Ectoine in the Treatment of Irritations and Inflammations of the Eye Surface

Abstract

The ocular surface is facing various unspecific stress factors resulting in irritation and inflammation of the epithelia, causing discomfort to the patients. Ectoine is a bacteria-derived extremolyte with the ability to protect proteins and biological membranes from damage caused by extreme environmental conditions like heat, UV-light, high osmolarity, or dryness. Evidence from preclinical and clinical studies attest its effectiveness in treating several epithelium-associated inflammatory diseases, including the eye surface. In this review, we analysed 16 recent clinical trials investigating ectoine eye drops in patients with allergic conjunctivitis or with other unspecific ocular inflammations caused by e.g. ophthalmic surgery. Findings from these studies were reviewed in context with other published work on ectoine. In summary, patients with irritations and unspecific inflammations of the ocular surface have been treated successfully with ectoine-containing eye drops. In these patients, significant improvement was observed in ocular symptoms of allergic rhinoconjunctivitis, postoperative secondary dry eye syndrome, or ocular reepithelisation after surgery. Using ectoine as an add-on therapy to antihistamines, in allergy patients accelerated symptom relief by days, and its use as an add-on to antibiotics resulted in faster wound closure. Ectoine is a natural substance with an excellent tolerability and safety profile thus representing a helpful alternative for patients with inflammatory irritation of the ocular surface, who wish to avoid local reactions and side effects associated with pharmacological therapies or wish to increase the efficacy of standard treatment regimen.

The Effectiveness of the Bacteria Derived Extremolyte Ectoine for the Treatment of Allergic Rhinitis

“…Results showed significant and clinically relevant improvement of allergic ocular symptoms such as watery eyes and itching. Although this review concentrates on allergic rhinitis and ectoine nasal spray, it is worth to mention that these results are in line with other studies showing positive effects of ectoine-based eye drops for the treatment of allergic conjunctivitis [ 68 – 71 ].…”

Topical Ectoine Application in Children and Adults to Treat Inflammatory Diseases Associated with an Impaired Skin Barrier: A Systematic Review

“…Moreover, the combination of different treatment approaches, such as ectoine treatment in combination with other pharmacological therapy, showed additional potential for reducing the need for pharmacological therapy. The conclusion on ectoine efficacy on inflammatory skin diseases is also supported by evidence gained from other indications such as upper respiratory inflammation [43], allergic rhinitis [42], and irritation and inflammation of the eye surface [44]. No evidence on the efficacy of ectoine in other inflammatory skin diseases such as psoriasis could be identified, but this might be an interesting indication for further research.…”

“…Within the last few years, the beneficial properties of ectoine have been demonstrated in several nonclinical [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and clinical studies involving different indications [32][33][34][35][36][37][38][39][40][41] in which ectoine-based formulations were successfully used to alleviate symptoms of skin impairments or mucous membranes at different sites of the human body, such as nose and eyes, mouth or airways. Moreover, topical administration of ectoine has been reviewed for various indications, such as allergic rhinoconjunctivitis [42] and upper airway inflammation [43], as well as irritation and inflammations of the eye surface [44]. However, there is no summary of clinical evidence of ectoine-containing formulations on inflammatory skin diseases characterized by an impaired skin barrier.…”

Observational study investigating Ectoin® Rhinitis Nasal Spray as natural treatment option of acute rhinosinusitis compared to treatment with Xylometazoline

“…A study with chronic rhinosinusitis patients applying the Ectoin ® Rhinitis Spray for a longer period as in the current study would be very interesting. Of note, application of Ectoin ® containing eye drops over a period of 6 months has already been reported [ 23 ] as well as 3 months intranasal application in children [ 24 ].…”