Radiosensitizing effect of ferulic acid on human cervical carcinoma cells in vitro.

Radiotherapy may be effectively combined with plant derived radiosensitizers. Ferulic acid, a naturally occurring phenolic acid, has been reported to have free radical producing properties. In the present study, the radiosensitisation potential of ferulic acid has been tested in two cervical cancer cell lines (HeLa and ME-180) in vitro. Percentage of growth inhibition (MTT assay), colony survival, levels of lipid peroxidation (TBARS, CD and LHP), antioxidant status (SOD, CAT, GPx and GSH), oxidative DNA damage (% tail DNA, tail length, tail moment and Olive tail moment), apoptotic morphological changes (AO/EtBr staining) and intracellular ROS levels (DCFH-DA) were estimated. The present results show that ferulic acid (FA) enhances radiation effects by increasing lipid peroxidative markers in HeLa and ME-180 cells. We observed significant enhancement of ROS levels during ferulic acid plus radiation treatment. FA treatment alone increased intracellular ROS levels indicate its prooxidant nature. Similarly, we observed enhanced oxidative DNA damage and apoptotic morphological changes in FA plus radiation treated cells. The present data suggest radiation sensitizing property of FA in cervical cancer cells. Further investigations warrants to substantiate the present findings.

Serous macular detachment as a predictor of resolution of macular edema with intravitreal triamcinolone injection.

BACKGROUND AND OBJECTIVE: To evaluate serous macular detachment as a predictor for response of macular edema to intravitreal triamcinolone acetonide. PATIENTS AND METHODS: Sixteen eyes (16 patients) with macular edema and serous macular detachment secondary to diabetic retinopathy (n = 11) or branch vein occlusion (n = 5) were prospectively enrolled. After intravitreal triamcinolone acetonide injection (4 mg/0.1 mL), they were reevaluated at 1 week and 1 and 3 months. The main outcome measure was change in central macular thickness. RESULTS: The mean baseline central macular thickness was 651.13 +/- 245.96 microm. One month after intravitreal triamcinolone acetonide injection, central macular thickness decreased to 255.38 +/- 80.64 microm (P < .0001). After 3 months, central macular thickness increased marginally to 329.69 +/- 161.98 microm, still significantly less than baseline (P < .0001). There was a significant correlation between the height of serous macular detachment and reduction in central macular thickness at 1 (r = .827) and 3 (r = .835) months (P< .0001). CONCLUSION: When serous macular detachment coexists with vascular or microvascular macular edema, it responds to intravitreal triamcinolone acetonide in direct proportion to the height of the serous macular detachment. However, the response begins to fade by 3 months.

Does in vitro susceptibility predict clinical outcome in bacterial keratitis?

PURPOSE: To determine whether clinical outcomes in bacterial keratitis are associated with antibiotic susceptibility. DESIGN: Retrospective, ancillary study using data and samples from a completed randomized clinical trial. METHODS: Forty-two patients were enrolled with culture-confirmed bacterial keratitis at Aravind Eye Hospital in South India. All patients received topical moxifloxacin and were randomized to receive either topical prednisolone phosphate or placebo. Outcomes included time to epithelialization, best spectacle-corrected visual acuity (BSCVA), and infiltrate/scar size at three months. Bacterial isolates were cultured, and minimum inhibitory concentration (MIC) to moxifloxacin was measured using Etests. Multiple linear regression was used to assess the effect of MIC on outcome, adjusting for enrollment characteristics. RESULTS: MIC was associated with three-month infiltrate/scar size: each two-fold increase in MIC was associated with a 0.33-mm average diameter increase in scar size (P=.01). MIC was not associated with three-month BSCVA (P=.71) or time to epithelialization (P=.35). CONCLUSIONS: MIC was associated with infiltrate/scar size in bacterial keratitis. An ongoing larger, multicenter trial should provide further information on whether this association is maintained across subgroups of organisms.

Evaluation of patient age as a risk factor for intraocular pressure elevation after intravitreal triamcinolone.

PURPOSE: To evaluate the effect of patient age on intraocular pressure (IOP) response after intravitreal injection of triamcinolone acetonide (IVTA). DESIGN: Interventional case series. METHODS: A total of 164 outpatients (164 eyes) aged 21 to 80 years (mean, 56.8 years), presenting with exudative age-related maculopathy (51) or macular edema of various etiologies (113), received IVTA (4 mg/0.1 ml). The primary outcome measure was IOP elevation >21 mm Hg. Patients were re-evaluated at one week, and one, three, and six months. RESULTS: The mean baseline IOP was 15.07 mm Hg; the mean rise was 6.6 mm Hg. IOP >21 mm Hg was observed in 42 (25.6%) patients. In the age group

Association of VEGF and eNOS gene polymorphisms in type 2 diabetic retinopathy.

PURPOSE: Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis, and nitric oxide (NO) is an upstream and downstream regulator of VEGF mediated angiogenesis. VEGF and NO have been suggested to play an important role in the pathogenesis of microvascular complications in diabetic retinopathy (DR). The objective of this study was to examine the genetic variations of the VEGF and eNOS gene and assess their possible relationship to DR in type 2 diabetic patients in the Indian population. METHODS: In this study, 210 unrelated patients were enrolled and categorized into two study groups: a DR group, consisting of patients with proliferative diabetic retinopathy, and a diabetic without retinopathy (DWR) group comprised of patients with type 2 diabetes of more than 15 years duration who showed no signs of DR or had fewer than five dots or blot hemorrhages. Association of the genetic polymorphisms in the promoter and 5' UTR region of VEGF and the intron4 region of eNOS were studied. Total genomic DNA was isolated from peripheral blood leukocytes. PCR-RFLP analysis was performed for all samples to evaluate the genotypes. The distributions of the genotypes were compared using the chi2 test. Haplotype estimation and multiple logistic regression analysis were carried out to analyze the significance of polymorphisms. RESULTS: We investigated four reported polymorphisms in the VEGF (5' UTR, promoter) and one reported polymorphism (intron 4) in the eNOS gene in Type 2 diabetes patients with (n=120) and without (n=90) retinopathy. The genotype distribution of the C(-7)T, T(-1498)C, and C(-634)G polymorphisms of VEGF differed significantly between patients with DR and DWR (p=0.001, p=0.0001, and p=0.021, respectively). Allele C in the -1498 region (p=0.0001) and T in -7 region (p=0.002) were also found to be significantly increased in patients with retinopathy. Calculated odds ratios (OR) for three heterozygous genotypes of C(-7)T, T(-1498)C, and C(-634)G regions were 4.17 (95% CI: 1.90-9.18, p=0.0001), 4.37 (95% CI: 2.44-7.84, p=0.0001), and 2.33 (95% CI: 1.24-4.36, p=0.008), respectively, and was found to be significantly higher in the DR group when compared with the DWR group. Multiple logistic regression analysis revealed that the nongenetic parameters, age (p=0.024) and duration of diabetes (p=0.009), and the genetic parameters, like VEGF C(-7)T (p=0.002) and T(-1498)C (p=0.001) polymorphisms, were significantly associated with DR. The frequencies of haplotype consisting of the majority of alleles in VEGF were found to be significantly associated with DR. The genotype distribution of eNOS did not differ significantly between the two study groups, and therefore the eNOS intron 4 polymorphism was considered to be less significant. CONCLUSIONS: This is the first study to report VEGF and eNOS gene polymorphisms in patients with DR in the Indian population. The data suggest that the polymorphisms in the 5' UTR and promoter region of VEGF could be regarded as a major genetic risk factor for DR.

Concurrent use of 5% natamycin and 2% econazole for the management of fungal keratitis.

PURPOSE: To determine if concurrent use of 5% natamycin and 2% econazole offers greater benefits than monotherapy with 5% natamycin for the management of fungal keratitis. METHODS: Subjects presenting to the cornea service were treated with 5% natamycin and 2% econazole used concurrently. We compared the results with a historical control of patients treated with 5% natamycin in the same calendar year. The same clinical and examination protocol including inclusion and exclusion criteria was used for both groups. RESULTS: We compared results of 47 subjects on concurrent use of 5% natamycin and 2% econazole with all 53 subjects who had received 5% natamycin in a previous study (historical controls). Baseline characteristics were similar between the 2 groups. There were no significant differences (P=0.9) between the 2 arms for success (defined as a healed or healing ulcer). CONCLUSIONS: Concurrent use of 5% natamycin and 2% econazole does not appear to offer additional benefits over monotherapy with 5% natamycin for the management of fungal keratitis.