Clinical Study
Eye (2006) 20, 71–79. doi:10.1038/sj.eye.6701811; published online 4 March 2005
Immunopathogenesis of conjunctival remodelling in vernal keratoconjunctivitis
A M Abu El-Asrar1, S Al-Mansouri1, K F Tabbara1, L Missotten2 and K Geboes3
- 1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- 2Department of Ophthalmology, University of Leuven, Belgium
- 3Laboratory of Histochemistry and Cytochemistry, University of Leuven, Belgium
Correspondence: Professor AM Abu El-Asrar, Department of Ophthalmology, King Abdulaziz University Hospital, Airport Road, PO Box 245, Riyadh 11411, Saudi Arabia. Fax: 966 1 4775724/4775741; E-mail: abuasrar@KSU.edu.sa
Received 10 November 2004; Accepted 12 November 2004; Published online 4 March 2005.
Abstract
Purpose
To study the processes involved in mediating conjunctival remodelling in vernal keratoconjunctivitis (VKC) by investigating the expression of integrin receptors, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), transforming growth factor-
(TGF-), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), and Ki67 antigen, which is a marker for cell proliferation.
Methods
Conjunctival biopsy specimens from 16 patients with active VKC and nine control subjects were studied by immunohistochemical techniques using monoclonal and polyclonal antibodies directed against the integrin 
3 and 6 subunits, EGFR, VEGF, TGF-, bFGF, PDGF, and Ki67 antigen. The phenotype of inflammatory cells expressing growth factors was examined by double immunohistochemistry.
Results
In the normal conjunctiva, very weak immunoreactivity was observed for EGFR and VEGF in epithelial cells, and for 3 and 6 integrin subunits on basal epithelial cells, and on vascular endothelial cells in the upper substantia propria. There was no immunoreactivity for the other antibodies. In VKC specimens, strong staining for 3 and 6 integrin subunits was observed on the membranes of basal and suprabasal epithelial cells, and all vascular endothelial cells. Immunoreactivity for Ki67 antigen was observed in the nuclei of the basal and suprabasal epithelial cells. Strong immunoreactivity was observed for EGFR in the deeper layers of the epithelium, and for VEGF in all epithelial cells. Inflammatory cells expressing EGFR, VEGF, TGF-, bFGF, and PDGF were noted in 8, 9, 11, 10, and 10 specimens, respectively. The majority of inflammatory cells expressing growth factors were eosinophils (45
4%) and monocytes/macrophages (354%).
Conclusions
Chronic conjunctival inflammation in VKC is associated with increased staining of 3, and 6 integrin subunits, EGFR, VEGF, TGF-, bFGF, and PDGF that might mediate conjunctival remodelling.
Keywords:
allergy, conjunctiva, growth factors, integrins, Ki67 antigen
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