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Biomedical subjects

M D Willcox

Publications and source records attributed to M D Willcox.

At least 37 records · Page 2Linked to original sources
PubMed2000

Contact lens wear alters the production of certain inflammatory mediators in tears.

Contact lens wear has been associated with an increased risk of corneal infection and/or inflammation. We studied the hypothesis that contact lens wear alters the number of polymorphonuclear leukocytes (PMNs) on the cornea during sleep and the levels of inflammatory mediators in the tear film. Three groups of subjects were analysed: a non-contact lens wearing group (NCLW), non-adapted (neophyte) contact lens wearers (NACLW) who wore lenses during sleep for the first time in this study and adapted contact lens wearers (ACLW) who normally wore lenses on a daily wear schedule. Ocular PMNs were collected by a non-contact irrigation technique and their numbers counted after staining. Tears were collected from each group and analysed using ELISAs for the presence of the PMN chemoattractants IL-8 and LTB(4)and the cytokines IL-1beta, IL-6 and GM-CSF. Corneal irrigation data demonstrated significantly higher numbers of PMNs from NACLW (P<0.05) compared to the other groups. ACLW showed significantly fewer PMNs (P =0.03) compared to NCLW group. The NACLW group had significantly lower concentrations (P<0. 05) of IL-8, LTB(4)and IL-6 in their tears after 8 hr of sleep compared to the other groups. The ACLW group had significantly (P<0. 05) higher levels of IL-8 at most time points compared to the other two groups. The levels of the chemoattractants IL-8 and LTB(4)in tears were inversely related to the numbers of PMNs from the corneal surface and the chemotaxis of PMNs in vitro. During one night sleep in contact lenses the numbers of PMNs and the concentration of certain inflammatory mediators are significantly altered compared to no lens wear. However, this alteration changes from NACLW to ACLW. This may have effects on the ability of the eye to defend itself during contact lens wear.

Adult↗
PubMed2000

Modulation of tear film protein secretion with phosphodiesterase inhibitors.

A double-blind randomized clinical study was conducted to determine whether nicardipine hydrochloride was a useful treatment for dry eye.We examined its effect on the tear film, ocular surface and ocular comfort. Nicardipine hydrochloride, 3-isobutyl-1-methylxanthine and pilocarpine hydrochloride were dissolved in an artificial tear vehicle and applied topically to one eye of 12 subjects on separate days. Ocular physiology, ocular comfort and tear volume were assessed. The trial was repeated with nicardipine in an aqueous gel vehicle. Tears were collected and assessed for protein concentration and protein profile, using electrophoresis and mass spectrometry. Nicardipine induced conjunctival redness and symptoms of dryness and irritation. There was no change in total tear protein concentration or volume. An increase in a 68 kDa protein was observed, this was probably due to conjunctival vessel dilation and leakage of albumin. The adverse symptomatology and increased conjunctival redness experienced with nicardipine make it an undesirable treatment for dry eye.

1-Methyl-3-isobutylxanthine↗
PubMed2000

Pro-inflammatory cytokine/chemokine gene expression in human corneal epithelial cells colonized by Pseudomonas aeruginosa.

Pro-inflammatory cytokines interleukin-6 (IL-6), interleukin-1beta (IL- 1beta), tumour necrosis factor-alpha (TNF-alpha) and chemokine interleukin-8 (IL-8) may play a significant role in the regulation of bacterial corneal infection. The aim of this study was to investigate the gene expression of these four mediators in a human corneal epithelial cell line challenged with Pseudomonas aeruginosa within 12 h. Human corneal epithelial monolayers were colonized with P. aeruginosa strains Paerl, 6206 and 6294. Expression of IL-6, IL-8, IL-1beta and TNF-alpha was analysed using semi-quantitative reverse transcription-polymerase chain reaction. Results showed that both IL-6 and IL-8 mRNA were expressed very early (4 h) during bacterial colonization and remained at high levels until the end of the experiment. Expression of IL-1beta and TNF-alpha mRNA appeared at 8 h after bacterial stimulation. No expression of IL-8, IL-1beta and TNF-alpha mRNA was observed in unstimulated cells. Interleukin-6 mRNA was expressed at low levels in unstimulated cells. In conclusion, bacterial colonization of human corneal epithelial cells induced expression of IL-6 and IL-8 mRNA earlier and at higher levels than IL-1beta and TNF-alpha mRNA.

Cell Count↗
PubMed2000

Invasive strains of Pseudomonas aeruginosa are able to cause epithelial cell cytotoxicity that is dependent on bacterial cell density.

The purpose of this study was to investigate the hypothesis that quorum-sensing systems are involved in the ability of invasive Pseudomonas aeruginosa strains to cause corneal epithelial cell death. Two invasive strains, 6294 and PAOI, were co-cultured with human corneal epithelial cells at different bacterial concentrations (10(5), 10(7) and 10(9) CFU/mL). Cytotoxicity was measured using a cytotoxicity assay kit. The levels of autoinducer in the supernatant were examined using a reporter strain of Agrobacterium tumefaciens (A136). Protease production was also monitored. Cytotoxicity of both strains was dependent on bacterial density; a moderate to high concentration of bacterial cells (10(7) and 10(9) CFU/mL) caused 70% to 94% loss of cell variability. Cytotoxicity was significantly correlated with enhanced autoinducer and protease production (r>0.95, P<0.05). These results indicate that the invasive strains regulate the production of virulence factors and, in turn, induce chronic dose-related cytotoxicity.

Agrobacterium tumefaciens↗
PubMed2000

Staphylococcus aureus causes acute inflammatory episodes in the cornea during contact lens wear.

The aim of this investigation was to determine the ability of Staphylococcus aureus to cause keratitis during contact lens wear in the rabbit. Rabbits were fitted with hydrogel lenses and wore them on an extended wear schedule for 7 weeks. At the end of each week of wear, one drop of S. aureus was added to the eyes, and the eyes were monitored using slit lamp bio-microscopy, with subsequent microbial and histological studies of the cornea. In the presence of S. aureus, keratitis occurred after 3 weeks of lens wear, a condition that was characterized by diffuse infiltration of the peripheral cornea and limbal redness. In the absence of bacteria, there was no infiltration until week 6. Contact lens wear also prolonged the retention of bacteria in the eye. Extended contact lens wear and S. aureus caused non-ulcerative keratitis in a rabbit model, and disturbances in the ability of the eye to remove bacteria.

Acute Disease↗
PubMed2000

Protein microanalysis of animal tears.

Sub-microlitre volumes of normal koala, mouse, dog, rat and cat tears were fractionated using size exclusion-high performance liquid chromatography (SE - HPLC), giving reproducible profiles which were different for each species. Microlitre volumes of tears were also fractionated using sodium dodecylsulphate-polyacrylamide gel electrophoresis (SDS - PAGE), resulting in good separation of individual tear proteins with a species specific distribution. Tears from koalas with conjunctivitis and mice with keratitis were similarly examined and showed mostly quantitative changes. These simple, rapid techniques gave reproducible results and, in contrast to conventional separation techniques, used easily obtainable volumes (as little as 0.75 microl) of tears. Their expansion could allow isola tion, identification and quantitation of individual tear components, enabling effective investigation of changes occurring in disease.

Animals↗
PubMed2000

A new species of oral Streptococcus isolated from Sprague-Dawley rats, Streptococcus orisratti sp. nov.

Taxonomic studies were performed on an unusual oral Streptococcus strain isolated from Sprague-Dawley rats. The isolates were alpha-haemolytic, bile-tolerant, aesculin-hydrolytic and unable to grow in 6.5% NaCl. They fermented lactose, sucrose and trehalose. They were distinguished from other recognized species of oral and viridans streptococci by several biochemical characteristics and by Lancefield's group antigen, as well as by unique DNA-DNA hybridization characteristics. 16S rDNA sequence studies confirmed the genealogical distinctiveness of the species. The results of the study demonstrated that the isolates represented a new species of the oral and viridans streptococci. The name Streptococcus orisratti sp. nov. is proposed for the new species. The type strain is A63T (= ATCC 700640T).

Animals↗
PubMed1999

Effect of nutrient limitation on adhesion characteristics of Pseudomonas aeruginosa.

Pseudomonas aeruginosa causes a variety of diseases in humans including lung and ocular infections. Infections of the cornea are usually associated with wearing contact lenses and can result in loss of vision. This study aimed to determine the effect of carbon or nitrogen limitation on the adhesion to contact lenses of a strain of Ps. aeruginosa isolated from contact lens-related corneal inflammation. Cells were grown in a continuous culture apparatus in varying levels of glucose or ammonia to effect nutrient limitation. Adhesion to contact lenses was measured as total counts and viable counts. The cell surface hydrophobicity and charge were measured using adhesion to surface-modified Sepharose. Changes in lipopolysaccharide were determined using 1D SDS-PAGE and changes in cell-surface proteins were measured using 2D gel electrophoresis. The more the cultures were nitrogen limited, the greater the increase in adhesion to unworn hydrogel contact lenses 0.3 x 10(3) - 2.2 x 10(3) cells/mm2 on Etafilon A lenses. Cells that were carbon limited showed a greater increase in adhesion to contact lenses when the lenses had been coated in artificial tears. It appeared that lipopolysaccharide may have been involved in the constitutive adhesion to unworn lenses that occurred during C-limitation, whereas changes in the outer membrane proteins contributed to the increased adhesion under nitrogen limitation, or the change in adhesion that occurred to carbon-limited cells using contact lenses coated in artificial tears. Nine cell-surface proteins appeared during nitrogen limitation with kDa/pI of 75/4.8, 4.9, 5.0; 62/5.6; 89/6.5; 38/6.4; 28/1.5; 18/6.4; 12/4.5. Any or all of these may have been involved in the increased adhesion and further experiments are underway to examine this possibility.

Bacterial Adhesion↗
PubMed1999

Lactoferrin increases the susceptibility of S. epidermidis biofilms to lysozyme and vancomycin.

PURPOSE: The tear cationic protein lactoferrin increases the activity of various antimicrobial agents against suspended bacterial cultures including Staphylococcus epidermidis, the predominant causative agent of intraocular lens biofilm infections. We investigated the ability of lactoferrin to enhance the activity of vancomycin and lysozyme against biofilms of a clinical S. epidermidis isolate. METHODS: Biofilms were prepared on soft contact lenses and cells released from the biofilm surface were collected from the surrounding broth. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against the intact biofilm, released cells and suspended bacteria were evaluated using vancomycin with and without lactoferrin. RESULTS: Lactoferrin induced a two-fold reduction in the MBC of vancomycin for biofilm (p < 0.01) and biofilm-released cells from 64 microg/ml to 32 microg/ml and similarly decreased the MIC for biofilm-released cells (p < 0.01) from 32 microg/ml to 16 microg/ml. With or without lactoferrin, the MIC of vancomycin for suspended cells (2 and 4 microg/ml respectively) was less (p < 0.01) than that of both the biofilm (32 and 32 microg/ml) and biofilm-released cells (16 and 32 microg/ml). Lactoferrin did not reduce the MIC of lysozyme, but, at a lysozyme concentration of 16 mg/ml, did significantly (p < 0.05) reduce the number of viable biofilm and biofilm-released cells. CONCLUSIONS: Lactoferrin displays potential as an adjunctive agent to vancomycin in the treatment of S. epidermidis biofilm infections, such as endophthalmitis, associated with intraocular lenses.

Anti-Bacterial Agents↗
PubMed1999

Incidence of contamination of preserved saline solutions during normal use.

PURPOSE: To ascertain the incidence of microbial contamination of preserved contact lens saline solutions with normal patient use. METHODS: Eight different brands of preserved saline were dispensed to 40 patients attending optometric practices in the Sydney area. After specific periods of time (7 to 28 days), the samples were collected and the solution bottle nozzles and contents underwent microbial analysis. RESULTS: The overall contamination rate was approximately 26% for contents only and 55% for nozzles of preserved saline solutions. This rate remained constant for all periods of use. Coagulase-negative Staphylococci were most frequently isolated. No Acanthamoebae were isolated. Saline preserved with ethylene-diamine-tetraacetic acid (EDTA) in conjunction with sorbic acid showed the highest percentage of sterility. CONCLUSIONS: The results of this study show that preserved saline became contaminated with gram-positive bacteria. This is in contrast to our previously published paper using unpreserved saline, where contamination was predominantly with gram-negative bacteria. The overall contamination rates with preserved saline were lower than for unpreserved saline.

Contact Lens Solutions↗
PubMed1999

Contact lens-induced peripheral ulcers with extended wear of disposable hydrogel lenses: histopathologic observations on the nature and type of corneal infiltrate.

PURPOSE: Contact lens-induced peripheral ulcer (CLPU), a sudden-onset adverse event observed with extended wear of hydrogel lenses, is characterized by a single, small, circular, focal anterior stromal infiltrate in the corneal periphery or midperiphery. The condition is always associated with a significant overlying epithelial loss and resolves in a scar. The aim was to determine, by using histopathologic techniques, the nature and type of the corneal infiltrate of these events. METHODS: Three CLPUs observed in three patients using disposable hydrogel lenses on an extended-wear schedule were examined. The eye was topically anesthetized, and a corneal section including all of the infiltrate was taken. A small triangular piece of conjunctiva immediately adjacent to the infiltrate was sectioned. The tissue was immediately fixed, processed, stained using hematoxylin and eosin and periodic acid-Schiff stains, and examined by using light microscopy. RESULTS: The diameter of these three corneal infiltrates varied from 0.3 to 0.6 mm. Histopathology of the corneal sections revealed a focal epithelial loss corresponding to the infiltrated stroma in all three patients. The adjacent epithelium was thinned. Bowman's layer was intact in two patients and had a localized area of loss in the remaining patient. The anterior stroma was densely infiltrated with polymorphonuclear leukocytes and had focal areas of necrosis. The infiltration was most dense in the region immediately underlying Bowman's layer. No other infiltrative cell type was seen in any of the sections. Histopathology of the conjunctiva revealed features consistent with normal conjunctival tissue. CONCLUSIONS: On histopathology of CLPU, distinctive features (i.e., focal corneal epithelial loss, an intact Bowman's membrane, and a localized infiltration of the anterior stroma with polymorphonuclear leukocytes) were seen. These features suggest that the event is an acute inflammatory process and probably noninfective in nature.

Adolescent↗
PubMed1998

Development of mini-gel technology in two-dimensional electrophoresis for mass-screening of samples: application to tears.

Despite the extensive literature available on tear proteins and lipids, very little has been reported on the tear fluid as a whole and it's changes in contact lens wear or ocular diseased patients. Initially a human reflex tear two-dimensional map was created by Molloy et al. (Electrophoresis 1997, 18, 2811-2815), using this information a process for mass-screening was established. The large format two-dimensional technique was evaluated, using a basal tear reference map, and modified to describe a fast, efficient and cost effective method of protein separation. The use of one pH 3-10 18 cm nonlinear immobilised pH gradient (IPG) strip and two mini-gels for the second-dimensional sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) results in an effective separation of tear proteins which will be applied in diagnostic studies of tear samples.

Acrylic Resins↗
PubMed1998

Chemotactic activity of tears and bacteria isolated during adverse responses.

Inflammatory processes are characterized by the dynamic influx of leukocytes. This leukocyte recruitment and activation is thought to be initiated by chemical signals including chemotactic factors. This study was designed to investigate the chemotactic activity in different tear types and bacteria isolated during adverse responses to contact lens wear. Chemotactic activity was determined by quantitating in vitro neutrophil migration using a microchemotaxis chamber. Results demonstrated that tears collected immediately after 8 hours sleep (P<0.001) and tears collected during adverse responses (P<0.001) showed significantly higher chemotactic activity compared to reflex tears. Specific neutralizing antibodies to IL-8, LTB4 and C5a were added to closed eye and adverse response tears. Pre-incubation of closed eye tears with antibodies to IL-8 showed a significant reduction in chemotactic activity (P<0.0001), whereas a significant reduction of PMN migration in adverse response tears was observed after pre-treatment with antibodies to LTB4 (P<0.0001). However no difference in chemotactic activity was observed after incubation with antibody to C5a or irrelevant antibody. Dot blots demonstrated that closed eye tears contained approximately 150 ng ml-1 IL-8 and adverse response tears contained 2 ng ml-1 IL-8. Most Gram negative bacteria isolated from contact lenses caused directed migration of PMNs. Addition of neutralizing antibody to LPS significantly abrogated the chemotactic activity of bacterial cells (P<0.001). Our findings provide evidence that IL-8 during eye closure, and bacterial chemotactic substances and LTB4 during contact lens induced adverse responses, are responsible for the recruitment of PMNs.

Chemotaxis, Leukocyte↗
PubMed1998

Cytokine and lipid inflammatory mediator profile of human tears during contact lens associated inflammatory diseases.

Contact lens induced acute red eye (CLARE) and contact lens induced peripheral ulcer (CLPU) are among the most common contact lens induced inflammatory reactions. Both CLARE and CLPU are characterized by corneal infiltration which indicates the presence of chemoattractants and other inflammatory mediators. The aim of this study was to characterize the cytokine and chemotactic lipid inflammatory mediator profile in the tears of people experiencing CLARE or CLPU. Cytokines IL-1 beta, IL-6, IL-8, GM-CSF and LTB4 in tears were measured by antibody sandwich and competition inhibition enzyme-linked immunosorbent assays (ELISA). Platelet activating factor-like activity was measured by a degranulation assay by measuring the release of labelled serotonin from platelets. The functional role GM-CSF and chemoattractants were determined by flow cytometry and chemotaxis. Increased levels of cytokines and chemoattractants were detected in both CLARE and CLPU tears. CLPU tears showed increased levels of LTB4 (P = 0.002) and PAF-like activity (P = 0.047) whereas CLARE tears showed increased levels of GM-CSF (P = 0.002). IL-8 (P < 0.05). LTB4 (P = 0.002) and PAF-like activity (P = 0.047) compared to control tears. Flow cytometric analysis revealed that incubation of PMN with CLARE tears increased the number of IgA receptors indicating that the GM-CSF in CLARE tears was active. Combinations of suboptimal concentrations (which were found in CLARE and CLPU tears) of IL-8 with either LTB4 or PAF significantly (P < 0.0001) enhanced the chemotactic activity for PMN compared to their individual effects. Our data highlight the possible pathophysiological roles of these inflammatory mediators in leukocyte recruitment and activation during ocular inflammatory responses. The results suggests that GM-CSF, IL-8 and LTB4 are active during corneal pathology and LTB4 or IL-8 may maintain the contact lens induced PMN response in vivo.

Acute Disease↗
PubMed1998

An ocular strain of Pseudomonas aeruginosa is inflammatory but not virulent in the scarified mouse model.

Pseudomonas aeruginosa is the most common pathogen among contact lens-associated infections. This study investigated the response of the murine cornea to infection with an ocular strain of P. aeruginosa isolated from a subject with an inflammatory adverse response to contact lens wear termed CLARE. Although this bacterium was isolated in confluency (greater than 2000 cfu lens-1) from the lens at the time of the inflammatory episode, no infection of the cornea subsequently developed. Male C57BL/6J mice (20 per strain) had their corneas scratched with a 26 gauge needle (3 parallel 1.0 mm wounds in the left eye only). The incisions were centered over the pupillary axis and penetrated the epithelial cell basal lamina and into the superficial stroma. The CLARE strain was found to persist (viable bacteria could be cultured from corneal homogenates) up to 8 hr, as did the virulent control strain ATCC 19660. At 24 hr, only ATCC 19660 could be cultured, indicating an inability of the strain isolated from CLARE, Paer1, to persist in the eye consistent with the human inflammatory episode. Histological examination of the mouse tissue showed further differences between infection by the two strains. Infection with ATCC 19660 resulted in tissue necrosis and a large population of polymorphonuclear leukocytes (PMNs) recruited to the wound site. In contrast, during infection with the CLARE strain, PMN recruitment was reduced and temporally delayed. The CLARE strain grew as well as ATCC 19660 in vitro but produced less protease activity, in particular less elastase. The decreased PMN response and decreased protease production by the CLARE strain may have been responsible for the lack of ocular damage and apparent healing of the wound. P. aeruginosa strains are considered to be invasive or cytotoxic to corneal tissue, however this strain may represent a third inflammatory type consistent with its differing pathology.

Animals↗
PubMed1998

The proinflammatory cytokines and arachidonic acid metabolites in human overnight tears: homeostatic mechanisms.

The tear film plays an important role in the defense of the external ocular surface. During sleep a number of changes take place, including increased production and release of various inflammatory mediators. We have studied the hypothesis that closed-eye tears contain proinflammatory cytokines and lipid inflammatory mediators, which serve to recruit polymorphonuclear leukocytes (PMNs) and regulate the function of PMNs and IgA during sleep. We investigated interleukin-1beta, interleukin-6, interleukin-8, monocyte chemotactic protein 1, granulocyte-macrophage colony stimulating factor (GM-CSF), leukotriene B4 (LTB4), and platelet activating factor (PAF) in open and closed-eye tears of normal healthy subjects. Results showed that IL-6, IL-8, GM-CSF, LTB4, and PAF were present in high levels in closed-eye tears compared to open-eye tears. Closed-eye tears were able to recruit neutrophils, with maximal recruitment after 8 hr of sleep, suggesting that chemokine IL-8 and the lipid chemoattractant LTB4 were active. Flow cytometric analysis revealed that incubation of neutrophils with closed-eye tears up-regulated the surface expression of IgA receptor, indicating that the GM-CSF in tears was functionally active. Up-regulation of cytokines and the lipid inflammatory mediator LTB4 during eye closure are noteworthy, as each of these cytokines has an established role in initiation and amplification of the inflammatory response. IL-8 and LTB4 may act as potent chemoattractants and activators for PMNs, whereas IL-6 and GM-CSF potentiate the secretion and function of IgA and enhance neutrophil responsiveness to proinflammatory agonists.

Adult↗