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Fucito M, Spedicato M, Felletti S, Yu AC, Busin M, Pasti L, Franchina FA, Cavazzini A, De Luca C, Catani M. A Look into Ocular Diseases: The Pivotal Role of Omics Sciences in Ophthalmology Research. ACS MEASUREMENT SCIENCE AU 2024; 4:247-259. [PMID: 38910860 PMCID: PMC11191728 DOI: 10.1021/acsmeasuresciau.3c00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 06/25/2024]
Abstract
Precision medicine is a new medical approach which considers both population characteristics and individual variability to provide customized healthcare. The transition from traditional reactive medicine to personalized medicine is based on a biomarker-driven process and a deep knowledge of biological mechanisms according to which the development of diseases occurs. In this context, the advancements in high-throughput omics technologies represent a unique opportunity to discover novel biomarkers and to provide an unbiased picture of the biological system. One of the medical fields in which omics science has started to be recently applied is that of ophthalmology. Ocular diseases are very common, and some of them could be highly disabling, thus leading to vision loss and blindness. The pathogenic mechanism of most ocular diseases may be dependent on various genetic and environmental factors, whose effect has not been yet completely understood. In this context, large-scale omics approaches are fundamental to have a comprehensive evaluation of the whole system and represent an essential tool for the development of novel therapies. This Review summarizes the recent advancements in omics science applied to ophthalmology in the last ten years, in particular by focusing on proteomics, metabolomics and lipidomics applications from an analytical perspective. The role of high-efficiency separation techniques coupled to (high-resolution) mass spectrometry ((HR)MS) is also discussed, as well as the impact of sampling, sample preparation and data analysis as integrating parts of the analytical workflow.
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Affiliation(s)
- Maurine Fucito
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
| | - Matteo Spedicato
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
| | - Simona Felletti
- Department
of Environmental and Prevention Sciences, University of Ferrara, via L. Borsari 46, Ferrara 44121, Italy
| | - Angeli Christy Yu
- Department
of Translational Medicine and for Romagna, University of Ferrara, via Aldo Moro 8, 44124 Ferrara, Italy
| | - Massimo Busin
- Department
of Translational Medicine and for Romagna, University of Ferrara, via Aldo Moro 8, 44124 Ferrara, Italy
| | - Luisa Pasti
- Department
of Environmental and Prevention Sciences, University of Ferrara, via L. Borsari 46, Ferrara 44121, Italy
| | - Flavio A. Franchina
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
| | - Alberto Cavazzini
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
- Council
for Agricultural Research and Economics, via della Navicella 2/4, Rome 00184, Italy
| | - Chiara De Luca
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
| | - Martina Catani
- Department
of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, via L. Borsari 46, 44121 Ferrara, Italy
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Liu R, Ma R, Yan X. Balanced activation of Nrf-2/ARE mediates the protective effect of sulforaphane on keratoconus in the cell mechanical microenvironment. Sci Rep 2024; 14:6937. [PMID: 38521828 PMCID: PMC10960822 DOI: 10.1038/s41598-024-57596-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
Keratoconus (KC) is a progressive degenerative disease that usually occurs bilaterally and is characterized by corneal thinning and apical protrusion of the cornea. Oxidative stress is an indicator of the accumulation of reactive oxygen species (ROS), and KC keratocytes exhibit increased ROS production compared with that of normal keratocytes. Therefore, oxidative stress in KC keratocytes may play a major role in the development and progression of KC. Here, we investigated the protective effect of sulforaphane (SF) antioxidants using a hydrogel-simulated model of the cell mechanical microenvironment of KC. The stiffness of the KC matrix microenvironment in vitro was 16.70 kPa and the stiffness of the normal matrix microenvironment was 34.88 kPa. Human keratocytes (HKs) were cultured for 24 h before observation or drug treatment with H2O2 in the presence or absence of SF. The levels of oxidative stress, nuclear factor E2-related factor 2 (Nrf-2) and antioxidant response element (ARE) were detected. The high-stress state of HKs in the mechanical microenvironment of KC cells compensates for the activation of the Nrf-2/ARE signaling pathway. H2O2 leads to increased oxidative stress and decreased levels of antioxidant proteins in KC. In summary, SF can reduce endogenous and exogenous oxidative stress and increase the antioxidant capacity of cells.
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Affiliation(s)
- Ruixing Liu
- Department of Ophthalmology, Peking University First Hospital, Beijing, 100034, People's Republic of China
- People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, 450003, People's Republic of China
| | - Ruojun Ma
- People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, 450003, People's Republic of China
| | - Xiaoming Yan
- Department of Ophthalmology, Peking University First Hospital, Beijing, 100034, People's Republic of China.
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Wu X, Deng Q, Han Z, Ni F, Sun D, Xu Y. Screening and identification of genes related to ferroptosis in keratoconus. Sci Rep 2023; 13:13956. [PMID: 37626095 PMCID: PMC10457308 DOI: 10.1038/s41598-023-41194-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/23/2023] [Indexed: 08/27/2023] Open
Abstract
Corneal keratoconus (KC) is a dilated (ectatic) corneal disease characterized by a central thinning of the cornea, which causes protrusion into a conical shape that seriously affects vision. However, due to the complex etiology of keratoconus, its entire mechanism remains unclear and there is no mechanism-directed treatment method. Ferroptosis is a novel programmed cell death mechanism related to lipid peroxidation, stress, and amino acid metabolism, which plays a crucial role in various diseases. This study aimed to explore the relationship between keratoconus and ferroptosis, to provide new insights into the mechanism of keratoconus development, and potential treatment options based on further elucidation of this mechanism. The corresponding mRNA microarray expression matrix data of KC patients were obtained from GEO database (GSE204791). Weighted co-expression network analysis (WGCNA) and support vector machine recursive feature elimination (SVM-RFE) were selected to screen hub genes, which were overlapped with ferroptosis genes (FRGs) from FerrDb. GO and GSEA were performed to analyze differential pathways, ssGSEA was used to determine immune status, and then, feasible drugs were predicted by gene-drug network. Additionally, we predicted the miRNA and IncRNA of hub genes to identify the underlying mechanism of disease so as to predict treatment for the disease. The epithelial transcriptome from keratoconus tissue mRNA microarray data (GSE204791) was extracted for the main analysis, including eight epithelial cells and eight epithelial control cells. The differential genes that were overlapped by WGCAN, SVM-RFE and FRGs were mainly related to oxidative stress, immune regulation, cellular inflammation, and metal ion transport. Through further analysis, aldo-keto reductase family 1 member C3 (AKR1C3) was selected, and negatively correlated with mature CD56 natural killer (NK) cells and macrophages. Then, gene-drug interaction network analysis and miRNA prediction were performed through the website. It was concluded that four immune-related drugs (INDOMETHACIN, DAUNORUBICIN, DOXORUBICIN, DOCETAXEL) and a miRNA (has-miR-184) were screened to predict potential drugs and targets for disease treatment. To our knowledge, this was the first report of KC being associated with ferroptosis and prompted search for differential genes to predict drug targets of gene immunotherapy. Our findings provided insight and a solid basis for the analysis and treatment of KC.
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Affiliation(s)
- Xiaojun Wu
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China
| | - Qing Deng
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China
| | - Zhe Han
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China
| | - Feixue Ni
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China
| | - Daxi Sun
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China
| | - Yuxue Xu
- School of Pharmacology, Binzhou Medical University, Guanhai Rd 346, Yantai, 264003, China.
- Shandong Technology Innovation Center of Molecular Targeting and Intelligent Diagnosis and Treatment, Yantai, 264003, China.
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Ren S, Yang K, Fan Q, Wang Q, Zhu M, Yin S, Gu Y, Xu L. Bioinformatics analysis of key candidate genes and pathways in Chinese patients with keratoconus. Exp Eye Res 2023; 231:109488. [PMID: 37116607 DOI: 10.1016/j.exer.2023.109488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 04/30/2023]
Abstract
Keratoconus (KC) is a multifactorial disease in which genetic factors played important roles in its pathogenesis. The purpose of the current study was to identify the key candidate genes and pathways in Chinese patients with KC through bioinformatics analysis. Totally, we identified 71 candidate genes by analyzing the results of whole exome sequencing on 51 Chinese patients with KC, combining with previous reports on differential expression at transcription and protein levels in KC. Gene enrichment analysis with GeneCodis demonstrated that two significantly enriched terms including 21 genes in biological process (BP) were detected, and six significantly enriched terms containing 14 genes in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were discovered. The STRING was utilized to construct the protein-protein interaction (PPI) network of identified genes. The result showed that a PPI network consisted of 14 nodes with 14 edges was constructed, and two gene modules were obtained. Eight hub genes (LAMB3, LAMA3, LAMA1, ITGA6, ITGA3, COL6A3, COL6A2, and COL6A1) were identified as key candidate genes for KC by cytoHubba in Cytoscape. Functional enrichment analysis with ClueGO and CluePedia indicated that the ECM-receptor interaction was the key pathway accounted for KC. The findings might provide novel insights on the genetic basis of KC.
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Affiliation(s)
- Shengwei Ren
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China; Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China
| | - Kaili Yang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Qi Fan
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Qing Wang
- Henan University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, Zhengzhou, 450003, China
| | - Meng Zhu
- Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China
| | - Shanshan Yin
- Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China
| | - Yuwei Gu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Liyan Xu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, 450003, China.
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Karamichos D, Nicholas SE, Khan A, Riaz KM. Collagen Crosslinking for Keratoconus: Cellular Signaling Mechanisms. Biomolecules 2023; 13:696. [PMID: 37189443 PMCID: PMC10135890 DOI: 10.3390/biom13040696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
Collagen crosslinking (CXL) is a widely used treatment to halt the progression of keratoconus (KC). Unfortunately, a significant number of patients with progressive KC will not qualify for CXL, including those with corneas thinner than 400 µm. The present study aimed to investigate the molecular effects of CXL using in vitro models, mirroring the normal, as well as thinner corneal stroma seen in KCs. Primary human corneal stromal cells were isolated from healthy (HCFs) and keratoconus (HKCs) donors. Cells were cultured and stimulated with stable Vitamin C resulting in 3D self-assembled extracellular matrix (ECM), cell-embedded, constructs. CXL was performed on (a) thin ECM with CXL performed at week 2 and (b) normal ECM with CXL performed at week 4. Constructs without CXL served as controls. All constructs were processed for protein analysis. The results showed modulation of Wnt signaling, following CXL treatment, as measured by the protein levels of Wnt7b and Wnt10a, correlated to the expression of α-smooth muscle actin (SMA). Further, the expression of a recently identified KC biomarker candidate, prolactin-induced protein (PIP), was positively impacted by CXL in HKCs. CXL-driven upregulation of PGC-1 and the downregulation of SRC and Cyclin D1 in HKCs were also noted. Although the cellular/molecular impacts of CXL are largely understudied, our studies provide an approximation to the complex mechanisms of KC and CXL. Further studies are warranted to determine factors influencing CXL outcomes.
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Affiliation(s)
- Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, IREB-505, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Sarah E. Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, IREB-505, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Asher Khan
- Dean McGee Eye Institute, University of Oklahoma, 608 Stanton L Young Blvd, Oklahoma City, OK 73104, USA
- College of Medicine, University of Oklahoma, 800 Stanton L Young Blvd, Oklahoma City, OK 73117, USA
| | - Kamran M. Riaz
- Dean McGee Eye Institute, University of Oklahoma, 608 Stanton L Young Blvd, Oklahoma City, OK 73104, USA
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Xu L, Yang K, Zhu M, Yin S, Gu Y, Fan Q, Wang Y, Pang C, Ren S. Trio-based exome sequencing broaden the genetic spectrum in keratoconus. Exp Eye Res 2023; 226:109342. [PMID: 36502923 DOI: 10.1016/j.exer.2022.109342] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/09/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Keratoconus (KC) is a complex corneal disorder with genetic factors involving in its pathogenesis. The genetic etiology of KC has not been fully elucidated. In this study, we aimed to expand the genetic spectrum in KC by trio-based exome sequencing. Trio-based exome sequencing was conducted in 20 patients with KC and their unaffected parents to broaden the genetic spectrum of the disease. With a series of filtering criteria, de novo, recessive homozygous, and compound heterozygous variants in candidate genes were identified, and the candidate genes were classified for further analysis. Finally, we identified 60 variants in 32 candidate genes through trio-based exome sequencing. Among the candidate genes, 10 genes (ARHGEF10, ARHGEF17, ASPM, FLNA, NDRG1, NEB, PLS3, STARD8, SYNE1, TTN) were classified as cytoskeleton-related genes, 4 genes (COL28A1, SDK1, STAB1, TENM2) were classified as cell adhesion-related genes, and 18 genes (APLP2, BCORL1, CCNB3, FOXN1, FUT8, GALNT10, HEPH, HHIP, HMGB3, HS6ST2, JADE3, KIAA0040, MCF2L, MYOF, QRICH2, RPS6KA6, SMARCA1, TNRC6A) were classified into other genes group. Additionally, the candidate rare deleterious variants in TTN were highly repeated in 25% trios. In conclusion, the study provided new insights into the genetic spectrum of KC which might underlie the genetic etiology for the disease. The findings would improve our understanding of pathogenesis in KC and provide critical clues to future functional validation.
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Affiliation(s)
- Liyan Xu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Kaili Yang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Meng Zhu
- Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China
| | - Shanshan Yin
- Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China
| | - Yuwei Gu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Qi Fan
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Yawen Wang
- Henan University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, Zhengzhou, 450003, China
| | - Chenjiu Pang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Shengwei Ren
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China; Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, 450003, China.
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Xu L, Yang K, Yin S, Gu Y, Fan Q, Wang Y, Zhao D, Ren S. Family-based exome sequencing identifies candidate genes related to keratoconus in Chinese families. Front Genet 2022; 13:988620. [PMID: 36118869 PMCID: PMC9478549 DOI: 10.3389/fgene.2022.988620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Keratoconus (KC) is a complex corneal disorder with a strong genetic component. The present study aimed to identify candidate genes related to KC in Chinese families.Methods: Family-based exome sequencing was performed in ten patients suffering from KC who belong to five families with two affected members in each. The candidate rare variants were identified with multi-step bioinformatics analysis. The STRING website was used to perform the protein interaction of the identified genes.Results: Our analyses identified 32 candidate rare variants in 13 genes by family-based exome sequencing. The molecular analyses of identified genes showed that EPCAM directly interacted with CTNNB1 of the Hippo signaling pathway and focal adhesion pathway, and directly interacted with CTNNB1, CDH1 of the WNT signaling pathway. SHROOM3 directly interacted with ROCK2, ROCK1 of the focal adhesion pathway. SYNE1 directly interacted with MUSK of the extracellular matrix organization pathway. TEK directly interacted with VEGFA, SHC1, PIK3R1, GRB2 of the focal adhesion pathway. TTN directly interacted with CAPN3 of the extracellular matrix organization pathway.Conclusion: The EPCAM, SHROOM3, SYNE1, TEK, and TTN genes were potential high-risk candidate pathogenic genes of familial KC. The findings might significantly improve our understanding of the genetic etiology of the disease, providing novel insights on KC pathogenesis.
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Affiliation(s)
- Liyan Xu
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
| | - Kaili Yang
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
| | - Shanshan Yin
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institution, Zhengzhou, China
| | - Yuwei Gu
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
| | - Qi Fan
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
| | - Yawen Wang
- Henan University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, Zhengzhou, China
| | - Dongqing Zhao
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
| | - Shengwei Ren
- Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institute, People’s Hospital of Zhengzhou University, Henan University People’s Hospital, Zhengzhou, China
- *Correspondence: Shengwei Ren,
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Lalgudi VG, Shetty R, Nischal KK, Ziai S, Koaik M, Sethu S. Biochemical and molecular alterations and potential clinical applications of biomarkers in keratoconus. Saudi J Ophthalmol 2022; 36:7-16. [PMID: 35971485 PMCID: PMC9375466 DOI: 10.4103/sjopt.sjopt_203_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/05/2021] [Accepted: 02/19/2022] [Indexed: 11/06/2022] Open
Abstract
Keratoconus (KC) is a complex multifactorial corneal ectatic disorder, with disease onset commonly in the second-third decades significantly affecting quantity, quality of vision, and quality of life. Several pathways and factors such as eye rubbing, inflammatory, oxidative, metabolic, genetic, and hormonal among others have been studied in the last two decades. However, the management of KC is still based on a few "one-size fits all" approaches and is predominantly guided by topo/tomographic parameters. Consideration of the several novel factors which have the potential to be biomarkers in addressing several unanswered questions in the disease process could help in the better predictive ability of progression or vision loss and customization of treatment options. This article delves into the understanding of these novel factors or biomarkers based on the pathogenesis of KC and features a special focus on their potential clinical applications and their future role in personalized medicine.
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Affiliation(s)
- Vaitheeswaran G. Lalgudi
- Department of Cornea, External Disease and Refractive Surgery, University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, ON, Canada,Address for correspondence: Dr. Vaitheeswaran G. Lalgudi, Department of Cornea, External Disease and Refractive Surgery, University of Ottawa Eye Institute, The Ottawa Hospital, 501, Smyth Road, Ottawa, ON, Canada. E-mail:
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Kanwal K. Nischal
- UPMC Eye Centre, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA,Department of Pediatric Ophthalmology and Strabismus, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Setareh Ziai
- Department of Cornea, External Disease and Refractive Surgery, University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, ON, Canada,Department of Ophthalmology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Mona Koaik
- Department of Cornea, External Disease and Refractive Surgery, University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, ON, Canada,Department of Ophthalmology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Swaminathan Sethu
- Molecular and Genetic Research, GROW Laboratories, Narayana Nethralaya Foundation, Bengaluru, Karnataka, India
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de Barros MRM, Chakravarti S. Pathogenesis of keratoconus: NRF2-antioxidant, extracellular matrix and cellular dysfunctions. Exp Eye Res 2022; 219:109062. [PMID: 35385756 DOI: 10.1016/j.exer.2022.109062] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022]
Abstract
Keratoconus (KC) is a degenerative disease associated with cell and extracellular matrix (ECM) loss that causes gradual thinning and steepening of the cornea and loss of vision. Collagen cross linking with ultraviolet light treatment can strengthen the ECM and delay weakening of the cornea, but severe cases require corneal transplantation. KC is multifactorial and multigenic, but its pathophysiology is still an enigma. Multiple approaches are being pursued to elucidate the molecular changes that underlie the corneal phenotype to identify relevant genes for tailored candidate searches and to develop potential biomarkers and targets for therapeutic interventions. Recent proteomic and transcriptomic studies suggest dysregulations in oxidative stress, NRF2-regulated antioxidant programs, WNT-signaling, TGF-β, ECM and matrix metalloproteinases. This review aims to provide a broad update on the transcriptomic and proteomic studies of KC with a focus on findings that relate to oxidative stress, and dysregulations in cellular and extracellular matrix functions.
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Affiliation(s)
| | - Shukti Chakravarti
- Department of Ophthalmology, NYU Grossman School of Medicine, NY, 10016, USA; Department of Pathology, NYU Grossman School of Medicine, NY, 10016, USA.
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