Corticosteroids in the Management of Infectious Keratitis: A Concise Review

Sharma, Bhavana; Soni, Deepak; Mohan, Rajiv R.; Sarkar, Deepayan; Gupta, Rituka; Chauhan, Khushboo; Karkhur, Samendra; Morya, Arvind Kumar

doi:10.1089/jop.2021.0040

Cited by 6 publications

(3 citation statements)

References 88 publications

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“…Most of the treatments for BK aim to inhibit bacterial growth and control corneal inflammation with adjuvant steroid drugs, such as medroxyprogesterone . The use of steroid drugs, however, may reduce the secretion of fibrin and growth factors, resulting in opaque corneal tissue or ecchymosis that affects vision . Thus, the above treatments do not satisfactorily promote corneal wound healing.…”

Section: Introductionmentioning

confidence: 99%

“…8 The use of steroid drugs, however, may reduce the secretion of fibrin and growth factors, resulting in opaque corneal tissue or ecchymosis that affects vision. 9 Thus, the above treatments do not satisfactorily promote corneal wound healing. Currently administered drugs are mostly small molecules, but there is much room for improvement in terms of bioavailability and corneal retention.…”

Section: ■ Introductionmentioning

confidence: 99%

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In Situ Hybridization of Polymeric Curcumin to Arginine-Derived Carbon Quantum Dots for Synergistic Treatment of Bacterial Infections

Jian

Anand

Lai

et al. 2023

ACS Appl. Mater. Interfaces

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Effective infectious keratitis treatment must eliminate the pathogen, reduce the inflammatory response, and prevent persistent damage to the cornea. Infectious keratitis is generally treated with broad-spectrum antibiotics; however, they have the risk of causing corneal epithelial cell damage and drug resistance. In this study, we prepared a nanocomposite (Arg-CQDs/pCur) from arginine (Arg)-derived carbon quantum dots (Arg-CQDs) and polymeric curcumin (pCur). Partial carbonization of arginine hydrochloride in the solid state by mild pyrolysis resulted in the formation of CQDs, which exhibited enhanced antibacterial activity. pCur was formed by the polymerization of curcumin, and further crosslinking reduced its cytotoxicity and improved antioxidative, anti-inflammatory, and pro-proliferative activities. The pCur in situ conjugated with Arg-CQDs to form the Arg-CQDs/pCur nanocomposite, which showed a minimum inhibitory concentration of ca. 10 μg mL–1, which was >100-fold and >15-fold lower than that of the precursor arginine and curcumin, respectively, against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. The Arg-CQDs/pCur nanocomposite with combined antibacterial, antioxidative, anti-inflammatory, pro-proliferative properties, and long-term retention on cornea enabled synergistic treatment of bacterial keratitis. In a rat model, it can effectively treat P. aeruginosa-induced bacterial keratitis at a concentration 4000-fold lower than the commercially used drug, Sulmezole eye drops. Arg-CQDs/pCur nanocomposites have great potential for application in antibacterial and anti-inflammatory nanoformulations for clinical use to treat infectious diseases.

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Section: Introductionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

In Situ Hybridization of Polymeric Curcumin to Arginine-Derived Carbon Quantum Dots for Synergistic Treatment of Bacterial Infections

Jian

Anand

Lai

et al. 2023

ACS Appl. Mater. Interfaces

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“…It has been hypothesized that local metabolism of cortisol could take place at the ocular surface as cortisol could be produced by corneal epithelial cells [13]. In clinical practice, to control inappropriate corneal inflammation and relieve patients' symptoms, topical GCs are part of most therapeutic regimens, even in infectious keratitis [14], although they might delay corneal epithelial wound healing [15]. However, the effects of GCs vary as a function of the dose, the duration and timing of use, and is dependent on their chemical formulation.…”

Section: Introductionmentioning

confidence: 99%

Spironolactone Eyedrop Favors Restoration of Corneal Integrity after Wound Healing in the Rat

Rodrigues-Braz,

Zhu,

Gélizé

et al. 2023

Pharmaceuticals

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Abnormal corneal wound healing can compromise corneal transparency and lead to visual impairment. Mineralocorticoid receptor antagonists (MRA) are promising candidates to promote corneal remodeling with anti-inflammatory properties and lack gluococorticoids-associated side effects. In this preclinical study, a new polymer-free hydroxypropyl-gamma-cyclodextrin-based eyedrop containing 0.1% spironolactone (SPL), a potent but non-water-soluble MRA, was investigated for its ocular surface tolerance and efficacy in a rat model of corneal wound healing. SPL eyedrops were stable for up to 9 months at 4 °C. The formulation was well-tolerated since no morphological changes or inflammatory reactions were observed in the rat cornea after multiple daily instillations over 7 days. SPL eyedrops accelerated rat corneal wound healing, reduced corneal edema and inflammation, enhanced epithelial integrity, and improved nerve regeneration, suggesting restoration of corneal homeostasis, while potassium canrenoate, an active and soluble metabolite of SPL, had no effect. SPL eyedrops could benefit patients with impaired corneal wound healing, including that secondary to glucocorticoid therapy. Repurposing known drugs with known excipients will expedite translation to the clinic.

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Efficacy and Safety of Ophthalmic Preparations of Glucocorticoids in Patients with Epidemic Keratoconjunctivitis: A Systematic Review and Meta-analysis

Liu

Han

et al. 2022

Ther Innov Regul Sci

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Corticosteroids in the Management of Infectious Keratitis: A Concise Review

Cited by 6 publications

References 88 publications

In Situ Hybridization of Polymeric Curcumin to Arginine-Derived Carbon Quantum Dots for Synergistic Treatment of Bacterial Infections

In Situ Hybridization of Polymeric Curcumin to Arginine-Derived Carbon Quantum Dots for Synergistic Treatment of Bacterial Infections

Spironolactone Eyedrop Favors Restoration of Corneal Integrity after Wound Healing in the Rat

Efficacy and Safety of Ophthalmic Preparations of Glucocorticoids in Patients with Epidemic Keratoconjunctivitis: A Systematic Review and Meta-analysis

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