Latrunculin B and substratum stiffness regulate corneal fibroblast to myofibroblast transformation.

The transformation of keratocytes and fibroblasts to myofibroblasts is important to corneal wound healing as well as formation of stromal haze. The purpose of this study was to determine the effect of latrunculin B, an actin cytoskeleton disruptor in conjunction with a fundamental biophysical cue, substrate stiffness, on myofibroblast transformation in vitro and in vivo. Rabbit corneal fibroblasts were cultured on substrates of differing compliance (1.5, 22, and 71 kPa) and tissue culture plastic (TCP; > 1 GPa) in media containing 0 or 10 ng/ml TGFß1 for 72 h. Cells were treated with 0.4 µM Lat-B or DMSO for 30 min every 24 h for 72 h. RNA was collected from cells and expression of alpha-smooth muscle actin (α-SMA), keratocan, and ALDH1A1 determined using qPCR; immunocytochemistry was used to assess α-SMA protein expression. A rabbit phototherapeutic keratectomy (PTK) model was used to assess the impact of 0.1% Lat-B (n = 3) or 25% DMSO (vehicle control, n = 3) on corneal wound healing by assessment of epithelial wound size with fluorescein stain and semi-quantitative stromal haze scoring by an observer masked to treatment group as well as Fourier-domain optical coherence tomography (FD-OCT) at set time points. Statistical analysis was completed using one-way or two-way analysis of variance. Treatment with Lat-B versus DMSO resulted in significantly less αSMA mRNA (P ≤ 0.007) for RCF cells grown on 22 and 71 kPa substrates as well as TCP without or with TGFß1, and significantly decreased α-SMA protein expression in RCFs cultured on the intermediate (22 kPa) stiffness in the absence (P = 0.028) or presence (P = 0.018) of TGFß1. Treatment with Lat-B versus DMSO but did not significantly alter expression of keratocan or ALDH1A1 mRNA in RCFs (P > 0.05) in the absence or presence of TGFß1, but RCFs grown on stiff hydrogels (71 kPa) had significantly more keratocan mRNA expression versus the 22 kPa hydrogel or TCP (P < 0.001) without TGFß1. Administration of topical Lat-B BID was well tolerated by rabbits post-PTK but did not significantly alter epithelial wound closure, stromal haze score, stromal haze thickness as measured by FD-OCT in comparison to DMSO-treated rabbits. When corneal stromal cells are cultured on substrates possessing biologically relevant substratum stiffnesses, Lat-B modulates mRNA and protein expression of α-SMA and thus modulates myofibroblast transformation. At a dose and dose-frequency that reduced IOP in human glaucoma patients, Lat-B treatment did not substantially impact corneal epithelial or stromal wound healing in a rabbit PTK model. While a significant impact on wound healing was observed at the concentration and dose frequency reported here was not found, encouraging in vitro data support further investigations of topically applied Lat-B to determine if this compound can reduce stromal fibrosis.

Correcting a Fundamental Flaw in the Paradigm for Antimicrobial Susceptibility Testing.

The emergence and prevalence of antibiotic-resistant bacteria are an increasing cause of death worldwide, resulting in a global 'call to action' to avoid receding into an era lacking effective antibiotics. Despite the urgency, the healthcare industry still relies on a single in vitro bioassay to determine antibiotic efficacy. This assay fails to incorporate environmental factors normally present during host-pathogen interactions in vivo that significantly impact antibiotic efficacy. Here we report that standard antimicrobial susceptibility testing (AST) failed to detect antibiotics that are in fact effective in vivo; and frequently identified antibiotics that were instead ineffective as further confirmed in mouse models of infection and sepsis. Notably, AST performed in media mimicking host environments succeeded in identifying specific antibiotics that were effective in bacterial clearance and host survival, even though these same antibiotics failed in results using standard test media. Similarly, our revised media further identified antibiotics that were ineffective in vivo despite passing the AST standard for clinical use. Supplementation of AST medium with sodium bicarbonate, an abundant in vivo molecule that stimulates global changes in bacterial structure and gene expression, was found to be an important factor improving the predictive value of AST in the assignment of appropriate therapy. These findings have the potential to improve the means by which antibiotics are developed, tested, and prescribed.

The effect of needle gauge, needle type, and needle orientation on the volume of a drop.

OBJECTIVE: The purpose of this study was to determine impact of needle gauge, type, and orientation on average volume of drop dispensed. PROCEDURE: Five needle gauges (22G, 23G, 25G, 27G, and 30G) were examined. For each gauge, volume of drop delivered was determined for standard sharp beveled tip, blunt tip, and after breaking off of the sharp needle from the hub. Vertical and horizontal orientation of the needle was tested for effect on drop volume for 22-G and 30-G sharp beveled needles. RESULTS: Mean drop volume was affected by needle gauge, needle orientation, and whether the needle had been broken off from its hub. Mean drop volume scaled directly with needle diameter with drop volumes of 25.0 µL (±20.2) and 83.9 µL (±16.5) being found for 30-gauge and 22-gauge needles, respectively. Intermediate gauges (27, 25, 23G) yielded intermediate drop volumes. Blunt needles tended to produce larger drop volumes compared to sharp beveled needles, but these differences did not reach statistical significance. Breaking off of the needle from the hub produced substantially larger drop volumes with little difference being found between needle gauges. Average volumes of 1 drop from a 22-G vertical, 22-G horizontal, 30-G vertical, and 30-G horizontal sharp beveled needle were 20.2, 9.1, 10.1, and 3.3 µL, respectively. CONCLUSIONS: These findings have relevance for controlled delivery of topical ophthalmic medications to patients.