Therapeutic measures for sulfur mustard-induced ocular injury. (1st April 2021)

• Record Type: Journal Article
• Authors: Gore, Ariel; Kadar, Tamar; Dachir, Shlomit; Horwitz, Vered
• Is Part Of: Toxicology letters. Volume 340(2021)
• Page Start: 58
• Page End: 66
• Publication Date: 2021-04-01
• Subjects: Sulfur mustard -- Ocular injury -- Animal models -- Inflammation -- Topical steroids -- MMPs -- VEGF; Toxicology -- Periodicals; 363.179
• DOI: 10.1016/j.toxlet.2021.01.006
• Languages: English
• ISSNs: 0378-4274

Abstract

Highlights: Sulfur mustard induced ocular injury remains a challenge for medical professionals. Current treatments are based mainly on the clinical manifestation of this injury. Standard steroidal treatment is beneficial but not sufficient. Impaired ocular tissues may require unique treatment measures. Changes in specific factors during the injury may suggest novel therapeutic options. Abstract: The use of sulfur mustard (SM) in global terrorism is still a relevant threat to both civilian population and military personnel. Casualties exposed to SM may present mild, moderate or severe acute ocular lesions followed by a complete ocular resolution, chronic lesions or re-emerged ocular pathologies after a latent period. Current treatment for SM-induced ocular injury is based mainly on the clinical manifestation at the different stages of the injury and includes pharmaceutical and surgical interventions. These therapeutic measures are beneficial but not sufficient, and the ocular injury remains a continuous challenge for medical professionals. This review focuses on treatment experience carried out in humans and studied in animal models, for both SM-induced ocular acute injury and late pathology. In general, therapeutic measures are based on clinical features of the ocular injury or on the involvement of specific factors during the ocular injury that point out towards potential treatments. Anti-inflammatory treatments and limbal stem cell transplantation techniques were developed based on the clinical manifestation of the ocular injury. Optional therapies for impaired corneal innervation and endothelium are suggested for future research. Additionally, studies on potential treatments with anti-matrix metalloproteinase (MMP), anti-vascular endothelial growth factor (VEGF) and anti-IL-6 agents are discussed. Consequently, future studies may reveal the potential of additional pharmacological and biological treatments or advanced cellular and molecular biology methods to serve as novel therapeutic measures and techniques for this complicated ocular injury.