Episcleritis

Episcleritis characterizes a self-limiting, benign inflammatory disease involving the episclera, which refers to the vascular layer under the conjunctiva that is superficial and lies above the sclera. Protheragen is at the forefront of episcleritis diagnostics and therapeutics development, offering a range of services to support the entire drug development lifecycle.

Overview of Episcleritis

Episcleritis is an ocular inflammation that is comparatively less severe and is marked by an episode of redness and swelling of the episcleral area which is the superficial layer of the sclera. This condition occurs more frequently than scleritis and is recurrent in nature; flares can happen over many years and at unpredictable intervals. Although it does not usually endanger a patient's eyesight, episcleritis can lead to considerable discomfort and cosmetic problems. It is necessary to differentiate between episcleritis and scleritis because the latter impacts vision and is much more critical. There are two types of episcleritis: simple episcleritis which is sectoral, and nodular episcleritis which appears as a raised nodule.

Fig.1 Bar diagram showing types of episcleritis. (Zhang X., et al., 2023)

Pathogenesis of Episcleritis

Although the mechanisms of episcleritis are not fully elucidated, current evidence suggests that it is due to an inflammation of blood vessels innervated by immune systems which is localized to a confined area. The main contributing pathogenic components are:

• Vascular Dysregulation: Edema and hyperemia caused by prostaglandin-mediated vasodilation results in the dilation of episcleral vessels.
• Immune Complex Deposition: In rare autoimmune-associated cases, immune complexes may trigger a non-necrotizing inflammatory response.
• Cytokine Involvement: Elevated levels of IL-6 and TNF-α have been observed in episcleral tissue, suggesting a role for pro-inflammatory cytokines.
• Infectious Triggers: Viral (e.g., herpes simplex, varicella-zoster) or bacterial (e.g., Lyme disease, syphilis) agents may induce episcleritis in susceptible individuals.

Therapeutics Development for Episcleritis

Topical Corticosteroids

Topical corticosteroids are used as first-line therapeutics for episcleritis. Fluorometholone 1% and prednisolone acetate 1% eye drops are routinely prescribed. These agents are quite effective in alleviating inflammation and redness.

Topical Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Topical pharmacological NSAIDs have better efficacy than corticosteroids or may be used in conjunction. For example, topical diclofenac sodium ophthalmic solution has shown great efficacy in cases suffering from episcleritis.

Oral NSAIDs

When topical therapy alone is inadequate, indomethacin and other oral NSAIDs might be recommended. These medications offer greater anti-inflammatory benefits and can help manage more advanced or persistent forms of episcleritis.

Systemic Corticosteroids

Systemic corticosteroids may be prescribed in refractory or severe cases of episcleritis. This method is more frequently used for scleritis and is regarded for episcleritis when other therapies have not been effective.

Our Services

Protheragen's thorough research and development efforts dedicate themselves to the advancement of episcleritis diagnostics and therapeutics. By offering tailored services, we guarantee unparalleled project support for our clients, which meets their specific needs.

Diagnostics Development

• Karyotype Analysis Service
• Omics Analysis Service
• Biomarker Development Service
• Artificial Intelligence Service
• Customized Diagnostics Development

Therapeutic Development

• Small Molecule Drug
• Cell Therapy
• Gene Therapy
• Therapeutic Antibody
• Therapeutic Peptide
• Therapeutic Protein
• Customized Therapy Development

Disease Models

• β-glucan Induction Models
• Conjunctival Incision or Injection of Inflammatory Agents
• Silver Nitrate Induction Models
• Conjunctival Epithelial Cell Models

Protheragen recognizes that all clients differ in their specific needs and demands. We customize our episcleritis service offerings to facilitate the exacting process of developing appropriate diagnostics and therapeutics for the condition. If you are interested in our services, please feel free to contact us.

References

• Zhang, Xin, Qixiang Zhao, and Bei Li. "Current and promising therapies based on the pathogenesis of Graves' ophthalmopathy." Frontiers in Pharmacology 14 (2023): 1217253.
• Li, Xueting, et al. "Recent advances in graves ophthalmopathy medical therapy: a comprehensive literature review." International Ophthalmology 43.4 (2023): 1437-1449.