Utilization of Polydeoxyribonucleotide (PDRN) to Treat Ulcerative and Conjunctiva Cornea

Utilization of Polydeoxyribonucleotide (PDRN) to Treat Ulcerative and Conjunctiva Cornea
Mehrnoosh Hashemi,^1,*
1. Pharmacy student, Department of Pharmacology , Faculty of pharmacy and Pharmaceutical science, Tehran Medical Science, Islamic Azad University, Tehran, Iran
Introduction: Polydeoxyribonucleotide (PDRN) considered a biopolymer low molecular weight DNA consisting of a random deoxyribonucleotide arrangement. PDRN is generally extracted from sperm and trout’s testicles (Oncorhynchus mykiss) and salmon (Oncorhynchus keta) with an extraction process to obtain over 95% purity. PDRN has been reported for binding with adenosine A2A receptors resulting in tissue regeneration, anti-inflammatory, collagen synthesis, the stimulation of cell migration and proliferation of specific cells such as endothelial cells, fibroblasts and osteoblasts. Activation of the adenosine receptor pathway has been represented to be effective in improving tissue remodeling and reducing the inflammatory response. Corneal conjunctival ulcers and damages recognized as one of the annoying eye disorders. The ulcer of the cornea is a withdrawal in the corneal epithelium which is a potentially serious risk for vision. The increasing amount of lens usage and lasic surgeries leads to micro damages, ulcerative disease of the cornea and conjunctiva from contact lens usage. Most of the preclinical and clinical studies on PDRNs regeneration attribute focused on skin, and only a few are about ophthalmic tissues. The present review aims to declare the advantages of PDRN in ophthalmic disorders.
Methods: Identifying the studies included in this review was performed with PubMed search strategy and following terms: “PDRN” OR “Polydeoxyribonucleotide” AND “Cornea” with the restrictions of publication year (between 1990 and 30th August 2020) and language (English). The included papers with the following eligibility criteria: studies containing PDRN extraction techniques, corneal tissue regeneration, PDNR pharmacological mechanisms and pharmaceutical products in the market.
Results: More than 30 studies were identified with our search strategy and finally, with performing another additional search 15 studies were selected. Based on the case-control studies re-epithelialization and wound healing with PDRN in the cornea were reported. Studies represent tissue repairing, increase in cell growth, proliferation and therapeutic angiogenesis. Moreover, PDRN counted as a source of energy and nutrition supply to the cornea. Also, the activation of the adenosine A2A receptor results in the anti-inflammatory effect of PDRN. One of the important determinants of PDRN’s safety is the lack of effects on the immune system.
Conclusion: The wound healing and tissue repairing are PDRN unique features which make it a new advancement in the pharmacotherapy. In clinical trials, PDRN is considered as an ophthalmic therapeutic agent for the corneal epithelial wound caused by contact lens usage and ulcerative disease. Pharmacological properties of PDRN represent that in addition to stimulating the regenerative and healing process of the corneal epithelium, it is considered as a source of metabolic energy for the corneal tissues to extend their physiological functions. The administration of PDRN eye drops about four times a day is well endured by patients during the re-epithelialization therefore it is essential to expand PDRN ophthalmic formulations, dosage forms and eye drops. Eye drops are more desirable for patients because of clinical proofs and evidence.
Keywords: Polydeoxyribonucleotide (PDRN), Corneal conjunctiva, Re-Epithelium