Studies on corneal polysaccharides. VI. Isolation of dermatan sulfate from corneal scar tissue

Keratocyte phenotype mediates proteoglycan structure: a role for fibroblasts in corneal fibrosis

In pathological corneas, accumulation of fibrotic extracellular matrix is characterized by proteoglycans with altered glycosaminoglycans that contribute to the reduced transparency of scarred tissue. During wound healing, keratocytes in the corneal stroma transdifferentiate into fibroblasts and myofibroblasts. In this study, molecular markers were developed to identify keratocyte, fibroblast, and myofibroblast phenotypes in primary cultures of corneal stromal cells and the structure of glycosaminoglycans secreted by these cells was characterized. Quiescent primary keratocytes expressed abundant protein and mRNA for keratocan and aldehyde dehydrogenase class 3 and secreted proteoglycans containing macromolecular keratan sulfate. Expression of these marker compounds was reduced in fibroblasts and also in transforming growth factor-beta-induced myofibroblasts, which expressed high levels of alpha-smooth muscle actin, biglycan, and the extra domain A (EDA or EIIIA) form of cellular fibronectin. Collagen types I and III mRNAs were elevated in both fibroblasts and in myofibroblasts. Expression of these molecular markers clearly distinguishes the phenotypic states of stromal cells in vitro. Glycosaminoglycans secreted by fibroblasts and myofibroblasts were qualitatively similar to and differed from those of keratocytes. Chondroitin/dermatan sulfate abundance, chain length, and sulfation were increased as keratocytes became fibroblasts and myofibroblasts. Fluorophore-assisted carbohydrate electrophoresis analysis demonstrated increased N-acetylgalactosamine sulfation at both 4- and 6-carbons. Hyaluronan, absent in keratocytes, was secreted by fibroblasts and myofibroblasts. Keratan sulfate biosynthesis, chain length, and sulfation were significantly reduced in both fibroblasts and myofibroblasts. The qualitatively similar expression of glycosaminoglycans shared by fibroblasts and myofibroblasts suggests a role for fibroblasts in deposition of non-transparent fibrotic tissue in pathological corneas.

Proteoglycan expression during transforming growth factor beta -induced keratocyte-myofibroblast transdifferentiation

Keratocytes of the corneal stroma secrete a unique population of proteoglycan molecules considered essential for corneal transparency. In healing corneal wounds, keratocytes exhibit a myofibroblastic phenotype in response to transforming growth factor beta (TGF-beta), characterized by expression of alpha-smooth muscle actin. This study examined proteoglycan and collagen expression by keratocytes in vitro during the TGF-beta-induced keratocyte-myofibroblast transition. TGF-beta-treated primary bovine keratocytes developed myofibroblastic features, including actin stress fibers anchored to paxillin-containing focal adhesions, cell-associated fibronectin, alpha(5) integrin, and alpha-smooth muscle actin. Collagen I and III protein and mRNA increased in response to TGF-beta. Secretion of [(35)S]sulfate-labeled keratan sulfate proteoglycans decreased markedly in response to TGF-beta. Dermatan sulfate proteoglycans, however, increased in size and abundance. Protein and mRNA transcripts for normal stromal proteoglycans (lumican, keratocan, mimecan, and decorin) all decreased in response to TGF-beta, but protein expression and mRNA for biglycan, a proteoglycan present in fibrotic tissue, was markedly up-regulated. These results show that TGF-beta in vitro induces a proteoglycan expression pattern similar to that of corneal scars in vivo. This altered proteoglycan expression occurred coordinately with transdifferentiation of keratocytes to the myofibroblastic phenotype, implicating these cells as the source of fibrotic tissue in nontransparent corneal scars.

The corneal stroma: an inhomogeneous structure

PURPOSE

This study was conducted to determine the elemental composition of the human cornea. Special attention was paid to corneal stroma inhomogeneity.

METHODS

Seventy human corneas were examined by means of energy-dispersive X-ray analysis. Epithelium, subepithelium, middle stroma, sub-Descemet layer, Descemet's membrane and endothelium were subjected to repeated measurements.

RESULTS

In the cellular layers the phosphorus concentrations were high [0.35 mol/kg dry weight (dw) in the epithelium and 0.403 mol/kg dw in the endothelium]. Similar concentrations were found for sulphur (0.38 mol/kg dw in the epithelium). Stromal layers showed high contents of sulphur: 0.26 mol/kg dw. The phosphorus concentration was found to be higher in the subepithelium than in the middle stroma. Sulphur concentrations were highest in Descemet's membrane, followed by the subepithelium and the middle stroma.

DISCUSSION

Nucleic acids and energy-containing phosphates explain the high levels of phosphorus in the cellular layers. The high sulphur concentrations may be related to the phosphoadenosinphosphosulfate and protein turnover in the epithelium. We interpret the inhomogeneous distribution of phosphorus in the stroma as a function of the density of keratocytes. An evaluation of all known sulphur-containing biochemical components of the stroma (0.217 mol sulphur/kg dw) corresponds to our measurements. In contrast to former results we find the corneal stroma to be an inhomogeneous structure.

Synthesis of stromal glycosaminoglycans in response to injury

Our goal is to examine the synthesis and deposition of corneal glycosaminoglycans (GAGs) in response to a wound created by the insertion of porous discs into stromal interlamellar pockets. The disc and the surrounding stromal tissue were assayed and compared to contralateral control stroma and to sham operated corneas at 14, 42, and 84 days. The tissue and/or discs were removed and labeled with 35S-sulfate for 18 h; GAGs were extracted with 4 M guanidine-HCl. Extracts were chromatographed on Q-Sepharose columns, bound proteoglycans were eluted with a linear salt gradient, and radioactive fractions were analyzed. Total GAG content was determined colorimetrically, using dimethylmethylene blue. Specific GAGs were determined using enzymatic digestion with selective polysaccharide lyases and protein cores were examined using SDS-PAGE. The nonbound fractions from the chromatography were assayed for TGF-beta using Western blot analysis and for hyaluronic acid using an 125I-radiometric assay. Specific GAGs were localized 42 days after the disc had been implanted in the stroma. The placement of the discs into the stroma resulted in a decrease in the total amount of GAG. However, the ratio of dermatan-chondroitin sulfate and heparan sulfate to keratan sulfate increased in the surrounding tissue and disc. Hyaluronic acid was elevated at day 14 in the surrounding tissue, and not until day 84 in the disc. Western blot analysis of surrounding tissue extracts revealed forms of TGF-beta that migrated with an apparent molecular mass of 63 and 43 kDa. The results indicate that the insertion of discs into interlamellar pockets causes changes in the sulfation and proportion of the glycosaminoglycans in the surrounding tissue and the disc. These changes are coincident with the appearance of TGF-beta. After 84 days, the population of glycosaminoglycans in the disc begins to resemble the surrounding stroma. This model will allow us to examine further the synthesis and deposition of proteins following an extensive wound in which cells must migrate to the wound site and then undergo extensive remodeling.

Altered lectin binding sites in keratoconus corneas

We investigated the glycoconjugates in frozen sections of keratoconus corneas, using a panel of 12 biotin- or fluorescein isothiocyanate-labeled lectins. No differences between the lectin binding sites of the epithelium, endothelium and Descemet's membrane of normal and keratoconus corneas could be observed. However, in contrast to normal corneas, intense staining with peanut agglutinin (PNA) could be detected at breaks in Bowman's layer, in scar tissue and in the adjacent stroma. Furthermore, in the majority of cases binding sites for Phaseolus vulgaris erythroagglutinin (PHA-E) and increased staining with Ricinus communis agglutinin I (RCA-I) and Lens culinaris agglutinin (LCA) could also be detected in ruptures in Bowman's layer and in scar tissue. These data suggest that the scarred regions of the anterior stroma in keratoconus corneas may contain oligosaccharides with terminal D-galactose (beta 1-3)-D-N-acetylgalactosamine disaccharides (recognized by PNA), increased amounts of glycoconjugates with terminal beta-galactose residues (recognized by RCA-I), increased amounts of glycoconjugates with glucose/mannose residues (recognized by LCA), and finally, biantennary complex-type glycopeptides containing two outer galactose residues and a residue of N-acetylglucosamine (recognized by PHA-E). Since corneal scars due to causes other than keratoconus revealed lectin binding sites (particularly for PNA and to a lesser extent also for PHA-E, LCA and RCA-I) similar to those seen in scar tissue of keratoconus corneas, we conclude that it is mainly scar formation that may be responsible for the altered lectin binding sites in keratoconus.

Unique parameters in the healing of linear partial thickness penetrating corneal incisions in rabbit: immunohistochemical evaluation

The healing of penetrating nonperforating linear corneal incisions in rabbit was analysed immunohistochemically. Regeneration of the basement membrane (BM) zone was evaluated by analysing the following components using monoclonal antibodies (MAbs): 1) an antigen designated AgHEBM1 (a 66k Mr polypeptide), 2) type VII collagen which is associated with anchoring fibrils and 3) an antigen designated Ag63/D7 which is associated with the lamina densa and anchoring plaques. Concomitant activity in the regenerating stroma was evaluated by analysing the distribution of 1) fibronectin, 2) keratan sulfate and 3) a fetal antigen, designated AgM12, (an intermediate filament associated protein with a Mr of 130k). Synthesis of the BM zone components was not evident at day 2 postwounding but was seen at day 7, only at the deepest aspects of the wounds. Re-establishment of a continuous BM zone was evident by day 60. The stromal regeneration had started by day 7, at the deepest aspect of the wounds, as judged from the distribution of stromal antigens including the fetal antigen AgM12. The number of activated cells (cells expressing AgM12) had decreased significantly by day 30 and diminished by day 60. Between day 30 and day 180 the thickness of the regenerated tissues had not increased significantly although the stroma had not yet reached its normal thickness. Even after six months, the epithelial plug persisted and the concentration of the sulfated epitopes of keratan sulfates in the regenerated stromal matrix were less than in the surrounding nonwounded regions. The cessation of expression of AgM12, by the cells in regenerating stroma, coincided with the relative decrease in extracellular matrix syntheses. The return of the stromal cells to the quiescent state also coincided with re-establishment of a continuous BM zone between the epithelium and the stroma in the regenerated tissue. These observations suggested that the synthesis, assembly and remodeling of stromal and epithelial extracellular matrices during the healing of penetrating corneal wounds may be influenced by the interactions between activated stromal cells and epithelial cells.

[Histochemical investigation of acid mucopolysaccharides in corneal wound healing of lamellar corneal grafts]

Histochemical investigations were carried out in a series of toluidine blue preparations of pH 3.8-5.2 of unfixed frozen corneal sections of lamellar keratoplasties in rabbit eyes to show alterations in the pattern of acid mucopolysaccharides during wound healing. The metachromasia in lamellar auto- and homokeratoplasties is mainly reduced in the region of the vertical host-graft junction. When using virgin silk the zone of reduced metachromasia in the vertical junction is broader compared with a 9/0-Nylon suture. The metachromasia of the lamellar transplant becomes normal in autokeratoplasties (Table 1) after a fortnight and in homokeratoplasties after 3 weeks; otherwise the metachromasia during the wound healing shows no significant difference in auto- and homokeratoplasties. The normal pattern of mucopolysaccharides in the corneal stroma does not return in the vertical host-graft junction, but this scar becomes smaller over a period of time (Fig. 3, 4, 5). There are no significant alterations of metachromasia found in the horizontal host-graft junction during wound healing between 1 day and 6 months, but starting from the 7th day after the lamellar keratoplsty using PAS-stain a small more PAS-intensive coloured line in the horizontal host-graft junction which is still there 6 months after the operation (Fig. 1, 2). When the 9/0 Nylon suture remains for 3 months, corneal vascularisation develops predominantly in the horizontal junction between host and lamellar graft. The graft becomes cloudy and the metachromasia remains reduced as long as 9 months after the suture has been removed (Table 2).

A light microscopic study of ground substance changes in alkali-burned corneas

Retrocorneal fibrous membranes occurred in 100% of 33 rabbit eyes burned with 4N sodium hydroxide. All membranes exhibited markedly positive colloidal iron/Alcian blue ground substance staining relative to unburned sections of the same corneas and to normal controls. Retrocorneal fibrous membranes also gradually acquired PAS reactivity greater than either unburned sections of the same corneas or uninjured eyes. Colloidal iron/Alcian blue reactivity of retrocorneal fibrous membranes was similar to that which developed in the alkali-induced stromal scars. One histologic section revealed retrocorneal membranogenesis by stromal components that had penetrated a small alkali-induced break in Descemet's membrane.

The synthesis of glycosaminoglycans by cultures of rabbit corneal endothelial and stromal cells

Confluent monolayer cultures of rabbit corneal endothelial and stromal cells were incubated independently with [35S]sulphate and [3H]glucosamine for 3 days. AFter incubation, labelled glycosaminoglycans were isolated from the growth medium and from a cellular fraction. These glycosaminoglycans were further characterized by DEAE-cellulose column chromatography and by sequential treatment with various glycosamino-glycan-degrading enzymes. Both endothelial and stromal cultures synthesized hyaluronic acid as the principal product. The cell fraction from the stromal cultures, however, had significantly less hyaluronic acid than that from the endothelial cultures. In addition, both types of cells synthesized a variety of sulphated glycosaminoglycans. The relative amounts of each sulphated glycosaminoglycan in the two cell lines were similar, with chondroitin 4-sulphate, chondroitin 6-sulphate and dermatan sulphate as the major components. Heparan sulphate was present in smaller amounts. Keratan sulphate was also identified, but only in very small amounts (1-3%). The presence of dermatan sulphate and the high content of hyaluronic acid are similar to the pattern of glycosaminoglycans seen in regenerating or developing tissues, including cornea.