title: New developments in the pharmacological modulation of wound healing after glaucoma filtration surgery.
abstract: Despite the advent of many new devices for glaucoma surgery, scarring is the main cause of suboptimal pressure control and surgical failure in all forms of surgery. The cytotoxic antimetabolites, 5-flurouracil and mitomycin C both prolong success but with the increased risk of blinding complications. A greater understanding of the cellular mechanisms of the wound healing response has led to the identification and modulation of potential therapeutic targets. These include transforming factor β, inflammatory mediators, the acute phase protein serum amyloid P, vascular endothelial growth factor and the matrix metallaproteinases. While optimal drug delivery is still a major challenge, modulating these effects either directly or through downstream signalling promises to yield anti-scarring efficacy, while minimising side effects.
authors.affiliation: National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, UK.
authors.forename: Alastair
authors.initials: A
authors.lastname: Lockwood
authors.forename: Stephen
authors.initials: S
authors.lastname: Brocchini
authors.forename: Peng Tee
authors.initials: PT
authors.lastname: Khaw
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000818:Animals; D005347:Fibroblasts / Q000166:cytology / Q000502:physiology; D018463:Filtering Surgery; D005901:Glaucoma / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D061965:Matrix Metalloproteinase Inhibitors / Q000494:pharmacology; D020782:Matrix Metalloproteinases / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000209:Acute-Phase Proteins; D036341:Intercellular Signaling Peptides and Proteins; D061965:Matrix Metalloproteinase Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D020782:Matrix Metalloproteinases