Personalized Medicine in Ocular Fibrosis: Myth or Future Biomarkers

Abstract

Significance: Fibrosis-related events play a part in the pathogenesis or failure of treatment of virtually all the blinding diseases around the world, and also account for over 40% of all deaths. It is well established that the eye and other tissues of some group of patients, for example Afro-Caribbean people, scar worse than others. However, there is a current lack of reliable biomarkers to stratify the risk of scarring and postsurgical fibrosis in the eye.Recent Advances: Recent studies using genomics, proteomics, metabolomics, clinical phenotyping, and high-resolution in vivo imaging techniques have revealed potential novel biomarkers to identify and stratify patients at risk of scarring in different fibrotic eye diseases.Critical Issues: Most of the studies, to date, have been done in animals or small cohorts of patients and future research is needed to validate these results in large longitudinal human studies. Detailed clinical phenotyping and effective biobanking of patient tissues will also be critical for future biomarker research in ocular fibrosis.Future Directions: The ability to predict the risk of scarring and to tailor the antifibrotic treatment regimen to each individual patient will be an extremely useful tool clinically to prevent undertreating, or exposing patients to unnecessary treatments with potential side effects. An exciting future prospect will be to use new advances in genotyping, namely next-generation whole genome sequencing like RNA-Seq, to develop a customized gene chip in ocular fibrosis. Successful translation of future biomarkers to benefit patient care will also ultimately require a strong collaboration between academics, pharmaceutical, and biotech companies.

Aqueous Humor Levels of Cytokines and Growth Factors in Patients with Congenital Aniridia

“…Поскольку интраокулярный фиброз часто ассоциирован с острым или хроническим воспалительным процессом и ангиогенезом (рост эпиретинальных мембран, пролиферативная диабетическая ретинопатия (ПДР), возрастная макулярная дегенерация, ретинопатия недоношенных и пр. [7][8][9]), важно было оценить содержание провоспалительных цитокинов и ангиогенных фактора роста (VEGF) у пациентов с ВА и сравнить их концентрацию с группой пациентов без аниридии. Анализ показал отсутствие статистически значимых различий в уровне основных медиаторов воспаления (IL-1β, IL-6, IL-8, IL-12, IL-17A и MCP-1) между группами (р > 0,05).…”

History, presence, and future of mitomycin C in glaucoma filtration surgery

“…These new GFS drugs may avoid several of the side effects of MMC and maybe also the individual variability between patients. In the future, medication may be personalized taking account of individual differences in fibrosis [98].…”

Biomarkers and Surrogate Endpoints in Drug Development: A European Regulatory View

“…Efficacy endpoints alone are not the only area for biomarker or method development. Recently published scientific literature reviews the current status and work in progress to investigate possible novel methods with potential applications in ophthalmic drug development in various contexts of use such as detecting earlier stages of disease, classifying prognosis, or identifying responders in indications ranging across retinal vascular and degenerative diseases, [22][23][24] postsurgical fibrosis, 25 ocular surface disease, 26,27 ocular oncology, 28 and uveitis. 29…”