Febuxostat Attenuates the Induction of Vascular Cell Adhesion Protein 1 by TNF-α in Human Umbilical Vein Endothelial Cells.

In a randomized trial, higher all-cause and cardiovascular mortality was observed in treatment with febuxostat than with allopurinol in patients with coexisting gout and serious cardiovascular conditions. In this study, we focus on an intervention of febuxostat or allopurinol as an anti-inflammatory treatment to reduce the transcription of nuclear factor-kappa B (NF-κB) and production of relevant inflammatory factors. We evaluated the effect of febuxostat on vascular cell adhesion protein 1 (VCAM-1) induction in cultured human umbilical vein endothelial cells (HUVECs). Cells were exposed to tumor necrosis factor (TNF)-α (10 ng/mL) treatment for 24 h. Febuxostat or allopurinol (0.1-100 µM) was added to the bath medium 15 min before TNF-α treatment. VCAM-1 levels in HUVECs increased after 24-h TNF-α treatment (n = 4). Febuxostat and allopurinol significantly suppressed VCAM-1 induced by treatment with TNF-α in a dose-dependent manner (p < 0.05, n = 4). Furthermore, these drugs suppressed the NF-κB protein levels in the nucleus 4 h after TNF-α treatment (n = 3 or 4). Our results suggest that TNF-α induces VCAM-1 production via NF-κB, which can be blocked by febuxostat or allopurinol. The effect of febuxostat treatment on cardiovascular events may be associated with protection against the infiltration of lymphocytes or monocytes through VCAM-1 induction in inflamed endothelial cells such as arterial sclerosis.

Corneal iron ring formation associated with overnight orthokeratology.

PURPOSE: To describe a case of iron deposition in both eyes after overnight orthokeratology. METHODS: This is a case report of a 31-year-old man who underwent overnight orthokeratology. The subject was fitted with rigid gas-permeable contact lenses of reverse-geometry design to correct myopia. RESULTS: The prefitting manifest refraction was -4.75 -0.25 x 175 in the right eye and -4.50 -0.25 x 175 in the left eye. There was no corneal abnormality until 9 months after treatment, but development of corneal arcuate lines in both eyes was observed at the 1-year follow-up visit. Visual acuity was not affected. The deposition pattern corresponded to the outside border of central flatter zone, as shown on the corneal topography map. CONCLUSION: The current findings suggest that tear pooling between the corneal surface and the back surface of the contact lens plays a role in the development of corneal iron ring after orthokeratology with reverse-geometry contact lenses.

Influence of overnight orthokeratology on corneal endothelium.

PURPOSE: To evaluate the influence of overnight orthokeratology on the corneal endothelium. METHODS: Fifty-two eyes of 31 patients undergoing overnight orthokeratology for myopia were examined. They wore the lens every night and were followed up for at least 1 year. The corneal endothelium was examined with specular microscopy to calculate mean endothelial cell density, coefficient of variation of cell area, and percentage of hexagonal cells. Data obtained at 1-year follow-up examinations were compared with those at the baseline examinations using a paired t test. RESULTS: Orthokeratology significantly reduced manifest refraction from -2.32 +/- 1.18 D (mean +/- standard deviation) to -0.16 +/- 0.33 D (P < 0.0001) and improved uncorrected visual acuity from 0.77 +/- 0.29 to -0.07 +/- 0.10 logMAR (P < 0.0001). The endothelial cell density did not change significantly (2879 +/- 231 cells/mm before and 2864 +/- 260 cells/mm after treatment, P = 0.252). The coefficient of variation of cell area was 22.3 +/- 2.7 at baseline and 22.1 +/- 2.4 at 1-year posttreatment, which did not change significantly (P = 0.537). The percentage of hexagonal cells was 72.8 +/- 10.2% pretreatment and 72.5 +/- 10.9% posttreatment (P = 0.800). CONCLUSIONS: Overnight orthokeratology for 1 year did not influence the density or morphology of corneal endothelial cells.

Quantitative evaluation of regular and irregular corneal astigmatism in patients having overnight orthokeratology.

PURPOSE: To quantitatively assess changes in regular and irregular corneal astigmatism in patients having overnight orthokeratology. SETTING: Matsumoto Eye Clinic, Ibaraki, Japan. METHODS: A prospective study was conducted of 64 eyes of 39 patients having overnight orthokeratology for myopia. Inclusion criteria were an uncorrected visual acuity (UCVA) of 20/20 or better after treatment and a minimum follow-up of 3 months. Using Fourier series harmonic analysis, videokeratography data were decomposed into spherical component, regular astigmatism, asymmetry (tilt or decentration), and higher-order irregularity. RESULTS: Orthokeratology significantly reduced the manifest refraction from -2.60 diopters (D) +/- 1.13 (SD) to -0.17 +/- 0.31 D (P<.0001, paired t test) and improved the UCVA from 0.82 +/- 0.30 to -0.11 +/- 0.06 logMAR (P<.0001). Regular astigmatism increased significantly from 0.53 +/- 0.23 D preoperatively to 0.63 +/- 0.40 D postoperatively (P =.0206). The asymmetry component increased significantly from 0.35 +/- 0.22 D to 0.64 +/- 0.40 D (P<.0001). Higher-order irregularity did not change significantly: 0.14 +/- 0.11 D before treatment and 0.17 +/- 0.20 D after treatment (P =.2166). The amount of myopic correction correlated significantly with the increase in the asymmetry component (Pearson correlation coefficient, R = 0.40, P =.0009) but not with the increase in regular astigmatism (R = 0.24, P =.055). CONCLUSIONS: Irregular corneal astigmatism significantly increased, even in clinically successful orthokeratology cases. The effect of the changes on visual function should be studied further.