Recombinant Human Nerve Growth Factor (Cenegermin)-Driven Corneal Wound Healing Process: An Evidence-Based Analysis

Chiara Bonzano; Sara Olivari; Carlo Alberto Cutolo; Angelo Macrì; Daniele Sindaco; Davide Borroni; Elisabetta Bonzano; Carlo Enrico Traverso

doi:10.3389/fphar.2021.760507

Recombinant Human Nerve Growth Factor (Cenegermin)-Driven Corneal Wound Healing Process: An Evidence-Based Analysis

Front Pharmacol. 2022 Jan 28:12:760507. doi: 10.3389/fphar.2021.760507. eCollection 2021.

Authors

Chiara Bonzano^{1

2}, Sara Olivari^{1

2}, Carlo Alberto Cutolo^{1

2}, Angelo Macrì², Daniele Sindaco^{1

2}, Davide Borroni³, Elisabetta Bonzano^{4

5}, Carlo Enrico Traverso^{1

2}

Affiliations

¹ Eye Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
² IRCCS San Martino Polyclinic Hospital, Genoa, Italy.
³ Cornea Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
⁴ Department of Radiation Oncology, IRCCS San Matteo Polyclinic Foundation, Pavia, Italy.
⁵ PhD School in Experimental Medicine, University of Pavia, Pavia, Italy.

Abstract

Purpose: To evaluate anterior segment optical coherence tomography (AS-OCT) to detect the wound healing process as per monitoring the effectiveness of cenegermin to treat moderate to severe neurotrophic keratoplasty. Methods: A retrospective chart review was realized to identify patients treated with cenegermin at the Clinica Oculistica, University of Genoa, Italy. All patients underwent careful examinations at baseline and follow-up visits. AS-OCT scans centered on the minimum corneal thickness (CT) area were always performed. We compared findings of AS-OCT with the findings from the slit-lamp examination. A linear regression analysis was used to evaluate factors associated with corneal healing. A further analysis, including a control group treated with 50% autologous serum (AS), was done to investigate and compare the efficacy of cenegermin. Results: Data from 16 eyes were studied. The average patients' age was 60.9 ± 21.1 years; five (31.2%) eyes experienced persistent epithelial defect and 11 (68.8%) eyes had neurotrophic corneal ulcer. The average reepithelialization time was 3.9 ± 0.5 weeks in the cenegermin group versus 5.9 ± 1.9 weeks in the AS group (p < 0.01). The AS-OCT scans revealed an average CT at the thinnest point of 276.3 ± 74.1 μm before treatment with an average increase of 176.5 ± 60.3 μm at the end of the cenegermin treatment (B = -0.15; p = 0.035). The AS-OCT percentage increase in corneal thickness between the two groups was statistically significant (p < 0.02). Conclusion: Understanding the cascade of events involved in the nerve growth factor-driven corneal wound healing process is clinically meaningful for the clinician. AS-OCT is an effective tool for systematic anterior segment imaging, allowing the detailed detection of the front-to-back layered corneal structure for quantitative analysis and monitoring of the healing process.

Keywords: anterior segment optical coherence tomography (AS-OCT); autologous serum; cenegermin; corneal diseases; neurotrophic keratoplasty; ocular pharmacology; pharmacological targets; rh-NGF.