Biocompatibility of a Synthetic Biopolymer for the Treatment Of
Total Page:16
File Type:pdf, Size:1020Kb
perim Ex en l & ta a l ic O p in l h t C h f Journal of Clinical & Experimental a o Sarfare et al., J Clin Exp Ophthalmol 2015, 6:5 l m l a o n l r o DOI: 10.4172/2155-9570.1000475 g u y o J Ophthalmology ISSN: 2155-9570 ResearchResearch Article Article OpenOpen Access Access Biocompatibility of a Synthetic Biopolymer for the Treatment of Rhegmatogenous Retinal Detachment Shanta Sarfare1*, Yann Dacquay1, Syed Askari2, Steven Nusinowitz1 and Jean-Pierre Hubschman1 1Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA 2Medicus Biosciences, 2528 Qume Drive, Unit 1, San José, California 95131, USA Abstract Objective: The aim of this study is to evaluate the retinal safety and toxicity of a novel synthetic biopolymer to be used as a patch to treat rhegmatogenous retinal detachment. Methods: Thirty one adult wild type albino mice were divided in 2 groups. In Group A (n=9) 0.2 µl balanced salt solution (BSS) and in Group B (n=22), 0.2 µl biopolymer was injected in the subretinal space. Trans-scleral subretinal injection was performed in one eye and the fellow eye was used as control. In both groups, in vivo color fundus photography, electroretinogram (ERG), spectral domain optical coherence tomography (SD-OCT) were performed before injection and at days 7 and 14 post-intervention. Histological analysis was performed following euthanization at days 1, 7 and 21 post-injection. Results: The biopolymer was visualized in the subretinal space in vivo by SD-OCT and post-life by histology up to 1 week after the injection. There were no significant differences in ERG parameters between the two groups at 1 and 2 weeks post-injection. Minimal inflammatory response and loss of photoreceptor cells was only observed in the immediate proximity of the site of scleral perforation, which was similar in both groups. Overall integrity of the outer, inner retina and retinal pigment epithelial (RPE) layers was unaffected by the presence of the biopolymer in the subretinal space. Conclusions: Functional and histological evaluation suggests that the synthetic biopolymer is non-inflammatory and non-toxic to the eye. It may represent a safe therapeutic agent in the future, for the treatment of rhegmatogenous retinal detachment. Keywords: Retinal detachment; Retinal adhesive; Retinal tear which has the ability to effectively seal the retinal breaks in retinal detachment surgery. Introduction Polyethylene glycol (PEG) derivatives with molecular weights 10 Retinal detachment is the separation of the neurosensory retina from kilo Dalton (kDa) and higher are generally recognized as safe and non- the RPE, and is a potentially blinding ocular condition. Rhegmatogenous toxic [20] and therefore have been extensively used in medical devices retinal detachments are the most common type of retinal detachments and as drug carriers in pharmaceuticals applications [21-23]. Our and are secondary to retinal holes and/or breaks, which allow fluid study aims to evaluate the potential ocular and in particular the retinal from the vitreous cavity to enter the space between the RPE and the toxicity of a PEG-derived ophthalmic biopolymer through clinical, neurosensory retina. Individuals with myopia, as well as history of electrophysiological and histological evaluations. cataract surgery, trauma or ocular infections have a higher risk of developing rhegmatogenous retinal detachment [1-3]. Left untreated, a Methods chronic retinal detachment can lead to complications such as proliferative Animals vitreoretinopathy (PVR), vision loss and permanent blindness [4]. Albino Balb/c mice 6–8 weeks of age purchased from Jackson Standard treatment for rhegmatogenous retinal detachment Laboratories, ME maintained on 12/12 hours light/dark cycle were used involves scleral buckling and/or pars plana vitrectomy (PPV). in this study. All experiments were performed with IACUC-approved Endotamponade agents such as air, sulfur hexafluoride (SF6), protocols and following the ARVO Statement for the Use of Animals in octafluoropropane (C3F8) gas or silicone oil are used to maintain Ophthalmic and Vision Research. the retina in place and reduce fluid flow through the retinal opening until the retinopexy scar heals [5-8]. Although tamponade agents are successful in achieving reattachment, they have several disadvantages *Corresponding author: Shanta Sarfare, Ora, Inc., 300 Brickstone Square, such as head positioning, travel restrictions, limited vision for up to 2 Andover, Massachusetts, USA, Tel: 978-685-8900 extension 9532; Fax: 978-689- months, silicone oil adhesion to intraocular lenses, cataract, glaucoma, 0020; E-mail: [email protected] keratopathy and need for second surgery [9-13]. Received August 28, 2015; Accepted September 10, 2015; Published September 14, 2015 Some retinal adhesive products have been previously tested [14- Citation: Sarfare S, Dacquay Y, Askari S, Nusinowitz S, Hubschman JP (2015) 20]. The advantage of using retinal adhesives is that they can be used Biocompatibility of a Synthetic Biopolymer for the Treatment of Rhegmatogenous as a patch to cover and seal the retinal holes and/or retinal breaks and Retinal Detachment. J Clin Exp Ophthalmol 6: 475. doi: 10.4172/2155- eliminate the need for gas or silicone oil tamponade. However, these 9570.1000475 agents demonstrated severe retinotoxicity, inflammatory reaction, Copyright: © 2015 Sarfare S, et al. This is an open-access article distributed under difficulty of delivery or limited efficacy [14,15,17,19]. There is currently the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and no product available that is non-toxic to the ocular structures and source are credited. J Clin Exp Ophthalmol ISSN: 2155-9570 JCEO, an open access journal Volume 6 • Issue 5 • 1000475 Citation: Sarfare S, Dacquay Y, Askari S, Nusinowitz S, Hubschman JP (2015) Biocompatibility of a Synthetic Biopolymer for the Treatment of Rhegmatogenous Retinal Detachment. J Clin Exp Ophthalmol 6: 475. doi: 10.4172/2155-9570.1000475 Page 2 of 8 Generation of the ophthalmic biopolymer Functional evaluation The ophthalmic pre-formulation developed by Medicus Electroretinography (ERG): Dark adapted rod-mediated ERGs Biosciences (San José, California) comprises of three compounds: were recorded to blue flashes (Wratten 47A, maxλ =470 nm). Bilateral one containing 8 nucleophilic groups (8-arm-PEG 20K amine), the ERG recordings were performed on 16 mice, at baseline 1 week prior second also containing 8 nucleophilic groups and 8 degradable acetate and 1 and 2-weeks post injection, as previously described [29]. ERGs groups (8-arm-PEG 20K amine acetate) and the third containing 4 were recorded from the cornea using a gold loop electrode, referenced electrophilic groups (4-arm-PEG 20K amide ester) in a stoichiometric to a similar gold wire in the mouth. The mouse eye was positioned in ratio; an aqueous buffer and a viscosity enhancer [24-27]. The polymer front of an opening in a large integrating sphere in which brief flashes was designed to be degraded in 2-weeks by selecting degradable acetate of light at 1 Hz interval were presented. Responses were amplified groups, numbers of crosslinking sites and the polymer concentration in 10,000 × (Grass P511 High Performance AC Amplifier), band-pass the solution. Retinal adherence and the viscosity of the polymer were filtered (0.1-300 Hz), digitized using an I/O board (PCI-6221; National enhanced with the use of hydroxyl methyl propyl methyl cellulose. The Instruments, Austin, TX) and averaged. polymer demonstrated in previous study similar adhesive properties as Histological evaluation: Light, electron microscopy and the retina when tested in our laboratory [28]. All reactive PEG materials immunocytochemistry. were purchased from JenKem Corp, Plano, Texas. The firmness, adhesion, and elastic modulus of the polymer were characterized by Paraffin embedded tissue (FFPE): Eyes from mice (group A, n=3; a Texture Analyzer (TA.XT.plus) with Exponent software (v6.0) using group B, n=13) 3 weeks post-injection were fixed in 10% neutral buffered various probes. The components in the injection kit were mixed, formalin, paraffin embedded and sectioned. Consecutive 5-μm sections filtered and injected into the subretinal space as a liquid biopolymer were stained with hematoxylin and eosin (H&E) for light microscopy which solidifies at pH 7.4 at a pre-set time of 90–300 sec and adheres and processed for TUNEL labeling or immunohistochemistry. to the tissue. Plastic embedded tissue: Mouse eyes (group A, n=3; group B, Subretinal injections n=6) were oriented with respect to site of injection using cautery iron or tissue marker pen, fixed with a mixture of 2% paraformaldehyde: Eyes were dilated with 2.5% phenylephrine (HUB Pharmaceuticals, 2.5% glutaraldehyde in 0.1M sodium phosphate buffer (pH 7.4) and Rancho Cucamonga, CA) and 0.5% tropicamide (Akorn processed as previously described [30]. Sections of 1µm thickness Pharmaceuticals, Lake Forest, IL). Mice were anesthetized with stained with Toluidine blue were imaged with a Zeiss Axiophot ketamine (100 mg/kg; Phoenix Pharmaceuticals) and xylazine (8 mg/ microscope and ultra-thin sections stained with uranium and lead salts kg; Lloyd Laboratories). Goniovisc (2.5%) (HUB Pharmaceuticals, were imaged using Zeiss EM910 electron microscope. Rancho Cucamonga, CA) was applied to the eye to maintain corneal