PTERYGIUM - physio pathogenic mechanisms and clinical treatment

• Grant number: 23/02014-0
• Support Opportunities: Regular Research Grants
• Start date: November 01, 2023
• End date: October 31, 2025
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Silvana Artioli Schellini
• Grantee: Silvana Artioli Schellini
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• Associated researchers: Carlos Roberto Padovani ; Claudia Aparecida Rainho ; Magda Massae Hata Viveiros

Abstract

Four different studies are involved in this project, as described below:1) Study 1 - using the systematic review technique, possible candidate genes and mechanisms involved in the development of pterygium can be detected. An extensive search for articles related to gene expression in pterygium in the databases will be performed. Abstracts and titles will be reviewed by two independent researchers and doubts will be discussed together. Selected articles and data will be collected in an Excel table (authors' names, year of publication, sample characterization, type of study, and analysis method. The identified genes, including target and housekeeping, will be tabulated. The results will be statistically analyzed.2) Study 2 - we will investigate the DNA methylation pattern of CDH1 (cadherin 1), CDH2 (cadherin 2), and VIM (vimentin) genes in pterygium. Excised pterygium fragments will be prepared for genomic DNA study. Enzymatic digestion and extraction by organic solvents will be applied in freshly collected tissue samples. DNA methylation analysis will be performed by MS-PCR (Methylation Specific-Polymerase Chain Reaction). Data will be transferred to tables for statistical analysis.3) Study 3 - we will evaluate in vitro the expression and distribution of inflammatory cytokines and vascular proliferation factors in the supernatant of cultured cells from the body or head of primary or recurrent pterygium. Tissues obtained from the exeresis of primary or recurrent pterygia will be cultured. The supernatant of cultures will be collected and used to analyze the dosages of IL-1², IL-6, IL-8, IL10, VEGF, MMP1, and TNF-alpha. The results will be submitted for statistical analysis.4) Study 4 - bevacizumab is an anti-angiogenic substance, to be injected intralesionally, in order to determine whether there is a regression of an already installed lesion, which could represent an advance in the clinical treatment of the lesion. Patients with primary pterygium will be divided into group 1 which will receive an intralesional application of 2.5mg and group 2, an application of 5 mg of bevacizumab (Avastin®; F-Hoffman-La Roche, Basel, Switzerland) subconjunctival will be studied through parameters clinical (complaints and satisfaction) and ophthalmological (visual acuity, biomicroscopy and quantitative examination of the lesion) before and after six months of treatment application. All analyses will be blinded and applying statistical methods. (AU)