Zusammenfassung
Ziel
Der Nachstar ist die häufigste Komplikation nach erfolgreicher Kataraktchirurgie. 10 Jahre nach Operation benötigen bis zu 42% der Patienten mit Acryllinsen und scharfer Kante eine Nd:YAG-Kapsulotomie. Akkomodative und multifokale Intraokularlinsen weisen zum Teil sogar noch höhere Nachstarraten auf. Eine pharmakologische Prophylaxe mit Alkylphosphocholinen (APC) könnte eine effektive Alternative darstellen.
Methode
Als In-vitro-Modell diente die humane Linsenepithelzelllinie HLE-B3. Nach Inkubation mit APC in unterschiedlichen Konzentrationen (0,01; 0,1 und 1 mM) in Gegenwart von 5% Serum erfolgten der Trypanblau-Ausschlusstest und der Live/Dead-Test. Die Proliferation der Zellen wurde mit dem Tetrazoliumreduktionsassay bestimmt. Die Untersuchung der Anhaftung der Zellen wurde mittels mit Fibronektin und erstmals auch mit Laminin beschichteten Platten durchgeführt.
Ergebnisse
APC können die Proliferation von humanen Linsenepithelzellen in Gegenwart von nur 5% Serum dosisabhängig hemmen. Die Proliferation wurde zu mehr als 60% durch APC-Konzentrationen von 0,1 µM inhibiert, ebenso wie auch die Anhaftung der Linsenepithelzellen um mindestens 50% in Gegenwart von 0,1 µM APC.
Schlussfolgerung
APC hemmen die Proliferation und Anhaftung von humanen Linsenepithelzellen in-vitro. Die Substanz ist topisch applizierbar und eine intraoperative Anwendung zur pharmakologischen Nachstarprophylaxe mit APC grundsätzlich möglich.
Abstract
Background
Posterior capsule opacification (PCO) is one of the major concerns in modern cataract surgery. Ten years after successful surgery, Nd:YAG capsulotomy is required in up to 42% of patients with an acrylic sharp-edged intraocular lens (IOL). Some accommodative and multifocal IOLs display even higher capsulotomy rates. Pharmacologic prophylaxis with alkylphosphocholines (APCs) could be a novel option in PCO prevention.
Methods
The human lens epithelial cell line HLE-B3 served as an in-vitro model. After incubation with APCs in different concentrations (0.01, 0.1, and 1 mM), the trypan blue exclusion assay and the live/dead test were performed at serum concentrations of only 5%. Cell proliferation was assessed with the MTT test. Evaluation of cell attachment was done with fibronectin- and laminin-coated wells.
Results
APCs can inhibit the proliferation of human lens epithelial cells in the presence of only 5% serum in a dose-dependent manner. Proliferation inhibition of 60% and attachment inhibition of about 50% were reached at concentrations of 0.1 µM.
Conclusion
APCs inhibit proliferation and attachment of human lens epithelial cells in nontoxic concentrations in vitro. The substance can be applied topically, and an intraoperative application for pharmacologic PCO prophylaxis is feasible.
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Liegl, R., Kernt, M., Obholzer, K. et al. Alkylphosphocholine hemmen die Proliferation und Anhaftung von Linsenepithelzellen. Ophthalmologe 107, 937–940 (2010). https://doi.org/10.1007/s00347-010-2128-5
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DOI: https://doi.org/10.1007/s00347-010-2128-5