Adult care providers' perspectives on the transition to adult care for emerging adults with Type 1 diabetes: a cross-sectional survey.

AIMS: To assess adult diabetes care providers' current transition practices, knowledge about transition care, and perceived barriers to implementation of best practices in transition care for emerging adults with Type 1 diabetes mellitus. METHODS: We administered a 38-item web-based survey to adult diabetes care providers identified through the Québec Endocrinologist Medical Association and Diabetes Québec. RESULTS: Fifty-three physicians responded (35%). Fewer than half of all respondents (46%) were familiar with the American Diabetes Association's transition care position statement. Approximately one-third of respondents reported a gap of >6 months between paediatric and adult diabetes care. Most (83%) believed communication with the paediatric team was adequate; however, only 56% reported receiving a medical summary and 2% a psychosocial summary from the paediatric provider. Respondents believed that the paediatric team should improve emerging adults' preparation for transition care by developing their self-management skills and improve teaching about the differences between paediatric and adult-oriented care. Only 31% had a system for identifying emerging adults lost to follow-up in adult care. Perceived barriers included difficulty accessing psychosocial services, emerging adults' lack of motivation, and inadequate transition preparation. Most (87%) were interested in having additional resources, including a self-care management tool and a registry to track those lost to follow-up. CONCLUSIONS: Our findings highlight the need to better engage adult care providers into transition care practices. Despite adult physicians' interest in transition care, implementation of transition care recommendations and resources in clinical care remains limited. Enhanced efforts are needed to improve access to mental health services within the adult healthcare setting.

[Multicentric evaluation of a self-screening questionnaire for occupational bladder cancer]. / Évaluation multicentrique d'un auto-questionnaire de dépistage des cancers de vessie d'origine professionnelle.

OBJECTIVE: Evaluate a self-screening questionnaire for bladder cancer of occupational origin and analyse an influence of exposure to a carcinogen bladder tumor on prognosis. PATIENTS AND METHODS: Five hundred and thirty-one patients followed, between 2005 and 2010, for bladder cancer in two university centers have received a self-screening questionnaire derived from questionnaire KVP 08. Patients who responded positively to at least one of the items were considered to have a self-screening questionnaire "positive". Patients were finally invited to take an appointment for consultation in occupational pathology. RESULTS: The response rate to self-screening questionnaire was 39.9% (212/531). It was "positive" in 82 cases (38.7%). Among the 82 patients with a self-screening questionnaire "positive", 46 patients consulted in occupational pathology (56%). Occupational exposure to a bladder carcinogen was documented in 91.3% of cases. Among the 22 patients who consulted in occupational pathology with a self-screening questionnaire "negative", an occupational exposure to a bladder carcinogen was documented in 13.6% of cases. The sensibility of the self-screening questionnaire was 91.3%, the specificity 86.4% and the accuracy 89.7%. The relative risk to have an occupational exposure if the self-screening questionnaire was "positive" was 6.69. The analysis of groups "positive" versus "negative" does not reveal any statistically significant difference in terms of tumor aggressiveness and disease-free survival. CONCLUSION: The self-screening questionnaire was considered relevant with good reliability for detection of occupational exposure to a bladder carcinogen.

[Prostatic Stromal Tumors of Uncertain Malignant Potential (STUMP): definition, pathology, prognosis and management]. / Tumeur stromale prostatique à potentiel malin incertain (STUMP) : définition, anatomopathologie, pronostic et prise en charge.

Prostatic Stromal Tumors of Uncertain Malignant Potential (STUMP) are rare tumor of the prostate of mesenchymal origin, accounting, with sarcoma for 0.1-0.2% of all malignant prostatic tumours. They however require to be individualized, to differentiate it from a benign prostatic hyperplasia or a sarcoma of the prostate. The therapeutic management should be made keeping in mind the risk of degeneration towards a malignant shape. Although the appropriate treatment is unknown, radical prostatectomy seem to be the treatment of reference, especially for young patient or for extensive lesion.

Developing a model of a patient-group pathway to accessing cancer clinical trials in Canada.

Background: Colorectal Cancer Canada, in partnership with a Scientific Advisory Committee, is developing a Canadian Patient Group Pathway to Accessing Cancer Clinical Trials ("Pathway"). A central element of the Pathway is presented here-namely, a set of recommendations and tools aimed at each stakeholder group. Methods: A summary of the peer-reviewed and grey literature informed discussions at a meeting, held in June 2017, in which a cross-section of stakeholders reached consensus on the potential roles of patient groups in the cancer clinical trials process, barriers to accessing cancer clinical trials, best practice models for patient-group integration, and a process for developing the Pathway. Canadian recommendations and tools were subsequently developed by a small working group and reviewed by the Scientific Advisory Committee. Results: The major output of the consensus conference was agreement that the Clinical Trials Transformation Initiative (ctti) model, successfully applied in the United States, could be adapted to create a Canadian Pathway. Two main differences between the Canadian and American cancer clinical research environments were highlighted: the effects of global decision-making and systems of regulatory and funding approvals. The working group modified the ctti model to incorporate those aspects and to reflect Canadian stakeholder organizations and how they currently interact with patient groups. Conclusions: Developing and implementing a Canadian Pathway that incorporates the concepts of multi-stakeholder collaboration and the inclusion of patient groups as equal partners is expected to generate significant benefits for all stakeholders. The next steps to bring forward a proposed Pathway will involve engaging the broader cancer research community. Clinical trial sponsors will be encouraged to adopt a Charter recognizing the importance of including patient groups, and to support the training of patient groups through an independent body to ensure quality research partners. Integration of patient groups into the process of developing "real world" evidence will be advanced by a further consensus meeting being organized by Colorectal Cancer Canada for 6-7 November 2018.

Effect of equilibration time on the motility and functional integrity of canine spermatozoa frozen in three different extenders.

The present work aimed to assess the effect of equilibration time on post-thaw motility parameters of canine sperm frozen in three extenders: 6% low-density lipoproteins (LDL), 6% liposomes (LIPO), and 40% egg yolk plasma (EYP). A second experiment is aimed at evaluating the functional integrity of canine spermatozoa frozen in the three extenders at the best equilibration time found in the experiment one. In the first experiment, 20 ejaculates harvested from 7 dogs, were frozen in three extenders (LDL, LIPO, and EYP) after four equilibration times (30min, 1h, 3h, and 6h). The semen was evaluated after thawing using an image analyser (HT-IVOS 14.0). The 6h equilibration time gave better results of motility and progressive motility in the three studied extenders. (LDL: 58.9% vs. 42.7%; LIPO: 54.4% vs. 31.9%; EYP: 55.4% vs 40.5% for motility 6 vs. 1h). In the second experiment, 10 ejaculates taken from 6 dogs were frozen under the same conditions as the previous experiment, after 6h equilibration time. The integrity parameters of the spermatozoal membrane (hypo-osmotic swelling test, and SYBR14/propidium Iodide staining), acrosome (FITC-Pisium sativum Aglutinin staining), and DNA (acridine orange staining) were evaluated at three different stages: post-dilution (T0), post-equilibration, and post-thawing. Post-thaw results were as follows: membrane integrity (HOSt: 62;6% vs 58% vs 64.4%; SYBR14/IP: 63.6% vs 57.9% vs 64.8%); acrosome integrity (FITC-PSA: 79.4% vs 74% vs 76.2%) and DNA integrity (Acridine-orange: 98.9% vs 98.5% vs 98.7%) respectively for LDL vs. LIPO vs. EYP. No significant difference existed between the extenders tested; thus 6%LIPO and 40%EYP could be good candidates for replacement of 6%LDL in the protection of canine sperm during the freeze-thaw process without altering motility and integrity parameters.

Can Chlamydia abortus be transmitted by embryo transfer in goats?

The objectives of this study were to determine (i) whether Chlamydia abortus would adhere to or penetrate the intact zona pellucida (ZP-intact) of early in vivo-derived caprine embryos, after in vitro infection; and (ii) the efficacy of the International Embryo Transfer Society (IETS) washing protocol for bovine embryos. Fifty-two ZP-intact embryos (8-16 cells), obtained from 14 donors were used in this experiment. The embryos were randomly divided into 12 batches. Nine batches (ZP-intact) of five embryos were incubated in a medium containing 4 × 10(7)Chlamydia/mL of AB7 strain. After incubation for 18 hours at 37 °C in an atmosphere of 5% CO2, the embryos were washed in batches in 10 successive baths of a phosphate buffer saline and 5% fetal calf serum solution in accordance with IETS guidelines. In parallel, three batches of ZP-intact embryos were used as controls by being subjected to similar procedures but without exposure to C. abortus. The 10 wash baths were collected separately and centrifuged for 1 hour at 13,000 × g. The washed embryos and the pellets of the 10 centrifuged wash baths were frozen at -20 °C before examination for evidence of C. abortus using polymerase chain reaction. C. abortus DNA was found in all of the infected batches of ZP-intact embryos (9/9) after 10 successive washes. It was also detected in the 10th wash fluid for seven batches of embryos, whereas for the two other batches, the last positive wash bath was the eighth and the ninth, respectively. In contrast, none of the embryos or their washing fluids in the control batches were DNA positive. These results report that C. abortus adheres to and/or penetrates the ZP of in vivo caprine embryos after in vitro infection, and that the standard washing protocol recommended by the IETS for bovine embryos, failed to remove it. The persistence of these bacteria after washing makes the embryo a potential means of transmission of the bacterium during embryo transfer from infected donor goats to healthy recipients and/or their offspring. Nevertheless, the detection of C. abortus DNA by polymerase chain reaction does not prove that the bacteria found was infectious. Further studies are required to investigate whether enzymatic and/or antibiotic treatment of caprine embryos infected by C. abortus would eliminate the bacteria from the ZP.

Direct regulatory effect of fatty acids on macrophage lipoprotein lipase: potential role of PPARs.

Atherosclerosis is a major complication of type 2 diabetes. The pathogenesis of this complication is poorly understood, but it clearly involves production in the vascular wall of macrophage (Mo) lipoprotein lipase (LPL). Mo LPL is increased in human diabetes. Peripheral factors dysregulated in diabetes, including glucose and free fatty acids (FAs), may contribute to this alteration. We previously reported that high glucose stimulates LPL production in both J774 murine and human Mo. In the present study, we evaluated the direct effect of FAs on murine Mo LPL expression and examined the involvement of peroxisome proliferator-activated receptors (PPARs) in this effect. J774 Mo were cultured for 24 h with 0.2 mmol/l unsaturated FAs (arachidonic [AA], eicosapentaenoic [EPA], and linoleic acids [LA]) and monounsaturated (oleic acid [OA]) and saturated FAs (palmitic acid [PA] and stearic acid [SA]) bound to 2% bovine serum albumin. At the end of this incubation period, Mo LPL mRNA expression, immunoreactive mass, activity, and synthetic rate were measured. Incubation of J774 cells with LA, PA, and SA significantly increased Mo LPL mRNA expression. In contrast, exposure of these cells to AA and EPA dramatically decreased this parameter. All FAs, with the exception of EPA and OA, increased extra- and intracellular LPL immunoreactive mass and activity. Intracellular LPL mass and activity paralleled extracellular LPL mass and activity in all FA-treated cells. In Mo exposed to AA, LA, and PA, an increase in Mo LPL synthetic rate was observed. To evaluate the role of PPARs in the modulatory effect of FAs on Mo LPL gene expression, DNA binding assays were performed. Results of these experiments demonstrate an enhanced binding of nuclear proteins extracted from all FA-treated Mo to the peroxisome proliferator-response element (PPRE) consensus sequence of the LPL promoter. PA-, SA-, and OA-stimulated binding activity was effectively diminished by immunoprecipitation of the nuclear proteins with anti-PPAR-alpha antibodies. In contrast, anti-PPAR-gamma antibodies only significantly decreased AA-induced binding activity. Overall, these results provide the first evidence for a direct regulatory effect of FAs on Mo LPL and suggest a potential role of PPARs in the regulation of Mo LPL gene expression by FAs.

In vitro bovine embryo production in a synthetic medium: embryo development, cryosurvival, and establishment of pregnancy.

The aim of this study was to develop an in vitro embryo culture medium without either fetal calf serum or BSA, using various growth factors and cytokines (GFs-CYKs; IGF-I, IGF-II, bFGF, LIF, GM-CSF, TGF-ß1, and PDGF-BB), and other molecules with surfactant and embryotrophic properties, such as recombinant albumin (RA) and hyaluronan (HA). The first part of the study was dedicated to define the best combination of GFs-CYKs + RA + HA for optimal embryonic development. Next, we compared development rates and embryo quality (inner cell mass [ICM]-to-total cell number [TCN] ratio), and postthaw survival and hatching rates using this synthetic medium (T1) and a control medium: synthetic oviduct fluid + BSA + ITS (insulin, transferrin, and selenium). The blastocyst rates were significantly higher with T1 than those with the control at 7 and 8 days after fertilization. There was no significant difference in TCN or the ICM/TCN ratio between the two treatments. Survival and hatching rates 48 hours after thawing were similar for both treatments. Finally, nine embryo transfers were conducted using fresh and previously frozen Day-7 blastocysts to evaluate the in vivo viability of embryos produced in this synthetic medium; four gestations were obtained from six fresh embryos and one gestation from three frozen embryos. In conclusion, the fetal calf serum and BSA-free medium, supplemented with GFs-CYKs + RA + HA, improved embryo development and gave comparable ICM/TCN ratios and postthaw survival rates to the control with BSA. Fresh and frozen embryos produced in this medium are viable for embryo transfer. This fully synthetic method of embryo culture is a useful means of reducing the risk of disease transmission via embryo transfer.

Suppression of Toll-like receptor-mediated innate immune responses at the ocular surface by the membrane-associated mucins MUC1 and MUC16.

Membrane-associated mucins (MAMs) expressed on the ocular surface epithelium form a dense glycocalyx that is hypothesized to protect the cornea and conjunctiva from external insult. In this study, the hypothesis that the MAMs MUC1 and MUC16, expressed on the apical surface of the corneal epithelium, suppress Toll-like receptor (TLR)-mediated innate immune responses was tested. Using an in vitro model of corneal epithelial cells that are cultured to express MAMs, we show that reduced expression of either MUC1 or MUC16 correlates with increased message and secreted protein levels of the proinflammatory cytokines interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF-α) following exposure of cells to the TLR2 and TLR5 agonists, heat-killed Listeria monocytogenes and flagellin, respectively. As mice express Muc1 (but not Muc16) in the corneal epithelium, a Muc1(-/-) mouse model was used to extend in vitro findings. Indeed, IL-6 and TNF-α message levels were increased in the corneal epithelium of Muc1(-/-) mice, in comparison with wild-type mice, following exposure of enucleated eyes to the TLR2 and TLR5 agonists. Our results suggest that the MAMs MUC1 and MUC16 contribute to the maintenance of immune homeostasis at the ocular surface by limiting TLR-mediated innate immune responses.

The Amount of MUC5B mucin in cervical mucus peaks at midcycle.

The physical character and amount of mucus secreted by the endocervix changes dramatically during the menstrual cycle to facilitate sperm migration at the time of midcycle ovulation. Mucins are highly glycosylated, high-molecular-weight proteins, which are the major structural components of the protective mucus gel covering all wet-surfaced epithelia, including that of the endocervix. We have previously demonstrated that the endocervical epithelium expresses messenger RNA (mRNA) of three of the large gel-forming mucins, designated MUC5AC, MUC5B, and MUC6, with mRNA of MUC5B predominating. Because mucin protein levels may be regulated posttranscriptionally, measurement of MUC5B protein levels with cycle are needed for correlation to mRNA levels. Measurement of specific mucin gene products within mucus secretions has been limited by availability of specific, well-characterized antibodies and by volume requirements of the isolation protocols for mucins, which include CsCl density centrifugation and fraction isolation. To measure MUC5B protein within the cervical mucus through the hormone cycle, we developed a polyclonal antibody specific to the mucin. The antibody, designated no. 799, is to a synthetic peptide mimicking a 19-amino-acid segment of an intercysteine-rich region within the D4 domain in the 3' region of the MUC5B protein. It recognizes native as well as denatured MUC5B on immunoblot, is preadsorbable with its peptide, and binds to apical secretory vesicles of epithelia expressing MUC5B. We used the MUC5B antibody along with a cervical mucin standard cervical mucin isolate in enzyme-linked immunosorbent assay to determine the relative amount of MUC5B mucin in samples of human cervical mucus taken through the menstrual cycle. We demonstrate a peak of MUC5B mucin in human cervical mucus collected at midcycle, compared with mucus from early or late in the cycle. This peak in MUC5B content coincides with the change in mucus character that occurs at midcycle, suggesting that this large mucin species may be important to sperm transit to the uterus.

An organ culture system for study of adherence of Pseudomonas aeruginosa to normal and wounded corneas.

An organ culture system has been developed to study the adherence of Pseudomonas aeruginosa to unwounded corneas and to corneas healing after a 3 mm central epithelial debridement. The Pseudomonas strain was isolated from a human corneal ulcer; suspensions containing 1 X 10(8) colony-forming units/ml (CFU/ml) of bacteria were incubated with the corneas for the last 30 min of the 18 hr culture period. The distribution pattern and number of adherent bacteria on the ocular surface were determined by morphometric analysis of scanning electron micrographs. Few bacteria (25 +/- 15/mm2) adhered to the apical cells of unwounded corneas. There was a definite region-specific distribution of adherent bacteria on healing corneas. There was a definite region-specific distribution of adherent bacteria on healing corneas. Most bacteria were found on the denuded basal lamina in front of the leading edge of the migrating epithelium (360,700 +/- 49,000/mm2). Appreciable but lower numbers adhered to the apical membrane of leading-edge cells (37,700 +/- 6,100/mm2) and to the central portion of the denuded basal lamina (28,800 +/- 10,700/mm2). No bacteria were found adherent to the apical cells of the stratified epithelium behind the leading edge of the epithelium migrating to cover the wound. A similar region-specific distribution of adherent bacteria was found when corneas were inverted in the bacterial suspension and when corneas were incubated in the bacterial suspension for 15 rather than 30 min. Corneas preincubated with the lectin, succinyl-concanavalin A, showed significantly decreased bacterial adherence, indicating a possible role for mannose moieties of wound surface glycoconjugates in bacterial adherence.

Anchoring fibrils form a complex network in human and rabbit cornea.

Anchoring fibril distribution, depth of penetration into the stroma, and pattern of histochemical localization of type VII collagen (the anchoring fibril collagen) were studied in normal human and rabbit corneas. Electron micrographs of cross sections and sections taken parallel to the basement membrane demonstrate that anchoring fibrils insert into the basal lamina and then splay out laterally. They are more readily seen in sections taken parallel to the basal lamina, where they are observed to form a complex branching and anastomosing network below the basal lamina. Distal to the basal lamina, anchoring fibrils appear to insert into patches of dense extracellular matrix termed "anchoring plaques." Average depth of penetration of anchoring fibrils into stroma is 0.60 and 0.54 microns for human and rabbit, respectively. Monoclonal antibodies to type VII collagen localize only to the basement membrane-anchoring fibril zone of both human and rabbit corneas. No obvious differences in anchoring fibril structure or distribution were observed between human corneas, which have a Bowman's layer, and rabbit corneas, which do not.

Localization of smooth muscle myosin-containing cells in the aqueous outflow pathway.

Cells containing smooth muscle myosin were localized in the human aqueous outflow pathway by immunohistochemical techniques. In the majority of eyes, immunoreactive cells were observed adjacent to the collector channels and slightly distal to the outer wall of Schlemm's canal. In a few eyes, smooth muscle myosin was localized to cells in the juxtacanalicular tissue and the trabecular meshwork. The immunoreactive cells from these regions may be true smooth muscle cells or pericytes, which can contain smooth muscle myosin. No obvious differences were observed in the pattern of distribution of smooth muscle myosin-containing cells in a comparison of age groups. In the majority of eyes, we observed an apparent direct insertion of the longitudinal portion of the ciliary muscle in the corneoscleral meshwork far internal to the scleral spur.

Reassembly of the anchoring structures of the corneal epithelium during wound repair in the rabbit.

Reappearance of the structures involved in adhesion of the corneal epithelium to the stroma was studied in healing 7 mm keratectomy wounds in rabbit corneas. Corneas were taken at 48 and 66 hr, 1, 2, 3, 4, 6 and 8 weeks, and 4, 6 and 12 months post-wounding. Immunolocalization of bullous pemphigoid antigen (BPA), laminin and type VII collagen was used to determine time and sequence of appearance of hemidesmosomes, basement membrane and anchoring fibrils, respectively. Electron micrographs from three regions in the wound were used to correlate the immunohistochemical data and to quantitate the increase in basal cell membrane occupied by hemidesmosomes and the increase in basement membrane over healing time. Evidence of resynthesis of the adhesion structures was present at the wound margin before epithelial wound closure (48 hr). BPA, laminin and type VII collagen co-localized, indicating that hemidesmosomes, basement membrane and anchoring fibrils reappeared synchronously. Reappearance of the structures proceeded from wound margin to the center, and by 1 week BPA, laminin, and type VII collagen were present in discontinuous segments across the wound. From 2 weeks to 6 months, the segments became more continuous, and anchoring fibril networks were discerned at 4 weeks. Strata of type VII collagen and laminin were present within the newly synthesized stromal matrix at wound margin at 1 week, continuous across the wound bed by 2-4 weeks, and still present at 6 months; however, at 12 months, only a few strata of type VII collagen were present below the basement membrane at wound center.(ABSTRACT TRUNCATED AT 250 WORDS)

Human corneal and conjunctival epithelia express MUC1 mucin.

PURPOSE: To determine if human corneal and conjunctival epithelial synthesize MUC1 mucin, a membrane-spanning mucin present in a variety of simple epithelia. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) was carried out to examine the expression of MUC1 mRNA by epithelial cells, using total cellular RNA prepared from cultured corneal epithelial cells and conjunctival epithelial cells stripped from the ocular surface with nitrocellulose filter paper. Northern blot analysis was performed to examine the transcription of MUC1 gene in cultured corneal epithelial cells. In situ hybridization histochemistry was performed to determine distribution of MUC1 mRNA in ocular surface epithelium. Human milk fat globule antibody (HMFG-1) and monoclonal antibody 139H2, which are specific for MUC1 core protein, were used in immunoblot analysis, immunohistochemistry, or both, to determine the presence and distribution of MUC1. RESULTS: MUC1 mRNA was detected in cultured corneal and ex vivo conjunctival epithelial cells by RT-PCR. Northern blot analysis showed production of two different sizes of transcripts in the cultured corneal epithelium. Expression of MUC1 mRNA was observed in all layers of corneal epithelium. By immunoblot analysis, HMFG-1 binding (> 200 kd) was detected in human cultured corneal epithelium, and its binding was enhanced by neuraminidase pretreatment. Immunohistochemically, HMFG-1 binding was observed along the apical membranes of corneal epithelium after neuraminidase pretreatment. In the conjunctiva, HMFG-1 and 139H2 binding were detected in the basal region and sporadically on the apical surface, but not in the goblet cells. CONCLUSIONS: The stratified epithelia of the cornea and conjunctiva synthesize MUC1 mucin. This transmembrane mucin may have a role in tear film spread and may prevent adhesion of foreign debris, cells, or pathogens to the ocular surface.

Integrins in the wounded and unwounded stratified squamous epithelium of the cornea.

PURPOSE: The authors determined the synthesis, cell surface expression, and localization of integrins in the rat corneal epithelium to detect whether any changes in integrins occur during epithelial migration in response to simple debridement wounding. METHODS: Immunoprecipitation analysis of extracts from either metabolically or surface-labeled rat epithelia was done to assess the synthesis and cell surface expression of integrins in the normal cornea. The localization of integrins was determined by indirect immunofluorescence of frozen sections obtained from control corneas and from those after debridement wounding. Immunoblotting of extracts from time course experiments was done on organ cultures of rat corneas after debridement to determine if any changes in the amounts of integrins occurred. The cell adhesion function of integrins on control and migrating epithelial cells was evaluated by cell adhesion assays. RESULTS: The data indicated that the corneal epithelium has a variety of distinct integrin subunits including beta 1, beta 4, beta 5, alpha 2, alpha 3, alpha 5, alpha 6, and alpha v. Although beta 1, beta 5, alpha 2, alpha 3, and alpha v were localized to sites of apparent cell-cell contact, alpha 5, alpha 6, and beta 4 were localized specifically to the basal membrane of the basal cells. Little change occurred in the localization of integrins in the migrating epithelial sheets. At 3, 6, 9, 12, 18, and 24 hr after wounding, the amount of the beta 1, beta 4, alpha 3, alpha 5, and alpha 6 integrin subunits (as measured by immunoblots) was not altered relative to that of the control corneas. Adhesion assays also showed no differences in adhesion of stationary versus migrating corneal epithelial cells to fibronectin and laminin. CONCLUSIONS: Integrin localization, production, and cell adhesion function in the stratified squamous epithelium of the cornea are not dramatically altered during epithelial cell migration over simple debridement wounds. Integrins in the cell membrane at sites of cell-cell interaction and as components of the hemidesmosomes in stationary epithelia may be available for rapid recruitment as epithelial cell migration proceeds.

Development of the anchoring structures of the epithelium in rabbit and human fetal corneas.

The sequence of development of the components of the corneal adhesion complex (hemidesmosomes, basal lamina and anchoring fibrils) was studied in rabbit and human fetal corneas using electron microscopy and histochemical localization of type VII (anchoring fibril) collagen. In the rabbit, basal lamina was present at 15 days gestation, followed by hemidesmosomes (HDs) and anchoring fibrils (AFs) at 20 days gestation. Type VII collagen was first localized at 20 days. At 25 days, HDs remained low compared to the adult value. During human corneal development, basal lamina was present at 8 weeks gestation. Through 12 weeks of gestation, no HDs or AFs were discernible nor was there any type VII localization. At 13-19 weeks, HDs and cross-banded AFs were seen, and localization of type VII collagen was first noted. A palisade of filaments extending perpendicularly from the basal lamina into the underlying stroma was discernible from 13 to 27 weeks. A distinct Bowman's layer was present at 19 weeks. By 27 weeks, HDs/micron membrane were greater than or equal to the adult value, and AF penetration into the underlying stroma was also greater than or equal to the adult value. Bowman's layer had not reached adult values by term. These data indicate that after basal lamina deposition, HDs and AFs develop synchronously in both species. In humans the palisade of filaments may be the precursor of Bowman's layer, and the AF network develops within Bowman's layer.

Biosynthetic responses of the rabbit cornea to a keratectomy wound.

Following a corneal wound involving removal of the epithelium and basement membrane, the epithelium must migrate across bare stroma. To examine the effect of the removal of the basement membrane on epithelial migration and on protein and glycoprotein synthesis in both the epithelium and stroma, we performed superficial keratectomies on rabbits and allowed the corneas to heal in organ culture. We then analyzed the following parameters: (1) rate of epithelial wound closure; (2) proteins synthesized during epithelial wound closure in both the epithelium and stroma using SDS-PAGE; and (3) presence of fibronectin in the epithelium and stroma using immunodot blots and immunofluorescence. We found that: (1) a 7 mm keratectomy wound heals in 66 hr with a maximal rate of epithelial migration of 0.83 mm2/hr; (2) four proteins, 400+K, 220K, 70K, and 58K, are present in the epithelium migrating to close the wound that are not seen in the control epithelium; (3) a 220K band is seen in the wounded stroma but not in control stroma; and (4) fibronectin represents 2% of the total protein in the stroma 66 hr post-keratectomy but less than 0.02% in wounded epithelium, unwounded epithelium, and unwounded stroma.

Characteristics of a glycoprotein in the ocular surface glycocalyx.

A monoclonal antibody has been produced that binds to the apical squames (flattened cells) of the rat ocular surface epithelium and to the goblet cells of the conjunctiva. Immunoelectron microscopic localization of the antigen indicates that in apical cells it is present along the apical-microplical membrane in the region of the glycocalyx. In subapical squames, the antigen is in cytoplasmic vesicles. In some goblet cells, the antigen is in the Golgi network, and in others, it is located primarily in the membrane of the mucous granules. SDS-PAGE and immunoblot analysis demonstrate that the molecular weight of the antigen is greater than 205 kD, and the electrophoretic band stains with Alcian blue followed by silver stain. Periodate oxidation of immunoblots and cryostat sections removes antibody binding. Neuraminidase treatment of cryostat sections does not remove antibody binding, whereas N-glycanase does. Taken together, these data indicate that the antigen recognized by the monoclonal antibody is a carbohydrate epitope on a high-molecular-weight, highly glycosylated glycoprotein in the glycocalyx of the ocular surface epithelium and goblet cell mucin granule membrane. The antigen appears to be stored within cytoplasmic vesicles and reaches the glycocalyx when cells differentiate to the apical-most position where the glycocalyx interfaces with the mucin layer of the tear film.

Alteration in goblet cell numbers and mucin gene expression in a mouse model of allergic conjunctivitis.

PURPOSE: To determine whether the number of filled conjunctival goblet cells and mucin gene expression are altered in a mouse model of allergic conjunctivitis. METHODS: A/J mice were sensitized intraperitoneally with cat dander or the peptide P3-1 from the protein Fel d1. Two weeks later, the mice were challenged for 7 consecutive days with eye drops containing the allergens. Conjunctival tissue was harvested at 0, 6, 24, or 48 hours after final antigen challenge. Control samples were naïve animals and mice sensitized with cat dander and challenged with OVA-peptide or PBS. The mean number of filled goblet cells per square millimeter in three forniceal fields for each group was determined in wholemounts of conjunctiva prepared using rhodamine-phalloidin labeling followed by confocal microscopy. RNA was isolated from conjunctiva of the contralateral eye and taken for relative quantitation of mRNA of the goblet cell mucin Muc5AC and the epithelial membrane-spanning mucin Muc4, by real-time RT-PCR. RESULTS: The number of filled goblet cells was significantly decreased with both cat dander and P3-1, after final ocular challenge (P < 0.001). The most significant decrease over naïve mice was seen at 6 hours after final challenge with both allergens. The number of filled goblet cells was still decreased but was returning toward naïve levels at 24 hours (P < 0.05), and at 48 hours no significant difference was seen compared with naïve, PBS-treated, and OVA-peptide-treated control samples. For both cat dander and P3-1, Muc5AC and Muc4 mRNA was found to be decreased at the time of final ocular challenge. The level of Muc5AC mRNA from goblet cells rebounded from the decrease to show an increase over control by 24 hours after final challenge, and by 48 hours, the mRNA level had returned to naïve control range. In contrast, significant increases in Muc5AC mRNA were evident after final control challenge with PBS or OVA-peptide, indicating a potential irritant effect of drop application. The Muc4 mRNA level was significantly reduced at all time points except 24 hours after the last challenge. By comparison with allergen-challenged eyes, no change in Muc4 message levels was noted at any time point in OVA-peptide- or PBS-treated control eyes. CONCLUSIONS: These findings demonstrate that, in the conjunctiva of mice, repetitive application of allergens induces a reduction in the number of filled goblet cells and a decrease in Muc5AC and Muc4 mRNAs. After a period of 24 to 48 hours, the goblet cell number return to naïve levels, and goblet cell mucin mRNA levels return to above or within normal range, indicating a rapid recovery in the mucus secretion system.