6 · Emerging therapies — cellular, gene & innovative
Substance P (FGLM-NH₂) + IGF-1 (SSSR) — synergistic combination
Review — modulators of corneal healing › 6 · Emerging therapies — cellular, gene & innovative › Substance P (FGLM-NH₂) + IGF-1 (SSSR) — synergistic combination
Substance P (FGLM-NH₂) + IGF-1 (SSSR) — synergistic combination
Derivative peptides · Nakamura/Nishida (Osaka/Kyoto) · investigational/compounded
Oxford IV
Weak–Investigational
Future · niche
Mechanism of actionSynergy is essential (neither agent alone is effective): substance P (FGLM-NH₂) + IGF-1 (SSSR) cooperatively stimulate epithelial migration and attachment (↑α5 integrins, fibronectin assembly), replacing the neuropeptide support lost in the denervated cornea.
IndicationsNeurotrophic keratopathy with PED (post-herpetic, diabetic, surgical/denervation, leprosy).
Route & dosageCombined eye drops several times/day (investigational/compounded; no standardised commercial formulation).
Level of evidenceOxford IV (open-label, uncontrolled series) · Scale: Weak–Investigational.
| FDA / EU MA | No approval. (To be distinguished from cenegermin/Oxervate, a different, approved molecule.) |
|---|---|
| Availability | Investigational/compounded, mainly in Japan. |
Key studies: Nishida/Chikama et al., Jpn J Ophthalmol 2007 (neurotrophic PED) — PMID 18158595 ; Yamada/Chikama et al., Br J Ophthalmol 2008 — PMID 18511539 ; tetrapeptides for leprous keratopathy, Ophthalmology Science 2024 — PMID 39717761.
See also: Gabison E. “Corneal wound-healing agents”. In: SFO 2023 Report — Médicaments et biothérapies en ophtalmologie, chapter 21. Full text, open access (in French).