ROCK Inhibitors as an Alternative Therapy for Corneal Grafting: A Systematic Review

by Selleckchem | Feb 15 2024

Currently, corneal blindness is affecting >10 million individuals worldwide, and there is a significant unmet medical need because only 1.5% of transplantation needs are met globally due to a lack of high-quality grafts. In light of this global health disaster, researchers are developing corneal substitutes that can resemble the human cornea in vivo and replace human donor tissue. Thus, this review examines ROCK (Rho-associated coiled-coil containing protein kinases) inhibitors as a potential corneal wound-healing (CWH) therapy by reviewing the existing clinical and nonclinical findings. The systematic review was done from PubMed, Scopus, Web of Science, and Google Scholar for CWH, corneal injury, corneal endothelial wound healing, ROCK inhibitors, Fasudil, Netarsudil, Ripasudil, Y-27632, clinical trial, clinical study, case series, case reports, preclinical study, in vivo, and in vitro studies. After removing duplicates, all downloaded articles were examined. The literature search included the data till January 2023. This review summarized the results of ROCK inhibitors in clinical and preclinical trials. In a clinical trial, various ROCK inhibitors improved CWH in individuals with open-angle glaucoma, cataract, iris cyst, ocular hypertension, and other ocular diseases. ROCK inhibitors also improved ocular wound healing by increasing cell adhesion, migration, and proliferation in vitro and in vivo. ROCK inhibitors have antifibrotic, antiangiogenic, anti-inflammatory, and antiapoptotic characteristics in CWH, according to the existing research. ROCK inhibitors were effective topical treatments for corneal infections. Ripasudil, Y-27632, H-1152, Y-39983, and AMA0526 are a few new ROCK inhibitors that may help CWH and replace human donor tissue.

Comments:

That's an extensive review focusing on a significant issue in ophthalmology. The exploration of ROCK inhibitors as a potential therapy for corneal wound healing (CWH) appears promising, especially in addressing the global shortage of high-quality grafts for corneal transplants.

The diverse range of conditions in which ROCK inhibitors showed potential benefits—open-angle glaucoma, cataract, iris cyst, ocular hypertension, and other ocular diseases—underscores their broad applicability in treating corneal injuries.

It's fascinating to note their multifaceted effects, including enhancing cell adhesion, migration, and proliferation, while possessing antifibrotic, antiangiogenic, anti-inflammatory, and antiapoptotic characteristics. This wide array of positive effects suggests their potential for various stages of wound healing and multiple types of corneal injuries.

Moreover, the mention of newer ROCK inhibitors like Ripasudil, Y-27632, H-1152, Y-39983, and AMA0526 showcases the ongoing advancements in this field, potentially offering more options for effective CWH therapies in the future.

The emphasis on the need for alternatives to human donor tissue is crucial, given the shortage of available grafts. Developing corneal substitutes that mimic the human cornea and the possibility of using ROCK inhibitors as part of these substitutes could significantly impact the treatment landscape for corneal blindness.

Overall, this review highlights a promising direction in addressing the unmet medical needs related to corneal blindness and suggests that ROCK inhibitors hold significant potential as a part of future therapies for CWH and related ocular conditions.