Topical Insulin for Ocular Surface Disease.

IF 1.9 4区 医学 Q2 OPHTHALMOLOGY Journal of Ocular Pharmacology and Therapeutics Pub Date : 2024-05-01 Epub Date: 2024-03-22 DOI:10.1089/jop.2024.0016
Pau Cid-Bertomeu, Magí Vilaltella, Mireia Martínez, Marta Mir, Valentín Huerva
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Abstract

Background: Insulin and insulin-like growth factor (IGF)-1 receptors are present in ocular tissues such as corneal epithelium, keratocytes, and conjunctival cells. Insulin plays a crucial role in the growth, differentiation, and proliferation of corneal epithelial cells, as well as in wound healing processes in various tissues. Purpose: This review explores the potential role of topical insulin in the treatment of ocular surface diseases. Specifically, it examines its impact on corneal nerve regeneration, sub-basal plexus corneal nerves, and its application in conditions like corneal epithelial defects, dry eye disease, and diabetic keratopathy. Methods: The review analyzes studies conducted over the past decade that have investigated the use of topical insulin in ocular surface diseases. It focuses on indications, drug preparation methods, side effects, efficacy outcomes, and variations in insulin concentrations and dosages used. Results: While off-label use of topical insulin has shown promising results in refractory corneal epithelial defects, its efficacy in dry eye disease is yet to be demonstrated. Variations in concentrations, dilutions, and dosing guidelines have been reported. However, limited data on ocular penetration, ocular toxicity, and systemic side effects pose challenges to its widespread utility. Conclusion: This review synthesizes findings from ocular investigations on topical insulin to assess its potential applicability in treating ocular surface and corneal diseases. By highlighting indications, preparation methods, side effects, and efficacy outcomes, it aims to provide insights into the current status and future prospects of using topical insulin in ophthalmic practice.

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治疗眼表疾病的局部胰岛素。
背景:胰岛素和胰岛素样生长因子(IGF)-1 受体存在于角膜上皮细胞、角膜细胞和结膜细胞等眼组织中。胰岛素在角膜上皮细胞的生长、分化和增殖以及各种组织的伤口愈合过程中发挥着至关重要的作用。目的:本综述探讨了局部胰岛素在治疗眼表疾病中的潜在作用。具体而言,它研究了胰岛素对角膜神经再生、基底丛下角膜神经的影响,以及在角膜上皮缺损、干眼症和糖尿病角膜病变等疾病中的应用。方法:本综述分析了过去十年间对局部胰岛素在眼表疾病中应用的研究。重点关注适应症、药物制备方法、副作用、疗效结果以及所用胰岛素浓度和剂量的变化。结果:虽然标签外使用胰岛素治疗难治性角膜上皮缺损取得了良好效果,但其对干眼症的疗效仍有待证实。有报告称,胰岛素的浓度、稀释度和剂量指南存在差异。然而,有关眼部渗透、眼部毒性和全身副作用的数据有限,这对其广泛应用构成了挑战。结论本综述综合了有关局部胰岛素的眼部研究结果,以评估其在治疗眼表和角膜疾病方面的潜在适用性。通过强调适应症、制备方法、副作用和疗效结果,旨在为眼科实践中局部使用胰岛素的现状和未来前景提供见解。
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来源期刊
CiteScore
4.60
自引率
4.30%
发文量
72
审稿时长
1 months
期刊介绍: Journal of Ocular Pharmacology and Therapeutics is the only peer-reviewed journal that combines the fields of ophthalmology and pharmacology to enable optimal treatment and prevention of ocular diseases and disorders. The Journal delivers the latest discoveries in the pharmacokinetics and pharmacodynamics of therapeutics for the treatment of ophthalmic disorders. Journal of Ocular Pharmacology and Therapeutics coverage includes: Glaucoma Cataracts Retinal degeneration Ocular infection, trauma, and toxicology Ocular drug delivery and biotransformation Ocular pharmacotherapy/clinical trials Ocular inflammatory and immune disorders Gene and cell-based therapies Ocular metabolic disorders Ocular ischemia and blood flow Proliferative disorders of the eye Eyes on Drug Discovery - written by Gary D. Novack, PhD, featuring the latest updates on drug and device pipeline developments as well as policy/regulatory changes by the FDA.
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