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Book
Les transports de la cornée : impacts pharmacothérapeutiques
Authors: --- ---
Year: 2011 Publisher: Bruxelles: UCL,

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Abstract

The eye is a spectacular sensory organ, known to be sophisticated. These last years, ophthalmology and ophtalmopharmacology have strongly progressed due to technological advances. For topically administered drugs, the first structure affected is the cornea. Therefore it forms the primary rate-limiting permeability barrier to compound absorption into the anterior chamber of the eye. Ocular drug absorption into anterior ocular tissue is determined either by passive diffusion, facilitated diffusion or by active transport. The scientific literature gives us information about the expression of many transporters in the corneal epithelium which can act as drug delivery system. We can classify transporters both as influx or efflux transporters. Efflux transporters include MRP1 4,5,6 and MDR1. They play an important role in the protection of ocular tissue, indeed, the mechanism of efflux enhance ocular drug penetration. Influx transporters include peptides transporters such as PEPTs, ATB0, +, LAT They may be particularly important in absorption, distribution and clearance of their drug substrate in the eye. The discovery of such transporters in the corneal epithelium is an interesting theme of research that cans enrich the field of ophatlmopharmacology. Indeed, understanding the substrate specificity and the structure- activity relationships of various transporter proteins might make it possible to design prodrugs that are targeted to specific transporter. This point of view is very important to develop new drugs which could treat ocular pathologies such as inflammations, infections and glaucoma. Research about cornea transporters move forward and continue to grow. It is evident that the knowledge about this subject is currently quite limited. Extensive studies are needed to clarify the role and clinical significance of drug transporters in the eye but the future is promising in this regard L’œil est un organe sensoriel spectaculaire et étonnamment sophistiqué. Ces dernières années, les avancées technologiques ont permis de faire des progrès considérables en ce qui concerne l’ophtalmologie et l’ophtalmopharmacologie. Lors de l’application topique de substances actives au niveau de l’œil, la première structure touchée est la cornée. Celle-ci forme une barrière limitante et perméable à l’absorption de substances actives au niveau de la chambre antérieure de l’œil. L’absorption de tels composés se fait donc selon différents phénomènes, tels qu’un transport passif, actif ou encore un transport facilité. L’analyse de la littérature scientifique nous apprend que la cornée exprime de façon non négligeable des transporteurs. On y retrouve des transporteurs à efflux tels que le MRP1,4,5,6, MDR1, qui jouent un rôle important au niveau de la protection des tissus oculaires, en empêchant toute pénétration de substance active. On retrouve également des transporteurs à influx de type peptidiques comme les PEPTs, ATB0, +, LAT, etc... Ceux-ci sont étroitement impliqués dans l’absorption, la distribution et la clairance d’un principe actif au niveau de l’œil. La découverte de ces transporteurs au niveau de la cornée offre une cible de recherche très intéressante et apporte ainsi une réelle avancée dans le domaine de l’ophtalmopharmacologie. En effet, en connaissant la spécificité des substrats et les relations de structure-activité entre le substrat et divers transporteurs, on peut facilement imaginer la création de prodrogues qui cibleraient de manière spécifique les transporteurs, où comment transformer une molécule incapable de traverser un transporteur en un substrat idéal? Ceci est particulièrement intéressant pour les pathologies oculaires telles que les inflammations, les infections et le glaucome. La recherche sur les transporteurs de la cornée va de l’avant et ne cesse de progresser. Cependant, les connaissances à ce sujet restent limitées et d’autres études sont nécessaires pour clarifier le rôle et l’importance clinique de ces transporteurs


Book
Adenovirus Epithelial Keratitis and Thygeson's Superficial Punctate Keratitis : In Vivo Morphology in the Human Cornea
Author:
ISBN: 3642216331 9786613449566 1283449560 364221634X Year: 2012 Publisher: Berlin, Heidelberg : Springer Berlin Heidelberg : Imprint: Springer,

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Abstract

Adenovirus epithelial keratitis and Thygeson's superficial punctate keratitis (TSPK) are apparently disparate diseases. While adenovirus eye infections are very common, caused by a known agent, and highly infectious, TSPK is comparatively rare, of unknown causation, and seemingly non-contagious. Despite these differences, the two diseases are often confused in clinical practice owing to the similarity between adenovirus epithelial infiltrates and ‘coarse’ epithelial TSPK lesions. This book presents the morphological features, dynamics, and sequelae of adenovirus and Thygeson's keratitides captured at high magnification in the living human cornea. It thereby fills the existing void between conventional photographs and slit-lamp observations. Case reports demonstrate the importance of patient history in differential diagnosis, illustrate the need for familiarity with early manifestations of adenovirus infections, and assist in the diagnosis of rare variants of TSPK. Furthermore, the detailed observations on the natural course of the diseases ensure that the book will serve not only as a diagnostic tool but also as a reference when evaluating the effects of potential new treatments.

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