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標題: Effects of Topical Lactoferrin, Platelet-Rich plasma and Autologous Serum on Corneal Epithelial Healing in Rabbits
作者: Hsin-Yu Chen
關鍵字: 乳鐵蛋白;血小板濃厚血漿;角膜潰瘍;lactoferrin;platelet-rich plasma;corneal ulcer
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角膜潰瘍起因於上皮受損過度或保護機制功能不足,為小動物臨床醫學常見疾病之一,治療原則為移除病因、預防繼發性細菌感染、緩解疼痛與發炎等症狀,以及促進角膜癒合。自體血清與血小板濃厚血漿眼藥水皆富含生長因子、細胞激素與其他能促進角膜癒合的物質,可用於治療角膜潰瘍,但因需抽取多量血液,於小動物臨床應用上有所限制。乳鐵蛋白存在於正常淚液中,除了能抑制病原微生物生長,亦可能具有降低炎症反應與促進角膜上皮癒合之功能。本研究目的為評估並比較商品化乳鐵蛋白、血小板濃厚血漿眼藥水與自體血清眼藥水對於促進角膜上皮癒合之療效。實驗對象為20隻紐西蘭白兔,共40個眼睛,將其分為8組,實驗一除了控制組外,於誘導角膜上皮缺損後分別給予0.5%、1%、2%乳鐵蛋白眼藥水、10%血小板濃厚血漿眼藥水或50%自體血清眼藥水,每日2次,每組各6個眼睛;實驗二則增加點藥頻率至每日10次,分別給予0.5%乳鐵蛋白或10%血小板濃厚血漿眼藥水,每組各2個眼睛。於誘導角膜上皮缺損後第 0、4、8、16、20、24、28、32、40、44、48、52、56、64、68、72、76、80、88、92、96、100 小時觀察其臨床症狀與角膜上皮缺損面積,並於實驗結束後進行角膜組織病理學檢查與眼藥水微生物學檢查;於100小時內,共38個角膜(95%)達完全癒合,各組角膜上皮缺損面積、癒合面積、癒合時間、平均癒合速率皆無顯著差異(p >0.05),組織病理學檢查可見各組皆癒合良好,且所有眼藥水皆未受到細菌汙染。本實驗結果顯示,使用 0.5%、1%、2%乳鐵蛋白、10%血小板濃厚血漿或50%自體血清眼藥水,皆無顯著促進角膜上皮癒合或改善臨床症狀之療效。

Corneal ulcers usually result from excessive corneal epithelial injury or lack of protective mechanisms, and it is a common disease in small animal ophthalmology. The treatment protocol is to identify and remove the pathogenic cause, prevent secondary infection, relieve pain, control the inflammatory process, and promote corneal healing. Autologous serum and platelet-rich plasma (PRP) eyedrops are blood derivatives containing cytokine, growth factors and other components which may accelerate corneal healing. Both eyedrops are effective in the treatment of corneal ulceration; however, the clinical application in small animal ophthalmology is often limited by the requirement of a considerable amount of blood to be drawn, which is not feasible in some patients. Lactoferrin is a glycoprotein found in normal tears, besides the antimicrobial activity, it may also harbor the ability to suppress inflammation and promote corneal healing. The purpose of this study is to evaluate and compare the efficacy of topical lactoferrin, platelet-rich plasma and autologous serum in corneal epithelial wound healing. Twenty New Zealand albino rabbits (40 eyes) were used in this study and divided into eight groups. In experiment 1, except for the control group, the eyes were treated with topical 0.5%, 1%, or 2% lactoferrin, 10% PRP, or 50% autologous serum twice a day, respectively (n=6 in each group). In experiment 2, the eyes were treated with topical 0.5% lactoferrin or 10% PRP ten times a day, respectively (n=2 in each group). Clinical signs and corneal epithelial defect area were recorded at 0, 4, 8, 16, 20, 24, 28, 32, 40, 44, 48, 52, 56, 64, 68, 72, 76, 80, 88, 92, 96 and 100 hours after induction of corneal epithelial defect. At 100 hours post-injury, the corneas were excised for histopathological examination, and the eyedrops were cultured for sterility analysis. Thirty eight corneas (95%) were completely healed within 100 hours post-injury. There was no statistically difference in the corneal epithelial defect area, healing area, complete heal time, and mean healing rate among the groups. Histopathological examination of the corneas showed normal healing features. All of the eyedrops remain sterile after 100 hours of storage. Treatment with topical 0.5%, 1%, or 2% lactoferrin, 10% PRP, or 50% autologous serum did not reveal the efficacy of accelerating corneal epithelial healing or improving clinical signs in this study.
其他識別: U0005-0608201515425400
Rights: 同意授權瀏覽/列印電子全文服務,2018-08-21起公開。
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