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A. F. Laplante, P. Carrier, A. Deschambeault, F. A. Auger, L. Germain; Therapeutic Agents Used to Treat Chemical Burns Have Various Effects on the Reepithelialization of Tissue-Engineered Human Corneas. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1888.
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Some cocktails of medications were shown by animal and human studies to have a beneficial effect on the healing of chemically burned eyes, especially on limiting the perforation rate. However, this was reported without addressing the effect of each agent separately and without focussing on the reepithelialization process. Therefore, we studied the individual effect on reepitheliazation of many therapeutic agents used clinically.
We conducted an in vitro study using tissue-engineered corneas, produced by the culture of human cells. Corneas were reconstructed by stacking together sheets of fibroblasts and seeding them with epithelial cells. These reconstructed corneas were then wounded with a 6-mm punch biopsy and placed on a reconstructed stroma. They were treated twice a day with different pharmacologic agents. On the 3rd day, photographs were taken and used to measure the reepithelialized surfaces. A statistical analysis was conducted. Histology was studied with Masson trichrome staining.
In comparison to wounds treated with phosphate buffer saline, acetylcysteine 10%, citrate 3,2% or 10% significantly reduced the reepithelialization process; human serum significantly accelerated it; prednisolone 1% or dexamethasone 10% had no effect. Platelet-rich or platelet-poor plasma significantly accelerated the reepithelialization compared to the control (citrate 3,2%). The reepithelialization was significantly inhibited by ascorbate 10% in comparison to untreated wounds. Histology of wounds treated with citrate 10% or acetylcysteine 10% showed a short and often thin reepithelializing epithelium. Wounds treated with platelet-rich plasma showed a long reepithelializing epithelium that often was thick and presented an underneath acellular matrix.
We studied the impact on reepithelialization of therapeutic agents used to treat chemical burns. As citrate, acetylcysteine and ascorbate were shown to inhibit reepithelialization and affect the histology, we suggest to limit their use to severe chemical burns. Human serum or plasma might be beneficial.
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