[Clinical and morphological aspects of the use of palpebral implants made of noble metals]. / Kliniko-morfologicheskie aspekty primeneniya pal'pebral'nykh implantatov iz blagorodnykh metallov.

Loading of the upper eyelid with palpebral implants made of noble metals is the modern standard of surgical treatment for paralytic lagophthalmos, and is aimed at increasing the mobility of the upper eyelid and normalizing involuntary blinking movements. This review presents the results of morphological studies, including immunohistochemical studies, reflecting the features of biointegration of palpebral implants in uncomplicated and complicated course of the postoperative period, and describes the modern understanding of the causes and immunopathological processes underlying the development of nonspecific inflammatory response, which is one of the most serious complications that often becomes an indication for implant removal.

Mechanisms of sterile inflammation after intravitreal injection of antiangiogenic drugs: a narrative review.

BACKGROUND: Intraocular inflammation is an uncommon but potentially vision-threatening adverse event related to anti-VEGF therapy. This is of increasing importance given both the volume of injections performed, as well as the increased prevalence of inflammation seen with newer anti-VEGF agents. Brolucizumab, the newest anti-VEGF agent, has been associated with an inflammatory retinal vasculitis and the underlying mechanism is unclear. Reviewing potential mechanisms and clinical differences of intraocular inflammation may assist clinicians and scientists in reducing the risk of these events in the future. OBSERVATIONS: Two types of inflammation are seen with intravitreal injections, acute onset sterile inflammation and delayed onset inflammatory vasculitis. Acute onset inflammation can be subcategorized into subclinical anterior chamber inflammation and sterile uveitis/endophthalmitis. Subclinical anterior chamber inflammation can occur at rates as high as 19% after intravitreal anti-VEGF injection. Rates of sterile uveitis/endophthalmitis range from 0.05% to 4.4% depending on the anti-VEGF agent. Inflammatory vasculitis is only associated with brolucizumab and occurred in 3.3% of injections according to the post hoc review of the HAWK/HARRIER data. In addition, silicone oil from syringes can induce immunogenic protein aggregates. Agitation of the syringe, freeze thawing, shipping and improper storage prior to injection may increase the amount of silicone oil released from the syringe. CONCLUSION: The main factors which play a role in intraocular inflammation after anti-VEGF injection can be divided into three causes: patient-specific, medication-specific and delivery-specific. The majority of clinically significant inflammation seen after intravitreal injection is an acute onset inflammatory response with most patients recovering baseline VA in 3-5 weeks. The presence of pain, hypopyon, severe anterior chamber reaction, hyperemia and significant vision loss may help distinguish infectious from non-infectious etiologies of post injection inflammation. Avoiding temperature fluctuation, mechanical shock, agitation during transport and handling of syringes/drugs, and the use of SO-free syringes may help minimize intraocular inflammation. While a definitive mechanism has not yet been established, current knowledge of the clinical presentation and vitreous histopathology of brolucizumab-retinal vasculitis favors an auto-immune type IV hypersensitivity reaction.

One-Pot Synthesis of Fe/N-Doped Hollow Carbon Nanospheres with Multienzyme Mimic Activities against Inflammation.

Inflammation, including infectious and noninfectious inflammation, are a growing threat to public health worldwide. For different types of inflammation, more specific and intensified therapy is needed. Nanozymes are able to regulate levels of radical reactive oxygen species (ROS) to suppress inflammation, becoming potential anti-inflammatory agents. Herein, hollow porous carbon spheres codoped with nitrogen and iron (Fe/N-HCNs) are synthesized through a one-pot strategy, which exerted multienzyme mimicking activities, including peroxidase (POD)-, oxidase (OXD)-, catalase (CAT)-, and superoxide dismutase (SOD)-like activities. Moreover, these activities were promoted by the removal of iron oxides produced in the synthesis process. Based on the study of multienzyme activities, we designed two kinds of animal inflammatory models, bacteria-infected wound and inflammatory bowel disease, to evaluate the anti-inflammation ability of Fe/N-HCNs. The results indicated that Fe/N-HCNs could increase ROS levels through performing their POD-like activity in a weak acid environment to catalyze H2O2 against bacteria-infected wound healing, whereas Fe/N-HCNs with the capability of scavenging ROS in a neutral environment could also be unitized to treat noninfectious inflammatory bowel disease. Together, our study provided evidence that the prominent multienzyme activities of Fe/N-HCNs could be used as an anti-inflammatory alternative for both infectious and noninfectious inflammation.