East meets West: The Use of Traditional Chinese Medicine in Ocular Surface Therapy

Abstract

Cornea haze and scarring is a complication of ocular surface ablation procedures as well as an end result of cornea injury. Damaged corneal epithelial cells activate myofibroblasts to secrete inflammatory cytokines and fibrogenic growth factors. Current treatments, including corticosteroids or mitomycin C have potentially blinding complications, including cataract, glaucoma and cornea-scleral melting. Lycium barbarum polysaccharide (LBP) has been used in Traditional Chinese Medicine (TCM) for over a thousand years. LBP is extracted from goji berries and are formed from a group of sugars including glucose, arabinose, galactose, mannose, rhamnose and xylose. In our in vitro experiments, we demonstrated the potent anti-cornea scarring effects of LBP. LBP significantly reduces the myofibroblast expression of fibrotic proteins, including α-SMA as well as keratocyte secretion of extracellular matrix proteins, including collagen type I and III. We further demonstrated that LBP selectively affects viability of myofibroblasts while sparing the keratocytes. In comparison, dexamethasone solution was shown to significantly reduce viability of both differentiated and undifferentiated keratocytes. Our findings suggest that LBP may serve as a potent inhibitor of cornea haze after ocular surface ablation procedures without the adverse effects of mitomycin C and steroids.