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Contact lens-related corneal infection: Intrinsic resistance and its compromise.
Prog Retin Eye Res. 2020 05; 76:100804.PR

Abstract

Contact lenses represent a widely utilized form of vision correction with more than 140 million wearers worldwide. Although generally well-tolerated, contact lenses can cause corneal infection (microbial keratitis), with an approximate annualized incidence ranging from ~2 to ~20 cases per 10,000 wearers, and sometimes resulting in permanent vision loss. Research suggests that the pathogenesis of contact lens-associated microbial keratitis is complex and multifactorial, likely requiring multiple conspiring factors that compromise the intrinsic resistance of a healthy cornea to infection. Here, we outline our perspective of the mechanisms by which contact lens wear sometimes renders the cornea susceptible to infection, focusing primarily on our own research efforts during the past three decades. This has included studies of host factors underlying the constitutive barrier function of the healthy cornea, its response to bacterial challenge when intrinsic resistance is not compromised, pathogen virulence mechanisms, and the effects of contact lens wear that alter the outcome of host-microbe interactions. For almost all of this work, we have utilized the bacterium Pseudomonas aeruginosa because it is the leading cause of lens-related microbial keratitis. While not yet common among corneal isolates, clinical isolates of P. aeruginosa have emerged that are resistant to virtually all currently available antibiotics, leading the United States CDC (Centers for Disease Control) to add P. aeruginosa to its list of most serious threats. Compounding this concern, the development of advanced contact lenses for biosensing and augmented reality, together with the escalating incidence of myopia, could portent an epidemic of vision-threatening corneal infections in the future. Thankfully, technological advances in genomics, proteomics, metabolomics and imaging combined with emerging models of contact lens-associated P. aeruginosa infection hold promise for solving the problem - and possibly life-threatening infections impacting other tissues.

Authors+Show Affiliations

School of Optometry, University of California, Berkeley, CA, USA; Graduate Group in Vision Science, University of California, Berkeley, CA, USA; Graduate Groups in Microbiology and Infectious Diseases & Immunity, University of California, Berkeley, CA, USA. Electronic address: fleiszig@berkeley.edu.School of Optometry, University of California, Berkeley, CA, USA.School of Optometry, University of California, Berkeley, CA, USA.School of Optometry, University of California, Berkeley, CA, USA.Graduate Group in Vision Science, University of California, Berkeley, CA, USA.School of Optometry, University of California, Berkeley, CA, USA.School of Optometry, University of California, Berkeley, CA, USA; College of Pharmacy, Touro University California, Vallejo, CA, USA.

Pub Type(s)

Journal Article
Review
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31756497

Citation

Fleiszig, Suzanne M J., et al. "Contact Lens-related Corneal Infection: Intrinsic Resistance and Its Compromise." Progress in Retinal and Eye Research, vol. 76, 2020, p. 100804.
Fleiszig SMJ, Kroken AR, Nieto V, et al. Contact lens-related corneal infection: Intrinsic resistance and its compromise. Prog Retin Eye Res. 2020;76:100804.
Fleiszig, S. M. J., Kroken, A. R., Nieto, V., Grosser, M. R., Wan, S. J., Metruccio, M. M. E., & Evans, D. J. (2020). Contact lens-related corneal infection: Intrinsic resistance and its compromise. Progress in Retinal and Eye Research, 76, 100804. https://doi.org/10.1016/j.preteyeres.2019.100804
Fleiszig SMJ, et al. Contact Lens-related Corneal Infection: Intrinsic Resistance and Its Compromise. Prog Retin Eye Res. 2020;76:100804. PubMed PMID: 31756497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contact lens-related corneal infection: Intrinsic resistance and its compromise. AU - Fleiszig,Suzanne M J, AU - Kroken,Abby R, AU - Nieto,Vincent, AU - Grosser,Melinda R, AU - Wan,Stephanie J, AU - Metruccio,Matteo M E, AU - Evans,David J, Y1 - 2019/11/20/ PY - 2019/04/27/received PY - 2019/11/05/revised PY - 2019/11/12/accepted PY - 2021/05/01/pmc-release PY - 2019/11/23/pubmed PY - 2019/11/23/medline PY - 2019/11/23/entrez KW - Contact lens KW - Corneal infection KW - Epithelial barrier function KW - Innate defenses KW - Para-inflammation KW - Pseudomonas aeruginosa SP - 100804 EP - 100804 JF - Progress in retinal and eye research JO - Prog Retin Eye Res VL - 76 N2 - Contact lenses represent a widely utilized form of vision correction with more than 140 million wearers worldwide. Although generally well-tolerated, contact lenses can cause corneal infection (microbial keratitis), with an approximate annualized incidence ranging from ~2 to ~20 cases per 10,000 wearers, and sometimes resulting in permanent vision loss. Research suggests that the pathogenesis of contact lens-associated microbial keratitis is complex and multifactorial, likely requiring multiple conspiring factors that compromise the intrinsic resistance of a healthy cornea to infection. Here, we outline our perspective of the mechanisms by which contact lens wear sometimes renders the cornea susceptible to infection, focusing primarily on our own research efforts during the past three decades. This has included studies of host factors underlying the constitutive barrier function of the healthy cornea, its response to bacterial challenge when intrinsic resistance is not compromised, pathogen virulence mechanisms, and the effects of contact lens wear that alter the outcome of host-microbe interactions. For almost all of this work, we have utilized the bacterium Pseudomonas aeruginosa because it is the leading cause of lens-related microbial keratitis. While not yet common among corneal isolates, clinical isolates of P. aeruginosa have emerged that are resistant to virtually all currently available antibiotics, leading the United States CDC (Centers for Disease Control) to add P. aeruginosa to its list of most serious threats. Compounding this concern, the development of advanced contact lenses for biosensing and augmented reality, together with the escalating incidence of myopia, could portent an epidemic of vision-threatening corneal infections in the future. Thankfully, technological advances in genomics, proteomics, metabolomics and imaging combined with emerging models of contact lens-associated P. aeruginosa infection hold promise for solving the problem - and possibly life-threatening infections impacting other tissues. SN - 1873-1635 UR - https://www.unboundmedicine.com/medline/citation/31756497/Contact_lens-related_corneal_infection:_Intrinsic_resistance_and_its_compromise L2 - https://linkinghub.elsevier.com/retrieve/pii/S1350-9462(19)30091-6 DB - PRIME DP - Unbound Medicine ER -
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