New Approach for Anti-fibrotic Therapy for Glaucoma

University of Birmingham (UK) scientists have shown that a novel low molecular weight dextran-sulphate, ILB® could play a key role in treating open angle glaucoma (OAG), a neurodegenerative disease, affecting over 70 million people worldwide, by lowering increased intraocular pressure (IOP) within the eye’s main fluid drainage site.,

OAG develops slowly over many years, leading to excessive matrix deposition (fibrosis), which in turn can lead to increased intraocular pressure (IOP), causing damage to the optic nerve and blindness. 

The research has shown that that ILB can normalise matrix deposition inside the eye in a pre-clinical model used to mimic these aspects of human glaucoma, paving the way for new anti-fibrotic therapies to be developed for the disease.

The Birmingham scientists focussed on an inflammatory pathway that is common to several diseases and involves Transforming Growth Factorβ (TGFβ), a signalling molecule that communicates between cells and orchestrates both inflammation and fibrosis.  TGFβ’s role in OAG is well known, with patients demonstrating higher levels in their aqueous humour and laboratory studies showing that artificially increasing TGFβ within the eye can lead to fibrosis. They found that ILB has multimodal actions across many genes that resolve inflammatory and fibrotic cellular processes.  When they progressed their work into a pre-clinical experimental model of glaucoma, they found that daily subcutaneous injections of ILB significantly (p<0.01) reduced extracellular matrix levels within the eye’s main drainage site, normalised the eye’s pressure and prevented degeneration of retinal neurons.  The research was conducted by Dr Lisa Hill, from the Institute of Clinical Sciences and Dr Hannah Botfield, from the Institute of Inflammation and Ageing.  They commented:  “We are truly excited by these results, which show a way forward for a glaucoma treatment that can reverse the fibrotic process that causes the disease.”  

Dr Hill is working closely on this with Mr Imran Masood, a consultant ophthalmic surgeon at Sandwell and West Birmingham NHS Trust and Professor Liam Grover, a biomaterials expert from the University’s Healthcare Technologies Institute, to develop a topical alternative treatment that avoids injection.