Cancer
drug reduces scarring of the eye
Quick
Med Technologies, Inc.
July
9, 2003
A
drug originally developed to treat cancer has been found to dramatically
reduce scarring of the eye.
In
theory, the drug should also reduce scarring in other tissues, including
the skin.
Studies
by a team led by Peng Tee Khaw at the Moorfields Eye Hospital in London,
U.K., suggest that the drug Ilomastat (Quick-Med Technologies, Inc.) can
reduce scarring by as much as 80%, and that the healed area has a more
normal structure, reported the June 18, 2003, issue of New Scientist (www.newscientist.com).
"This
is a dramatic reduction in scar tissue," says Khaw. And since the
same scarring mechanism controls the way tissues heal throughout the body,
he says, the drug should reduce scarring after burns or plastic surgery,
too.
Scarring
is at least partly due to the body's rush to try and close any wound as
soon as possible to prevent infections. Cells near and in the wound release
enzymes called matrix metalloproteinases, or MMPs (also called collagenases),
that break down the intricate collagen matrix that holds cells together.
It's a case of having to break it before you can remake it, says Khaw.
As
the complex collagen structure is broken down, cells called fibroblasts
migrate to the wound and the surrounding area, and actively begin to contract
the tissue, a bit like gardeners compacting cuttings for the compost heap
after pruning a bush. This contraction process can continue for months
after an injury. The contraction helps to close the wound, but the end
result is a disorderly mass of collagen that forms disfiguring and sometimes
painful scar tissue.
"Contraction
is one of the greatest enemies of tissue regeneration," says Khaw.
It is a particularly big problem after eye operations, he adds, because
the precise positioning of collagen proteins in the matrix affects the
optical properties.
Various
drugs are already used to reduce scarring of the eye, including anti-cancer
drugs that trigger cell suicide, or apoptosis. But these drugs are far
from ideal, since by killing cells they prevent healing as well as scarring,
and can occasionally cause complications.
It
has long been suspected that MMPs played an important role in wound healing,
so Khan's team decided to test the effects of various MMP inhibitors.
These inhibitors, including Ilomastat, were developed to treat cancer,
as it was thought that preventing the breakdown of the collagen matrix
might stop cancerous cells migrating around the body. But the drugs were
not effective.
Tests
on tissue grown in culture, however, show that Ilomastat can reduce contractile
scarring by up to 80%. And when Khan's team injected it into the inner
lining of the eyes of rabbits after they had undergone a type of surgery
used to treat glaucoma, there was also a dramatic reduction in scarring.
"We
appear to be regulating the way the individual fibroblasts remodel and
migrate within the matrix," Khaw says. "The tissue appears to
be healthy and functioning."
The
team is now looking for partners to develop the method further and get
it to human trials.
Other
scarring experts still need convincing. "I don't think it will transfer
beyond eyes," says Mark Ferguson at Manchester University. In the
past, he says, other groups have tried using MMP inhibitors on the skin
but they found that it actually prevents healing.
But
Khaw says that these researchers applied MMP inhibitors directly to the
surface of the skin, even though the contraction that leads to scarring
occurs beneath the outermost layer of skin.
His
method involves injecting Ilomastat into the underlying layers where the
contraction occurs.
Timing
is also crucial, Khaw says. If the inhibitors are applied too soon, before
contraction has started, then healing is indeed impaired. Recent studies
of mice in which one or more of the genes that code for MMPs have been
"knocked out" have also revealed noticeable differences in the
healing process, Khaw adds - further evidence that that MMPs play a key
role in healing in all tissues. This article was prepared by Biotech Week
editors from staff and other reports.
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