Pharmacological prevention of radiation-induced dry eye-an experimental study in a rabbit model

  • Julia Beutel
  • Christina Schroder
  • Katharina von Hof
  • Dirk Rades
  • Hartwig Kosmehl
  • Thilo Wedel
  • Peter Sieg
  • Gerd Geerling
  • Samer George Hakim
Laboratory Investigation
First Online:
Received:
Revised:
Accepted:

Abstract

Purpose

To evaluate the radioprotective effect of lidocaine, amifostine and pilocarpine on lacrimal glands.

Methods

Twenty-five rabbits were randomized into five groups: the control, irradiated/sham-treated, irradiated/lidocaine-pretreated, irradiated/amifostine-pretreated and irradiated/pilocarpine-pretreated groups. One week before irradiation, 72 h and 1 month afterward, the inferior lacrimal gland was investigated histomorphologically, immunohistochemically [tenascin-C and alpha smooth muscle actin (α-SMA)] and functionally using scintigraphy and the Schirmer test.

Results

Compared with control animals, the lacrimal ejection fraction (LEF) in the irradiated/sham-treated group was significantly reduced 72 h afterwards. Pilocarpine- as well as amifostine-pretreated animals showed a slightly lower reduction. Lidocaine stabilized the LEF. Immunohistochemically, a significant loss of α-SMA and an up-regulation of tenascin-C expression in irradiated/untreated glands were evident. Pretreatment with lidocaine and amifostine-but not with pilocarpine-induced lower up-regulation of TN-C expression 72 h after radiation. One month after irradiation a reduction of the immunhistochemical changes at all was found. Ultrastructural damage was observed in irradiated/non-treated and pilocarpine-pretreated glands, whereas lidocaine and amifostine preserved the ultrastructure.

Conclusion

Morphologic and functional findings could prove a prevailing protection profile of amifostine and especially of lidocaine on lacrimal glands. This may provide a prophylactic approach in the radioprotection of the lacrimal glands during radiotherapy of the orbital region.

Keywords

Amifostine Dry eye Lidocaine Pilocarpine Radiation Tear secretion 
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Notes

Acknowledgement

The authors would like to thank Mrs. G. Knebel (Institute of Anatomy, University of Luebeck) for her painstaking assistance in the transmission electron microscopic studies.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Julia Beutel
    • 1
    • 2
  • Christina Schroder
    • 1
  • Katharina von Hof
    • 3
  • Dirk Rades
    • 4
  • Hartwig Kosmehl
    • 5
  • Thilo Wedel
    • 6
  • Peter Sieg
    • 7
  • Gerd Geerling
    • 8
  • Samer George Hakim
    • 7
  1. 1.Department of OphthalmologyUniversity Hospital Schleswig-HolsteinLuebeckGermany
  2. 2.University Eye Hospital, Centre of OphthalmologyEberhard-Karls University of TuebingenTuebingenGermany
  3. 3.Department of Radiology and Nuclear MedicineUniversity Hospital Schleswig-HolsteinLuebeckGermany
  4. 4.Department of Radiation OncologyUniversity Hospital Schleswig-HolsteinLuebeckGermany
  5. 5.Institute of PathologyHelios Medical CentreErfurtGermany
  6. 6.Institute of AnatomyChristian Albrecht University of KielKielGermany
  7. 7.Department of Maxillofacial SurgeryUniversity Hospital Schleswig-HolsteinLuebeckGermany
  8. 8.Department of OphthalmologyUniversity of WürzburgWürzburgGermany

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