Ectoine in the Treatment of Irritations and Inflammations of the Eye Surface.

The ocular surface is facing various unspecific stress factors resulting in irritation and inflammation of the epithelia, causing discomfort to the patients. Ectoine is a bacteria-derived extremolyte with the ability to protect proteins and biological membranes from damage caused by extreme environmental conditions like heat, UV-light, high osmolarity, or dryness. Evidence from preclinical and clinical studies attest its effectiveness in treating several epithelium-associated inflammatory diseases, including the eye surface. In this review, we analysed 16 recent clinical trials investigating ectoine eye drops in patients with allergic conjunctivitis or with other unspecific ocular inflammations caused by e.g. ophthalmic surgery. Findings from these studies were reviewed in context with other published work on ectoine. In summary, patients with irritations and unspecific inflammations of the ocular surface have been treated successfully with ectoine-containing eye drops. In these patients, significant improvement was observed in ocular symptoms of allergic rhinoconjunctivitis, postoperative secondary dry eye syndrome, or ocular reepithelisation after surgery. Using ectoine as an add-on therapy to antihistamines, in allergy patients accelerated symptom relief by days, and its use as an add-on to antibiotics resulted in faster wound closure. Ectoine is a natural substance with an excellent tolerability and safety profile thus representing a helpful alternative for patients with inflammatory irritation of the ocular surface, who wish to avoid local reactions and side effects associated with pharmacological therapies or wish to increase the efficacy of standard treatment regimen.

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Copyright © 2021 Andreas Bilstein et al.

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AB reports personal fees from bitop AG. AH is employee of bitop AG. RM reports personal fees from ALK; grants from ASIT biotech; personal fees from Allergopharma; personal fees from Allergy Therapeutics; grants and personal fees from Bencard; grants from Leti, grants, personal fees, and nonfinancial support from Lofarma; nonfinancial support from Roxall; grants and personal fees from Stallergenes; grants from Optima; personal fees from Friulchem; personal fees from Hexal; personal fees from Servier; personal fees from Klosterfrau; nonfinancial support from Atmos; personal fees from Bayer; nonfinancial support from Bionorica; personal fees from FAES; personal fees from GSK; personal fees from MSD; personal fees from Johnson & Johnson; personal fees from Meda; personal fees and nonfinancial support from Novartis; nonfinancial support from Otonomy; personal fees from Stada; personal fees from UCB; nonfinancial support from Ferrero; grants from bitop AG; grants from Hulka; personal fees from Nuvo; and grants from Ursapharm, outside the submitted work.