OAG se desenvolve lentamente ao longo de muitos anos. A deposia§a£o excessiva de matriz (fibrose) no local de drenagem de fluido principal do olho pode levar ao aumento da pressão intraocular (PIO), resultando em danos ao nervo a³ptico
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)
Glaucoma agudo de a¢ngulo fechado do olho direito (pressão intraocular era de 42 no olho direito). Crédito: James Heilman, MD / Wikipedia
Cientistas da Universidade de Birmingham, no Reino Unido, demonstraram que um novo sulfato de dextrano de baixo peso molecular, ILB, pode desempenhar um papel fundamental no tratamento do glaucoma de a¢ngulo aberto (OAG), uma doença neurodegenerativa que afeta mais de 70 milhões de pessoas em todo o mundo e causa cegueira irreversavel .
OAG se desenvolve lentamente ao longo de muitos anos. A deposição excessiva de matriz (fibrose) no local de drenagem de fluido principal do olho pode levar ao aumento da pressão intraocular (PIO), resultando em danos ao nervo a³ptico . 1
A pesquisa, relatada na npj Regenerative Medicine , mostrou que o ILB pode normalizar a deposição da matriz dentro do olho e diminuir a PIO em um modelo pré- clanico usado para imitar esses aspectos do glaucoma humano, abrindo caminho para que novas terapias anti-fibra³ticas sejam desenvolvido para a doena§a.
OAG éuma doença complexa e tem se mostrado difacil desenvolver uma terapaªutica eficaz para direcionar as vias bioquímicas envolvidas. As terapias existentes funcionam principalmente reduzindo a produção de fluido no olho, não as causas subjacentes, e atémesmo as terapias mais recentes tem mostrado sucesso limitado na clanica. 2
Os cientistas de Birmingham se concentraram em uma via inflamata³ria comum a várias doenças e envolve o Fator Transformador de Crescimento β (TGFβ), uma molanãcula sinalizadora que se comunica entre as células e orquestra a inflamação e a fibrose. O papel do TGFβ em OAG bem conhecido, com pacientes demonstrando naveis mais elevados em seu humor aquoso e estudos de laboratório mostrando que o aumento artificial de TGFβ dentro do olho pode levar a fibrose 3,4 .
Os cientistas descobriram que o ILB tem ações multimodais em muitos genes que resolvem processos celulares inflamata³rios e fibra³ticos. Quando eles progrediram em seu trabalho em um modelo experimental pré-clanico de glaucoma, eles descobriram que as injeções subcuta¢neas dia¡rias de ILB significativamente (p <0,01) reduziram os naveis de matriz extracelular dentro do local de drenagem principal do olho, normalizou a pressão do olho e preveniu a degeneração dos neura´nios da retina . A pesquisa foi conduzida pela Dra. Lisa Hill, do Institute of Clinical Sciences, e pela Dra. Hannah Botfield, do Institute of Inflammation and Aging. Eles comentaram: "Estamos realmente entusiasmados com esses resultados, que mostram um caminho a seguir para um tratamento do glaucoma que pode reverter o processo fibra³tico que causa a doena§a."
Os médicos que trabalham com oftalmologia geralmente preferem a terapaªutica local em vez de administrada sistemicamente, pois éuma via de administração mais segura e mais aceita¡vel para os pacientes.
Dr. Hill estãoliderando um projeto para formular uma alternativa ta³pica que evitara¡ a necessidade de injeção. Ela estãotrabalhando em estreita colaboração com o Sr. Imran Masood, um cirurgia£o ofta¡lmico consultor da Sandwell and West Birmingham NHS Trust e o Professor Liam Grover, um especialista em biomateriais do Healthcare Technologies Institute da University, para avaliar o uso de um novo gel de fluido de diluição de cisalhamento para o resolução do glaucoma.
O gel fluido de diluição de cisalhamento foi desenvolvido para uso como colarios que são retidos por um longo período de tempo após a administração, e patentes foram registradas para seu uso sozinho e em combinação com outras terapaªuticas. 5 Estudos anteriores demonstraram que o gel fluido reduz as cicatrizes da ca³rnea quando aplicado topicamente e éuma molanãcula portadora eficaz para outras terapaªuticas. 6