Pharmacological vitreolysis
A method of treating or preventing a disorder, or a complication of a disorder, of an eye of a subject comprising contacting a vitreous and/or aqueous humor with a composition comprising a truncated form of plasmin comprising a catalytic domain of plasmin (TPCD). TPCDs include, but are not limited to, miniplasmin, microplasmin and derivatives and variants thereof. The methods of the invention can be used to reduce the viscosity of the vitreous, liquefy the vitreous, induce posterior vitreous detachment, reduce hemorrhagic blood from the eye, clear or reduce materials toxic to the eye, clear or reduce intraocular foreign substances from the eye, increase diffusion of a composition administered to an eye, reduce extraretinal neovascularization and any combinations thereof. The method can be used in the absence of, or as an adjunct to, vitrectomy.
1. A method of increasing diffusion of an agent administered to the vitreous of an eye of a subject, comprising contacting the vitreous with a microplasmin prior to or concomitant with contacting the vitreous with the agent, wherein the method results in increasing diffusion of the agent in the vitreous of the eye of the subject.
2. The method according to claim 1 wherein said agent is selected from the group consisting of hyaluronidase, chondroitinase ABC, chondroitinase AC, chondroitinase B, chondroitin 4-sulfatase, chondroitin 6-sulfatase, β-glucuronidase, collagenase, dispase, RGD containing peptides, echistatin, falvoridin, anti-integrin antibody, P2Y receptor antagonists, urea, hydroxyurea, thiourea, anti-angiogenic agents, VEGF inhibitors, PlGF inhibitors, and any combination thereof.
3. The method according to claim 2 wherein said VEGF inhibitor is an anti-VEGF antibody, a VEGF-aptamer, or a soluble VEGF receptor.
4. The method according to claim 2 wherein said PlGF inhibitor is an anti-PlGF antibody, a PlGF-aptamer, or a soluble PIGF receptor.
5. The method according to claim 1 wherein said microplasmin is selected from the group consisting of recombinant microplasmin, stabilized microplasmin, and stabilized, recombinant microplasmin.
6. The method according to claim 1 wherein the step of contacting the vitreous with microplasmin comprises injecting microplasmin into the vitreous.
7. The method according to claim 1 wherein said microplasmin is a human microplasmin.
8. The method according to claim 1 wherein the subject is a human.
9. The method according to claim 1 wherein the amount of microplasmin contacted with the vitreous is in the range of 0.005 mg to 0.2 mg per eye.
10. The method according to claim 1 wherein said microplasmin is stabilized by contacting with a stabilizing agent, or is purified in the presence of a stabilizing agent.
11. The method according to claim 10 wherein said stabilizing agent is selected from the group consisting of tranexamic acid, hexanoic acid, lysine, serine, threonine, methionine, glutamine, alanine, glycine, isoleucine, valine, alanine, aspartic acid, polyhydric alcohol, a pharmaceutically acceptable carbohydrate, glucosamine, thiamine, niacinamide, an acidic buffer, a salt, and any combination thereof.
12. The method according to claim 11 wherein said acidic buffer is comprising acetic acid, benzoic acid, carboxylic acid, citric acid, hydrochloric acid, lactic acid, malic acid or tartaric acid.
13. The method according to claim 11 wherein said salt is calcium chloride, magnesium chloride, potassium chloride or sodium chloride.
14. The method according to claim 1 wherein said microplasmin consists of a double chain polypeptide selected from the group consisting of amino acids 531 to 791, 532 to 791, and 543 to 791 of SEQ ID NO:10, wherein the peptide bond between Arg561 and Val 562 is cleaved by a plasminogen activator.
15. The method according to claim 1 wherein said microplasmin is an activated microplasminogen wherein said microplasminogen is encoded by SEQ ID NO:3.
16. The method according to claim 1 wherein said microplasmin is produced by recombinant expression in a yeast.
17. The method according to claim 16 wherein said yeast is Pichia pastoris.