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Cyclosporine-loaded delivery system for the treatment of keratoconjunctivitis sicca: a pilot study

PURPOSE: The present work aimed to present the development of a conjunctival mucosa system for the controlled delivery of cyclosporine A (CsA) in the treatment of keratoconjunctivitis sicca (KCS). METHODS: The conjunctival mucosa system was prepared in the form of films containing chitosan as the polymer and CsA as the drug (25%w/v). The films were applied to the conjunctival sac of one eye from normal rabbits (n=6), and the evaluation of lachrymal production was performed daily, before and after application, for seven days. Clinical examination was executed daily on the eyes of each animal during the entire period of study. Histological analyses were carried out at the end of the study. RESULTS: The average amount of lachrymal production changed from 9.88 ± 0.37 mm/min to 16.02 ± 0.38 mm/min, respectively, before and after applying the systems, which indicates an increase of approximately 60%. All rabbits presented hyperemia in the palpebral conjunctiva and tearing. Hyperemia continued for 48h after the application of the systems with spontaneous resolution, and tearing was diagnosed throughout the entire study. No other sign of undesirable reactions could be observed. Moreover, no histological changes could be identified in the bulbar and palpebral conjunctival mucosa. CONCLUSION: The developed systems proved to be safe and efficient in this pilot study and present a promising future for the treatment of KCS. Other studies are warranted to evaluate the released concentration of CsA as well as the feasibility and toxicity of these systems in a more prolonged treatment.

Keratoconjunctivitis sicca; Cyclosporine; Drug delivery system


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