Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen cases of herpes simplex epithelial keratitis, which failed to heal following IDU therapy, were treated with Ara-A 3% ointment applied fives times daily. Epithelial disease resolved in fourteen cases with Ara-A and mean healing time was 6,6 days. No sign of ocular or adnexal toxicity were noted.
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PMID:[Adenine-arabinoside in the treatment of idu-resistant herpes simplex keratitis (author's transl)]. 15 54

Fifty-seven patients with ocular herpes simplex (HS) infection were studied for evaluation of existing methods for virus isolation and its application in diagnosis of HS infection. Virus was isolated in 90% of 34 cases with keratitis dendritica, when specimens were taken within eight days of onset of symptoms. The same isolation frequency was obtained in 10 cases of palpebral herpes with conjunctivitis. No isolation was possible in 11 cases of keratitis disciformis. Laboratory confirmation was obtained within four days in 70% of the positive cases. Ten strains of HS virus type 1 were examined for IDU resistance, 5 strains isolated prior to and 5 during IDU treatment. Nine of the strains had the same degree of sensitivity. One strain isolated during treatment was found to be highly resistant.
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PMID:Ocular herpes simplex infection. A clinical evaluation of virus isolation and studies on iodo-deoxyuridine resistance. 20 39

Amphotericin B methyl ester (AME), a semisynthetic derivative of amphotericin B, was studied in the rabbit cornea for its potential role in prevention and therapy of HSV, vaccinia virus, and vesicular stomatitis virus. It was effective in the prevention of lesion formation by these three viruses and dose-related antiviral effects were shown. Of these viruses HSV was the most sensitive to AME. The antiviral effect of AME was additive with those of IDU and ribavirin. However, it was not effective in treating established lesions due to HSV and vaccinia virus. Since its mode of action is to bind to the sterol sites of the viral envelope, it is suggested that AME should also be effective against other enveloped DNA and RNA viruses. A new method of therapy for epithelial herpetic keratitis in humans using a combination of AME with MWD is proposed.
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PMID:Potential role of amphotericin B methyl ester in the prevention and therapy of herpetic keratitis. 20 16

The authors report two cases of severe herpetic keratitis and briefly discuss the possible mechanism of acquired idoxuridine resistance of herpes simplex virus. They believe that acquired resistance to IDU may be due to the treatment itself because of activity site of the inhibitor, i.e. the viral DNA.
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PMID:[Acquired idoxuridine resistance of herpes simplex virus. Clinical data (author's transl)]. 22 Jul 19

Idoxuridine which was first used in 1960 (Kaufman et al., 1962), has been for many years the only antiviral agent available in the treatment of herpetic keratitis. It is however no more successful than is mechanical removal of diseased epithelium (Patterson & Jones, 1967), and furthermore it may give rise to serious toxic side effects. The search for an alternative medication is therefore a pressing one. Trifluorothymidine (F3T) has, in recent years, been shown to be more effective than IDU and to be free from significant toxicity. Both of these drugs are pyrimidine nucleosides. Adenine Arabinoside or Arabinoside-A (Ara-A) is, by contrast, a purine nucleoside. It is thought to exert its antiviral effect by blocking DNA polymerase and ribonucleotide reductase.
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PMID:Treatment of herpetic keratitis. 41 44

New antiviral compounds are being tested constantly and may be of considerable value with increasing availability. More than 200 analogues of purines and pyrimidines have been found to inhibit DNA and RNA viruses. Adenine arabinoside is most effective against disseminated herpes simplex virus and disseminated herpes zoster. Idoxuridine is useful in treatment of herpetic keratitis. Interferon still is in the experimental stage, and, because of its short half-life and high cost, it probably will not be released in the near future. Amantadine appears to be useful in prevention of A2 influenza, but its value against swine flu has not been established. Methisazone is effective in prevention of smallpox and in the treatment of complications of vaccinia.
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PMID:Viral chemotherapy. 58 11

Large scale, multiclinic evaluations of vidarabine (Ara-A, Vira A, adenine arabinoside) for treating herpetic keratitis have been conducted as double-blind studies (169 patients) in comparison with IDU and open studies (146 patients). In the open studies, the disease in the majority of patients had been refractory to IDU. The effects of vidarabine and IDU were approximately the same in improvement of symptoms (lacrimination, photophobia, sensitivity) and percent of and time for corneal reepithelialization. With vidarabine, significantly more patients had improved distant visual acuity than did with IDU. In the open studies, vidarabine also was effective. Of 116 patients whose ulcers had not responded to IDU, 91 (78%) had reepithelialization within four weeks of treatment with vidarabine. On the basis of results from these studies, vidarabine appears to be a safe and effective drug for treating herpes simplex keratitis.
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PMID:Vidarabine therapy of simple and IDU-complicated herpetic keratitis. 79 69

Only a few agents with antiviral activity are available for regular clinical use. Amantadine hydrochloride is effective in the prophylaxis of influenza A2. Idoxuridine and adenine arabinoside have found application as topical agents in the treatment of herpes simplex keratitis. Adenine arabinoside is also under investigation in the treatment of disseminated infections due to herpes zoster and herpes simplex. Ribavirin, an agent with a wide spectrum of activity in vitro, has not fulfilled expectations in clinical trials. Because of the near eradication of smallpox, methisazone has become less important as a prophylactic agent in smallpox.
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PMID:Antiviral agents. 92 44

The double-stranded RNA interferon inducer polyinosinic-polycytidylic acid (In-Cn) was used to treat acute dendritic keratitis in man in a double-blind manner with IDU. The success rate for this agent was similar to IDU and was found efficacious in cases not responsive to IDU. Prophylaxis with In-Cn did not prevent recurrences of epithelial herpes, but such recurrences were responsive to IDU or In-Cn.
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PMID:Therapeutic use of inducers of interferon on Herpes simplex keratitis in humans. 110 35

The efficacy of 3% Ara-A ophthalmic ointment (Vira A) has been evaluated on 100 epithelial herpetic keratitis; the poor intra-ocular penetration of Ara-A explains the exclusion of stromal keratitis and kerato-unveitis. Patients were treated 5 times a day until complete epithelial healing of ulcers, then twice a day during 7 days. Healing was obtained within 10.6 days for 87% of the patients, who have been treated by Ara-A at first (n = 77) or after failure of IDU or of IDC (n = 23). The healing rate was higher for the 52 first ocular episodes (92%) than for the 48 recurrences (81%); it decreases to 77% for recurrences after failure of IDU or IDC. Geographic ulcers heal in 76% of cases only. Their length has no influence on their healing. The longest healing time, 10.6 days, can be explained by the long period of time before beginning to apply Ara-A, 12.8 days: significative correlation between both periods of time is highlighted and shows the advantage of an early treatment. The need for a local corticotherapy (n = 8) does not hinder healing in 15.5 days. Two weeks after discontinuation of the treatment, 3 patients presented a relapse, sensitive to a 2nd Ara-A course; a maintenance treatment, superior to 7 days, is necessary. Tolerance to Vira A ointment is good. Indications of Ara-A during ocular herpes are superficial keratitis, especially those resistant to IDU or, from experimental data, to ACV, and their prevention by a possible long term treatment.
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PMID:[Treatment of superficial herpes simplex keratitis with vidarabine (Vira A): multicenter study of 100 cases]. 222 99


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