wIRA has been shown to reduce chlamydial infections in vitro and in vivo and might therefore offer an innovative therapeutic approach for fighting trachoma. However, since the eye is a highly temperature- and radiation-sensitive organ, a safety assessment of the ocular structures affected by wIRA treatment is required to establish wIRA as a potentially successful treatment option for clinical application. A prerequisite for this is to demonstrate that wIRA does not have adverse side-effects such as inducing a non-physiological temperature increase which causes cell stress and damage to ocular tissues and which, in turn, is ultimately associated with impaired vision. Likewise, the potential negative impact of non-thermal photochemical effects of wIRA irradiation needs to be investigated. Data from our ex vivo studies in pig and mouse models, as well as in vivo data in a guinea pig model, provide good evidence for the safe use of wIRA to treat chlamydial infections. These studies have excluded a non-physiological temperature rise as well as the activation of heat and stress-induced proteins after wIRA irradiation with therapy-relevant irradiances. Nevertheless, additional detailed in vitro and in vivo studies are needed to further advance the clinical use of wIRA.
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