homoharringtonine and Postoperative-Complications

To study the antiproliferative effects of homoharringtonine (Hh) on glaucoma filtering surgery.. In a randomized control clinical trial, 78 patients (88 eyes) with refractory glaucoma underwent trabeculectomy with and without Hh. In the Hh-treated eyes (n = 46), the therapeutic dose of Hh was: intraoperative application of Hh 0.4 mg and postoperative subconjunctival injections of Hh 0.62 +/- 0.20 mg (ranged 0.53 - 0.75 mg). In the control eyes (n = 42), Hh was not used. The follow-up period was 18 to 48 months, and the data were analyzed by using the life-table method of Kaplan-Meier.. The cumulative success probability in Hh group was 84.5% and that in control group was 50.9%, the difference being significant (P < 0.05). The cumulative percentage of functioning bleb in Hh group was 84.2% and that in control group was 52.9% (P < 0.05). The rates of corneal erosion were 23.9% and 7.1%, and the rates of conjunctival wound leak were 6.5% and 2.4% in Hh and control group respectively. There was no significant change in corneal endothelial density following the use of Hh (P > 0.05).. The study indicates that Hh is a safe and effective antiproliferative agent for the use in glaucoma filtering surgery, it not only can increase the success probability considerably, but also maintain at least the postoperative IOP at relatively low normal level for 3 years.

Topics: Adult; Female; Filtration; Glaucoma; Harringtonines; Homoharringtonine; Humans; Male; Postoperative Complications

The prevention of surgery-induced intraarticular fibrosis remains a challenge following orthopedic surgery. Homoharringtonine (HHT) has been reported to have positive effects in preventing various kinds of fibrosis. However, little is known regarding its effect as well as the potential mechanism of HHT in preventing surgery-induced intraarticular fibrosis.. Various concentrations of HHTs were locally applied in vivo to reduce knee intraarticular fibrosis in rabbits. Histological macroscopic assessments such as hematoxylin and eosin (HE) staining, Masson's trichrome staining, and Picric-sirius red polarized light were used to evaluate the effect of HHT in reducing intraarticular fibrosis. CCK-8, cell cycle assay, and EdU incorporation assay were used in vitro to detect HHT's effect on inhibiting fibroblast viability and proliferation. The effect of HHT on fibroblast differentiation, extracellular matrix production, and apoptosis were evaluated by western blot, flow cytometry, immunofluorescent staining, and TUNEL analysis. Moreover, the expressions of PI3K/AKT/mTOR signaling pathway were detected.. The results demonstrated that HHT could reduce the formation of intraarticular fibrosis. HHT was also found to induce fibroblast apoptotic cell death in a dose- and time-dependent manner in vitro. Moreover, HHT could effectively inhibit the production of the extracellular matrix secreted by fibroblasts and inhibited the expression of p-PI3K, p-AKT, and p-mTOR in a dose-dependent manner. After treating with insulin-like growth factor-1 (IGF-1), an activator of the PI3K/AKT axis, the expressions of pro-apoptosis-related proteins were decreased, and the fibroblast apoptosis rate was also inhibited.. In conclusion, this study demonstrated that HHT could reduce the formation of intraarticular fibrosis through the inhibition of fibroblast proliferation, extracellular matrix production, and the induction of fibroblast apoptotic cell death. Furthermore, its potential mechanism may be through the suppression of the PI3K/AKT/mTOR signaling pathway.

Topics: Apoptosis; Cell Line; Cell Proliferation; Depression, Chemical; Extracellular Matrix; Fibroblasts; Fibrosis; Homoharringtonine; Humans; Knee Joint; Phosphatidylinositol 3-Kinases; Postoperative Complications; Proto-Oncogene Proteins c-akt; Signal Transduction; TOR Serine-Threonine Kinases

The cultures of human lens epithelial cells taken from both normal and cataractous lenses were established in vitro. The biological characteristics and the histological changes of the cells were investigated. 5-Fluorouracil (5-Fu), Homoharring tonine (HH) and Harmeline (H) were used for the inhibition of the proliferative cells in the experiment. The results revealed that the in vitro survival capacity of the human lens epithelial cells is limited and the proliferative capacity of the cells is negatively correlated to the donor age. HH and H can effectively inhibit the lens epithelial cell proliferation. Based on the results of this report, performing small and smoothly edged anterior capsulorhexis in extracapsular cataract extraction may possibly decrease the incidence of the post-operative opacification of the posterior capsule.

Topics: Adolescent; Adult; Age Factors; Cataract; Cell Division; Cells, Cultured; Child; Child, Preschool; Epithelial Cells; Epithelium; Fluorouracil; Harmaline; Harringtonines; Homoharringtonine; Humans; Infant; Lens Capsule, Crystalline; Postoperative Complications