Oral Cimetidine Adjuvant Therapy for Recalcitrant, Diffuse Conjunctival Papillomatosis

Chang, Shu‐Wen; Huang, Zei-Lun

doi:10.1097/01.ico.0000214221.05991.ed

Cited by 20 publications

(13 citation statements)

References 25 publications

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“…Various adjunctive therapeutic modalities such as double freeze-thaw cryotherapy, CO 2 laser, oral cimetidine, and topical MMC or interferon α-2b have been suggested to reduce the recurrence rate of conjunctiva papilloma. [ 2 3 4 5 6 7 8 9 10 11 ] In our series, the most common treatment modality was surgical excision with adjunctive cryotherapy, and/or topical MMC, and/or CO 2 laser, which got a relatively lower recurrence rate (7%) in these patients as compared to those without adjunctive treatment (50%). The double freeze-thaw cryotherapy is a preferred method of adjunctive therapy for squamous cell papillomas with less scarring formation and a relatively lower recurrence rate.…”

Section: Discussionmentioning

confidence: 70%

“…Other interventions including perilesional cryotherapy, intralesional or topical interferon-α injection, carbon dioxide (CO 2 ) laser, topical mitomycin-C (MMC), and oral cimetidine have been reported to be as adjunctive treatments. [ 2 3 4 5 6 7 8 ] Despite the multiple choices of treatment modalities for treating conjunctival papilloma, recurrences are not uncommon. In this study, we investigate the clinical features, treatment, and postoperative outcome of conjunctival papilloma, to identify the related significant factors for recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Conjunctival papilloma: Clinical features, outcome, and factors related to recurrence

Huang

Yang

et al. 2018

Taiwan J Ophthalmol

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PURPOSE:The purpose of the study was to evaluate the clinical features, treatment, and outcome of patients with conjunctival papilloma.MATERIALS AND METHODS:Twenty-two patients (22 eyes) with biopsy-proven conjunctival papilloma between January 2005 and January 2015 in a tertiary medical center were retrospectively reviewed. Clinical profiles, treatment, outcome, and factors related to recurrence were evaluated.RESULTS:There were 16 males (73%) and 6 females (27%), with a mean age of 47 years. The most common location of conjunctival papilloma was the caruncle (43%), followed by palpebral conjunctiva (29%), bulbar conjunctiva (14%), and fornix (14%). Recurrence developed in five patients (22.7%). The risk of postoperative recurrence was significantly related to the presence of bulbar conjunctival papilloma with corneal involvement (P = 0.043) and surgical excision alone (P = 0.039). One case with multiple recurrences developed nonkeratinizing carcinoma. Two young females developed conjunctival papilloma even after receiving human papillomavirus vaccinations.CONCLUSION:The recurrence of conjunctival papilloma is not uncommon, especially for those patients underwent surgical excision alone. Surgical excision with adjunctive therapy and long-term follow-up is rational for the treatment of conjunctival papilloma.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Conjunctival papilloma: Clinical features, outcome, and factors related to recurrence

Huang

Yang

et al. 2018

Taiwan J Ophthalmol

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“…The management of papilloma is difficult because local excisions through cryotherapy may not excise diffuse and multifocal lesions; thus, multiple topical treatments have been suggested, including interferon-alpha (IFN- α ) and mitomycin-C, with variable success rates [ 12 , 13 ]. Several adjuvant therapies have also been suggested, such as oral cimetidine, which acts as a systemic immunomodulatory [ 14 ]. Accordingly, the current patient was treated with sufficient treatments for HPV, including topical IFN- α 2b and oral cimetidine, but there was no clinical response to anti-HPV management at the three-month follow-up, although the lesion resolved a few days after administration of 600 mg/three times a day of IV acyclovir.…”

Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus and Human Papillomavirus Coinfections in Hyperimmunoglobulin E Syndrome Presenting as a Conjunctival Mass Lesion

Akbari

Elmi

2017

Case Reports in Medicine

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Hyperimmunoglobulin E syndrome (HIES) or Job's syndrome is a rare immunodeficiency disease with less than 200 cases reported worldwide, among which few cases are reported with lesions due to herpes simplex virus (HSV) or human papillomavirus (HPV). This case study presents a rare case of HIES with coinfection of HSV and HPV. A 12-year-old boy, previously diagnosed with HIES, presented with a large conjunctival mass lesion. The presence of HPV in the lesion was confirmed by biopsy and by using the line-probe assay method to detect the HPV genome. However, the mass lesion did not respond to anti-HPV therapy with topical interferon-α2b (IFN-α2b) and oral cimetidine but improved promptly after intravenous (IV) acyclovir, which is often administered for cutaneous herpetic lesions. This suggested the presence of HSV in the conjunctival mass. Review of pathology and HSV immunohistochemical staining confirmed the presence of HSV as a coinfection. The likelihood that the mass arose from an abnormal host response to HSV and HPV due to HIES was considered, but coexisting infection with these two viruses and HIES has not been reported in the literature; therefore, such cases require further investigation.

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“…For example, oral cimetidine facilitates the healing of benign gastric ulcer at a dosage of 300 mg with meals and at bedtime (Isenberg et al ., ). At higher dosage, it results in augmentation of both cellular and humoral immunity and has been used clinically for papillomatosis treatment (Chang and Huang, ). Similarly, the minimum concentration of MOX needed to inhibit 90% of pathogens commonly encountered is in the range of 0.25–2.5 μg·mL –1 (Kernt et al ., ).…”

Section: Discussionmentioning

confidence: 99%

Moxifloxacin modifies corneal fibroblast‐to‐myofibroblast differentiation

Chen

Wang

2013

British J Pharmacology

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BACKGROUND AND PURPOSEFibroblast-to-myofibroblast differentiation is associated with scarring, an important issue in corneal surgery. Moxifloxacin (MOX), commonly applied to prevent post-operative infection, would benefit more if it modifies fibroblast-to-myofibroblast differentiation other than antimicrobial activity. Our purpose was to explore whether MOX has anti-fibrotic effect in human corneal fibroblasts (HCFs). EXPERIMENTAL APPROACHHCFs were incubated in MOX-containing medium concurrently with TGF-b1 (co-treatment), before (pretreatment) or after (post-treatment) adding TGF-b1. HCF contractility was evaluated with a type I collagen gel contraction assay. Expression of a-smooth muscle actin (a-SMA), Smad2, phospho-Smad2-Ser467, Smad4 and Smad7 was determined by immunoblotting. Formation of a-SMA-positive filaments and distribution of active Smad2 were observed under confocal microscopy. Expression of TGF-b receptor types I (TGFBR1) and II (TGFBR2) was assessed with flow cytometry. KEY RESULTSMOX did not affect gel contractility or a-SMA filament formation in HCFs without TGF-b1 stimulation. MOX did, however, retard HCF-containing gel contractility and a-SMA filament formation following TGF-b1 stimulation in the pretreatment and co-treatment groups but not in the post-treatment group. MOX blocked the expression of Smad2, phospho-Smad2-Ser467 and TGFBR1 under TGF-b1 incubation. Additionally, MOX enhanced Smad7 expression in TGF-b1-incubated HCFs, but did not interfere with TGF-b-triggered Smad2 nuclear translocation or Smad4 expression. CONCLUSIONS AND IMPLICATIONSMOX inhibited TGF-b-induced fibroblast-to-myofibroblast differentiation via blocking TGFBR1 and enhancing Smad7 expression. MOX should be used before or during surgery to achieve these effects. These results suggest a de novo mechanism by which MOX participates in corneal wound healing. AbbreviationsHCFs, human corneal fibroblasts; MOX, moxifloxacin; TGFBR1, TGF-b receptor type I; TGFBR2, TGF-b receptor type II; a-SMA, a-smooth muscle actin

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Oral Cimetidine Adjuvant Therapy for Recalcitrant, Diffuse Conjunctival Papillomatosis

Cited by 20 publications

References 25 publications

Conjunctival papilloma: Clinical features, outcome, and factors related to recurrence

Conjunctival papilloma: Clinical features, outcome, and factors related to recurrence

Herpes Simplex Virus and Human Papillomavirus Coinfections in Hyperimmunoglobulin E Syndrome Presenting as a Conjunctival Mass Lesion

Moxifloxacin modifies corneal fibroblast‐to‐myofibroblast differentiation

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