24/04/2026
👁️ “From Norwegian Soil to Saving Sight: The Miracle of Cyclosporine”
Curious origin of eyedrop - Dr Chua 25/4/2026
When your eyes feel gritty, stinging, and overwhelmingly dry, your first instinct is probably to reach for a bottle of artificial tears 💧. But what happens when simply adding moisture isn’t enough?
For decades, eye doctors struggled to help patients with severe dry eyes or those whose bodies were rejecting sight-saving corneal transplants 👁️. The breakthrough we needed didn’t come from a high-tech lab—it came from a handful of dirt 🌱.
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The Accidental Discovery 🍄
In the early 1970s, scientists were examining soil samples from the Hardangervidda plateau (Fig. 1) 🇳🇴—a desolate, windswept mountain range in Norway. Hidden within that cold earth, they discovered a microscopic fungus called Tolypocladium inflatum (Fig. 1; insert)
When researchers studied this humble fungus, they realised it produced a unique molecule. This molecule, Cyclosporine, had an extraordinary superpower: it could selectively quieten the human immune system 🛡️.
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A Revolution in Transplants 🔬
Initially, Cyclosporine changed the world of medicine by making organ transplants safer. Normally, the body sees a new organ (like a kidney or a cornea) as an “invader” ⚔️ and tries to destroy it. Cyclosporine acts like a peacekeeper 🤝, gently dampening the body’s natural defence system to stop it from attacking the new tissue. In ophthalmology, this was a game-changer, helping to ensure that high-risk corneal transplants weren’t rejected 👁️.
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Redefining Dry Eye (Fig. 2): The Tag-Team Strategy 👁️
But the story of this fungal derivative doesn’t end in the operating theatre. Scientists soon realised that severe dry eye isn’t just a lack of water 💧; it’s often caused by inflammation 🔥. An overactive immune system sends specialised “soldier” cells (called T-cells) to attack the tear glands, effectively shutting down your natural plumbing.
This is where Cyclosporine (Fig. 3); often paired with a short course of steroids, becomes a medical marvel ✨.
1. The “Fire Extinguisher” (Steroids) 🔥
When a patient’s eyes are severely inflamed, doctors often start with steroid drops. Steroids are incredibly powerful and work instantly to put out the “fire” of inflammation 🔥➡️🧯. However, steroids are a bit like a double-edged sword ⚖️—if you use them for too long, they can cause serious side effects like glaucoma or cataracts.
2. The “Long-Term Peacekeeper” (Cyclosporine) 🤝
This is the clever bit. By introducing Cyclosporine alongside the steroids, doctors can eventually taper off the steroids entirely. Cyclosporine takes over the job of keeping the T-cells in check without the nasty long-term risks. It tackles the root cause, allowing your tear glands to heal and start producing your own natural tears again 💧.
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Nature’s Pharmacy 🌿
Today, this molecule discovered in Norwegian soil 🇳🇴 is a frontline defence against severe dry eye syndrome and intense allergic conditions. It’s a brilliant reminder that sometimes, the most sophisticated medical treatments are simply secrets borrowed from nature 🌱.
So, the next time you see a patch of moss or a mushroom 🍄, give it a nod of thanks—it might just be the reason someone can see clearly today 👁️✨.
🍄🟫 🍄 🇳🇴 🍄🟫 🍄 🇳🇴 🍄🟫 🍄 🇳🇴 🍄🟫 🍄 🇳🇴 🍄🟫 🍄 🇳🇴 🍄🟫 🍄 🇳🇴
👁️《从挪威土壤到重见光明：环孢素（Cyclosporine）的奇迹》
有趣的眼药由来 - 蔡鐘能眼科医生写于25/4/2026
当您的眼睛感到干涩、刺痛，甚至有强烈的异物感时，您的第一反应可能是随手拿起一瓶人造泪液 💧。但是，如果单纯补水已经起不到作用了，该怎么办呢？
几十年来，眼科医生在治疗严重干眼症或角膜移植排斥反应时，经常感到束手无策 👁️。然而，我们苦苦寻找的突破口并非来自高科技实验室，而是源于一捧不起眼的泥土 🌱。
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意外的发现 🍄
1970年代初，科学家们在分析采集自挪威**哈当厄尔高原（Hardangervidda plateau; 图 1）**的土壤样本时，在这片荒凉且寒冷的土地中发现了一种名为 Tolypocladium inflatum （图1小插图）的微小真菌 🇳🇴。
经过深入研究，科学家惊讶地发现这种真菌能产生一种独特的分子。这个分子就是环孢素（Cyclosporine），它拥有一种非凡的“超能力”：能够精准地平息人体过度活跃的免疫系统 🛡️。
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器官移植的革命 🔬
最初，环孢素的出现彻底改变了医学界，让器官移植变得更加安全。通常情况下，人体会将新移植的器官（如肾脏或角膜）视为“入侵者” ⚔️ 并试图摧毁它。环孢素就像一位和平使者 🤝，它能温和地抑制免疫系统的攻击，保护新组织不受伤害。在眼科学领域，这成了高风险角膜移植手术的救星，保住了无数患者的视力 👁️。
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重新定义干眼症（图2），黄金搭档策略 👁️
这种真菌衍生物的故事并没有止步于手术室。科学家随后发现，严重的干眼症不仅仅是“缺水”那么简单 💧，其根源往往是慢性发炎 🔥。失控的免疫系统会派出名为 T细胞 的“士兵”去攻击泪腺，导致您的天然泪液分泌系统陷入瘫痪。
这就是为什么环孢素（图3）在配合短期**类固醇（Steroids）**使用时，会被视为医学上的奇迹 ✨。
1. “灭火器”——类固醇 🔥
当患者眼部炎症非常严重时，医生通常会先使用类固醇滴眼液。类固醇药力强劲，能迅速扑灭发炎的“火苗” 🔥➡️🧯。然而，类固醇是一把双刃剑 ⚖️——长期使用可能导致严重的副作用，例如青光眼（眼压升高）或白内障（晶状体混浊）。
2. “长期和平使者”——环孢素 🤝
这正是环孢素的高明之处。通过在疗程中加入环孢素，医生可以逐渐减少并最终停用类固醇。环孢素接手了克制 T细胞的工作，却不会带来青光眼或白内障的长期风险。它从根源解决问题，让泪腺得到喘息和修复的机会，重新恢复分泌天然、健康的泪液 💧。
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大自然的药剂师 🌿
今天，这种从挪威土壤中发现的分子 🇳🇴，已成为对抗严重干眼症和严重过敏性眼疾（如春季角结膜炎）的前线防御武器 👁️。它提醒了我们：有时候，最顶尖的医疗方案其实是向大自然借来的秘密 🌱。
所以，下次当您看到一片苔藓或一朵小蘑菇 🍄 时，不妨在心里默默感谢它——因为它或许就是让某人能够清晰看世界的功臣 👁️✨。
#蔡鐘能眼科医生 #干眼症 #眼科 #角膜移植 #免疫系统 #眼睛健康 #医疗知识 #医学科普
