Despite the effort to optimize soft contact lens performance, almost half of the 140 million contact lens wearers worldwide experience symptoms of ocular dryness and discomfort, especially towards the end of the day. These symptoms are attributed to reduced compatibility between the contact lens and the ocular surface and are the main reason for contact lens discontinuation. As the interactions of the contact lens-eye interface are dynamic, the surface properties play a key role in improving ocular compatibility, comfort and overall performance of contact lenses. One promising method to reduce adverse interfacial interactions between the contact lens and the ocular surface is to modify the contact lens surface with a biomimetic layer inspired by the ocular surface and the tear film. Hyaluronic acid (HA) is a non-sulfated glycosaminoglycan naturally found in the ocular environment providing ocular hydration and lubrication. Proteoglycan 4 (PRG4), a mucin-like glycoprotein naturally produced at the ocular surface contributes to natural lubrication during blinking and to tear film stability. Surface modification with HA or PRG4 has been shown to result in improved wetting, lubricating and antifouling properties. Moreover, HA and PRG4 have been previously found to interact and synergistically reduce friction further. In the current work, novel HA and PRG4-grafted soft contact lens surfaces were prepared, and the impact of the surface tethered layer on important contact lens properties was assessed. Furthermore, the potential synergistic effect between HA and rhPRG4 on the examined properties was evaluated. Surface immobilization of HA on model conventional (pHEMA) and silicone (pHEMA-co-TRIS) hydrogel contact lenses was achieved by thiol-ene “click” chemistry, while full-length recombinant human PRG4 (rhPRG4) was surface grafted via carbonyldiimidazole (CDI) linking chemistry respectively. The chemical structure after each modification step was determined by attenuated total reflectance FTIR (FTIR-ATR) and X-ray photoelectron spectroscopy (XPS) analyses. HA-grafted model soft contact lenses were characterized by improved surface wettability, antifouling and water retentive properties, while a decreasing trend in boundary friction was observed but only for the HA-grafted pHEMA-co-TRIS materials. Surface-tethering of rhPRG4 was found to effectively enhance the surface wettability and boundary lubricating properties of pHEMA-co-TRIS hydrogels only, whereas both rhPRG4-grafted pHEMA and pHEMA-co-TRIS materials exhibited lower protein sorption and dehydration rate. Overall, the surface immobilization processes followed herein did not alter the optical transparency of the model soft contact lenses or their in vitro compatibility with human corneal epithelial cells. Finally, there was evidence that HA and rhPRG4 synergistically interacted, further improving the contact lens properties. However, the degree of HA/rhPRG4 synergy was found to be dependent on the configuration of the formed HA/rhPRG4 complex as well as the composition of the substrate hydrogel material, with the noted improvement being more significant for the model silicone hydrogels. This is the first study to examine surface grafted full-length rhPRG4 and the effect of this modification on contact lens properties. Moreover, the study is the first to investigate the interactions between covalently tethered rhPRG4 and solutions containing HA. The results of this thesis demonstrate that HA and rhPRG4 are good candidates for the development of novel biomimetic surfaces, especially for silicone hydrogel contact lenses. The potential for using these compounds in synergy was also demonstrated, with wetting solutions of HA showing promise for modifying rhPRG4 modified materials to improve symptoms of discomfort. These naturally occurring ocular agents have the potential to improve the management of ocular dryness and discomfort, thus optimizing the overall soft contact lens performance. / Thesis / Doctor of Philosophy (PhD)

A cartilagem articular da cabeça da mandíbula (CAM) é constituída por uma cartilagem secundária recoberta por tecido conjuntivo fibroso e, portanto, definida como fibrocartilagínea. Ela é constantemente submetida a forças de compressão e cisalhamento decorrentes da mastigação necessitando de lubrificação e capacidade de reparo. O envelhecimento é considerado um dos principais fatores para o aparecimento de alterações degenerativas nas articulações sinoviais. A lubricina é reconhecidamente um proteoglicano encontrado nas cartilagens articulares cuja função primordial é a lubrificação limítrofe. A via SMAD2, tem sido associada à capacidade de manutenção e reparo da cartilagem, e a sua fosforilação na cadeia de ligação (p-SMAD2L) foi relacionada ao aumento no tempo de fosforilação na cadeia C-terminal (p-SMAD2) e da transcrição gênica. Objetivo: Estudar as alterações morfológicas da CAM e as expressões da lubricina, p-SMAD2L e do colágeno tipo I no envelhecimento. Métodos: cortes coronais da CAM de ratos wistar com 2, 12 e 24 meses de vida foram corados pelas técnicas da hematoxilina e eosina, azul de toluidina e safranina-O. A imuno-histoquímica foi usada para detectar a localização da lubricina, p-SMAD2L e colágeno tipo I. Resultados: Notou-se modificações estruturais atribuídas ao processo natural do envelhecimento da CAM. Ainda, se verificou um aumento do colágeno tipo I nas camadas mais profundas e cartilaginificação da matriz extracelular (MEC) nas camadas superficiais. No grupo idoso, houve redução na concentração de proteoglicanos, na expressão da lubricina e na densidade e porcentagem de células p-SMAD2L. Conclusões: a CAM sofre modificações com o envelhecimento, inclusive degenerativas, e diminui sua capacidade de lubrificação e reparo em virtude da menor expressão da lubricina e p-SMAD2L. Sugere-se que a p-SMAD2L está envolvida na produção e acúmulo da lubricina na CAM / The mandibular condylar cartilage (MCC) consists of a secondary cartilage covered by fibrous connective tissue and, therefore, defined as fibrocartilage. It is constantly subjected to compression and shear forces resulting from chewing requiring lubrication and repair capability. Aging is considered one of the main factors for the appearance of degenerative changes in synovial joints. Lubricin is a proteoglycan found in articular cartilages whose primary function is boundary lubrication. SMAD2 signaling pathway has been associated with cartilage maintenance and repair, and its phosphorylation in the linker region (p-SMAD2L) was related to the increase in half-life of C-terminal phospho-SMAD2 (p-SMAD2) and gene transcription. Objective: To study the morphological alterations of MCC and the expressions of the lubricin, p-SMAD2L and type I collagen in aging. Methods: Coronal sections of the MCC from wistar rats with 2, 12 and 24 months old were stained with hematoxylin and eosin, toluidine blue and safranin-O. Immunohistochemistry were used for detection of lubricin, p-SMAD2L and type I collagen. Also, the total cell density, p-SMAD2L cells density and percentage were determined. Results: Structural modifications of the MCC related with natural aging process were observed. An increase in the expression of type I collagen in the deeper layers and \"cartilaginification\" of the extracellular matrix (ECM) in the superficial layers were detected. In the old group, it was observed a reduction in proteoglycan content, in the expression of the lubricin and in the density and percentage of positive cells for the p-SMAD2L. Conclusion: MCC undergoes structural and degenerative modifications with aging and decreases its lubrication and repair capacity due to the lower expression of the lubricin and p-SMAD2L. This study suggests that p-SMAD2L is involved in the production and accumulation of the lubricin in MCC

A cartilagem articular da cabeça da mandíbula (CAM) é constituída por uma cartilagem secundária recoberta por tecido conjuntivo fibroso e, portanto, definida como fibrocartilagínea. Ela é constantemente submetida a forças de compressão e cisalhamento decorrentes da mastigação necessitando de lubrificação e capacidade de reparo. O envelhecimento é considerado um dos principais fatores para o aparecimento de alterações degenerativas nas articulações sinoviais. A lubricina é reconhecidamente um proteoglicano encontrado nas cartilagens articulares cuja função primordial é a lubrificação limítrofe. A via SMAD2, tem sido associada à capacidade de manutenção e reparo da cartilagem, e a sua fosforilação na cadeia de ligação (p-SMAD2L) foi relacionada ao aumento no tempo de fosforilação na cadeia C-terminal (p-SMAD2) e da transcrição gênica. Objetivo: Estudar as alterações morfológicas da CAM e as expressões da lubricina, p-SMAD2L e do colágeno tipo I no envelhecimento. Métodos: cortes coronais da CAM de ratos wistar com 2, 12 e 24 meses de vida foram corados pelas técnicas da hematoxilina e eosina, azul de toluidina e safranina-O. A imuno-histoquímica foi usada para detectar a localização da lubricina, p-SMAD2L e colágeno tipo I. Resultados: Notou-se modificações estruturais atribuídas ao processo natural do envelhecimento da CAM. Ainda, se verificou um aumento do colágeno tipo I nas camadas mais profundas e cartilaginificação da matriz extracelular (MEC) nas camadas superficiais. No grupo idoso, houve redução na concentração de proteoglicanos, na expressão da lubricina e na densidade e porcentagem de células p-SMAD2L. Conclusões: a CAM sofre modificações com o envelhecimento, inclusive degenerativas, e diminui sua capacidade de lubrificação e reparo em virtude da menor expressão da lubricina e p-SMAD2L. Sugere-se que a p-SMAD2L está envolvida na produção e acúmulo da lubricina na CAM / The mandibular condylar cartilage (MCC) consists of a secondary cartilage covered by fibrous connective tissue and, therefore, defined as fibrocartilage. It is constantly subjected to compression and shear forces resulting from chewing requiring lubrication and repair capability. Aging is considered one of the main factors for the appearance of degenerative changes in synovial joints. Lubricin is a proteoglycan found in articular cartilages whose primary function is boundary lubrication. SMAD2 signaling pathway has been associated with cartilage maintenance and repair, and its phosphorylation in the linker region (p-SMAD2L) was related to the increase in half-life of C-terminal phospho-SMAD2 (p-SMAD2) and gene transcription. Objective: To study the morphological alterations of MCC and the expressions of the lubricin, p-SMAD2L and type I collagen in aging. Methods: Coronal sections of the MCC from wistar rats with 2, 12 and 24 months old were stained with hematoxylin and eosin, toluidine blue and safranin-O. Immunohistochemistry were used for detection of lubricin, p-SMAD2L and type I collagen. Also, the total cell density, p-SMAD2L cells density and percentage were determined. Results: Structural modifications of the MCC related with natural aging process were observed. An increase in the expression of type I collagen in the deeper layers and \"cartilaginification\" of the extracellular matrix (ECM) in the superficial layers were detected. In the old group, it was observed a reduction in proteoglycan content, in the expression of the lubricin and in the density and percentage of positive cells for the p-SMAD2L. Conclusion: MCC undergoes structural and degenerative modifications with aging and decreases its lubrication and repair capacity due to the lower expression of the lubricin and p-SMAD2L. This study suggests that p-SMAD2L is involved in the production and accumulation of the lubricin in MCC