Intense pulsed light alleviates keratoconus by improving the local corneal microenvironment

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2024-11-19 DOI:10.1016/j.mehy.2024.111526

Zixiang Zhao , Yu Liu , Yuhao Zou , Yi Liu , Man Yu

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引用次数: 0

Abstract

Keratoconus (KC) is a corneal ectasia with a complex etiology, and its pathogenesis remains incompletely understood. Research indicates that the development of KC is closely linked to inflammation and local oxidative stress (OS) triggered by alterations in the microenvironment of the ocular surface. Intense pulsed light (IPL) has been shown to enhance the ocular surface microenvironment, decrease inflammatory cytokines, and mitigate oxidative stress associated with KC progression. We hypothesize that IPL may impede the advancement of KC through several mechanisms. IPL treatment could lead to a decrease in inflammatory mediators (such as IL-1, IL-17, IL-6, etc.) in the eyelid margin and ocular surface, as well as a reduction in matrix metalloproteinases (MMPs) levels in tears, while elevating tissue inhibitor of metalloproteinases (TIMPs) levels, thereby slowing down extracellular matrix (ECM) degradation. Moreover, IPL stimulates fibroblasts to upregulate the expression of type I and type III procollagen mRNA and enhance ECM synthesis. Additionally, IPL regulates tear reactive oxygen species (ROS) levels, elevating tissue superoxide dismutase (SOD) levels through light modulation, maintaining the balance between oxidation and antioxidation, and lessening OS-induced damage. Lastly, IPL diminishes the urge of patients to rub their eyes by alleviating the itching sensation. In conclusion, IPL holds promise as a potential therapeutic approach for managing KC.

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强脉冲光通过改善局部角膜微环境缓解角膜炎症状

角膜塑形镜（KC）是一种病因复杂的角膜异位症，其发病机制至今仍未完全明了。研究表明，KC 的发病与炎症和眼表微环境改变引发的局部氧化应激（OS）密切相关。强脉冲光（IPL）已被证明能改善眼表微环境，减少炎症细胞因子，减轻与 KC 进展相关的氧化应激。我们假设 IPL 可通过多种机制阻碍 KC 的发展。IPL 治疗可导致眼睑边缘和眼表面的炎症介质（如 IL-1、IL-17、IL-6 等）减少，泪液中的基质金属蛋白酶（MMPs）水平降低，而金属蛋白酶组织抑制剂（TIMPs）水平升高，从而减缓细胞外基质（ECM）降解。此外，IPL 还能刺激成纤维细胞上调 I 型和 III 型胶原蛋白 mRNA 的表达，促进 ECM 的合成。此外，强脉冲光还能调节泪液中活性氧（ROS）的水平，通过光调节提高组织超氧化物歧化酶（SOD）的水平，维持氧化和抗氧化之间的平衡，减轻操作系统引起的损伤。最后，强脉冲光还能减轻瘙痒感，从而减少患者揉眼的冲动。总之，强脉冲光有望成为控制 KC 的一种潜在治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.