A recent study compared the corneal epitheliotrophic factors present in undiluted autologous platelet-rich plasma and autologous serum eye drops for the treatment of moderate-to-severe dry eye disease. The researchers aimed to evaluate the concentrations of growth factors in both types of biological tear substitutes and assess their potential for tailored ophthalmic treatment.
The single-center, prospective trial was conducted at a tertiary university hospital in Bangkok, Thailand. 96 patients with moderate-to-severe DED were randomized to receive either 100% autologous platelet-rich plasma (APRP) or 100% autologous serum (AS) eye drops. The study measured concentrations of key growth factors, including epithelial growth factor (EGF), basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), β-nerve growth factor (β-NGF), platelet-derived growth factors (PDGF-AA, PDGF-BB), transforming growth factors (TGF-α, TGF-β1), and vascular endothelial growth factor (VEGF).
Led by Passara Jongkhajornpong, MD, of the Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital in Bangkok, the researchers also examined correlations between baseline patient characteristics and growth factor concentrations.
According to their article, recently published in Ophthalmology and Therapy, the undiluted APRP group had significantly higher concentrations of EGF (4.3-fold increase), bFGF (4.9-fold increase), and β-NGF (1.6-fold increase) compared with undiluted AS. Platelet concentrations positively correlated with EGF and VEGF in the APRP group as well.
The undiluted AS group had higher levels of HGF (3.8-fold increase), PDGF-AA (2.4-fold increase), PDGF-BB (1.6-fold increase), and VEGF (2.4-fold increase) compared with APRP. Also in the AS group, Sjögren’s syndrome was negatively correlated with PDGF-BB and VEGF, and diabetes mellitus was negatively correlated with HGF, TGF-α, and VEGF.
There were no significant differences in TGF-α and TGF-β1 concentrations between the 2 groups.
In previous research, the investigators found “100% APRP was not inferior to 100% AS in reducing dry eye symptoms and ocular surface staining in moderate-to-severe DED” in short-term use, they recalled in this study. “Despite having different growth factor concentration patterns, 100% APRP and 100% AS contain the same types of epitheliotrophic factor in sufficient levels to similarly improve ocular surface regeneration. Varying amounts of epitheliotrophic factors between APRP and AS might not directly imply the superiority of one eye drops over another, especially when they are of different concentrations.”
Because it contains more EGF and bFGF than AS, they noted that APRP could be preferable for early-stage ocular surface disorders and mucin-deficient dry eye. For persistent epithelial defects with or without stromal loss, they recommended AS as a primary treatment option because it contains more HGF, which can help to minimize inflammation and neovascularization and “heal the defects with less scarring.”
Patients were enrolled in the study, regardless of the etiology of their DED. The investigators noted this heterogeneity as 1 limitation of their study, in addition to other epitheliotrophic factors and their concentrations that were not examined and require further research.
Ultimately, they concluded, “these findings could allow ophthalmologists to apply either 100% APRP or 100% AS to dry eye and other ocular surface diseases and tailor treatments by targeting growth factor supply based on underlying pathophysiology.”
A full list of author disclosures can be found in the published research.
