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Please note that we are a research service provider, not a pharmacy or clinic, so we are unable to see patients and do not offer diagnostic and treatment services for individuals.

Epidemic Keratoconjunctivitis (EKC)

Epidemic Keratoconjunctivitis (EKC) is primarily driven by adenoviral agents and is associated with adenovirus D (AdV) which is a non-enveloped double-stranded DNA virus. Protheragen is dedicated to providing innovative epidemic keratoconjunctivitis (EKC) diagnostic and therapeutic development services, including preclinical research and customized solutions.

Overview of Epidemic Keratoconjunctivitis (EKC)

Epidemic Keratoconjunctivitis (EKC) constitutes an ocular infection of high contagiousness that results from specific factors of aetiological human adenoviruses (HAdV) of special D species types 8, 37, 53, 54, 56, and 64. It presents itself through an acute form of conjunctivitis having severe corneal involvement (corneal conjunctivitis), and the patient presents with symptoms of intense hyperemia, lacrimation, and subepithelial infiltrates (SEIs) within the cornea. These infiltrates can last for years and potentially, lead to visual complications, including blurring of vision, glare, and a feeling of foreign objects within the eyes.

Scheme of the routes of administration of anti-infectives into the eye.

Fig.1 Route of administration of anti-infective drugs. (Luaces-Rodríguez A., et al., 2018)

Diagnostic Methods for Epidemic Keratoconjunctivitis (EKC)

Antigen Detection Methods
Techniques such as immunofluorescence and immunochromatography are employed for swift acute diagnosis of EKC. These techniques are cost effective and results can be achieved within 10 minutes. However, their sensitivity is restricted by the phase of infection and the viral load in the infected eye, typically between 88% and 91%.
Viral Culture
Viral culture is still the gold standard in the identification of the causative virus. Various cell lines are cultured, including A549, Hep-2, and HeLa. Though very precise, cultivation of viruses is slow and takes 2 to over 21 days for some samples. Such a long duration makes it impractical for regular usage.
Molecular Methods
Traditional PCR techniques alongside real time PCR possess great sensitivity and accuracy and have reliable results within a short time frame. They are able to identify DNA fragments of a viral chromosome at low thresholds making them ideal for early detection and typing of adenovirus strains. However, the heterogenous genetics of the different types of adenoviruses makes the construction of universal primers difficult. For exact typing and recombination analysis, whole genome sequencing (WGS) is employed, however, it is expensive and slow which restricts its application to epidemiological studies.

Therapeutics Development for Epidemic Keratoconjunctivitis (EKC)

Antiviral Therapy

As of now, no particular antiviral therapy can address adenovirus infections. Antiviral drugs such as ganciclovir and cidofovir have been tested in vitro and in animals, but their effectiveness is of great concern. Deaths caused by toxicity pose limits to their application. Researcher's efforts are directed towards developing new classes of antiviral compounds that would selectively block adenovirus replication without significant side effects.

Immunomodulation

Topical corticosteroid and the calcineurin inhibitors cyclosporin A and tacrolimus have been used to control inflammation in moderation and have shown considerable promise in altering immune functions. Although these agents prove helpful in the therapeutics of chronic SEIs, they must be used cautiously because of numerous side effects. More recent data show that SEIs are significantly reduced with tacrolimus 0.03% compared to baseline levels prior to therapeutics.

Our Services

Protheragen offers comprehensive services for the development of diagnostics and therapeutics for Epidemic Keratoconjunctivitis (EKC). Our services include:

Diagnostics Development

Therapeutic Development

Disease Models

Cotton Rat Infection Models
New Zealand White Rabbit Infection Models
C57BL/6J Mouse Infection Models
Porcine Corneal Cell Culture Models

Preclinical Research

Protheragen offers customized services tailored to meet the specific needs of our clients. Our team works closely with researchers and developers to design and implement studies that address unique research questions and objectives. If you are interested in our services, please feel free to contact us.

References

Luaces-Rodríguez, Andrea, et al. "Review of intraocular pharmacokinetics of anti-infectives commonly used in the treatment of infectious Epidemic Keratoconjunctivitis (EKC)." Pharmaceutics 10.2 (2018): 66.
Vaziri, Kamyar, et al. "Epidemic Keratoconjunctivitis (EKC): state of the art." Clinical ophthalmology (2015): 95-108.
Relhan, Nidhi, Richard K. Forster, and Harry W. Flynn Jr. "Epidemic Keratoconjunctivitis (EKC): then and now." American journal of ophthalmology 187 (2018): xx-xxvii.