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Nội dung chi tiết: Wormstone_and_Eldred_2014_revision_3_29_April_2015

Wormstone_and_Eldred_2014_revision_3_29_April_2015

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015f East Anglia.Norwich.NR4 7TJUK‘Corresponding author - E-mail: i.m.wormstone@uea.ac.ukRunning title: Models for PCOKey words: Posterior Capsule Opacif

ication: Models: Lens: fibrosis: wound-healing11.AbstractMillions of people worldwide are blinded due to cataract formation. At present the only means Wormstone_and_Eldred_2014_revision_3_29_April_2015

of treating a cataract is through surgical intervention. A modern cataract operation involves the creation of an opening in the anterior lens capsule

Wormstone_and_Eldred_2014_revision_3_29_April_2015

to allow access to the fibre cells, which are then removed. This leaves in place a capsular bag that comprises the remaining anterior capsule and the

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015od visual restoration, but unfortunately, residual lens epithelial cells undergo a wound-healing response invoked by surgery, which in time commonly r

esults in a secondary loss of vision. This condition is known as posterior capsule opacification (PCO) and exhibits classical features of fibrosis, in Wormstone_and_Eldred_2014_revision_3_29_April_2015

cluding hyperproliferation, migration, matrix deposition, matrix contraction and transdifferentiation into myofibroblasts. These changes alone can cau

Wormstone_and_Eldred_2014_revision_3_29_April_2015

se visual deterioration, but in a significant number of cases, fibre differentiation is also observed, which gives rise to Soemmering’s ring and Elsch

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015 or delay visual deterioration resulting from PCO. A range of experimental platforms are available for the study of PCO that range from in vivo animal

models to in vitro human cell and tissue culture models. In the current review, we will highlight some of the experimental models used in PCO researc Wormstone_and_Eldred_2014_revision_3_29_April_2015

h and provide examples of key findings that have resulted from these approaches.22.IntroductionFibrosis is a condition that affects multiple organs an

Wormstone_and_Eldred_2014_revision_3_29_April_2015

d is associated with hyperproliferation, migration, matrix deposition, matrix contraction and transdifferentiation into myofibroblasts (Leask and Abra

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015 in virtually all cases (Eldred et al., 2011; Wormstone, 2002; Wormstone et al., 2009). In a number of patients, fibre differentiation IS also evident

, which gives rise to Soemmering's ring and Elschnig's pearls that can cause further visual deterioration (Findl et al.. 2010; van Bree et al., 2013a; Wormstone_and_Eldred_2014_revision_3_29_April_2015

van Bree et al., 2012). PCO affects millions of individuals (Eldred et al., 2011; Wormstone, 2002; Wormstone et al., 2009). Understanding the regulat

Wormstone_and_Eldred_2014_revision_3_29_April_2015

ory mechanisms that underpin this condition IS crucial if we are to advance treatment strategies that will prevent or delay visual deterioration resul

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015m of PCO and highlight some of the experimental platforms available for PCO research and provide examples of key findings that have resulted from thes

e approaches.Cataract is the major priority in the global initiative to eliminate avoidable blindness by the year 2020 (McCarty and Taylor. 2001). Due Wormstone_and_Eldred_2014_revision_3_29_April_2015

to medical and sociological advances we are in a time where longevity has been significantly extended and our ageing population is increasing (ht(p:/

Wormstone_and_Eldred_2014_revision_3_29_April_2015

/www.worldometers.info/world-population/). Consequently, the incidence of cataract will rise. Cataract surgery is already the most common operative pr

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015ults, It is blighted by a secondary loss of vision caused by PCO, which3requires further surgical intervention to restore vision in a patient. This af

fects the wellbeing of the individual and places a great financial burden on health care providers (Wormstone et al., 2009).A modern cataract operatio Wormstone_and_Eldred_2014_revision_3_29_April_2015

n involves making a small incision in the sclera or cornea to permit introduction of surgical tools with minimal physical disruption to the eye. An op

Wormstone_and_Eldred_2014_revision_3_29_April_2015

ening in the lens is made by creating a continuous curvilinear capsulorhexis (capsular tear) in the anterior capsule using a capsulotome; an alternati

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015s circular window in the anterior capsule allows access to the central regions of the lens that are typically associated with cataractous change. The

lens fibres are usually removed by phacoemulsification, but in some cases this is assisted by femtosecond laser treatment of the fibre cells and on ra Wormstone_and_Eldred_2014_revision_3_29_April_2015

re occasions traditional hydrodissection methods are required. Residual fibre cells are removed by irrigation/aspiration techniques. The product of ca

Wormstone_and_Eldred_2014_revision_3_29_April_2015

taract surgery is a capsular bag; which comprises a portion of the anterior and the entire posterior capsule. The bag remains within the eye and is su

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015(IOL) is placed within the capsular bag and in doing so restores refractive power. Following surgery light can pass freely along the visual axis throu

gh the transparent IOL and thin acellular posterior capsule. However, lens epithelial cells can resist the trauma of surgery and these robust cells in Wormstone_and_Eldred_2014_revision_3_29_April_2015

time re-colonise regions of the anterior capsule denuded by surgical abrasion. Most importantly cells colonise the previously cell-free posterior cap

Wormstone_and_Eldred_2014_revision_3_29_April_2015

sule and encroach upon the visual axis. Modifications to cell organisation and the underlying matrix can cause light scatter (van Bree et al.,42013b;

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015l posterior capsule and associated cells, in order to permit an uninterrupted path through the visual axis (Wormstone et al.. 2009); however this is b

oth expensive, logistically difficult with elderly patients and has associated medical risk, such as increased likelihood of retinal detachment (Ranta Wormstone_and_Eldred_2014_revision_3_29_April_2015

and Kivela, 1998).There are a number of factors that can increase the incidence of PCO, for example young age. intraocular inflammation and surgical

Wormstone_and_Eldred_2014_revision_3_29_April_2015

factors (Wormstone et al.. 2009). Many studies have shown that PCO rates can be diminished by improved IOL design (Hayashi et al.. 2001; Nishi et al..

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015ll require a Nd:YAG laser capsulotomy within 2 years of surgery (Li et al.. 2013) and these numbers continue to rise with greater post-surgical time (

Vock et al.. 2009). This places a strain on healthcare resources, medical time and the quality of a patient s life (Cleary et al., 2007). These proble Wormstone_and_Eldred_2014_revision_3_29_April_2015

ms are exacerbated in paediatric eyes, eyes with inflammation or with multifocal lOLs. Reducing the impact of PCO on patients is therefore of great pr

Wormstone_and_Eldred_2014_revision_3_29_April_2015

actical importance and novel approaches need to be developed.Our understanding of the biological processes governing PCO formation (figure 2) and how

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015us scientists and clinicians need to gather, interpret and apply information that furthers our understanding of PCO and its management. In order to ac

hieve this, a body of5experimental systems are required and should be viewed as a collection of tools that together can best answer key questions. PCO Wormstone_and_Eldred_2014_revision_3_29_April_2015

research is well served by a variety of experimental systems (Table 1). We will therefore go on to discuss developments with in vivo models, cell cul

Wormstone_and_Eldred_2014_revision_3_29_April_2015

ture systems and tissue culture models. With respect to any model It is vital that the experimental design and objectives are ultimately directed to t

Experimental Models for Posterior Capsule Opacification ResearchIan Michael Wormstone* and Julie Ann EldredSchool of Biological Sciences.University of

Wormstone_and_Eldred_2014_revision_3_29_April_2015e performed in veterinary practices and again PCO is a major problem in these patients. With respect to guiding our research programmes and specific e

xperiments it is important to examine the information provided through post-mortem analysis (Marcantonio et al.. 2000: Saika et al., 2002: Wormstone e Wormstone_and_Eldred_2014_revision_3_29_April_2015

t al.. 2002a) and patient imaging systems (Grewal et al., 2008: Ursell et al., 1998). Cell organisation, modifications, expression of genes or protein

Wormstone_and_Eldred_2014_revision_3_29_April_2015

s provide a snap-shot at the scene of the crime. It is. however, difficult to garner the processes that lead to these changes directly from such data.

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