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KMID : 0213520150290040270
Korean Journal of Ophthalmology
2015 Volume.29 No. 4 p.270 ~ p.279
In Vivo Effects of Preservative-free and Preserved Prostaglandin Analogs: Mouse Ocular Surface Study
Kim Jee-Hyun

Kim Eun-Joo
Kim Yeoun-Hee
Kim Yong-Il
Lee Se-Hyung
Jung Jae-Chang
Lee Kyoo-Won
Park Young-Jeung
Abstract
Purpose: Chronic use of topical hypotensive agents induces several side effects caused by preservatives.
The purpose of this study was to evaluate the effects of prostaglandin analogs with varying concentrations of
benzalkonium chloride (BAC), preservative-free (PF), and alternative preservatives on mouse corneal tissue.

Methods: Thirty-five, 8- to 10-week-old female C57BL/6 mice (five mice for each group) were used for this study. To the control group, we applied normal saline, and to each drug-treated group we applied 0.02% BAC, bimatoprost 0.01% (with BAC 0.02%), latanoprost 0.005% (with BAC 0.02%), travoprost 0.004% (with 0.001% polyquad) or tafluprost 0.0015% with/without 0.001% BAC, once a day (9 p.m.) for 4 weeks. Corneal fluorescein staining was evaluated in all groups. After harvest, the corneal tissues were embedded in paraffin and then Hematoxylin-Eosin stain was performed for histopathological examination. Immunofluorescence staining was done against TNF-¥á, IL-6, HLA DR, pJNK, and pAkt.

Results: In corneal fluorescein staining, severe punctate epithelial keratitis was seen in the groups of 0.02% BAC, 0.02% BAC containing bimatoprost 0.01% and latanoprost 0.005%. The surface desquamation, irregular surface, loss of cell borders, anisocytosis and stromal shrinkage were observed in the groups of BACcontaining eye drops. Moreover, the groups treated with BAC-containing eye drops have high inflammatory markers, significantly decreased cell viability-related signal, pAkt, and higher apoptosis-inducing signal, pJNK, than the control group. On the other hand, travoprost 0.004% and PF tafluprost 0.0015% have less cellular morphologic changes, lower inflammation, and higher cellular viability than BAC-containing formulations.

Conclusions: Corneal damage, increased inflammation and apoptosis and low cell viability were observed in BAC-containing groups. PF or alternatively preserved glaucoma medications seem to be a reasonable and viable alternative to those preserved with BAC.
KEYWORD
Benzalkonium compounds, Cornea, Pharmaceutical preservatives, Synthetic prostaglandins
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