A Case of Lens and Posterior Capsule Injury in Chandelier-Assisted Scleral Buckling for Rhegmatogenous Retinal Detachment.

Introduction: Rhegmatogenous retinal detachment (RRD) presents as a common ophthalmological emergency that impacts vision and may lead to blindness in the involved eye. Recently, chandelier-assisted scleral buckling (SB) is considered as one of procedures for the management of RRD. Herein, we present a case of acute cataract progression caused by a chandelier light during chandelier-assisted SB for RRD. Case Presentation: A 69-year-old male patient presented with right eye RRD. The best-corrected visual acuity (BCVA) was reduced to 20/40 in the right eye, and a retinal tear was observed at the upper temporal side with macula-off retinal detachment. The retinal tear was on the periphery, and the crystalline lens opacity was mild; therefore, the patient was treated with SB with a chandelier. Intraoperatively, posterior lens opacity was gradually observed, but it did not affect surgery. Thus, the surgery was completed as planned and retinal reattachment was confirmed. The day after surgery, the cataract had progressed, with a significantly decreased right BCVA of 20/400 in the right eye; therefore, cataract surgery was performed 2 months after the initial surgery. Because the posterior capsule had already ruptured, we performed lens extraction and anterior vitrectomy and fixed the intraocular lens with an optic capture. Postoperatively, the patient's BCVA had recovered to 20/40 in the right eye. Conclusion: SB with a chandelier is an effective treatment for visibility and educational purposes; however, several points of caution are raised. Proper care should be taken while handling the illumination in the SB.

A nerve-goblet cell association promotes allergic conjunctivitis through rapid antigen passage.

The penetration of allergens through the epithelial layer is the initial step in the development of allergic conjunctivitis. Although pollinosis patients manifest symptoms within minutes after pollen exposure, the mechanisms of the rapid transport of the allergens remain unclear. In the present study, we found that the instillation of pollen shells rapidly induces a large number of goblet cell-associated antigen passages (GAPs) in the conjunctiva. Antigen acquisition by stromal cells, including macrophages and CD11b+ dendritic cells, correlated with surface GAP formation. Furthermore, a substantial amount of antigen was transported to the stroma during the first 10 minutes of pollen exposure, which was sufficient for the full induction of an allergic conjunctivitis mouse model. This inducible, rapid GAP formation and antigen acquisition were suppressed by topical lidocaine or trigeminal nerve ablation, indicating that the sensory nervous system plays an essential role. Interestingly, pollen shell-stimulated GAP formation was not suppressed by topical atropine, suggesting that the conjunctival GAPs and intestinal GAPs are differentially regulated. These results identify pollen shell-induced GAP as a therapeutic target for allergic conjunctivitis.

The protective role of conjunctival goblet cell mucin sialylation.

Gel-forming mucins secreted by conjunctival goblet cells have been implicated in the clearance of allergens, pathogens, and debris. However, their roles remain incompletely understood. Here we show that human and mouse conjunctival goblet cell mucins have Alcian blue-detectable sialic acids, but not sulfates in the steady state. Interestingly, Balb/c mouse strain lacks this sialylation due to a point mutation in a sialyltransferase gene, St6galnac1, which is responsible for sialyl-Tn synthesis. Introduction of intact St6galnac1 to Balb/c restores the sialylation of conjunctival goblet cell mucus. Sialylated mucus efficiently captures and encapsulates the allergen particles in an impenetrable layer, leading to the protection of mice from the development of allergic conjunctivitis. Expression of ST6GALNAC1 and sialyl-Tn is upregulated in humans under conditions with chronic stimuli. These results indicate that the sialylated glycans on the ocular mucins play an essential role in maintaining the conjunctival mucosa by protecting from the incoming foreign bodies such as allergen particles.

Pollen shells and soluble factors play non-redundant roles in the development of allergic conjunctivitis in mice.

PURPOSE: We aimed to clarify the role of particulate allergen exposure to the conjunctiva in the development of allergic conjunctivitis. METHODS: We administered ragweed pollen suspension, pollen extract, pollen shell, particulate air pollutants, and their combinations to the mouse conjunctiva five days a week without prior sensitization. Clinical signs were scored. Histological changes, cellular infiltrations, mRNA expressions, lymph node cell recall responses, and serum immunoglobulin levels were assessed. Immune cell-depleting antibodies and ST2 knockout mice were used to investigate the cellular and molecular requirements. RESULTS: Pollen suspension, but not the extract or shell alone, induced robust eosinophilic conjunctivitis, accompanied by a proliferative response of epithelial cells. A combination of pollen extract and shell completely restored eosinophil accumulation. In addition, eosinophilic conjunctivitis was induced by a mixture of particulate air pollutants and pollen extract. Mechanistically, eosinophil accumulation was ameliorated by deficiency of the IL-33 receptor ST2 and abolished by depleting CD4+ T cells. Pollen shells, but not the extract, induced IL-33 release from conjunctival epithelial cells in vivo. CONCLUSIONS: Our results indicate the non-redundant roles for the allergens' particulate properties and soluble factors in the development of allergic conjunctivitis.

Characterization of a transglutaminase from scallop hemocyte and identification of its intracellular substrates.

Scallop hemocytes contain a transglutaminase (TGase) that is electrophoretically different from the TGase in the adductor muscle. The optimum temperature of the hemocyte TGase was lower (about 15 degrees C), compared with the muscle TGase (35-40 degrees C). Other properties, such as the high sodium chloride (NaCl) and CaCl2 concentrations required for activation, instability in salt solutions, and the Km values against monodansylcadaverine (MDC) and succinylated casein, were similar for both enzymes. When hemocyte homogenate was incubated with MDC at 10 degrees C, MDC was incorporated into the 230 k and 100 k proteins of the hemocytes. The 100 k protein was only detected in the supernatant, the 230 k protein was insoluble, and the 210 k protein was detected in both fractions. In the absence of MDC, the 230 k, 210 k, and 100 k proteins were cross-linked by endogenous transglutaminase. The 230 k protein was most quickly cross-linked and formed huge polymers within 5 min. These results suggest that if scallop tissues are injured, hemocyte transglutaminase may be activated, initially cross-linking the insoluble hemocyte 230 k protein, followed by the 210 k and 100 k proteins, to form a cross-linked protein matrix with inter cross-linking of hemocyte sheets, to stop the bleeding.

Aspolin, a novel extremely aspartic acid-rich protein in fish muscle, promotes iron-mediated demethylation of trimethylamine-N-oxide.

Trimethylamine-N-oxide (TMAO) is abundant in marine fish. Formaldehyde synthesis by TMAO demethylation during storage markedly deteriorates fish meat. In the present work, we cloned the extremely aspartic acid-rich proteins from skeletal muscle of a commercially important species, walleye pollack, in the course of molecular identification of trimethylamine-N-oxide demethylase (TMAOase). One of the cDNAs, designated as aspolin1, encodes an extremely aspartic acid-rich protein of 228 amino acids which is converted to the TMAOase after processing between Ala42 and Asp43. Mature aspolin1/TMAOase protein contains 179 Asp in 186 total amino acids. The other cDNA, designated as aspolin2, has a common nucleotide sequence with aspolin1 in the 5' part and encodes a protein which has an additional Asp polymer and a C-terminal cysteine-rich region. The amino acid sequence of the C-terminal cysteine-rich region of aspolin2 is highly homologous to the mammalian histidine-rich Ca2+-binding protein. Aspolin1/TMAOase and aspolin2 mRNA was most abundant in the skeletal muscle. A lower level of the mRNA was also detected in kidney, heart, spleen, and brain. Synthetic Asp polymer showed marked TMAOase activity in the presence of Fe2+, whereas a monomer and oligomers did not. Purified TMAOase protein bound to Fe2+ with low affinity, which may be responsible for the catalytic activity. Poly aspartic acid-Fe2+ complex generated after death would be involved in formaldehyde synthesis by the demethylation of TMAO during the storage of fish meat.