Cross-organ translation of antifibrotic strategies from skin and lung fibrosis to glaucoma filtration surgery
Year: 2026
Type: article
Abstract: Filtering bleb scarring after glaucoma filtration surgery (GFS) remains the leading cause of surgical failure, and current antimetabolites are limited by non-selective cytotoxicity that restricts their long-term use. Research on skin and lung fibrosis has accumulated extensive experience in antifibrotic mechanisms and therapeutic approaches. These tissues share a common transforming growth factor-beta (TGF-β)-driven program of fibroblast activation and extracellular matrix (ECM) remodeling with Tenon capsule fibroblasts, providing a theoretical basis for translating antifibrotic strategies across organs. From a cross-organ translational medicine perspective, this review systematically summarizes progress in translating antifibrotic research from skin and lung fibrosis to antiscarring therapy for GFS, focusing on four aspects: shared fibrotic mechanisms; repurposed approved drugs and emerging molecular targets; local drug delivery systems (DDS); and ophthalmology-specific translational challenges. It also highlights mechanotransduction via Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ), lysyl oxidase (LOX)-mediated ECM crosslinking, and the translational potential of local sustained-release delivery in filtering blebs. Building on this foundation, we propose that multi-target combination therapy, precision local delivery, and individualized antiscarring strategies based on biomarkers such as aqueous humor TGF-β 2 may represent important future directions for improving the long-term success rate of GFS.
Source: Frontiers in Pharmacology
Authors: Xiaolu Zhong, Guiling Zhao
Institution: Guangdong Medical College
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223688089