Therapeutic Targeting of Ocular Diseases with Emphasis on PI3K/Akt and OPRL Pathways by Hedera Helix L. Saponins: A New Approach for the Treatment of Pseudomonas Aeruginosa-Induced Bacterial Keratitis

This study explores the use of nanocomposite chitosan-coated penetration enhancer vesicles (PEVs) to improve the ocular delivery of saponins for treating Pseudomonas aeruginosa-induced bacterial keratitis. Three formulations, PEVI, PEVII, and PEVIII, were tested, with PEVIII showing the most promising results. PEVIII demonstrated strong in vitro antipseudomonal activity, significant reduction in corneal lesions, and decreased bacterial load compared to untreated and gentamicin-treated groups. It also reduced TNF-α, NF-κB, ROS levels, and OPRL virulence gene expression while enhancing PI3K/Akt activation. The study concludes that PEVIII is a promising treatment for P. aeruginosa keratitis.