Effect of penetration enhancer with novel corneal cross-linking using recombinant human decoron in porcine eyes

The aim of the study was to investigate the effectiveness of exogenous recombinant human decoron and an accompanying penetration-enhancing solution in stiffening ex-vivo porcine corneas both transepithelially and after de-epithelialization. Eight porcine paired eyes were treated transepithelially: o...

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Bibliographic Details
Published in:	Experimental eye research Vol. 206; p. 108542
Main Authors:	Pappa, Christopher S., Nguyen, B. Audrey, Mahmoud, Ashraf M., Agarwal, Gunjan, Roberts, Cynthia J.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-05-2021
Subjects:	Animals Collagen - pharmacology Corneal Stroma - drug effects Corneal Stroma - pathology Corneal Stroma - physiopathology Cross-Linking Reagents - pharmacology Disease Models, Animal Elasticity Epithelium, Corneal - drug effects Epithelium, Corneal - pathology Epithelium, Corneal - physiopathology Keratoconus - drug therapy Keratoconus - pathology Keratoconus - physiopathology Photosensitizing Agents - pharmacology Riboflavin - pharmacology Swine Ultraviolet Rays
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Summary:	The aim of the study was to investigate the effectiveness of exogenous recombinant human decoron and an accompanying penetration-enhancing solution in stiffening ex-vivo porcine corneas both transepithelially and after de-epithelialization. Eight porcine paired eyes were treated transepithelially: one eye with a pre-treatment solution (Pre-Tx), penetration enhancing solution (PE), and decoron while the fellow eye was treated by the same protocol but without decoron. A second group included 4 de-epithelialized pairs treated identically. The final group included 4 de-epithelialized pairs with one eye treated with Pre-Tx, PE, and decoron while the fellow eye was treated without PE. Uniaxial tensile testing was used to compare the corneal stiffness between the different treatment conditions. Residual tissue underwent immunohistochemistry analysis to evaluate the depth of penetration of decoron into the corneal stroma. There was no stiffening effect exhibited among corneas treated transepithelially with decoron compared to control (P > 0.05) and poor stromal penetration was exhibited on tissue analysis. Among de-epithelialized corneas, there was a significant stiffening effect seen in those treated with decoron at 3%, 4%, 5%, & 6% strain (P < 0.05) compared to control. Among de-epithelialized corneas there was also a significant stiffening effect seen in those treated with the PE and decoron at 4%, 5%, & 6% strain (P < 0.05) with improved stromal penetration confirmed by immunohistochemistry, versus without PE. De-epithelialization is necessary for effective stromal penetration of decoron. Depth of penetration and subsequent corneal stiffening may be improved with a penetration enhancing solution. Compared to riboflavin, decoron requires shorter treatment time and spares UV light exposure. •De-epithelialization is necessary for effective stromal penetration of decoron and stiffening of porcine corneas.•The effect may be amplified by using a penetration enhancing solution.•In comparison to cross-linking using riboflavin, decoron offers shorter treatment time and avoidance of UV light exposure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Present Addresses Cincinnati Eye Institute, 1945 CEI Drive, Cincinnati, OH 45242 Department of Mechanical and Aerospace Engineering, E503 Scott Laboratory, 201 W 19th Ave, The Ohio State University, Columbus, OH Department of Biomedical Engineering, Auburn Science and Center #275, West Tower, University of Akron, Akron OH 44325
ISSN:	0014-4835 1096-0007
DOI:	10.1016/j.exer.2021.108542