New Pharmacological Approaches for the Treatment of Neurotrophic Keratitis

Overview

Journal Front Pharmacol

Date 2022 Apr 8

PMID 35392574

Authors

Su Yin Koay

Daniel F P Larkin

Affiliations

Soon will be listed here.

Abstract

Neurotrophic keratitis (NK) is a rare degenerative condition that is caused by damage to the trigeminal nerve, with partial or complete loss of corneal sensory innervation. The loss of innervation leads to impaired healing of corneal epithelium, which subsequently results in punctate epithelial erosions, persistent epithelial defects, corneal ulcers and corneal perforation. Management of NK is often supportive and aims to promote epithelial healing and prevent progression of disease. Multiple novel pharmacological approaches have been proposed to address the underlying pathophysiology of NK, which are discussed in this paper.

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References

Anitua E, Muruzabal F, de la Fuente M, Riestra A, Merayo-Lloves J, Orive G . PRGF exerts more potent proliferative and anti-inflammatory effects than autologous serum on a cell culture inflammatory model. Exp Eye Res. 2016; 151:115-21. DOI: 10.1016/j.exer.2016.08.012. View

Versura P, Giannaccare G, Pellegrini M, Sebastiani S, Campos E . Neurotrophic keratitis: current challenges and future prospects. Eye Brain. 2018; 10:37-45. PMC: 6029608. DOI: 10.2147/EB.S117261. View

Deeks E, Lamb Y . Cenegermin: A Review in Neurotrophic Keratitis. Drugs. 2020; 80(5):489-494. DOI: 10.1007/s40265-020-01289-w. View

Nishida T, Chikama T, Morishige N, Yanai R, Yamada N, Saito J . Persistent epithelial defects due to neurotrophic keratopathy treated with a substance p-derived peptide and insulin-like growth factor 1. Jpn J Ophthalmol. 2007; 51(6):442-7. DOI: 10.1007/s10384-007-0480-z. View

Bonini S, Rama P, Olzi D, Lambiase A . Neurotrophic keratitis. Eye (Lond). 2003; 17(8):989-95. DOI: 10.1038/sj.eye.6700616. View

Grupcheva C, Laux W, Rupenthal I, McGhee J, McGhee C, Green C . Improved corneal wound healing through modulation of gap junction communication using connexin43-specific antisense oligodeoxynucleotides. Invest Ophthalmol Vis Sci. 2012; 53(3):1130-8. DOI: 10.1167/iovs.11-8711. View

Diaz-Valle D, Burgos-Blasco B, Gegundez-Fernandez J, Garcia-Caride S, Puebla-Garcia V, Pena-Urbina P . Topical insulin for refractory persistent corneal epithelial defects. Eur J Ophthalmol. 2020; 31(5):2280-2286. DOI: 10.1177/1120672120958307. View

Aifa A, Gueudry J, Portmann A, Delcampe A, Muraine M . Topical treatment with a new matrix therapy agent (RGTA) for the treatment of corneal neurotrophic ulcers. Invest Ophthalmol Vis Sci. 2012; 53(13):8181-5. DOI: 10.1167/iovs.12-10476. View

Khokhar S, Natung T, Sony P, Sharma N, Agarwal N, Vajpayee R . Amniotic membrane transplantation in refractory neurotrophic corneal ulcers: a randomized, controlled clinical trial. Cornea. 2005; 24(6):654-60. DOI: 10.1097/01.ico.0000153102.19776.80. View

10.

Aggarwal S, Kheirkhah A, Cavalcanti B, Cruzat A, Colon C, Brown E . Autologous Serum Tears for Treatment of Photoallodynia in Patients with Corneal Neuropathy: Efficacy and Evaluation with In Vivo Confocal Microscopy. Ocul Surf. 2015; 13(3):250-62. PMC: 4499014. DOI: 10.1016/j.jtos.2015.01.005. View

11.

Wang A, Weinlander E, Metcalf B, Barney N, Gamm D, Nehls S . Use of Topical Insulin to Treat Refractory Neurotrophic Corneal Ulcers. Cornea. 2017; 36(11):1426-1428. PMC: 5633504. DOI: 10.1097/ICO.0000000000001297. View

12.

Katzman L, Jeng B . Management strategies for persistent epithelial defects of the cornea. Saudi J Ophthalmol. 2014; 28(3):168-72. PMC: 4181455. DOI: 10.1016/j.sjopt.2014.06.011. View

13.

Sacchetti M, Lambiase A . Diagnosis and management of neurotrophic keratitis. Clin Ophthalmol. 2014; 8:571-9. PMC: 3964170. DOI: 10.2147/OPTH.S45921. View

14.

Mussano F, Genova T, Munaron L, Petrillo S, Erovigni F, Carossa S . Cytokine, chemokine, and growth factor profile of platelet-rich plasma. Platelets. 2016; 27(5):467-71. DOI: 10.3109/09537104.2016.1143922. View

15.

Yoon K, Im S, Park Y, Jung Y, Yang S, Choi J . Application of umbilical cord serum eyedrops for the treatment of dry eye syndrome. Cornea. 2006; 25(3):268-72. DOI: 10.1097/01.ico.0000183484.85636.b6. View

16.

You J, Hodge C, Hoque M, Petsoglou C, Sutton G . Human Platelets and Derived Products in Treating Ocular Surface Diseases - A Systematic Review. Clin Ophthalmol. 2020; 14:3195-3210. PMC: 7567560. DOI: 10.2147/OPTH.S265701. View

17.

Fai S, Ahem A, Mustapha M, Mohd Noh U, Bastion M . Randomized Controlled Trial of Topical Insulin for Healing Corneal Epithelial Defects Induced During Vitreoretinal Surgery in Diabetics. Asia Pac J Ophthalmol (Phila). 2017; 6(5):418-424. DOI: 10.22608/APO.201780. View

18.

Trinh T, Santaella G, Mimouni M, Mednick Z, Cohen E, Sorkin N . Assessment of response to multimodal management of neurotrophic corneal disease. Ocul Surf. 2020; 19:330-335. DOI: 10.1016/j.jtos.2020.11.003. View

19.

Yamada N, Yanai R, Kawamoto K, Nagano T, Nakamura M, Inui M . Promotion of corneal epithelial wound healing by a tetrapeptide (SSSR) derived from IGF-1. Invest Ophthalmol Vis Sci. 2006; 47(8):3286-92. DOI: 10.1167/iovs.05-1205. View

20.

Nishida T, Nakamura M, Ofuji K, Reid T, Mannis M, Murphy C . Synergistic effects of substance P with insulin-like growth factor-1 on epithelial migration of the cornea. J Cell Physiol. 1996; 169(1):159-66. DOI: 10.1002/(SICI)1097-4652(199610)169:1<159::AID-JCP16>3.0.CO;2-8. View