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Wang J, Liu F, Mo J, Gong D, Zheng F, Su J, Ding S, Yang W, Guo P. Exploring the causal relationship between body mass index and keratoconus: a Mendelian randomization study. Front Med (Lausanne) 2024; 11:1402108. [PMID: 39050542 PMCID: PMC11266172 DOI: 10.3389/fmed.2024.1402108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024] Open
Abstract
Background Despite reports suggesting a link between obesity and keratoconus, the causal relationship is not fully understood. Methods We used genome-wide association study (GWAS) data from public databases for a two-sample Mendelian randomization analysis to investigate the causal link between body mass index (BMI) and keratoconus. The primary method was inverse variance weighted (IVW), complemented by different analytical techniques and sensitivity analyses to ensure result robustness. A meta-analysis was also performed to bolster the findings' reliability. Results Our study identified a significant causal relationship between BMI and keratoconus. Out of 20 Mendelian randomization (MR) analyses conducted, 9 showed heterogeneity or pleiotropy. Among the 11 analyses that met all three MR assumptions, 4 demonstrated a significant causal difference between BMI and keratoconus, while the remaining 7 showed a positive trend but were not statistically significant. Meta-analysis confirmed a significant causal relationship between BMI and keratoconus. Conclusion There is a significant causal relationship between BMI and keratoconus, suggesting that obesity may be a risk factor for keratoconus.
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Affiliation(s)
- Jiaoman Wang
- The 2nd Clinical Medical College of Jinan University, Shenzhen, China
| | - Fangyuan Liu
- The 2nd Clinical Medical College of Jinan University, Shenzhen, China
| | - Jianhao Mo
- The 2nd Clinical Medical College of Jinan University, Shenzhen, China
| | - Di Gong
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Fang Zheng
- Department of Ophthalmology, Jinzhou Medical University, Jinzhou, China
| | - Jingjing Su
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Sicheng Ding
- The 2nd Clinical Medical College of Jinan University, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Ping Guo
- Shenzhen Eye Institute, Shenzhen Eye Hospital, Jinan University, Shenzhen, China
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Berger T, Szentmáry N, Chai N, Flockerzi E, Daas L, Stachon T, Seitz B. In Vitro Expression Analysis of Cytokines and ROS-Related Genes in Human Corneal Fibroblasts and Keratocytes of Healthy and Keratoconus Corneas. Ocul Immunol Inflamm 2024; 32:556-565. [PMID: 36799910 DOI: 10.1080/09273948.2023.2176325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE To investigate expression of cytokines and ROS-related genes in stromal cells of healthy and keratoconus (KC) corneas. METHODS Expression analysis was performed for cytokines including several interleukins (IL), Tumor necrosis factor-α (TNF-α), Transforming growth factor-β1 (TGF-β1), Interferon-γ (IFN-γ) and ROS-related genes such as Catalase, Glutathione peroxidase 1, NADPH oxidase 1, superoxide dismutase 1 in corneal fibroblasts (HCFs/KC-HCFs) or keratocytes (Keratocytes/KC-Keratocytes) by qPCR and ELISA. RESULTS Gene and protein expression of most inflammatory markers was decreased in keratocytes compared to fibroblasts, whereas no differences were found between healthy and keratoconus cells for the majority of cytokines measured. TNF-α expression was increased at gene (KC keratocytes) and protein levels (supernatant of Keratocytes/KC-Keratocytes) compared to corneal fibroblasts. No differential expression of ROS-related genes was detected between healthy and diseased cells in both fibroblasts and keratocytes. CONCLUSION Increased expression of several inflammatory markers described as altered in KC was not evident in KC cells in vitro.
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Affiliation(s)
- Tim Berger
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Ning Chai
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Elias Flockerzi
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Loay Daas
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Tanja Stachon
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
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Meng F, Ren S. Identification of hub genes and molecular pathways in keratoconus by integrating bioinformatics and literature mining at the RNA level. Int Ophthalmol 2024; 44:244. [PMID: 38904678 DOI: 10.1007/s10792-024-03071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/16/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE Keratoconus (KC) is a condition characterized by progressive corneal steepening and thinning. However, its pathophysiological mechanism remains vague. We mainly performed literature mining to extract bioinformatic and related data on KC at the RNA level. The objective of this study was to explore the potential pathological mechanisms of KC by identifying hub genes and key molecular pathways at the RNA level. METHODS We performed an exhaustive search of the PubMed database and identified studies that pertained to gene transcripts derived from diverse corneal layers in patients with KC. The identified differentially expressed genes were intersected, and overlapping genes were extracted for further analyses. Significantly enriched genes were screened using "Gene Ontology" (GO) and "Kyoto Encyclopedia of Genes and Genomes" (KEGG) analysis with the "Database for Annotation, Visualization, and Integrated Discovery" (DAVID) database. A protein-protein interaction (PPI) network was constructed for the significantly enriched genes using the STRING database. The PPI network was visualized using the Cytoscape software, and hub genes were screened via betweenness centrality values. Pathways that play a critical role in the pathophysiology of KC were discovered using the GO and KEGG analyses of the hub genes. RESULTS 68 overlapping genes were obtained. Fifty genes were significantly enriched in 67 biological processes, and 16 genes were identified in 7 KEGG pathways. Moreover, 14 nodes and 32 edges were identified via the PPI network constructed using the STRING database. Multiple analyses identified 4 hub genes, 12 enriched biological processes, and 6 KEGG pathways. GO enrichment analysis showed that the hub genes are mainly involved in the positive regulation of apoptotic process, and KEGG analysis showed that the hub genes are primarily associated with the interleukin-17 (IL-17) and tumor necrosis factor (TNF) pathways. Overall, the matrix metalloproteinase 9, IL-6, estrogen receptor 1, and prostaglandin-endoperoxide synthase 2 were the potential important genes associated with KC. CONCLUSION Four genes, matrix metalloproteinase 9, IL-6, estrogen receptor 1, and prostaglandin endoperoxide synthase 2, as well as IL-17 and TNF pathways, are critical in the development of KC. Inflammation and apoptosis may contribute to the pathogenesis of KC.
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Affiliation(s)
- Feiying Meng
- Henan Eye Hospital, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
- Eye Institute, Henan Academy of Innovations in Medical Science, Zhengzhou, China
| | - Shengwei Ren
- Henan Eye Hospital, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou, 450003, China.
- Eye Institute, Henan Academy of Innovations in Medical Science, Zhengzhou, China.
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Ferrini E, Posarelli C, Figus M, Lisi D, Gabbriellini G. A pilot study on Langerhans cells in keratoconus patients by in vivo confocal microscopy before and after corneal cross-linking and correlation with eye rubbing. Cont Lens Anterior Eye 2024:102170. [PMID: 38677927 DOI: 10.1016/j.clae.2024.102170] [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: 11/14/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE The aim of this study was to investigate the corneal microstructure and Langerhans cells using in vivo confocal microscopy in keratoconus patients before and after cross-linking, and to correlate the morphologic findings with clinical and patient-reported outcomes, including eye rubbing (ER) behavior. METHODS Patients with progressive keratoconus undergoing iontophoresis-assisted epithelium-on cross-linking (I-CXL) were consecutively enrolled. In vivo confocal microscopy was performed before and 6 months after treatment. Patients were asked to quantify their ER behavior on a Visual Analogue Scale (VAS) and completed the Keratoconus Outcomes Research Questionnaire and the Ocular Surface Disease Index questionnaires at the same time points. Visual acuity, tear osmolarity, topography, aberrometry, and pachymetry of both eyes were assessed. RESULTS Thirteen patients were included in this pilot study. Preoperatively, the mean Langerhans cells density was 35,615 cells per mm2, and the median morphology was 3. The mean ER VAS before treatment was 7,077 out of 10. The ER VAS showed significant positive correlations with both Langerhans cells density and morphology of the study eye. After treatment, a statistically significant reduction in ER VAS and in Langerhans cells variables was observed. The mean sub-basal plexus nerve density was comparable to pre-operative values 6 months after I-CXL. CONCLUSIONS Based on this preliminary evidence, the presence of high density of mature Langerhans cells in the central cornea of keratoconus patients and its correlation with eye rubbing support the role of inflammation in keratoconus. The reduction in these markers after treatment may suggest a potential of CXL in moderating immune-related inflammation and eye rubbing in the medium term.
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Affiliation(s)
- Erica Ferrini
- Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 50126 Pisa, Italy.
| | - Chiara Posarelli
- Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 50126 Pisa, Italy
| | - Michele Figus
- Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 50126 Pisa, Italy
| | - Domenico Lisi
- Azienda Ospedaliero-Universitaria Pisana, Via Paradisa 2, 56124 Pisa, Italy
| | - Giovanna Gabbriellini
- Ophthalmology, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Savi 10, 50126 Pisa, Italy
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Song T, Song J, Li J, Ben Hilal H, Li X, Feng P, Chen W. The candidate proteins associated with keratoconus: A meta-analysis and bioinformatic analysis. PLoS One 2024; 19:e0299739. [PMID: 38483957 PMCID: PMC10939257 DOI: 10.1371/journal.pone.0299739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
PURPOSE Keratoconus (KC) is a multifactorial disorder. This study aimed to conduct a systematic meta-analysis to exclusively explore the candidate proteins associated with KC pathogenesis. METHODS Relevant literature published in the last ten years in Pubmed, Web of Science, Cochrane, and Embase databases were searched. Protein expression data were presented as the standard mean difference (SMD) and 95% confidence intervals (CI). The meta-analysis is registered on PROSPERO, registration number CRD42022332442 and was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PRISMA). GO and KEGG enrichment analysis were performed, as well as the miRNAs and chemicals targeting the candidate proteins were predicted. PPI was analyzed to screen the hub proteins, and their expression was verified by RT-qPCR. RESULTS A total of 21 studies were included in the meta-analysis, involving 346 normal eyes and 493 KC eyes. 18 deregulated proteins with significant SMD values were subjected to further analysis. In which, 7 proteins were up-regulated in KC compared with normal controls, including IL6 (SMD 1.54, 95%CI [0.85, 2.24]), IL1B (SMD 2.07, 95%CI [0.98, 3.16]), TNF (SMD 2.1, 95%CI [0.24, 3.96]), and MMP9 (SMD 1.96, 95%CI [0.68, 3.24]). While 11 proteins were down-regulated in KC including LOX (SMD 2.54, 95%CI [-4.51, -0.57]). GO and KEGG analysis showed that the deregulated proteins were involved in inflammation, extracellular matrix (ECM) remodeling, and apoptosis. MMP9, IL6, LOX, TNF, and IL1B were regarded as hub proteins according to the PPI analysis, and their transcription changes in stromal fibroblasts of KC were consistent with the results of the meta-analysis. Moreover, 10 miRNAs and two natural polyphenols interacting with hub proteins were identified. CONCLUSION This study obtained 18 candidate proteins and demonstrated altered cytokine profiles, ECM remodeling, and apoptosis in KC patients through meta-analysis and bioinformatic analysis. It will provide biomarkers for further understanding of KC pathogenesis, and potential therapeutic targets for the drug treatment of KC.
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Affiliation(s)
- Ting Song
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Jie Song
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Jingyi Li
- College of Life Sciences, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Halima Ben Hilal
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Xiaona Li
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Pengfei Feng
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Weiyi Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
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Nowak-Wąs M, Wąs P, Czuba Z, Wojnicz R, Wyględowska-Promieńska D. Expression of Tissue Inhibitors of Metalloproteinases (TIMP-1, TIMP-2, TIMP-3, TIMP-4) in Blood Serum of Patients with Keratoconus. J Clin Med 2024; 13:1168. [PMID: 38398480 PMCID: PMC10889408 DOI: 10.3390/jcm13041168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The etiology of keratoconus is unclear. Current evidence suggests that inflammatory and systemic mechanisms might play a role in its pathophysiology. The proper interaction of proteolytic enzymes-matrix metalloproteinases-and their specific tissue inhibitors (TIMPs) within the cornea is essential in maintaining its structure, transparency and healing processes. The aim of the study was to determine the concentration of the TIMPs TIMP-1, TIMP-2, TIMP-3, and TIMP-4 in the blood serum samples of patients with keratoconus compared to the control group. METHODS The study encompassed 132 patients, of which 83 people constituted the study group and 49 the control group. The concentration of selected TIMPs was determined using the Human Magnetic Luminex® Performance Assay method. RESULTS In the study group, the concentrations of TIMP-1 and TIMP-3 were statistically significantly reduced, and TIMP-2 and TIMP-4 increased compared to the control group. The analysis of individual TIMPs in terms of their usefulness as potential predictors of keratoconus showed high results of diagnostic sensitivity and specificity for all TIMPs, in particular for TIMP-1 and TIMP-2. CONCLUSION The above results may indicate systemic disturbances in the TIMPs regulation among keratoconus patients. High diagnostic sensitivity and specificity of all TIMPs, in particular TIMP-1 and TIMP-2, may confirm their participation in the etiopathogenesis of this disease.
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Affiliation(s)
- Marta Nowak-Wąs
- Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Department of Ophthalmology, Kornel Gibinski University Clinical Center, Medical University of Silesia, 40-055 Katowice, Poland
| | - Paweł Wąs
- Department of Ophthalmology, Megrez Provincial Specialist Hospital in Tychy, 43-100 Tychy, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Romuald Wojnicz
- Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dorota Wyględowska-Promieńska
- Department of Ophthalmology, Kornel Gibinski University Clinical Center, Medical University of Silesia, 40-055 Katowice, Poland
- Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
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González-Atienza C, Sánchez-Cazorla E, Villoldo-Fernández N, del Hierro A, Boto A, Guerrero-Carretero M, Nieves-Moreno M, Arruti N, Rodríguez-Solana P, Mena R, Rodríguez-Jiménez C, Rosa-Pérez I, Acal JC, Blasco J, Naranjo-Castresana M, Ruz-Caracuel B, Montaño VEF, Ortega Patrón C, Rubio-Martín ME, García-Fernández L, Rikeros-Orozco E, Gómez-Cano MDLÁ, Delgado-Mora L, Noval S, Vallespín E. Whole-Exome Sequencing of 24 Spanish Families: Candidate Genes for Non-Syndromic Pediatric Keratoconus. Genes (Basel) 2023; 14:1838. [PMID: 37895187 PMCID: PMC10606385 DOI: 10.3390/genes14101838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Keratoconus is a corneal dystrophy that is one of the main causes of corneal transplantation and for which there is currently no effective treatment for all patients. The presentation of this disease in pediatric age is associated with rapid progression, a worse prognosis and, in 15-20% of cases, the need for corneal transplantation. It is a multifactorial disease with genetic variability, which makes its genetic study difficult. Discovering new therapeutic targets is necessary to improve the quality of life of patients. In this manuscript, we present the results of whole-exome sequencing (WES) of 24 pediatric families diagnosed at the University Hospital La Paz (HULP) in Madrid. The results show an oligogenic inheritance of the disease. Genes involved in the structure, function, cell adhesion, development and repair pathways of the cornea are proposed as candidate genes for the disease. Further studies are needed to confirm the involvement of the candidate genes described in this article in the development of pediatric keratoconus.
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Affiliation(s)
- Carmen González-Atienza
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Eloísa Sánchez-Cazorla
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Natalia Villoldo-Fernández
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - Almudena del Hierro
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Ana Boto
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Marta Guerrero-Carretero
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - María Nieves-Moreno
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Natalia Arruti
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Patricia Rodríguez-Solana
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Rocío Mena
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
| | - Carmen Rodríguez-Jiménez
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Irene Rosa-Pérez
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - Juan Carlos Acal
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - Joana Blasco
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - Marta Naranjo-Castresana
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
| | - Beatriz Ruz-Caracuel
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
- Clinical Bioinformatics Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Victoria E. F. Montaño
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
| | - Cristina Ortega Patrón
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - M. Esther Rubio-Martín
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Laura García-Fernández
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
| | - Emi Rikeros-Orozco
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
- Clinical Genetics Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - María de Los Ángeles Gómez-Cano
- Clinical Genetics Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Luna Delgado-Mora
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
- Clinical Genetics Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Susana Noval
- Department of Pediatric Ophthalmology, IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (N.V.-F.); (A.d.H.); (A.B.); (M.G.-C.); (N.A.); (I.R.-P.); (J.C.A.); (J.B.); (M.N.-C.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Elena Vallespín
- Molecular Ophthalmology Section, Medical and Molecular Genetics Institute (INGEMM) IdiPaz, Hospital Universitario La Paz, 28046 Madrid, Spain; (C.G.-A.); (E.S.-C.); (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.O.P.); (M.E.R.-M.); (L.G.-F.)
- European Reference Network on Eye Diseases (ERN-EYE), Hospital Universitario La Paz, 28046 Madrid, Spain
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (B.R.-C.); (E.R.-O.); (L.D.-M.)
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8
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Utsunomiya T, Ishibazawa A, Yoshioka T, Song YS, Yoshida K. Assessing effects of mechanical stimulation of fluid shear stress on inducing matrix Metalloproteinase-9 in cultured corneal epithelial cells. Exp Eye Res 2023; 234:109571. [PMID: 37468028 DOI: 10.1016/j.exer.2023.109571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Abstract
Blinking is regarded as mechanical stimulation of fluid shear stress on the corneal epithelial cells. Therefore, we evaluated whether fluid shear stress affects matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in cultured human corneal epithelial cells (HCECs). No other study has shown the influence of fluid shear stress on HCECs regarding mRNA expression and the protein levels of MMPs. Cultured HCECs were exposed to shear stress (0, 1.2, 12 dyne/cm2) for 12 and 24 h with the parallel-plate type of flow chamber. Gene expression of MMPs and TIMPs was measured by real-time polymerase reaction. Concentrations of MMP-1 and MMP-9 in cell lysates were determined using bead-based amplified luminescent proximity homogenous assay-linked immunosorbent assay. The expression of MMP-9 and MMP-1 in HCECs exposed to low and high flow for 12 and 24 h, respectively, increased significantly compared with those under static conditions. The expression of MMP-9 in the cells exposed to high flow for 24 h increased significantly compared with those under static and low flow conditions. Levels of MMP-9 in cell lysates exposed to fluid flow for 24 h were elevated significantly with increasing shear stress. Fluid shear stress exerted on HCECs affected MMPs, which was associated with inflammation and pathogenesis. Mechanical stress induced by blinking might influence expression of MMPs on the ocular surface. Further studies are warranted to establish the molecular mechanism of shear stress-induced alternations of MMPs.
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Affiliation(s)
- Tsugiaki Utsunomiya
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
| | - Akihiro Ishibazawa
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Takafumi Yoshioka
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Young-Seok Song
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Koichi Yoshida
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan; Department of Hospital Pharmacy & Pharmacology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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9
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Paterson T, Azizoglu S, Gokhale M, Chambers M, Suphioglu C. Preserved Ophthalmic Anti-Allergy Medication in Cumulatively Increasing Risk Factors of Corneal Ectasia. BIOLOGY 2023; 12:1036. [PMID: 37508465 PMCID: PMC10376818 DOI: 10.3390/biology12071036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
The prevalence of allergies is rising every year. For those who suffer from it, ocular inflammation and irritation can be inconvenient and unpleasant. Anti-allergy eyedrops are a readily available treatment for symptoms of ocular allergy (OA) and can help allergy sufferers regain normal function. However, the eye is a delicate organ, and multiuse eyedrops often utilise preservatives to deter microbial growth. Preservatives such as benzalkonium chloride (BAK) have been shown to induce decreased cell viability. Therefore, during a period of high localised inflammation and eye rubbing, it is important that the preservatives used in topical medicines do not contribute to the weakening of the corneal structure. This review explores ocular allergy and the thinning and protrusion of the cornea that is characteristic of the disease keratoconus (KC) and how it relates to a weakened corneal structure. It also describes the use of BAK and its documented effects on the integrity of the cornea. It was found that atopy and eye rubbing are significant risk factors for KC, and BAK can severely decrease the integrity of the corneal structure when compared to other preservatives and preservative-free alternatives.
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Affiliation(s)
- Tom Paterson
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Serap Azizoglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
- Deakin Optometry, School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Moneisha Gokhale
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
- Deakin Optometry, School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Madeline Chambers
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences (LES), Faculty of Science, Engineering and Built Environment (SEBE), Deakin University, 75 Pigdons Road, Geelong, VIC 3216, Australia
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10
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Pinheiro-Costa J, Lima Fontes M, Luís C, Martins S, Soares R, Madeira D, Falcão-Reis F, Carneiro Â. Serum inflammatory biomarkers are associated with increased choroidal thickness in keratoconus. Sci Rep 2023; 13:10862. [PMID: 37407658 DOI: 10.1038/s41598-023-37472-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
Inflammation may play a significant role in Keratoconus (KC), but the relationship between inflammatory markers and choroidal thickness (CT) is unknown. The purpose of this study was to evaluate serum inflammatory markers and correlate them with the choroidal profile of KC patients and control subjects. Forty patients with KC and 26 age-matched control subjects were enrolled in a cross-sectional case-control study. Choroidal profile was studied with a Spectralis Heidelberg apparatus and venous blood samples were collected. Neutrophil/lymphocyte ratio (NLR), monocyte/HDL ratio (MHR), platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) were calculated. Serum inflammatory biomarkers IL-1, IL-6 and TNF-alfa were also analyzed. KC group presented thicker choroids in each evaluated point when compared to the control group (subfoveal CT 417.38 ± 79.79 vs 299.61 ± 76.13, p < 0.001 for all measured locations). Mean values of NLR, PLR and SII were significantly higher in patients with KC (NLR p = 0.001; PLR p = 0.042; SII p = 0.007). Although KC patients presented higher mean levels of MHR, IL-1, IL-6 and TNF-α than control group, no significant differences were achieved. Positive correlations were found between subfoveal CT and NLR and SII (0.408, p = 0.001 and 0.288, p = 0.019 respectively). The results presented are in favor of a relationship between the increased CT and inflammatory mechanisms in KC patients. The elevated serum inflammatory indices NLR, SII and PLR provide additional evidence of a role for systemic inflammation in the pathophysiology of KC.
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Affiliation(s)
- João Pinheiro-Costa
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Mário Lima Fontes
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Carla Luís
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- i3S - Institute of Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Sandra Martins
- Department of Clinical Pathology, Centro Hospitalar Universitário São João, Porto, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - Raquel Soares
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- i3S - Institute of Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Dulce Madeira
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
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11
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Kowalska M, Mischi E, Stoma S, Nørrelykke SF, Hartnack S, Pot SA. How Modifications of Corneal Cross-Linking Protocols Influence Corneal Resistance to Enzymatic Digestion and Treatment Depth. Transl Vis Sci Technol 2023; 12:18. [PMID: 37191620 DOI: 10.1167/tvst.12.5.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Purpose The purpose of this study was to determine the effects of the Photoactivated Chromophore for Keratitis Corneal Cross-Linking (PACK-CXL) protocol modifications on corneal resistance to enzymatic digestion and treatment depth. Methods Eight hundred one ex vivo porcine eyes were randomly divided into groups of 12 to 86 corneas, treated with various epi-off PACK-CXL modifications, including acceleration (30 > 2 minutes, 5.4 J/cm2), increased fluence (5.4 > 32.4 J/cm2), deuterium oxide (D2O) supplementation, different carrier types (dextran versus hydroxypropyl methylcellulose [HPMC]), increased riboflavin concentration (0.1 > 0.4%), and riboflavin replenishment during irradiation (yes/no). Control group eyes did not receive PACK-CXL. A pepsin digestion assay was used to determine corneal resistance to enzymatic digestion. A phalloidin fluorescent imaging assay was used to determine the PACK-CXL treatment effect depth. Differences between groups were evaluated using a linear model and a derivative method, respectively. Results PACK-CXL significantly increased corneal resistance to enzymatic digestion compared to no treatment (P < 0.03). When compared to a 10 minute, 5.4 J/cm2 PACK-CXL protocol, fluences of 16.2 J/cm2 and higher increased corneal resistance to enzymatic digestion by 1.5- to 2-fold (P < 0.001). Other protocol modifications did not significantly change corneal resistance. A 16.2 J/cm2 fluence also increased collagen compaction in the anterior stroma, whereas omitting riboflavin replenishment during irradiation increased PACK-CXL treatment depth. Conclusions Increasing fluence will likely optimize PACK-CXL treatment effectiveness. Treatment acceleration reduces treatment duration without compromising effectiveness. Translational Relevance The generated data help to optimize clinical PACK-CXL settings and direct future research efforts.
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Affiliation(s)
- Malwina Kowalska
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Switzerland
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Elisa Mischi
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
- Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Szymon Stoma
- Image and Data Analysis Group (IDA), Scientific Center for Optical Electron Microscopy (ScopeM), Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Simon F Nørrelykke
- Image and Data Analysis Group (IDA), Scientific Center for Optical Electron Microscopy (ScopeM), Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
- Department of Systems Biology, Harvard Medical School, Boston, MA, USA
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Simon A Pot
- Ophthalmology Section, Equine Department, Vetsuisse Faculty, University of Zurich, Switzerland
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12
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Akoto T, Cai J, Nicholas S, McCord H, Estes AJ, Xu H, Karamichos D, Liu Y. Unravelling the Impact of Cyclic Mechanical Stretch in Keratoconus-A Transcriptomic Profiling Study. Int J Mol Sci 2023; 24:7437. [PMID: 37108600 PMCID: PMC10139219 DOI: 10.3390/ijms24087437] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/04/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
Biomechanical and molecular stresses may contribute to the pathogenesis of keratoconus (KC). We aimed to profile the transcriptomic changes in healthy primary human corneal (HCF) and KC-derived cells (HKC) combined with TGFβ1 treatment and cyclic mechanical stretch (CMS), mimicking the pathophysiological condition in KC. HCFs (n = 4) and HKCs (n = 4) were cultured in flexible-bottom collagen-coated 6-well plates treated with 0, 5, and 10 ng/mL of TGFβ1 with or without 15% CMS (1 cycle/s, 24 h) using a computer-controlled Flexcell FX-6000T Tension system. We used stranded total RNA-Seq to profile expression changes in 48 HCF/HKC samples (100 bp PE, 70-90 million reads per sample), followed by bioinformatics analysis using an established pipeline with Partek Flow software. A multi-factor ANOVA model, including KC, TGFβ1 treatment, and CMS, was used to identify differentially expressed genes (DEGs, |fold change| ≥ 1.5, FDR ≤ 0.1, CPM ≥ 10 in ≥1 sample) in HKCs (n = 24) vs. HCFs (n = 24) and those responsive to TGFβ1 and/or CMS. PANTHER classification system and the DAVID bioinformatics resources were used to identify significantly enriched pathways (FDR ≤ 0.05). Using multi-factorial ANOVA analyses, 479 DEGs were identified in HKCs vs. HCFs including TGFβ1 treatment and CMS as cofactors. Among these DEGs, 199 KC-altered genes were responsive to TGFβ1, thirteen were responsive to CMS, and six were responsive to TGFβ1 and CMS. Pathway analyses using PANTHER and DAVID indicated the enrichment of genes involved in numerous KC-relevant functions, including but not limited to degradation of extracellular matrix, inflammatory response, apoptotic processes, WNT signaling, collagen fibril organization, and cytoskeletal structure organization. TGFβ1-responsive KC DEGs were also enriched in these. CMS-responsive KC-altered genes such as OBSCN, CLU, HDAC5, AK4, ITGA10, and F2RL1 were identified. Some KC-altered genes, such as CLU and F2RL1, were identified to be responsive to both TGFβ1 and CMS. For the first time, our multi-factorial RNA-Seq study has identified many KC-relevant genes and pathways in HKCs with TGFβ1 treatment under CMS, suggesting a potential role of TGFβ1 and biomechanical stretch in KC development.
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Affiliation(s)
- Theresa Akoto
- Department of Cellular Biology & Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Jingwen Cai
- Department of Cellular Biology & Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Sarah Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Hayden McCord
- Department of Cellular Biology & Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Amy J. Estes
- Department of Ophthalmology, Augusta University, Augusta, GA 30912, USA
- James & Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Hongyan Xu
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Yutao Liu
- Department of Cellular Biology & Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- James & Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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13
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Yang Q, Wang S, He Y, Zhang Y. The research progress on the molecular mechanism of corneal cross-linking in keratoconus treatment. Cont Lens Anterior Eye 2023; 46:101795. [PMID: 36549953 DOI: 10.1016/j.clae.2022.101795] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
Keratoconus (KC) is a corneal anomaly that is manifested in a limited cone-like bulge with corneal thinning. Many molecules in the cornea change during the development of KC, including various components of the extracellular matrix, cytokines, cell connection, and cell adhesion-related proteins. Several treatment options are available, with corneal cross-linking (CXL) being the treatment of choice for early KC. However, postoperative complications have been reported in some CXL patients, mainly caused by corneal epithelial resection. Despite the fact that some novel approaches have helped to reduce some of the initial post-operative issues, their effectiveness seems to be inferior to that of the original CXL. To keep effectiveness while avoiding these negative effects, it is necessary to study the mechanism of CXL in KC treatment at the molecular level. This article provides a review of the molecular mechanism of CXL in the treatment of KC from four aspects: enzyme activity, signal transduction pathway, corneal-related proteins, and other KC-related molecules, further confirming the feasibility of CXL treatment of KC, providing new ideas for improving CXL.
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Affiliation(s)
- Qingyu Yang
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, China.
| | - Shurong Wang
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, China.
| | - Yuxi He
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, China
| | - Yan Zhang
- Department of Ophthalmology, 2nd Hospital of Jilin University, Changchun 130041, China.
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14
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Hage A, Knoeri J, Leveziel L, Majoulet A, Buffault J, Labbé A, Baudouin C. [From ocular itching to eye rubbing: a review of the literature]. J Fr Ophtalmol 2023; 46:173-184. [PMID: 36635208 DOI: 10.1016/j.jfo.2022.09.009] [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: 05/02/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
Ocular itching and eye rubbing are frequent complaints in an ophthalmology practice. Numerous studies address the consequences of eye rubbing, such as keratoconus. However, there are few studies concerning the pathophysiology of itching, its transmission pathways, or its interactions with eye rubbing. Through this literature review, we will address the various clinical, physiological and therapeutic aspects of this pair of symptoms with a variety of ocular consequences. We will then describe the state of the art in itching and scratching in dermatology, in order to draw a parallel between these two vicious cycles. A better understanding of the pathophysiology of ocular itching and eye rubbing, as well as new studies based on dermatological data, might allow more appropriate clinical management of our patients and their symptoms.
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Affiliation(s)
- A Hage
- Department of Ophthalmology III, National Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, Service 3-Pr Christophe Baudouin, 28, rue de Charenton, 75012, Paris, France.
| | - J Knoeri
- Department of Ophthalmology V, NATIONAL Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012, Paris, France
| | - L Leveziel
- Department of Ophthalmology V, NATIONAL Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012, Paris, France
| | - A Majoulet
- Department of Ophthalmology III, National Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, Service 3-Pr Christophe Baudouin, 28, rue de Charenton, 75012, Paris, France
| | - J Buffault
- Department of Ophthalmology III, National Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, Service 3-Pr Christophe Baudouin, 28, rue de Charenton, 75012, Paris, France
| | - A Labbé
- Department of Ophthalmology III, National Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, Service 3-Pr Christophe Baudouin, 28, rue de Charenton, 75012, Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvellines, 9, avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France; Sorbonne Université, inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012, Paris, France
| | - C Baudouin
- Department of Ophthalmology III, National Hospital Centre for Ophthalmology Quinze-Vingts, IHU FOReSIGHT, Service 3-Pr Christophe Baudouin, 28, rue de Charenton, 75012, Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvellines, 9, avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France; Sorbonne Université, inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012, Paris, France
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15
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Nichani PAH, Solomon B, Trinh T, Mimouni M, Rootman D, Singal N, Chan CC. Investigating the role of inflammation in keratoconus: A retrospective analysis of 551 eyes. Eur J Ophthalmol 2023; 33:35-43. [PMID: 36154720 PMCID: PMC9834323 DOI: 10.1177/11206721221125013] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Keratoconus (KCN), classically defined as a noninflammatory corneal ectasia, was recently associated with chronic inflammation. This study aimed to further evaluate the association between inflammation and KCN severity by assessing patient tear films. METHODS Retrospective chart review of consecutive patients (July 2016-February 2020) referred to a tertiary KCN centre. Using tomography Kmax values, the worst-eyes of patients with a diagnosis of KCN and tear film test results were included. Eyes were stratified as matrix metalloproteinase-9 (MMP9) positive or negative and analyzed using independent t and Pearson chi-squared tests. A p-value ≤ 0.05 was considered significant. RESULTS 551 (51.40%) unilateral eyes were included. Mean age was 30.1 years and 70.1% were male. 55.5% of the eyes were MMP9 positive. Mean corrected distance visual acuity was 20/30<συπ>-3</sup> Snellen and Kmax was 60.1 Diopters. MMP9 positive eyes had a higher Kmax (p = 0.048), and were more likely from patients who were male (p < 0.001), had a paediatric history of asthma (p = 0.042), and used glasses (p = 0.041). MMP9 negative eyes more likely corresponded to soft contact lens users (p = 0.012). No other significant differences were found in risk factors, topography, tomography, and tear film osmolarity. CONCLUSION MMP9 positive keratoconic eyes had significantly higher Kmax readings which may correlate with increased disease severity, supporting an association between keratoconus and inflammation. Further research is warranted to evaluate the role of targeted therapy and contact lens use on MMP9 levels in keratoconic eyes and whether disease progression is affected.
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Affiliation(s)
- Prem A H Nichani
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Solomon
- Termerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Michael Mimouni
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada,Kensington Eye Institute, Toronto, Ontario, Canada,Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Rootman
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada,Kensington Eye Institute, Toronto, Ontario, Canada,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Neera Singal
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada,Kensington Eye Institute, Toronto, Ontario, Canada,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Clara C Chan
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada,Kensington Eye Institute, Toronto, Ontario, Canada,Toronto Western Hospital, Toronto, Ontario, Canada,Clara C Chan, Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto Western Hospital, 6th Floor East Wing, Reception 1, 399 Bathurst Street, Toronto, Ontario, Canada. M5T 2S8.
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16
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Wolf J, Kammrath Betancor P, Maier P, Heinzelmann SU, Jiang J, Lange C, Reinhard T, Schlunck G, Lapp T. Transcriptional Profiling Provides New Insights into Organ Culture-Induced Changes in Human Donor Corneas. Int J Mol Sci 2022; 23:ijms232314507. [PMID: 36498835 PMCID: PMC9735924 DOI: 10.3390/ijms232314507] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Corneal transplantation is one of the most common forms of tissue transplantation worldwide. Donor corneal tissue used in transplantation is provided by eye banks, which store the tissue in culture medium after procurement. To date, the effects of cell culture on human corneal tissue have not been fully elucidated. Using the 3' RNA sequencing method for massive analysis of cDNA ends (MACE), we show that cultivation of corneal tissue leads to significant changes in a variety of molecular processes in human corneal tissue that go well beyond aspects of previously known culture effects. Functionally grouped network analysis revealed nine major groups of biological processes that were affected by corneal organ culture, among them keratinization, hypoxia, and angiogenesis, with genes from each group being affected by culture time. A cell type deconvolution analysis revealed significant modulations of the corneal immune cell profile in a time dependent manner. The results suggest that current culture conditions should be further refined and that prolonged cultivation may be detrimental. Recently, we showed that MACE enables transcriptional profiling of formalin-fixed and paraffin-embedded (FFPE) conjunctival tissue with high accuracy even after more than 10 years of storage. Here we demonstrate that MACE provides comparable results for native and FFPE corneal tissue, confirming that the technology is suitable for transcriptome analysis of a wide range of archived diseased corneal samples stored in histological archives. Finally, our data underscore the feasibility of bioinformatics cell-type enrichment analysis in bulk RNA-seq data to profile immune cell composition in fixed and archived corneal tissue samples, for which RNA-seq analysis of individual cells is often not possible.
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Affiliation(s)
- Julian Wolf
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
- Omics Laboratory, Stanford University, Palo Alto, CA 94304, USA
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94304, USA
- Correspondence: (J.W.); (T.L.)
| | - Paola Kammrath Betancor
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Philip Maier
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Sonja Ute Heinzelmann
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Jana Jiang
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Clemens Lange
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
- Ophtha-Lab, Department of Ophthalmology, St. Franziskus Hospital, 48145 Münster, Germany
| | - Thomas Reinhard
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Günther Schlunck
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
| | - Thabo Lapp
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg im Breisgau, Germany
- Correspondence: (J.W.); (T.L.)
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Ballesteros-Sánchez A, De-Hita-Cantalejo C, Sánchez-González MC, Bautista-Llamas MJ, Sánchez-González JM, Gargallo-Martínez B. Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population. Int Ophthalmol 2022; 43:1185-1192. [PMID: 36138270 PMCID: PMC10113286 DOI: 10.1007/s10792-022-02517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/11/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the choroidal thickness between patients with keratoconus undergoing cross-linking treatment and a healthy population, as well as to determine the factors that influence choroidal thickness. METHODS This was an observational, analytical, case-control study that was conducted from February 2021 to June 2021. Choroidal thickness was measured at different locations, including the subfoveal, nasal (1000 μm), temporal (1000 μm), superior (1000 μm) and inferior (1000 μm) locations using a Spectral-domain optical coherence tomography with enhanced depth imaging, which allowed us to obtain horizontal and vertical B-scans centered on the fovea. RESULTS This study included 21 patients with keratoconus (mean age, 21.86 ± 5.28 years) and 28 healthy patients (mean age, 24.21 ± 4.71 years). Choroidal thickness was significantly greater in patients with keratoconus than in healthy patients in each of the following measured locations: subfoveal (P < 0.001); nasal (1000 μm) (P < 0.001), temporal (1000 μm) (P < 0.001), superior (1000 μm) (P < 0.001) and inferior (1000 μm) (P < 0.001) locations. Variables such as age (ρ = - 0.09; P = 0.50) and refraction (ρ = 0.14; P = 0.34) were not found to be associated with choroidal thickness. In a stepwise multiple linear regression, the group was the single variable correlated with choroidal thickness (β = 0.88; P < 0.001). CONCLUSION Choroidal thickness is thicker in keratoconus patients treated with cross-linking than in the healthy population. This finding could be associated with inflammatory choroidal mechanisms in keratoconus patients, but more studies are needed. Age and refractive error do not seem to influence choroidal thickness.
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Affiliation(s)
- Antonio Ballesteros-Sánchez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain
- Departament of Physics of Condensed Matter, Optics Area, University of Seville, Seville, Spain
| | | | | | | | | | - Beatriz Gargallo-Martínez
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain
- Department of Ophthalmology, Optometry, Otorhinolaryngology and Anatomic Pathology, University of Murcia, Murcia, Spain
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Identification of Key Genes and Molecular Pathways in Keratoconus: Integrating Text Mining and Bioinformatics Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4740141. [PMID: 36051483 PMCID: PMC9427295 DOI: 10.1155/2022/4740141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/10/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022]
Abstract
Purpose. To identify the potential key genes and molecular pathways associated with keratoconus and allergic disease. Methods. The pubmed2ensembl database was used to identify the text mining genes (TMGs) collectively involved in keratoconus and allergic disease. The GeneCodis program was used to perform the Gene Ontology (GO) biological process and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of TMGs. The protein-protein interaction (PPI) network of the TMGs was established by STRING; the significant gene modules and hub genes of PPI were further performed using the Cytoscape software. The DAVID database was used to perform the GO and KEGG analyses of the significant module. Results. In total, 98 TMGs collectively involved in keratoconus and allergic disease were identified. 19 enriched biological processes including 71 genes and 25 enriched KEGG pathways including 59 genes were obtained. A TMG PPI network was constructed, and 51 genes/nodes were identified with 110 edges; 3 most significant modules and 12 hub genes were chosen from the PPIs. GO enrichment analysis showed that the TMGs were primarily associated with collagen catabolic process, extracellular matrix organization and disassembly, cell adhesion and migration, collagen-containing extracellular matrix, extracellular matrix, and structure organization. KEGG pathway analysis showed that these DEGs were mainly involved in the IL-17 signaling pathway, inflammatory bowel disease, rheumatoid arthritis, allograft rejection, T cell receptor signaling pathway, cytokine-cytokine receptor interaction, and TNF signaling pathway. Conclusions. The results revealed that IL10, IL6, MMP9, MMP1, HGF, VEGFA, MMP3, MMP2, TGFB1, IL4, IL2, and IFNG were potential key genes involved in keratoconus. IL-17 signaling pathway was the potential pathways accounting for pathogenesis and development of keratoconus.
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19
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López-López M, Regueiro U, Bravo SB, Chantada-Vázquez MDP, Pena C, Díez-Feijoo E, Hervella P, Lema I. Shotgun Proteomics for the Identification and Profiling of the Tear Proteome of Keratoconus Patients. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35551575 PMCID: PMC9123485 DOI: 10.1167/iovs.63.5.12] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The qualitative approach followed in this study aims to obtain an extensive view of the keratoconus (KC) tear proteome, which could highlight proteins previously undetected and enlarge our knowledge of the disease's pathophysiology. Methods Twenty-five patients diagnosed with KC and 25 control subjects were studied in a prospective, cross-sectional study. KC screening examinations, including clinical and tomographic examinations, were performed on all participants. Tear samples were collected using Schirmer strips and analyzed by liquid chromatography-tandem mass spectrometry in a data-dependent workflow. A spectral count was used as a semiquantification tool. The tear proteomes of both groups were identified and profiled, and the functional interactions and biological characterization of differential proteins were analyzed using in silico tools. Results We identified a total of 232 proteins, of whom 133 were expressed in both groups’ samples; 41 were observed only in control samples and 58 were identified just in tears of patients with KC. A semiquantitative analysis showed the dysregulation of 17 proteins in the KC samples. An in silico analysis linked proteins only expressed in KC samples to oxidative stress, skin development, and apoptosis. The dysregulation of proteins involved in iron transport, inflammation, oxidative stress, and protease inhibition was observed in the semiquantitative results. Conclusions A shotgun analysis showed that the tear proteome of patients with KC differed from controls by more than one-third of the total proteins identified, highlighting the relationship of the proteins only expressed in KC tears with processes of cell death, oxidative damage, and inflammation. The underexpression of proteins involved in iron pathways might support the iron imbalance as a contributing factor to cellular damage and death in KC disease.
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Affiliation(s)
- Maite López-López
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Uxía Regueiro
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana Belén Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Carmen Pena
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Elío Díez-Feijoo
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Institute of Ophthalmology (INGO), Conxo Provincial Hospital, Santiago de Compostela, Spain
| | - Pablo Hervella
- Neuroimaging and Biotechnology Group (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Isabel Lema
- Corneal Neurodegeneration Group (RENOIR), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Department of Surgery and Medical-Surgical Specialties, Faculty of Optics and Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Galician Institute of Ophthalmology (INGO), Conxo Provincial Hospital, Santiago de Compostela, Spain
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20
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Zhao X, Yuan Y, Sun T, Zhang Y, Chen Y. Associations Between Keratoconus and the Level of Sex Hormones: A Cross-Sectional Study. Front Med (Lausanne) 2022; 9:828233. [PMID: 35280869 PMCID: PMC8908379 DOI: 10.3389/fmed.2022.828233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To analyze the level of sex hormone in relation to keratoconus (KC). Methods Sixty-two eyes of 62 patients (12 females, 50 males) classified as KC and 120 eyes of 120 patients (21 females, 99 males) with mild to moderate myopia and astigmatism were analyzed. Plasma samples were collected and analyzed using a chemiluminescence immunoassay to determine the concentrations of estriol (E3), estradiol (E2), progesterone (P), and testosterone (T). Corneal morphological parameters, such as the central corneal thickness (CCT), thinnest corneal thickness (TCT), and maximum simulated keratometry (Kmax), were measured using Pentacam and Sirius. Results The mean age was 23.73 ± 5.16 years for patients with KC and 23.68 ± 6.10 years for patients treated with laser vision correction (LVC). Among the patients with KC, 12 were female (19.35%) and 50 were male (80.65%). The majority of patients with KC were between 20 and 30 years old. In female patients, the concentration of T in the KC group was significantly lower than that in the LVC group (0.86 ± 0.33 vs. 1.18 ± 0.58 nmol/L; P = 0.044). There were positive correlations between T, CCT (r = 0.395, P = 0.023) and TCT (r = 0.378, P = 0.030) in female patients. In male patients, E2 was higher in the KC group than the LVC group (143.75 ± 34.82 vs. 124.80 ± 43.56 pmol/L; P = 0.013), while T was significantly lower (11.59 ± 2.85 vs. 13.58 ± 4.77 nmol/L; P = 0.026). A positive correlation was found between E2 and Kmax (r = 0.222, P = 0.007) in male patients. Conclusions Conclusively, our results showed that T level was reduced in both female and male KC plasma, while E2 was increased in male KC plasma. Different levels of sex hormones are correlated with KC, which, may provide the basis of a new technique for screening and diagnosing KC with or without the assistance of current imaging techniques. Moreover, the correlations between sex hormone alterations and KC provide compelling insight into KC etiopathogenesis.
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Affiliation(s)
- Xiaorui Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yifei Yuan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Tong Sun
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yu Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yueguo Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Yıldız E, Aydemir D, Zibandeh N, Kuşan E, Gümüş K, Saraç Öİ, Karslıoğlu MZ, Çağıl N, Şahin A. Investigation of Mitophagy Biomarkers in Corneal Epithelium of Keratoconus Patients. Curr Eye Res 2022; 47:661-669. [DOI: 10.1080/02713683.2022.2025846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Erdost Yıldız
- Koç University Research Center for Translational Medicine, Koç University, 34450, Istanbul, Turkey
| | - Dilara Aydemir
- Koç University Research Center for Translational Medicine, Koç University, 34450, Istanbul, Turkey
| | - Noushin Zibandeh
- Koç University Research Center for Translational Medicine, Koç University, 34450, Istanbul, Turkey
| | - Eda Kuşan
- Koç University Research Center for Translational Medicine, Koç University, 34450, Istanbul, Turkey
| | - Koray Gümüş
- Department of Ophthalmology, Ankara Memorial Hospital, 06520, Ankara, Turkey
| | - Özge İlhan Saraç
- Department of Ophthalmology, Ankara Yıldırım Beyazıt University, 06010, Ankara, Turkey
| | | | - Nurullah Çağıl
- Department of Ophthalmology, Ankara Yıldırım Beyazıt University, 06010, Ankara, Turkey
| | - Afsun Şahin
- Koç University Research Center for Translational Medicine, Koç University, 34450, Istanbul, Turkey
- Department of Ophthalmology, Koç University Medical School, 34010, Istanbul, Turkey
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22
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Navel V, Malecaze J, Belville C, Choltus H, Henrioux F, Dutheil F, Malecaze F, Chiambaretta F, Blanchon L, Sapin V. Dysregulation of Receptor for Advanced Glycation End Products (RAGE) Expression as a Biomarker of Keratoconus. DISEASE MARKERS 2022; 2022:1543742. [PMID: 35075374 PMCID: PMC8783726 DOI: 10.1155/2022/1543742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/11/2021] [Accepted: 01/03/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Because of the implications of Receptor for Advanced Glycation End Products (RAGE) in keratoconus (KC), we describe a differential expression of RAGE transcripts and proteins in corneal tissues and tears of KC and healthy patients. METHODS Using a case-controlled study, corneal epitheliums and tears of KC and healthy subjects were obtained during corneal collagen cross-linking and photorefractive keratectomy (PKR) and during usual consultations. Quantitative reverse transcription (RT-qPCR) and Western-Blot were performed to analyze RAGE transcripts and proteins' expression in corneal tissues and tears. RESULTS One hundred and six patients were included in this study. The characteristics of the patients were as follows: 56 KC (25 corneal epithelium and 31 tears) and 50 control subjects (25 corneal epithelium and 25 tears). Transcripts of RAGE, HMGB1, and S100 family ligands were quantified by RT-qPCR, identifying a significantly higher expression of RAGE and HMGB1 in the healthy group than in the KC group (p = 0.03 and 0.04, respectively). Western Blot showed a significantly higher fl-RAGE expression in KC corneal epithelium than control (p < 0.001) and lower s-RAGE expression in KC tears than control (p = 0.04). CONCLUSIONS Linked with the inflammatory process occurring in KC pathophysiology, we propose for the first time that the RAGE expression (total and truncated forms of receptor and ligands) in KC corneal tissues and tear samples provides viable biomarkers.
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Affiliation(s)
- Valentin Navel
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000 Clermont-Ferrand, France
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Jean Malecaze
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000 Clermont-Ferrand, France
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Corinne Belville
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Héléna Choltus
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Fanny Henrioux
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- University of Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, F-63000 Clermont-Ferrand, France
| | - François Malecaze
- Ophthalmology Department, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Frédéric Chiambaretta
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Ophthalmology, F-63000 Clermont-Ferrand, France
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Loïc Blanchon
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
| | - Vincent Sapin
- Translational Approach to Epithelial Injury and Repair Team, University of Clermont Auvergne, CNRS UMR 6293, INSERM U1103, Genetic Reproduction and Development Laboratory (GReD), F-63000 Clermont-Ferrand, France
- Department of Biochemistry and Molecular Genetic, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France
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Santodomingo-Rubido J, Carracedo G, Suzaki A, Villa-Collar C, Vincent SJ, Wolffsohn JS. Keratoconus: An updated review. Cont Lens Anterior Eye 2022; 45:101559. [PMID: 34991971 DOI: 10.1016/j.clae.2021.101559] [Citation(s) in RCA: 168] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/23/2021] [Accepted: 12/12/2021] [Indexed: 02/06/2023]
Abstract
Keratoconus is a bilateral and asymmetric disease which results in progressive thinning and steeping of the cornea leading to irregular astigmatism and decreased visual acuity. Traditionally, the condition has been described as a noninflammatory disease; however, more recently it has been associated with ocular inflammation. Keratoconus normally develops in the second and third decades of life and progresses until the fourth decade. The condition affects all ethnicities and both sexes. The prevalence and incidence rates of keratoconus have been estimated to be between 0.2 and 4,790 per 100,000 persons and 1.5 and 25 cases per 100,000 persons/year, respectively, with highest rates typically occurring in 20- to 30-year-olds and Middle Eastern and Asian ethnicities. Progressive stromal thinning, rupture of the anterior limiting membrane, and subsequent ectasia of the central/paracentral cornea are the most commonly observed histopathological findings. A family history of keratoconus, eye rubbing, eczema, asthma, and allergy are risk factors for developing keratoconus. Detecting keratoconus in its earliest stages remains a challenge. Corneal topography is the primary diagnostic tool for keratoconus detection. In incipient cases, however, the use of a single parameter to diagnose keratoconus is insufficient, and in addition to corneal topography, corneal pachymetry and higher order aberration data are now commonly used. Keratoconus severity and progression may be classified based on morphological features and disease evolution, ocular signs, and index-based systems. Keratoconus treatment varies depending on disease severity and progression. Mild cases are typically treated with spectacles, moderate cases with contact lenses, while severe cases that cannot be managed with scleral contact lenses may require corneal surgery. Mild to moderate cases of progressive keratoconus may also be treated surgically, most commonly with corneal cross-linking. This article provides an updated review on the definition, epidemiology, histopathology, aetiology and pathogenesis, clinical features, detection, classification, and management and treatment strategies for keratoconus.
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Affiliation(s)
| | - Gonzalo Carracedo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Asaki Suzaki
- Clinical Research and Development Center, Menicon Co., Ltd., Nagoya, Japan
| | - Cesar Villa-Collar
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - James S Wolffsohn
- School of optometry, Health and Life Sciences, Aston University, Birmingham B4 7ET, United Kingdom
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[Histological changes in keratoconus and wound healing after corneal cross-linking]. Ophthalmologe 2021; 119:342-349. [PMID: 34874483 DOI: 10.1007/s00347-021-01537-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Keratoconus is classified as a corneal ectasia and is a multifactorial disease. In those affected, mostly adolescent patients visual deterioration occurs due to the development of irregular astigmatism. Treatment by corneal cross-linking (CXL) has been indicated in progressive disease for several years. OBJECTIVE To present the pathophysiology and histological changes in keratoconus as well as wound healing processes after CXL and their potential complications. MATERIAL AND METHODS Histological changes in keratoconus as well as wound healing processes after CXL and their potential complications are presented based on histological examination of corneal specimens with keratoconus with and without a condition after CXL. Relevant literature and own data are analyzed and discussed. RESULTS Besides inflammatory processes, atopic and genetic dispositions play a role in the development of keratoconus. The histological characteristics of keratoconus include changes in the epithelium, Bowman's layer and stroma. Wound healing processes after CXL include healing of the surface epithelium and transient loss of keratocytes and nerve fibers. CONCLUSION Keratoconus shows characteristic histopathological changes, such as epithelial irregularities, stromal thinning and breaks of Bowman's layer, whereas the endothelium and Descemet's membrane remain unchanged (apart from cases of corneal hydrops). After CXL wound healing processes can be followed primarily in vivo by confocal microscopy. Complications after CXL are rare. Persistent loss of keratocytes can be clinically manifested as a visually relevant scar.
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Lopes AG, de Almeida GC, Miola MP, Teixeira RM, Pires FCBL, Miani RA, de Mattos LC, Brandão CC, Castiglioni L. Absence of significant genetic alterations in the VSX1, SOD1, TIMP3, and LOX genes in Brazilian patients with Keratoconus. Ophthalmic Genet 2021; 43:73-79. [PMID: 34802378 DOI: 10.1080/13816810.2021.1992785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE To identify inherited or acquired mutations in the VSX1, SOD1, TIMP3 and LOX genes from the combined analysis of corneal and blood samples from patients with Keratoconus. METHODS The casuistry was consisted of samples of peripheral blood and corneal epithelium from 35 unrelated patients with Keratoconus who were submitted to corneal crosslink treatment. Also, blood and corneal epithelium samples from 89 non-keratoconic patients were used to compose the control group. Ophthalmologic evaluations included a clinical examination, topography and tomography. DNA samples were extracted from peripheral blood and from corneal epithelium in both groups and all coding regions of the VSX1, SOD1, TIMP3 and LOX genes were amplified by polymerase chain reaction, denatured and subjected to polyacrylamide gel electrophoresis. Mutational screening was performed by single-strand conformation polymorphism and direct DNA sequencing. RESULTS No pathogenic variant was found in all coding regions of VSX1, SOD1, TIMP3 and LOX genes, we detected only few SNPs (single-nucleotide polymorphisms). Among the polymorphisms stand out three of them, corresponding to the synonymous exchange of amino acids: exon 3 of VSX1 Ala182Ala and exon 3 of TIMP3 His83His and Ser87Ser; in patients with Keratoconus and also in control subjects. All the polymorphisms were found in samples of corneal epithelium and corresponding blood. CONCLUSION There is absence of KC pathogenic related to mutations in the VSX1, SOD1, TIMP3 and LOX genes in the studied patients.
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Affiliation(s)
- Alessandro Garcia Lopes
- Biology Department, Instituto De Biociências, Letras E, Universidade Estadual Paulista "Júlio De Mesquita Filho", São José do Rio Preto, São Paulo, Brazil.,Immunogenetics Laboratory, Molecular Biology Department, Faculdade De Medicina De São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Gildásio Castello de Almeida
- Ophthalmology Outpatient Clinic, Hospital De Base Da Fundação Faculdade Regional De Medicina (HB-, São José do Rio Preto, São Paulo, Brazil
| | - Marcos Paulo Miola
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade De Medicina De São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Ronan Marques Teixeira
- Biology Department, Instituto De Biociências, Letras E, Universidade Estadual Paulista "Júlio De Mesquita Filho", São José do Rio Preto, São Paulo, Brazil
| | | | | | - Luiz Carlos de Mattos
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade De Medicina De São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Cinara Cássia Brandão
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade De Medicina De São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
| | - Lilian Castiglioni
- Biology Department, Instituto De Biociências, Letras E, Universidade Estadual Paulista "Júlio De Mesquita Filho", São José do Rio Preto, São Paulo, Brazil.,Epidemiology and Collective Health, Faculdade De Medicina De São José Do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil
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Ates KM, Estes AJ, Liu Y. Potential underlying genetic associations between keratoconus and diabetes mellitus. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2021; 1:100005. [PMID: 34746916 PMCID: PMC8570550 DOI: 10.1016/j.aopr.2021.100005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 12/14/2022]
Abstract
Background Keratoconus (KC) is the most common ectatic corneal disease, characterized by significantly localized thinning of the corneal stroma. Genetic, environmental, hormonal, and metabolic factors contribute to the pathogenesis of KC. Additionally, multiple comorbidities, such as diabetes mellitus, may affect the risk of KC. Main Body Patients with diabetes mellitus (DM) have been reported to have lower risk of developing KC by way of increased endogenous collagen crosslinking in response to chronic hyperglycemia. However, this remains a debated topic as other studies have suggested either a positive association or no association between DM and KC. To gain further insight into the underlying genetic components of these two diseases, we reviewed candidate genes associated with KC and central corneal thickness in the literature. We then explored how these genes may be regulated similarly or differentially under hyperglycemic conditions and the role they play in the systemic complications associated with DM. Conclusion Our comprehensive review of potential genetic factors underlying KC and DM provides a direction for future studies to further determine the genetic etiology of KC and how it is influenced by systemic diseases such as diabetes.
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Affiliation(s)
- Kristin M. Ates
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Amy J. Estes
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Little LM, Randleman JB. Cogan syndrome masquerading as corneal ectasia. Am J Ophthalmol Case Rep 2021; 24:101215. [PMID: 34703949 PMCID: PMC8521122 DOI: 10.1016/j.ajoc.2021.101215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/16/2021] [Accepted: 10/03/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To report a case of Cogan syndrome that presented with the appearance of bilateral asymmetric corneal ectasia on Scheimpflug tomography. Methods Case Report and Literature Review. Results A 43-year-old woman previously diagnosed with keratoconjunctivitis sicca and presumed keratoconus presented with seven months of episodic eye pain and progressive bilateral blurry vision with new onset bilateral monocular diplopia. Review of symptoms were significant for tinnitus, vertigo, and sensorineural hearing loss that began many months after her initial presentation for visual symptoms. Scheimpflug tomography showed asymmetric focal steepening on anterior curvature with corresponding focal total corneal thinning, focal posterior elevation, and abnormal ARTMax (205 OD, 103 OS) and BAD-D (2.75 OD, 5.6 OS) values. Clinical examination was notable only for faint anterior corneal stromal inflammation without neovascularization, but there was significant corresponding focal hyperreflectivity on anterior segment optical coherence tomography (OCT) examination with focal epithelial hypertrophy rather than thinning. Given the combined findings of interstitial keratitis and sensorineural hearing loss the patient was diagnosed with Cogan syndrome. She responded well to topical steroids and systemic immunosuppressive therapy, with near resolution of her abnormal topographic and tomographic findings and resolution of monocular diplopia in both eyes. Conclusions Cogan syndrome should be suspected for any patient with corneal stromal findings and associated with vertigo and/or hearing loss. Anterior segment optical coherence tomography (OCT) can distinguish between ectatic and inflammatory diseases and may help make the appropriate diagnosis in subtle cases.
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Influence of interleukin 17 A and 17 F polymorphisms in keratoconus. Mol Biol Rep 2021; 48:7165-7170. [PMID: 34554386 DOI: 10.1007/s11033-021-06708-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/13/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Until a few years ago, keratoconus was defined as a noninflammatory degenerative disease. However, recent studies have shown that the altered balance between inflammatory cytokines, proteases, and protease inhibitors, as well as free radicals and oxidants, have a crucial role in the pathogenesis of this disease. The aim of this study is to investigate whether interleukin 17 A G197A (rs2275913) and interleukin 17 F T7488C (rs763780) polymorphisms are associated with keratoconus in patients from a population of the northwestern region of the State of São Paulo, Brazil. METHODS AND RESULTS 35 patients and 61 controls were enrolled. Genotyping of interleukin 17 A G197A and interleukin 17 F T7488C polymorphisms was carried out using the polymerase chain reaction-restriction fragment length polymorphism technique. Statistical analyses were conducted using the chi-square test, and an odds ratio with a 95% confidence interval was also calculated to evaluate the association between polymorphisms and disease. Evaluating interleukin 17 F T7488C, we found that the TT genotype is associated as a risk factor for keratoconus (P = 0.04; OR = 3.01; CI 1.11-8.14). As for evaluating interleukin 17 A G197A, the allele and genotype frequencies between patients and controls were compared and no statistically significant differences were found. CONCLUSIONS Our data showed that the interleukin 17 F T7488C polymorphisms may exert an influence in keratoconus.
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Navel V, Malecaze J, Pereira B, Baker JS, Malecaze F, Sapin V, Chiambaretta F, Dutheil F. Oxidative and antioxidative stress markers in keratoconus: a systematic review and meta-analysis. Acta Ophthalmol 2021; 99:e777-e794. [PMID: 33354927 DOI: 10.1111/aos.14714] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To conduct a systematic review and meta-analysis on the levels of oxidative stress markers and antioxidants in keratoconus compared to healthy subject. METHOD The PubMed, Cochrane Library, Embase, Science Direct and Google Scholar databases were searched on 1st June 2020 for studies reporting oxidative and antioxidative stress markers in keratoconus and healthy controls. Main meta-analysis was stratified by type of biomarkers, type of samples (tears, cornea, aqueous humour and blood) and type of corneal samples (stromal cells, epithelium and endothelium). RESULTS We included 36 articles, for a total of 1328 keratoconus patients and 1208 healthy controls. There is an overall increase in oxidative stress markers in keratoconus compared with healthy controls (standard mean deviation (SMD) = 0.94, 95% confidence interval (95% CI) 0.55-1.33), with a significant increase in reactive oxygen and nitrogen species (1.09, 0.41-1.78) and malondialdehyde (1.78, 0.83-2.73). There is an overall decrease in antioxidants in keratoconus compared with healthy controls (-0.63, -0.89 to -0.36), with a significant decrease in total antioxidant capacity/status (-1.65, -2.88 to -0.43), aldehyde/NADPH dehydrogenase (-0.77, -1.38 to -0.17), lactoferrin/transferrin/albumin (-1.92, -2.96 to -0.89) and selenium/zinc (-1.42, -2.23 to -0.61). Oxidative stress markers were higher in tears and in cornea of keratoconus than in aqueous humour, and antioxidants were decreased in tears, aqueous humour and blood without difference between sample type. Oxidative stress markers increased in stromal cells and antioxidants decreased in endothelium. CONCLUSION Oxidative stress markers and antioxidants were dysregulated in keratoconus, involving an imbalance of redox homeostasis in tears, cornea, aqueous humour and blood.
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Affiliation(s)
- Valentin Navel
- Ophthalmology CHU Clermont‐Ferrand University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
- Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team CNRS UMR 6293 INSERM U1103 Université Clermont Auvergne Clermont‐Ferrand France
| | - Jean Malecaze
- Ophthalmology CHU Clermont‐Ferrand University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
- Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team CNRS UMR 6293 INSERM U1103 Université Clermont Auvergne Clermont‐Ferrand France
| | - Bruno Pereira
- Clinical Research and Innovation Direction CHU Clermont–Ferrand University Hospital of Clermont Ferrand Clermont‐Ferrand France
| | - Julien S. Baker
- Department of Sport, Physical Education and Health Centre for Health and Exercise Science Research Hong Kong Baptist University Kowloon Tong Hong Kong
| | - François Malecaze
- Ophthalmology Department Pierre‐Paul Riquet Hospital University Hospital of Toulouse Toulouse France
| | - Vincent Sapin
- Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team CNRS UMR 6293 INSERM U1103 Université Clermont Auvergne Clermont‐Ferrand France
- Medical Biochemistry and Molecular Biology CHU Clermont‐Ferrand University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
| | - Frédéric Chiambaretta
- Ophthalmology CHU Clermont‐Ferrand University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
- Genetic Reproduction and Development Laboratory (GReD) Translational Approach to Epithelial Injury and Repair Team CNRS UMR 6293 INSERM U1103 Université Clermont Auvergne Clermont‐Ferrand France
| | - Frédéric Dutheil
- Preventive and Occupational Medicine CNRS, LaPSCo Physiological and Psychosocial Stress CHU Clermont‐Ferrand Université Clermont Auvergne University Hospital of Clermont‐Ferrand Clermont‐Ferrand France
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Kaya SG, Inanc-Surer S, Cakan-Akdogan G, Oktay G, Utine CA, Kalyoncu S. Roles of matrix metalloproteinases in the cornea: A special focus on macular corneal dystrophy. MEDICINE IN DRUG DISCOVERY 2021. [DOI: 10.1016/j.medidd.2021.100095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Liu PK, Chiu TY, Wang NK, Levi SR, Tsai MJ. Ocular Complications of Obstructive Sleep Apnea. J Clin Med 2021; 10:jcm10153422. [PMID: 34362205 PMCID: PMC8348497 DOI: 10.3390/jcm10153422] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022] Open
Abstract
Obstructive sleep apnea (OSA), the most common form of sleep-disordered breathing, is characterized by repetitive episodes of paused breathing during sleep, which in turn induces transient nocturnal hypoxia and hypercapnia. The high prevalence of OSA and its associated health consequences place a heavy burden on the healthcare system. In particular, the consequent episodic oxygenic desaturation/reoxygenation series and arousals from sleep in patients with OSA have the potential to trigger oxidative stress, elevated systemic inflammatory responses, and autonomic dysfunction with sympathetic activation. Given these adverse side-effects, OSA is highly correlated to many eye diseases that are common in everyday ophthalmic practices. Some of these ocular consequences are reversible, but they may permanently threaten a patient’s vision if not treated appropriately. Here, this article seeks to review the ocular consequences and potential pathophysiologic associations in patients with OSA. Understanding these OSA-related eye diseases may help clinicians provide comprehensive care to their patients.
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Affiliation(s)
- Pei-Kang Liu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-K.L.); (T.-Y.C.)
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Tzu-Yu Chiu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (P.-K.L.); (T.-Y.C.)
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Sarah R. Levi
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY 10032, USA; (N.-K.W.); (S.R.L.)
| | - Ming-Ju Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Sleep Disorders Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Respiratory Care, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 5601)
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Zhang J, Yang S, Tan Y, Wang Y. Effects of Mechanical Compression on Cell Morphology and Function in Human Corneal Fibroblasts. Curr Eye Res 2021; 46:1467-1473. [PMID: 34039223 DOI: 10.1080/02713683.2021.1904510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose: To explore the effect of mechanical compression (similar to that induced by eye rubbing) on cell morphology, proliferation, apoptosis, and extracellular matrix synthesis and degradation in human corneal fibroblasts.Materials and methods: Human corneal fibroblasts were isolated from corneal lenticule tissue of 10 patients after small incision lenticule extraction surgery. A system was established to mechanically compress corneal fibroblasts with pressure ranging from 0 to 524 Pa. Morphological changes, cell proliferation, apoptosis, and corneal matrix synthesis and degradation were examined using microscopy imaging, bromodeoxyuridine staining, flow cytometry, and qPCR analysis in human corneal fibroblasts after mechanical compression.Results: Human corneal fibroblasts showed short and thick cytoplasmic extensions, as well as a relatively low aspect ratio, suggesting significant morphological alterations caused by high levels of compressive stress. Mechanical compression inhibited cell proliferation and promoted cell apoptosis. Furthermore, compressive stress led to significant elevation in the expression of genes related to extracellular matrix degradation (matrix metalloproteinases MMP1 and MMP9) as early as 6 h after compression and moderate changes in the expression of tissue inhibitors of metalloproteinases. In addition, the mRNA expression levels of COL1A1, lumican, and vimentin were reduced 24 and 48 h after mechanical compression.Conclusions: Mechanical compression alters cell morphology, inhibits proliferation, induces apoptosis, upregulates genes related to extracellular matrix degradation, and downregulates corneal structural genes in human corneal fibroblasts. This study provides evidence that compressive stress significantly influences corneal keratocytes. Our findings suggest that this mechanical effect may be related to keratoconus associated with chronic eye rubbing.
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Affiliation(s)
- Jing Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.,Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China.,School of Optometry, Hong Kong Polytechnic University, Hong Kong, China
| | - Shu Yang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.,Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
| | - Youhua Tan
- Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.,Department of Biomedical Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.,Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
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Moleiro AF, Aires AF, Alves H, Viana Pinto J, Carneiro Â, Falcão-Reis F, Figueira L, Pinheiro-Costa J. The Role of Atopy in the Choroidal Profile of Keratoconus Patients. Clin Ophthalmol 2021; 15:1799-1807. [PMID: 33953539 PMCID: PMC8090985 DOI: 10.2147/opth.s301330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Although classically classified as a non-inflammatory condition, an inflammatory basis for keratoconus (KC) appears to be a growing evidence. Recently, it has been shown that KC patients have an increased choroidal thickness (CT). Among inflammatory disorders, atopy has been associated with KC development; therefore, the aim of this study was to evaluate if the increased CT in patients with KC is related to atopy. Methods This is an analytical cross-sectional study of patients with KC. Patients were classified as atopic and non-atopic according to their atopy history (allergic rhinoconjunctivitis (AR), asthma (AA) and/or atopic dermatitis (AD)) and were also classified based on their eye rubbing habits. Choroidal profile of all subjects was evaluated using a Spectralis optical coherence tomography (OCT) device with enhanced depth imaging (EDI) mode. CT was measured and compared between groups at the center of the fovea and at 500 µm intervals along a horizontal section. A multivariable analysis, adjusted for sex, age, spherical equivalent, history of medication and atopy, was performed to assess the influence of atopy in CT. Results Of the 80 patients included, 51 were atopic and 29 non-atopic. Atopic patients showed a thicker choroid in every measured location than the non-atopic patients (mean subfoveal CT 391.53 µm vs 351.17 µm, respectively), although the differences were not statistically different. The multivariable analysis revealed that being atopic makes the choroid statistically thicker, on average, 55.14 µm, when compared to non-atopic patients (p=0.043). Furthermore, patients who are frequent eye rubbers have significantly thicker choroids than non-rubbers (p=0.004). Conclusion Although some results do not reach statistical significance, atopic KC patients seem to have thicker choroids compared with non-atopic KC patients, suggesting a possible role for atopy in the choroidal profile of KC. This constitutes a completely new sight in this field of research that needs further investigation.
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Affiliation(s)
- Ana Filipa Moleiro
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Hélio Alves
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Viana Pinto
- Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Figueira
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Pinheiro-Costa
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
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Shoari A, Kanavi MR, Rasaee MJ. Inhibition of matrix metalloproteinase-9 for the treatment of dry eye syndrome; a review study. Exp Eye Res 2021; 205:108523. [PMID: 33662353 DOI: 10.1016/j.exer.2021.108523] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/06/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
Dry eye syndrome (DES) and tear dysfunction are multifactorial conditions affecting meibomian glands, lacrimal glands, and ocular surface. This ocular disorder can cause eye irritation, irregular cornea, corneal barrier disruption, and blurred vision. Uncontrolled increase in matrix metalloproteinase-9 (MMP-9) level and activity has been detected in the tears and ocular surface in the patients with DES, which has been proved to be related to disruption of tight junctions in apical corneal epithelium associated with severe signs of DES. These uncontrolled activities of MMP-9 lead to desquamation of ocular surface epithelia. Therefore, this review study was conducted to summarize the evidence regarding MMP-9 contribution in DES, and inhibition of MMP-9, as a therapeutic target for treatment of DES. For this purpose, herein, the related studies designed novel pharmaceutical compounds for direct and indirect inhibition of MMP-9 as treatment approaches for DES were reviewed. These compounds were designed to improve corneal barrier function, reduce inflammation on ocular surface, and restore tear production.
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Affiliation(s)
- Alireza Shoari
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Javad Rasaee
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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El-Massry A, Doheim MF, Iqbal M, Fawzy O, Said OM, Yousif MO, Badawi AE, Tawfik A, Abousamra A. Association Between Keratoconus and Thyroid Gland Dysfunction: A Cross-Sectional Case-Control Study. J Refract Surg 2021; 36:253-257. [PMID: 32267956 DOI: 10.3928/1081597x-20200226-03] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 02/25/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine the clinical association between thyroid gland dysfunction and keratoconus. METHODS This was a cross-sectional case-control study conducted between May 2018 and July 2019. After performing Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) examination, flat, steep, and maximum simulated keratometric readings were recorded for each patient. Serum concentrations of free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were measured. Further examinations by an endocrinologist were indicated for patients with positive laboratory results to confirm thyroid gland dysfunction. RESULTS One hundred eighty-seven patients with bilateral keratoconus and 187 sex- and age-matched healthy controls without keratoconus were analyzed. Mean age was 26.4 ± 8.2 years for the patients with keratoconus and 27.1 ± 9.4 years for the control patients, with no significant difference. The results showed that thyroid gland dysfunction prevalence was 10 of 187 patients with keratoconus (5.3%) and 2 of 187 control patients (1.1%), and the difference was statistically significant (P = .036). For the patients with keratoconus and thyroid gland dysfunction, 8 were women and 2 were men. Additionally, 6 patients (2 men and 4 women) had hyperthyrosis and 4 women had hypothyrosis. For controls, the two patients had hypothyrosis. CONCLUSIONS This study showed that there is a possible association between keratoconus and thyroid gland dysfunction, but more studies are needed to build upon these results. [J Refract Surg. 2020;36(4):253-257.].
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Weng S, Jan R, Wang J, Tseng S, Chang Y. Association between atopic keratoconjunctivitis and the risk of keratoconus. Acta Ophthalmol 2021; 99:e54-e61. [PMID: 32567209 DOI: 10.1111/aos.14509] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/04/2020] [Accepted: 05/21/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE To investigate the risk of keratoconus (KCN) in patients with atopic keratoconjunctivitis (AKC). METHODS This nationwide, retrospective, matched cohort study included 186 202 newly diagnosed AKC patients who were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 372.05, and selected from the Taiwan National Health Insurance Research Database. The age- and sex-matched control group included 186 202 non-AKC patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Patient information was collected between 1 January 2004 and 31 December 2011, and both groups of patients were tracked from the index date until December 2013. The incidence and risk of KCN (ICD-9-CM, code 371.6) were compared between the groups. A Cox proportional hazard regression analysis was performed to obtain the adjusted hazard ratio (HR) for KCN. The cumulative KCN incidence rate was calculated with the Kaplan-Meier analysis. RESULTS In total, 62 AKC patients and 26 controls developed KCN during the follow-up period. The incidence rate of KCN was 2.49 times (95% confidence interval [CI] = 1.57-3.93; p < 0.0001) higher in AKC patients than in controls. After adjusting for potential confounders, AKC patients were 2.25 times more likely to develop KCN than controls (adjusted HR, 2.25; 95% CI = 1.41-3.58; p < 0.05). CONCLUSION Atopic keratoconjunctivitis (AKC) patients had an increased risk of developing KCN. Therefore, AKC patients should be advised of this risk.
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Affiliation(s)
- Shih‐Feng Weng
- Department of Healthcare Administration and Medical Informatics College of Health Sciences Kaohsiung Medical University Kaohsiung Taiwan
- Department of Medical Research Kaohsiung Medical University Hospital Kaohsiung Taiwan
- Center for Medical informatics and Statistics Office of R&D Kaohsiung Medical University Kaohsiung Taiwan
| | - Ren‐Long Jan
- Department of Pediatrics Chi Mei Medical Center, Liouying Tainan Taiwan
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
| | - Jhi‐Joung Wang
- Department of Medical Research Chi Mei Medical Center Tainan Taiwan
- Department of Anesthesiology Chi Mei Medical Center Tainan Taiwan
- AI Biomed Center Southern Taiwan University of Science and Technology Tainan Taiwan
| | - Sung‐Huei Tseng
- Department of Ophthalmology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Department of Ophthalmology Chi Mei Medical Center Tainan Taiwan
| | - Yuh‐Shin Chang
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
- Department of Ophthalmology Chi Mei Medical Center Tainan Taiwan
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Tear Proteases and Protease Inhibitors: Potential Biomarkers and Disease Drivers in Ocular Surface Disease. Eye Contact Lens 2021; 46 Suppl 2:S70-S83. [PMID: 31369467 DOI: 10.1097/icl.0000000000000641] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tears are highly concentrated in proteins relative to other biofluids, and a notable fraction of tear proteins are proteases and protease inhibitors. These components are present in a delicate equilibrium that maintains ocular surface homeostasis in response to physiological and temporal cues. Dysregulation of the activity of protease and protease inhibitors in tears occurs in ocular surface diseases including dry eye and infection, and ocular surface conditions including wound healing after refractive surgery and contact lens (CL) wear. Measurement of these changes can provide general information regarding ocular surface health and, increasingly, has the potential to give specific clues regarding disease diagnosis and guidance for treatment. Here, we review three major categories of tear proteases (matrix metalloproteinases, cathepsins, and plasminogen activators [PAs]) and their endogenous inhibitors (tissue inhibitors of metalloproteinases, cystatins, and PA inhibitors), and the changes in these factors associated with dry eye, infection and allergy, refractive surgery, and CLs. We highlight suggestions for development of these and other protease/protease inhibitor biomarkers in this promising field.
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Jia HZ, Pang X, Peng XJ. Changes of matrix metalloproteinases in the stroma after corneal cross-linking in rabbits. Int J Ophthalmol 2021; 14:26-31. [PMID: 33469480 DOI: 10.18240/ijo.2021.01.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To observe changes in the content of matrix metalloproteinases (MMPs) in the corneal stroma after corneal cross-linking (CXL) in rabbits, and further explore the corneal pathophysiological process after CXL. METHODS Forty-two rabbits (42 eyes) were randomly divided into seven groups. One group served as the control group, while the other six groups were treated with CXL. The concentrations of MMPs in corneal stroma were evaluated through parallel reaction monitoring at baseline and 3, 7, 15, 30, 90, and 180d after treatment. RESULTS The levels of MMP-2 in the corneal stroma of rabbits were 0.76±0.07, 2.78±1.39, 4.12±0.69, 2.00±0.29, 2.00±0.30, 1.22±0.18, and 1.35±0.18 (10-9 mol/g) at baseline and 3, 7, 15, 30, 90, and 180d after treatment, respectively. The contents of tissue inhibitor of metalloproteinase-1 (TIMP-1) were 1.83±0.26, 7.94±0.58, 6.95±2.64, 3.81±0.48, 3.07±0.92, 1.72±0.19, and 1.69±0.74 (10-9 mol/g), respectively. The ratios of MMP-2/TIMP-1 were 0.42±0.33, 0.36±0.20, 0.62±0.10, 0.54±0.15, 0.68±0.13, 0.71±0.10, and 0.68±0.09, respectively. After CXL, the expression of MMP-2 and TIMP-1 in the rabbit corneal stroma was initially increased and subsequently decreased. The levels of MMP-2 remained higher than those recorded at baseline 180d after treatment, but it was not statistically significant. The levels of TIMP-1 returned to baseline levels at 90d after treatment. The ratio of MMP-2/TIMP-1 started to rise from 7d after CXL. It was significantly higher than that calculated at baseline 30-180d after CXL. The results for MMP-1, -3, -7, -9, -13, and TIMP-2 were negative. CONCLUSION CXL can lead to changes in the content of MMP-2 and TIMP-1 in the rabbit corneal stroma. The ratio of MMP-2/TIMP-1 remains higher versus baseline, indicating that MMP-2 is involved in the corneal pathophysiological process after CXL.
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Affiliation(s)
- Hong-Zhen Jia
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Xu Pang
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Xiu-Jun Peng
- Department of Ophthalmology, the Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
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40
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Pinheiro-Costa J, Correia PJ, Pinto JV, Alves H, Torrão L, Moreira R, Falcão M, Carneiro Â, Madeira MD, Falcão-Reis F. Increased choroidal thickness is not a disease progression marker in keratoconus. Sci Rep 2020; 10:19938. [PMID: 33203915 PMCID: PMC7673983 DOI: 10.1038/s41598-020-77122-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/03/2020] [Indexed: 11/27/2022] Open
Abstract
The recent findings of increased Choroidal Thickness (CT) in Keratoconus (KC) patients raised the question of whether CT could be an indicator of progressive KC. To test this hypothesis, we evaluated and compared the choroidal profile in progressive and non-progressive KC. We ran a cross-sectional observational study in 76 patients diagnosed with KC, age 14–30, to assess KC progression. Progression was defined as when at least two of the studied variables confirmed progression (Kmax, Km, PachyMin, D-Index, Astig, K2, 3 mm PCR). Included patients performed a Spectralis Optical Coherence Tomography (OCT) with enhanced depth image (EDI) technology to evaluate choroidal profile. Choroidal measurements were taken subfoveally and at 500 µm intervals from the fovea, in 7 different locations, and compared between groups. Multivariate linear regression analyses were also performed to assess the influence of CT in KC progression. Thirty-six eyes (47.4%) were classified as KC progressors. The mean subfoveal CT observed in the total sample was 382.0 (± 97.0) μm. The comparison between groups (progressive and non-progressive KC) showed no differences in the locations evaluated (mean subfoveal CT difference between groups was 2.4 μm, p = 0.915). In the multivariate analysis CT seems not be influenced by KC progression (B = 6.72 μm, 95% CI − 40.09 to 53.53, p = 0.775). Assessment of choroidal profile does not appear to be a useful tool to differentiate progressive and non-progressive KC. Further research is needed in order to better understand the role of choroid in KC.
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Affiliation(s)
- João Pinheiro-Costa
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. .,Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.
| | | | - João Viana Pinto
- Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Hélio Alves
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Torrão
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Raul Moreira
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria Dulce Madeira
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
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Abstract
PURPOSE OF REVIEW To review the updated literature regarding eye rubbing complications and its association with ocular allergy disorders. RECENT FINDINGS Atopy and ocular allergy disorders, mainly vernal keratoconjunctivitis (VKC), are strongly associated with rubbing-related complications, most probably via itching and watery eye sensations that trigger the habit of chronic eye rubbing. Vigorous and prolonged rubbing may lead to establishment of corneal remodeling and ectatic disorders, such as keratoconus. Keratoconus development in rubbed eyes can be caused by mechanical mechanisms of corneal thinning and its loss of rigidity, by elevated temperature of the epithelium during rubbing, by increased intraocular pressure (IOP) because of distending forces, and by inflammatory molecules that may serve as a causal mediator between eye rubbing and keratoconus. Other eye rubbing complications include acute hydrops and perforation, IOP spikes, iris prolapse and iridoschisis rupture of lens capsule and IOL dislocation, and even posterior segment disorders, such as glaucomatous optic neuropathy, retinal detachment and extrusion of implanted silicone oil in the eye. SUMMARY Chronic eye rubbing in allergic eye diseases can lead to progression of keratoconus, and to other rare anterior and posterior segment complications. Strategies eliminating eye rubbing and its consequences are vital, mainly among at-risk populations, such as young children and individuals with allergic ocular disorders or corneal transplants.
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Lopes AG, de Almeida Júnior GC, Teixeira RM, de Mattos LC, Brandão de Mattos CC, Castiglioni L. Absence of the c.169+50delTAAACAG mutation of SOD1 gene in a sample of keratoconus patients in Brazilian population. BMC Res Notes 2020; 13:328. [PMID: 32646478 PMCID: PMC7346509 DOI: 10.1186/s13104-020-05166-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/30/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To determine the presence of the 7-bp deletion c.169+50delTAAACAG in intron 2 of Superoxide Dismutase-1 gene in keratoconic patients from the State of São Paulo, Brazil, which promotes splicing variations, resulting in non-functional Superoxide Dismutase-1 antioxidant proteins, which may damage the corneal structure. RESULTS A group of 35 keratoconic patients, from whom 35 peripheral blood samples and 58 samples of corneal fragments were evaluated, and a control group of 89 individuals, from whom 41 blood samples and 149 samples of corneal fragments were collected. After the amplification of DNA fragments by polymerase chain reaction, mutational screening analysis was performed by enzymatic digestion, followed by direct sequencing. The absence of the 7-bp c.169+50delTAAACAG mutation in intron 2 of Superoxide Dismutase-1 gene was detected in the analyzed subjects of the 2 groups, both in the cornea and peripheral blood samples. Then, according to our results, there is no involvement of c.169+50delTAAACAG deletion in the pathogenesis of keratoconus in this population, once it was not detected. But we emphasize that studies involving this deletion must be continued in an attempt to elucidate this issue.
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Affiliation(s)
- Alessandro Garcia Lopes
- Biology Department, Instituto de Biociências, Letras e Ciências Exatas, IBILCE-UNESP, Universidade Estadual Paulista "Júlio de Mesquita Filho,", Rua Cristóvão Colombo, 2265, São José do Rio Preto, São Paulo, 15054-000, Brazil.,Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, São Paulo, 15090-000, Brazil
| | - Gildásio Castello de Almeida Júnior
- Ophthalmology Outpatient Clinic, Hospital de Base de São José do Rio Preto, Fundação Faculdade Regional de Medicina (HB-FUNFARME), Avenida Brigadeiro Faria Lima, 5544, São José do Rio Preto, São Paulo, 15090-000, Brazil
| | - Ronan Marques Teixeira
- Biology Department, Instituto de Biociências, Letras e Ciências Exatas, IBILCE-UNESP, Universidade Estadual Paulista "Júlio de Mesquita Filho,", Rua Cristóvão Colombo, 2265, São José do Rio Preto, São Paulo, 15054-000, Brazil
| | - Luiz Carlos de Mattos
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, São Paulo, 15090-000, Brazil
| | - Cinara Cássia Brandão de Mattos
- Immunogenetics Laboratory, Molecular Biology Department, Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - Lilian Castiglioni
- Biology Department, Instituto de Biociências, Letras e Ciências Exatas, IBILCE-UNESP, Universidade Estadual Paulista "Júlio de Mesquita Filho,", Rua Cristóvão Colombo, 2265, São José do Rio Preto, São Paulo, 15054-000, Brazil. .,Epidemiology and Health Department, Faculdade de Medicina de São José do Rio Preto (FAMERP), Avenida Brigadeiro Faria Lima, 5416, Vila São Pedro, São José do Rio Preto, São Paulo, 15090-000, Brazil.
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Yang J, Zhao S, Tian F. SP1-mediated lncRNA PVT1 modulates the proliferation and apoptosis of lens epithelial cells in diabetic cataract via miR-214-3p/MMP2 axis. J Cell Mol Med 2020; 24:554-561. [PMID: 31755246 PMCID: PMC6933388 DOI: 10.1111/jcmm.14762] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/02/2019] [Accepted: 09/13/2019] [Indexed: 12/12/2022] Open
Abstract
Emerging evidence illustrates the critical roles of long non-coding RNAs (lncRNAs) in the diabetes. However, the deepgoing regulation of lncRNA PVT1 in the diabetic cataract (DC) is still unclear. Here, present research investigates the pathologic roles and underlying mechanism by which lncRNA PVT1 regulates the DC pathogenesis. Human lens epithelial (HLE) B-3 cells were induced by the high glucose (HG) to simulate the DC microenvironment models. Results revealed that lncRNA PVT1 expression was up-regulated in the HG-induced HLE B-3 cells as compared to the normal glucose group. Transcription factor SP1 could bind with the promoter region of PVT1 and activate its transcription. Functionally, PVT1 knock-down could repress the proliferation and promote the apoptosis of HLE B-3 cells. Mechanistically, PVT1 acted as the 'miRNA sponge' to target miR-214-3p/MMP2 axis. This finding revealed a novel insight of lncRNA PVT1 for the DC pathogenesis, providing an inspiration for the DC mechanism.
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Affiliation(s)
- Jun Yang
- Tianjin Medical University Eye HospitalTianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and OphthalmologyTianjinChina
| | - Shaozhen Zhao
- Tianjin Medical University Eye HospitalTianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and OphthalmologyTianjinChina
| | - Fang Tian
- Tianjin Medical University Eye HospitalTianjin Medical University Eye Institute & Tianjin Medical University School of Optometry and OphthalmologyTianjinChina
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Khaled ML, Bykhovskaya Y, Gu C, Liu A, Drewry MD, Chen Z, Mysona BA, Parker E, McNabb RP, Yu H, Lu X, Wang J, Li X, Al-Muammar A, Rotter JI, Porter LF, Estes A, Watsky MA, Smith SB, Xu H, Abu-Amero KK, Kuo A, Shears SB, Rabinowitz YS, Liu Y. PPIP5K2 and PCSK1 are Candidate Genetic Contributors to Familial Keratoconus. Sci Rep 2019; 9:19406. [PMID: 31852976 PMCID: PMC6920454 DOI: 10.1038/s41598-019-55866-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022] Open
Abstract
Keratoconus (KC) is the most common corneal ectatic disorder affecting >300,000 people in the US. KC normally has its onset in adolescence, progressively worsening through the third to fourth decades of life. KC patients report significant impaired vision-related quality of life. Genetic factors play an important role in KC pathogenesis. To identify novel genes in familial KC patients, we performed whole exome and genome sequencing in a four-generation family. We identified potential variants in the PPIP5K2 and PCSK1 genes. Using in vitro cellular model and in vivo gene-trap mouse model, we found critical evidence to support the role of PPIP5K2 in normal corneal function and KC pathogenesis. The gene-trap mouse showed irregular corneal surfaces and pathological corneal thinning resembling KC. For the first time, we have integrated corneal tomography and pachymetry mapping into characterization of mouse corneal phenotypes which could be widely implemented in basic and translational research for KC diagnosis and therapy in the future.
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Affiliation(s)
- Mariam Lofty Khaled
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Yelena Bykhovskaya
- Department of Surgery and Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Chunfang Gu
- Inositol Signaling Group, Signal Transduction Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alice Liu
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Michelle D Drewry
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Zhong Chen
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Barbara A Mysona
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA
| | - Emily Parker
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Ryan P McNabb
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Hongfang Yu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Xiaowen Lu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Jing Wang
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Xiaohui Li
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics and Medicine at Harbor-UCLA, Torrance, CA, USA
| | - Abdulrahman Al-Muammar
- Department of Ophthalmology, Glaucoma Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics and Medicine at Harbor-UCLA, Torrance, CA, USA
| | - Louise F Porter
- Department of Eye and Vision Science, University of Liverpool, and St Paul's Eye Unit, Royal Liverpool Hospital, Liverpool, UK
| | - Amy Estes
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA
- Department of Ophthalmology, Augusta University, Augusta, GA, USA
| | - Mitchell A Watsky
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA
| | - Sylvia B Smith
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA
- Department of Ophthalmology, Augusta University, Augusta, GA, USA
| | - Hongyan Xu
- Department of Population Health Science, Augusta University, Augusta, GA, USA
| | - Khaled K Abu-Amero
- Department of Ophthalmology, Glaucoma Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Anthony Kuo
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Stephen B Shears
- Inositol Signaling Group, Signal Transduction Laboratory, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Yaron S Rabinowitz
- Department of Surgery and Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA.
- James and Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, USA.
- Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, USA.
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McKay TB, Priyadarsini S, Karamichos D. Mechanisms of Collagen Crosslinking in Diabetes and Keratoconus. Cells 2019; 8:cells8101239. [PMID: 31614631 PMCID: PMC6830090 DOI: 10.3390/cells8101239] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 12/14/2022] Open
Abstract
Collagen crosslinking provides the mechanical strength required for physiological maintenance of the extracellular matrix in most tissues in the human body, including the cornea. Aging and diabetes mellitus (DM) are processes that are both associated with increased collagen crosslinking that leads to increased corneal rigidity. By contrast, keratoconus (KC) is a corneal thinning disease associated with decreased mechanical stiffness leading to ectasia of the central cornea. Studies have suggested that crosslinking mediated by reactive advanced glycation end products during DM may protect the cornea from KC development. Parallel to this hypothesis, riboflavin-mediated photoreactive corneal crosslinking has been proposed as a therapeutic option to halt the progression of corneal thinning by inducing intra- and intermolecular crosslink formation within the collagen fibrils of the stroma, leading to stabilization of the disease. Here, we review the pathobiology of DM and KC in the context of corneal structure, the epidemiology behind the inverse correlation of DM and KC development, and the chemical mechanisms of lysyl oxidase-mediated crosslinking, advanced glycation end product-mediated crosslinking, and photoreactive riboflavin-mediated corneal crosslinking. The goal of this review is to define the biological and chemical pathways important in physiological and pathological processes related to collagen crosslinking in DM and KC.
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Affiliation(s)
- Tina B McKay
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.
| | - Shrestha Priyadarsini
- Department of Ophthalmology/Dean McGee Eye Institute, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA.
| | - Dimitrios Karamichos
- Department of Ophthalmology/Dean McGee Eye Institute, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA.
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