Correlación de niveles del factor de crecimiento transformante Beta-1 con severidad de vitreorretinopatía proliferativa en pacientes con desprendimiento de retina regmatógeno / Correlation of transforming growth factor Beta-1 vitreous levels with clinical severity of proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment

Objetivo: Correlacionar la concentración vítrea del factor de crecimiento transformante Beta-1 (TGFBeta-1), con el grado de severidad clínica de la vitreorretinopatía proliferativa (VRP). Diseño: Se realizó un estudio prospectivo, observacional, transversal de casos y controles. Participantes: Se incluyeron 40 pacientes con diagnóstico de VRP secundaria a desprendimiento de retina regmatógeno. Métodos: Se obtuvo vítreo en pacientes sometidos a vitrectomía pars plana por desprendimiento de retina regmatógeno, que fueron atendidos durante el periodo de agosto del 2015 a junio del 2016, en un centro de referencia nacional para la atención oftalmológica en la Ciudad de México, México. Se cuantificaron los niveles de TGFBeta-1 mediante técnica de ELISA. Se realizó una prueba ANOVA para la comparación de los distintos grupos junto con una prueba de Dunns post hoc. Se consideró una diferencia estadísticamente significativa al obtener p < 0,05. Resultados: Se cuantificaron los niveles de TGFBeta-1 y se encontraron las siguientes medias para cada grupo. En el grupo con VRP grado A, 1150,6 ± 452,08 pg/ml, VRP grado B: 1129,6 ± 365,54 pg/ml y VRP grado C: 1146,4 ± 330,21 pg/ml. El análisis estadístico no encontró diferencias significativas cuando se comparan los diferentes grupos de VRP (p = 0,53). Sin embargo, al realizar el análisis diferencial para cada grado de severidad, se observó un aumento estadísticamente significativo en la expresión de TGFBeta-1 en el grupo de pacientes con VRP-A, en relación con mayor número de días de evolución del desprendimiento (p = 0,03). Diferencias que no fueron estadísticamente significativas para VRP-B y C (p = 0,16) (p = 0,16). Conclusión: El comportamiento del TGFβ-1 no guardó relación directa con la severidad clínica, esto sugiere que debe haber otros factores involucrados en las etapas avanzadas de VRP, mientras que podría ser que el TGFβ-1 tenga mayor relevancia durante las etapas iniciales de la evolución clínica promoviendo la transición epitelial-mesenquimatosa debido a su mayor expresión en las etapas iniciales. De lo cual se puede concluir que cada isoforma desempeña un papel muy particular en el complejo proceso de la VRP

Objective: To correlate the vitreous concentration of transforming growth factor β-1 (TGF Beta-1) with the degree of clinical severity of proliferative vitreoretinopathy (PVR). Design: A prospective, observational, cross-sectional study carried out on cases and controls. Participants: The study included 40 patients with a diagnosis of PVR secondary to rhegmatogenous retinal detachment. Methods: Vitreous was obtained in patients undergoing pars plana vitrectomy by rhegmatogenous retinal detachment, who were treated during the period from August 2015 to June 2016, in a national reference centre for ophthalmological care in Mexico City, Mexico. The levels of TGFBeta-1 were quantified by ELISA technique. An ANOVA test was performed for the comparison of the different groups, together with a post-hoc Dunns test. A statistically significant difference was considered when obtaining P <.05. Results: The levels of TGFBeta-1 were quantified, and the following means were found for each group: In the group with PVR grade A, 1150.6 ± 452.08 pg / ml, PVR grade B: 1129.6 ± 365.54 pg / ml, and PVR grade C: 1146.4 ± 330.21 pg / ml. The statistical analysis did not find significant differences when comparing the different PVR groups. (P=.53). However, when performing the differential analysis for each level of severity, a statistically significant increase in the expression of TGFBeta-1 was observed in the group of patients with PVR-A at a greater number of days of evolution of the detachment. (P=.03). There were no statistically significant differences for PVR-B and PVR-C (P=.16 and P=.16, respectively). Conclusion: Although the levels of TGFBeta-1 are not directly related to the clinical severity grade, suggesting that there must be other factors involved in the advanced stages of PVR, TGFBeta-1 may have greater relevance during the initial stages of the clinical course by promoting the epithelial-mesenchymal transition due to its greater expression in PVR-A. Thus, it can be concluded that each isoform plays a very particular role in the complex process of PVR

Correlation of transforming growth factor ß-1 vitreous levels with clinical severity of proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment. / Correlación de niveles del factor de crecimiento transformante ß-1 con severidad de vitreorretinopatía proliferativa en pacientes con desprendimiento de retina regmatógeno.

OBJECTIVE: To correlate the vitreous concentration of transforming growth factor ß-1 (TGF ß-1) with the degree of clinical severity of proliferative vitreoretinopathy (PVR). DESIGN: A prospective, observational, cross-sectional study carried out on cases and controls. PARTICIPANTS: The study included 40 patients with a diagnosis of PVR secondary to rhegmatogenous retinal detachment. METHODS: Vitreous was obtained in patients undergoing pars plana vitrectomy by rhegmatogenous retinal detachment, who were treated during the period from August 2015 to June 2016, in a national reference centre for ophthalmological care in Mexico City, Mexico. The levels of TGFß-1 were quantified by ELISA technique. An ANOVA test was performed for the comparison of the different groups, together with a post-hoc Dunns test. A statistically significant difference was considered when obtaining P <.05. RESULTS: The levels of TGFß-1 were quantified, and the following means were found for each group: In the group with PVR grade A, 1150.6 ± 452.08 pg / ml, PVR grade B: 1129.6 ± 365.54 pg / ml, and PVR grade C: 1146.4 ± 330.21 pg / ml. The statistical analysis did not find significant differences when comparing the different PVR groups. (P=.53). However, when performing the differential analysis for each level of severity, a statistically significant increase in the expression of TGFß-1 was observed in the group of patients with PVR-A at a greater number of days of evolution of the detachment. (P=.03). There were no statistically significant differences for PVR-B and PVR-C (P=.16 and P=.16, respectively). CONCLUSION: Although the levels of TGFß-1 are not directly related to the clinical severity grade, suggesting that there must be other factors involved in the advanced stages of PVR, TGFß-1 may have greater relevance during the initial stages of the clinical course by promoting the epithelial-mesenchymal transition due to its greater expression in PVR-A. Thus, it can be concluded that each isoform plays a very particular role in the complex process of PVR.

Cicatricial changes in ocular pemphigus.

PURPOSE: To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. METHODS: A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. RESULTS: A total of 15 patients were identified, with a mean age of 68.27 ± 14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). CONCLUSIONS: The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series.

An imbalance between frequency of CD4+CD25+FOXP3+ regulatory T cells and CCR4+ and CCR9+ circulating helper T cells is associated with active perennial allergic conjunctivitis.

Allergic conjunctivitis (AC) is one of the most common eye disorders in ophthalmology. In mice models, it has been suggested that control of allergic conjunctivitis is a delicate balance between Tregs and inflammatory migrating effector cells. Our aim was to evaluate the frequency of Tregs and the frequency of homing receptors expressing cells in peripheral blood mononuclear cells (PBMC) from patients with perennial allergic conjunctivitis (PAC). The analyses of phenotypic markers on CD4+ T cells and both soluble or intracellular cytokines were performed by flow cytometry. CD4+CD25+ cells were 15 times more frequent in PBMC from patients than HC; the vast majority of these CD4+CD25+ cells were FOXP3-, and most of CD4+ T cells were CCR4+ and CCR9+ cells. Upon allergen-stimulation, no significant changes were observed in frequency of Treg; however, an increased frequency of CD4+CCR4+CCR9+ cells, CD4+CD103+ cells and CD4+CD108+ cells with increased IL-5, IL-6, and IL-8 production was observed. These findings suggest an immune dysregulation in PAC, characterized by diminished frequency of Tregs and increased frequency of circulating activated CD4+ T cells; upon allergen-stimulation, these cells were expressing cell-surface molecules related to mucosa homing and were able to trigger an inflammatory microenvironment.

Overexpression of peroxiredoxin 2 in pterygium. A proteomic approach.

Pterygium is one of the most frequent pathologies in ophthalmology, and is a benign, fibrovascular lesion originating from the bulbar conjunctiva. It is composed of an epithelium and highly vascular, subepithelial, loose connective tissue. The etiology of pterygium is not clearly understood; the most widely recognized originating factor is ultraviolet radiation. It has been proposed that pterygium and neoplasia have common features, raising the possibility that pterygium is a neoplastic-like growth disorder. In this study, proteomic analysis was performed to show that peroxiredoxin 2 is overexpressed in pterygia compared to healthy conjunctivas. Twelve pterygium specimens were obtained together with healthy conjunctival tissue from the same eyes. Total proteins of pterygia and healthy conjunctivas were analyzed in SDS-PAGE. This analysis showed protein bands expressed exclusively in pterygium samples at the range of 20-25 kDa. After this, 2D electrophoresis was performed for the separation of total proteins; differential spots expressed in pterygium were excised and sequenced. Mass spectrometry (MS) data were searched in the NCBInr and EST databases using the MASCOT program. The spot was identified as peroxiredoxin 2. Real-time PCR, western blot and immunohistochemistry showed that peroxiredoxin 2 was increased in pterygium compared to healthy conjunctiva. Although, these results suggest that overexpression of peroxiredoxin 2 in pterygium could protect the cell against oxidative stress-induced apoptosis, further studies are required to establish the functional role of peroxiredoxin 2 in pterygium to determine its role in peroxidation and apoptosis in this pathology.