (2005). The use of mucoadhesive polymers in ocular drug
delivery. Advanced Drug Delivery Reviews, 57(11), 1595—163 9.
Marshall, G. E., Konstas, A. G., & Lee, W. R. (1993). Collagens in ocular
s. The h Journal of Ophthalmology, 77(8), 515.
Mazzotta, C., Traversi, C., Baiocchi, S., Caporossi, 0., Bovone, C., Sparano,
M. C., Caporossi, A. . Corneal healing afier riboflavin iolet-A en
cross-linking determined by confocal laser scanning microscopy in vivo: early and late
modifications. American Journal of lmology, 146(4), 527-533. e521.
Meek, K. M., Tuft, S. J., Huang, Y., Gill, P. S., Hayes, S., Newton, R. H., &
Bron, A. J. (2005). Changes in collagen orientation and distribution in keratoconus
corneas. Investigative Ophthalmology & Visual Science, 46(6), 1948-1956.
Mencucci, R., Marini, M., Paladini, I., Sarchielli, E., Sgambati, E., Menchini,
U., & li, G. B. (2010). Effects of riboflavin/UVA corneal cross-linking on
cytes and collagen fibres in human cornea. Clinical & Experimental
Ophthalmology, 38(1), 49-56.
Mendler, M., Eich—Bender, S. G., Vaughan, L., Winterhalter, K. H., &
Bruckner, P. (1989). Cartilage contains mixed fibrils of collagen types II, IX, and XI.
The l of Cell Biology, 108(1), 191-197.
Menetrey, J., et al. (2000). Growth factors improve muscle healing in viva.
Journal of Bone & Joint Surgery, British Volume, 82(1), 131-137.
Niederer, R. L., Perumal, D., Sherwin, T., & McGhee, C. N. J. (2008). Laser
scanning in vivo confocal microscopy reveals reduced ation and reduction in cell
y in all layers of the keratoconic cornea. Investigative Ophthalmology & Visual
Science, 49(7), 2964—2970.
Nirmal, H. B., S. R. Bakliwal, S. P. Pawar . In—situ gel: New trends in
controlled and sustained drug delivery system. International Journal of PharmTech
Research, 2(2), 1398-1408.
W0 2016/140581 2016/050033
Patel, H. Y. et a1. (2005). The New Zealand National Eye Bank study 1991-
2003: a review of the source and management of corneal tissue. Cornea, 24(5), 576-5 82.
Patel, D., C. McGhee (2013). Understanding keratoconus: what have we
learned from the New Zealand perspective? Clinical and Experimental Optometry, 96(2),
1 83 -1 87.
Peran, M., et a1. (2011). Transdifferentiation: why and how? Cell Biology
International, 35(4), 373—379.
] Pramanik, S., Musch, D. C., Sutphin, J. E., & Farjo, A. A. (2006). Extended
long—term outcomes ofpenetrating keratoplasty for keratoconus. Ophthalmology, 1 13(9),
638.
Premaraj et a1. (2006). Sustained delivery ctive ne using a dense
collagen gel vehicle collagen gel delivery of bioactive ne. Arch Oral Biol. 51(4),
' ‘
“ '
325-33.
Rabinowitz, Y. S. (1998). Keratoconus. Survey of Ophthalmology, 42(4),
297-319.
Rabonitz, Y. S. (2004). Ectatic ers of the Cornea. In: The Cornea, 4th
edition. Lippincott Williams & Wilkins.
Romero-Jimenez, M., Santodomingo-Rubido, J., & Wolffsohn, J. S. (2010).
Keratoconus: a review. t Lens and Anterior Eye, 33(4), 157—166.
Rupenthal, I. D., Green, C. R., & Alany, R. G. (2011). Comparison of ion-
activated in situ gelling systems for ocular drug delivery. Part 2: Precorneal retention and
in vivo pharmacodynamic study. International Journal of Pharmaceutics.
] Schuldiner, M., Yanuka, O., Itskovitz-Eldor, J., Melton, D. A., & Benvenisty,
N. . Effects of eight growth factors on the entiation of cells derived from
human embryonic stem cells. Proceedings of the National Academy of Sciences, 97(21),
11307—11312.
Shah, M., Foreman, D. M., & Ferguson, M. W. (1995). Neutralisation of
TGF-beta 1 and TGF—beta 2 or ous addition of TGF-beta 3 to cutaneous rat
wounds reduces scarring. Journal of Cell Science, 108(3), 985-1002.
W0 2016/140581
Sherwin, T., & Brookes, N. H. . Morphological s in
conus: pathology or pathogenesis. Clinical & Experimental Ophthalmology, 32(2),
21 1 -2 1 7.
Spoerl, E., Huhle, M., & Seiler, T. (1998). Induction of links in corneal
tissue. Experimental Eye Research, 66(1), .
Takahashi, K., S. Yamanaka. (2006). ion ofpluripotent stem cells fiom
mouse embryonic and adult fibroblast cultures by defined factors. Cell, 126(4), 663 -676.
Tsang et a1. (1995). Characterization of inant soluble human
transforming growth factor-beta receptor type II (rhTGF-beta sRII). ne, 7(5), 3 89-
Wells, S. M. (2003). Mechanical design of elastic biopolymers. Physics in
Canada, 59(2), 67-74.
Wernig, M. et a1. (2007). In vitro reprogramming of fibroblasts into a
pluripotent ES-cell-like state. Nature, 51), 318-324.
Willshaw H. et a1. (2000). A Handbook of Paediatric Ophthalmology.
Pensord Press: United Kingdom.
Wilson, S. E., Netto, M., & Ambrosio, R. (2003). Corneal cells: chatty in
development, homeostasis, wound healing, and disease. American Journal of
OphthalmolOgY, 136(3), 530—536.
Winter, A., Breit, S., , D., Benz, K., Steck, E., Hauner, H., Richter, W.
(2003). Cartilage-like gene expression in differentiated human stem cell ids: A
comparison of bone marrow—derived and adipose tissue—derived stromal cells. Arthritis
& Rheumatism, 48(2), 418-429.
, Wollensak, G., Spoerl, E., & Seiler, T. (2003).. Riboflavin/ultraviolet—A—
induced collagen crosslinking for the treatment of keratoconus. American Journal of
Ophthalmology, 135(5), 620-627.
Wollensak, J., & Buddecke, E. (1990). Biochemical studies on human
corneal proteoglycans—a ison of normal and conic eyes. Graefe's Archive
for Clinical and Experimental Ophthalmology, 228(6), 517-523.
W0 2016/140581
Worster, A. A., Nixon, A. J., Brower-Toland, B. D., & Williams, J. (2000).
Effect of transforming growth factor [31 on chondrogenic differentiation of cultured
equine mesenchymal stem cells. American Journal of Veterinary Research, 61(9), 1003-
1 0 1 0.
Yamanaka, 8., HM. Blau. (2010). Nuclear reprogramming to a otent
state by three approaches. Nature, 465(7299), 704-712. '
Yoon Y. M., Oh C. D., Kim D. Y., Lee YS, Park J. W., Huh T. 3L., Kang S.
S., Chun J. S. (2000). mal growth factor negatively regulates chondrogenesis of
hymal cells by modulating the n kinase C-alpha, Erk-l, and‘p38 MAPK
signaling ys. Biol Chem. 275(16):12353-9. ‘
A person ofordinary skill in the art will readily appreciate from the disclosure
that later modifications, substitutions, and/or variations performing substantially the
same function or ing substantially the same result as embodiments or aspects
described herein may be utilised according to such related embodiments or aspects of the
present invention. Thus, the invention is intended to encompass, within its scope, the
ations, substitutions, and variations to processes, manufactures, compositions of
matter, compounds, means, methods, and/or steps disclosed herein.
] All nces, including patents and patent applications, cited in this
specification are hereby incorporated by reference. No admission is made that any
reference constitutes prior art. Nor does discussion of any reference constitute an
admission that such reference forms part ofthe common general knowledge in the art, in
New Zealand or in any other country.
Claims (20)
1. Use of a composition for preparing a medicament for: (i) treating or preventing a condition associated with a thinning or irregularity of a cornea; or (ii) treating or preventing a refractive error associated with a defect of a cornea, the composition sing: a TGFβ3 polypeptide, and dexamethasone or any salts, esters, or hydrides thereof, wherein: the TGFβ3 polypeptide comprises SEQ ID NO:1, or the TGFβ3 polypeptide comprises at least 100 amino acids of the amino acid sequence of SEQ ID NO:1, or the TGFβ3 polypeptide shares at least 90% sequence ty to the amino acid sequence of SEQ ID NO:1.
2. The use of claim 1, wherein: (a) the TGFβ3 polypeptide consists of the amino acid sequence of SEQ ID NO:1; and/or (b) the dexamethasone is dexamethasone phosphate.
3. The use of claim 1 or claim 2, wherein: (a) the ition comprises at least 8 ng/ml of the TGFβ3 polypeptide, or 10 to 100 ng/ml of the TGFβ3 polypeptide; and/or (b) the composition comprises at least 100 nM dexamethasone, or 40 to 4000 ng/ml thasone.
4. The use of any one of claims 1 to 3, wherein: (a) the composition is formulated as an eye drop; and/or (b) the composition is ated with gellan gum.
5. The use of any one of claims 1 to 4, wherein: (a) the composition is formulated for administration once daily or twice daily; and/or (b) the composition is ated for co-administration with one or more additional agents for the eye; and/or (c) the ition is formulated for administration in conjunction with use of one or more contact lenses, corneal s, corneal implants, or intrastromal rings.
6. The use of claim 5, wherein the one or more additional agents for the eye are selected from the group consisting of: anaesthetic agents, anti-inflammatory agents, antimicrobial agents, and lubricants.
7. The use of claim 5, wherein: (a) the one or more contact lenses, l inserts, corneal ts, or intrastromal rings are adapted to mould or hold corneal shape during and/or following treatment with the ition; and/or (b) the one or more contact lenses, corneal inserts, corneal implants, or intrastromal rings are adapted to act as a carrier for the composition or as a composition eluting device.
8. The use of any one of claims 1 to 7, wherein: for (i), the composition is formulated for administration in conjunction with corneal collagen crosslinking; or (ii), the composition is formulated for administration preceding or ing refractive surgery.
9. The use of claim 8, wherein the composition is formulated for administration prior to and/or subsequent to inking.
10. The use of any one of claims 1 to 9, wherein: (a) the condition is selected from the group ting of: keratoconus, myopia, astigmatism, and stromal dystrophies; and/or (b) the refractive error is associated with one or more of: myopia, hyperopia, astigmatism, or presbyopia.
11. Use of: (A) a TGFβ3 polypeptide, and (B) dexamethasone or any salts, esters, or hydrides thereof, for cture of ophthalmic medicament for: (i) treating or preventing a condition associated with a thinning or irregularity of a cornea; or (ii) treating or preventing a refractive error ated with a defect of a cornea, wherein: components (A) and (B) are adapted for sequential or simultaneous stration, and wherein: the TGFβ3 polypeptide comprises SEQ ID NO:1, or the TGFβ3 polypeptide comprises at least 100 amino acids of the amino acid sequence of SEQ ID NO:1, or the TGFβ3 polypeptide shares at least 90% sequence identity to the amino acid sequence of SEQ ID NO:1.
12. The use of claim 11, wherein: (a) the TGFβ3 polypeptide consists of the amino acid sequence of SEQ ID NO:1; and/or (b) t he dexamethasone is thasone phosphate.
13. The use of claim 11 or claim 12, wherein: (a) the composition of (A) comprises at least 8 ng/ml of the TGFβ3 polypeptide, or 10 to 100 ng/ml of the TGFβ3 polypeptide; and/or (b) the composition of (B) ses at least 100 nM dexamethasone, or 40 to 4000 ng/ml dexamethasone.
14. The use of any one of claims 11 to 13, wherein: (a) the administration is via an eye drop; and/or (b) the administration is via a ation with gellan gum.
15. The use of any one of claims 11 to 14, n: (a) the administration is once daily or twice daily; and/or (b) the administration includes co-administration with one or more additional agents for the eye; and/or (c) the stration is in conjunction with use of one or more contact lenses, corneal inserts, corneal implants, or intrastromal rings.
16. The use of claim 15, wherein the one or more additional agents for the eye are selected from the group ting of: anaesthetic agents, anti-inflammatory agents, crobial agents, and lubricants.
17. The use of claim 15, wherein: (a) the one or more contact lenses, corneal inserts, corneal implants, or intrastromal rings are adapted to mould or hold corneal shape during and/or following treatment with the composition; and/or (b) t he one or more contact lenses, corneal inserts, corneal implants, or intrastromal rings are adapted to act as a carrier for the composition or as a composition eluting device.
18. The use of any one of claims 11 to 17, n: for (i), the administration is in conjunction with corneal collagen crosslinking; or (ii), the administration is preceding or following refractive surgery.
19. The use of claim 18, wherein the administration is prior to and/or subsequent to crosslinking.
20. The use of any one of claims 11 to 19, wherein: (a) the ion is selected from the group consisting of: keratoconus, myopia, astigmatism, and stromal dystrophies; and/or (b) the tive error is associated with one or more of: myopia, hyperopia, astigmatism, or presbyopia.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
NZ705727 | 2015-03-05 | ||
NZ70572715 | 2015-03-05 | ||
PCT/NZ2016/050033 WO2016140581A1 (en) | 2015-03-05 | 2016-03-04 | Ophthalmic compositions and methods of use therefor |
Publications (2)
Publication Number | Publication Date |
---|---|
NZ735959A NZ735959A (en) | 2021-10-29 |
NZ735959B2 true NZ735959B2 (en) | 2022-02-01 |
Family
ID=
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11938168B2 (en) | Ophthalmic compositions and methods of use therefor | |
Bikbova et al. | Corneal changes in diabetes mellitus | |
Huxlin et al. | Topical rosiglitazone is an effective anti-scarring agent in the cornea | |
TW201615187A (en) | Composition and method for treating and relieving myopia | |
Li et al. | Riboflavin and ultraviolet A irradiation for the prevention of progressive myopia in a guinea pig model | |
US20110158958A1 (en) | Methods for treating ophthalmic disorders, diseases and injuries | |
CN105555363B (en) | Medical component and application thereof | |
Liu et al. | Bone marrow mesenchymal stem cells enhance autophagy and help protect cells under hypoxic and retinal detachment conditions | |
NZ735959B2 (en) | Ophthalmic compositions and methods of use therefor | |
Yao et al. | Effect of diclofenac sodium combined with nuclear rotation on the prevention of posterior capsule opacification: two-year follow-up | |
US20180353645A1 (en) | Lens regeneration using endogenous stem/progenitor cells | |
Yeh et al. | Pigment epithelial-derived factor peptide facilitates the regeneration of a functional limbus in rabbit partial limbal deficiency | |
Moore | Cornea and sclera | |
US20200038355A1 (en) | Antioxidants for use in ophthalmic surgery | |
Ziaei | Novel Options for the Treatment of Corneal Disease | |
Ziad et al. | Evaluation of Lycium Shawii Schult & Roem Eye Drops as a Novel Treatment for Old Corneal Scars in Rabbits | |
CN115721656A (en) | Pharmaceutical composition containing rebamipide or salt thereof, preparation method thereof and application thereof in preparing ophthalmic preparation | |
Albé | Keratoconus and Corneal Noninflammatory Ectasias | |
Sinha | Mechanistic understanding and potential targets for mustard gas keratopathy | |
US20200188441A1 (en) | Methods and compositions for reducing corneal endothelial cell loss | |
김수현 | Development of air assisted lamellar keratectomy for corneal haze model and deep anterior lamellar keratoplasty in dogs | |
Sethi et al. | A COMPARATIVE STUDY OF CONJUCTIVAL AUTOGRAFT IN PRIMARY AND RECURRENT PTERYGIUM IN SOUTHERN PART OF ODISHA | |
SUTPHIN | Corneal Crosslinking with Riboflavin and Ultraviolet A. Part II. Clinical Indications and Results |