title: Target drug delivery system as a new scarring modulation after glaucoma filtration surgery.
abstract: BACKGROUND
  Excessive wound healing following glaucoma filtration surgery is the main determinant of surgical failure, resulting from the activation of human Tenon's capsule fibroblasts (HTFs). To mitigate the excessive wound healing, the topic all use of antiproliferative agents, such as mitomycin C (MMC) and 5-fluorouracil (5-FU), has increased the surgery success rate, but the traditional administration of these agents can result in a variety of toxicities with nonspecific damage. However, modulation of the wound healing process to prevent excessive fibroblast proliferation and scar formation can play a major role in improving the outcome of surgery. Therefore, the search for alternative modes of drug delivery and new agents is needed to minimize the ocular complications and improve the success of surgery. We have shown that there is a postoperative over expression of the LDL receptor (LDLr) in the activated HTFs may provide a novel target for drug delivery systems.
  
  
  OBJECTIVE
  We hypothesize that anti fibrotic agents (MMC) encapsulated in LDLr targeting drug delivery system (LDL-MMC-chitosan nanoparticles) may be proposed in anti-scarring therapy to increase the safety and effectiveness and to reduce toxicity.
  
  
  METHODS
  A chitosan-based polymeric predrug of MMC was synthesized and its cytotoxicity was proved to be low. In addition, we propose hyaluronic acid film as a container to release LDL-MMC-chitosan nanoparticles gradually at subconjunctival filtering site after glaucoma filtration surgery to eliminate the LDL-MMC-chitosan nanoparticles. IMPLICATIONS OF THE HYPOTHESIS AND DISCUSSION: This strategy can be applicable to anti-scarring therapy during excessive conjunctival wound healing. This hypothesis integrates advantages of the targeting drug delivery and anti fibrotic agents, such as high efficiency, convenience, and lower the toxicity.
authors: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xian Lie Nan Road, 510060 Guangzhou, Guangdong, PR China.
authors: Tingting
authors: T
authors: Shao
authors: Xiaoning
authors: X
authors: Li
authors: Jian
authors: J
authors: Ge
mesh_terms: D048271:Chitosan / Q000737:chemistry; D002921:Cicatrix / Q000188:drug therapy* / Q000517:prevention & control; D004337:Drug Carriers / Q000737:chemistry; D016503:Drug Delivery Systems; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology; D005355:Fibrosis / Q000188:drug therapy / Q000517:prevention & control; D018463:Filtering Surgery / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000494:pharmacology; D016685:Mitomycin / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology; D053758:Nanoparticles / Q000737:chemistry; D011183:Postoperative Complications; D011973:Receptors, LDL / Q000737:chemistry; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D004337:Drug Carriers; D005343:Fibrinolytic Agents; D011973:Receptors, LDL; D016685:Mitomycin; D006820:Hyaluronic Acid; D048271:Chitosan