Abstract
Background: Underlying pathophysiology of posterior capsule opacification, a frequent visual disturbance postop complication of cataract surgery, is multifactorial. Several cytokines and growth factors, such as Transforming Growth Factor-? (TGF-?), Fibroblast Growth Factor 2 (FGF2), and Hepatocyte Growth Factor (HGF), have been found to play roles in the formation of PCO. Multiple advancements have been made including researches in therapeutic agents. Alteplase, a fibrinolytic agent, has been studied to decrease fibrin formation, which is a mechanism causing PCO. This study aimed to investigate the effect of alteplase on TGF-? expression in an anterior lens capsule fibrosis model resembling PCO. Methods: An experimental study was performed using cultured anterior lens capsule tissue taken during cataract surgery. Primary cell isolation culture and lens epithelial lens characterization were conducted. Following identification of lens epithelial cell and 90% confluency rate on cell culture, lens epithelial cells were divided into four groups and then scratched to induce inflammatory reaction resembling PCO process after cataract surgery. Doses of 25 mcg/ml, 50 mcg/ml, and 100 mcg/ml were then applied to each group of cell cultures with the other group serving as negative control. Using a fluorescein microscope, measurements to asses the influence of alteplase were taken 7 days after scratching by analyzing the intensity of fluoresce using FITC antibody of TGF-?. Results: The attenuation effect of alteplase to TGF-? expression was observed in all treatment groups; 25 µg/ml (15.5716x106 ±2.56558x106 ), 50 µg/ml (12.7364x106 ±1.67067x10 6 ), and 100 µg/ml group (7.8422x106 ±2.24941x106). The Tukey HSD posthoc tests found significant decrease between control group and each treatment group (p=0.019, p=0.000, and p=0.000; respectively). Conclusion: Alteplase within measure dose range holds potential effect in inhibiting fibrosis formation in PCO through attenuation of TGF-?
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