A Survey of Trachoma: The Histopathology and the Mechanism of Progressive Cicatrization of Eyelid Tissues

Güzey, Mustafa; Özardalı, İlyas; Başar, Emel; Aslan, Gönül; Satici, Ahmet; Karadede, Sezin

doi:10.1159/000027504

Cited by 47 publications

(32 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Serum amyloid A1 (SAA1) is an acute-phase protein, deposited at sites of inflammation. Amyloid deposition has previously been demonstrated in conjunctival biopsy tissue from individuals with trachomatous scarring (27).…”

Section: Discussionmentioning

confidence: 87%

Conjunctival Transcriptome in Scarring Trachoma

et al. 2011

View full text Add to dashboard Cite

Trachoma is a poorly understood immunofibrogenic disease process, initiated by Chlamydia trachomatis. Differences in conjunctival gene expression profiles between Ethiopians with trachomatous trichiasis (with [TTI] or without [TT] inflammation) and controls (C) were investigated to identify relevant host responses.Tarsal conjunctival swab samples were collected for RNA isolation and C. trachomatis PCR. Transcriptomewide microarray experiments were conducted on 42 samples (TTI, n ‫؍‬ 13; TT, n ‫؍‬ 15; C, n ‫.)41؍‬ Specific results were confirmed by using multiplex quantitative reverse transcription-PCR for 16 mRNA targets in an independent collection of case-control samples: 386 case-control pairs (TTI, n ‫؍‬ 244; TT, n ‫؍‬ 142; C, n ‫؍‬ 386). The gene expression profiles of cases were consistent with squamous metaplasia (keratins, SPRR), proinflammatory cytokine production (IL1␤, CXCL5, and S100A7), and tissue remodeling (MMP7, MMP9, MMP12, and HAS3). There was no difference in the level of IFN␥ between cases and controls. However, cases had increased INDO, NOS2A, and IL13RA2 and reduced IL13. C. trachomatis was detected in 1/772. Cases show evidence of ongoing inflammation and tissue remodeling, which were more marked where clinical inflammation was also present. Significantly, these processes appear to be active in the absence of current C. trachomatis infection. There was limited evidence of a T H 1 response (INDO and NOS2A) and no association between a T H 2 response and cases. The epithelium appears to be actively involved in late cicatricial stages of trachoma through the production of proinflammatory factors (IL1␤, CXCL5, and S100A7). Longitudinal studies are needed to investigate which etiological factors and pathways are associated with progressive scarring and whether simply controlling chlamydial infection will halt progression in people with established cicatricial disease.

show abstract

Section: Discussionmentioning

confidence: 87%

Conjunctival Transcriptome in Scarring Trachoma

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Histological studies of conjunctival biopsy specimens from scarred individuals show a chronic inflammatory cell infiltrate, especially in the substantia propria, with large numbers of lymphocytes (1,4,25,51). T cells, both CD4 ϩ and CD8…”

mentioning

confidence: 99%

Innate Immune Responses and Modified Extracellular Matrix Regulation Characterize Bacterial Infection and Cellular/Connective Tissue Changes in Scarring Trachoma

Weiss

Ramadhani

et al. 2012

Infect Immun

View full text Add to dashboard Cite

Trachoma is the most common infectious cause of blindness and a major public health problem in many developing countries. It is caused by recurrent ocular infection with Chlamydia trachomatis in childhood, with conjunctival scarring seen later in life. The pathogenesis of trachomatous scarring, however, is poorly understood, and this study was carried out to investigate the immunofibrogenic correlates of trachomatous conjunctival scarring. A case-control study of 363 cases with conjunctival scarring and 363 control participants was conducted. Investigations included in vivo confocal microscopy (IVCM) assessment, quantitative real-time PCR gene expression, C. trachomatis detection, and nonchlamydial bacterial culture. Trachomatous scarring was found to be strongly associated with a proinflammatory, innate immune response with increased expression of psoriasin, interleukin-1␤, tumor necrosis factor alpha, defensin-␤4A, chemokine ligand 5, and serum amyloid A1. There was also differential expression of various modifiers of the extracellular matrix, including metalloproteinases 7, 9, 10, and 12, tissue inhibitor of matrix metalloproteinase 1, and secreted protein acidic cystein-rich-like 1. The expression of many of these genes was also significantly associated with the presence of nonchlamydial bacterial infection. These infections had a marked effect on conjunctival immune processes, including an increased inflammatory infiltrate and edema seen with IVCM. This study supports the possibility that the immunofibrogenic response in scarring trachoma is partly stimulated by nonchlamydial bacterial infection, which is characterized by the expression of innate factors.

show abstract

“…Goblet cells, meibomian glands, lacrimal gland tissue and the ducts of these glands are compromised by sub-epithelial inflammation. 35 The histopathological findings of partial atrophy of meibomian glands and closure of the gland orifices suggest a decrease in the oily layer secretion, which is important in preventing rapid evaporation of the tear film. 36 A chain of events starts with the induction of sub-mucosal inflammation.…”

Section: Discussionmentioning

confidence: 99%

The effect of topical cyclosporine A treatment on corneal thickness in patients with trachomatous dry eye

Güzey

Satici

Karaman

et al. 2009

Clinical and Experimental Optometry

Self Cite

View full text Add to dashboard Cite

Purpose:The purpose of the present study was to evaluate the effect of topical cyclosporine A (CsA) treatment on corneal thickness (CT) in patients with trachomatous dry eye. Methods: Sixty-four patients with trachomatous dry eye with a Schirmer test showing 5 mm or less and a tear film break-up time (TFBUT) of five seconds or less were included. Thirty-two patients were treated with twice daily application of CsA (0.05% ophthalmic emulsion) plus non-preserved artificial tears, while the remaining 32 patients serving as controls received only non-preserved artificial tears. CT was measured using ultrasonic pachymetry at five locations of the central (CCT) and mid-peripheral cornea, at baseline and after one, three and six months of treatment. Results: At the sixth month of treatment, CT measurements were significantly changed in both groups, compared to baseline. In the CsA treatment group, the mean CCT before and after six months of treatment were 517.4 Ϯ 36.2 and 546.5 Ϯ 32.4 mm, respectively (p < 0.001); yielding an average CCT increase of 29.1 Ϯ 8.0 mm (5.62 per cent) from baseline. In the control group, corresponding figures were 520.2 Ϯ 34.2 and 526.0 Ϯ 35.4 mm, respectively (p < 0.01), with an average increase of 5.8 Ϯ 3.1 mm (1.11 per cent). Conclusions: In the present study, the CsA treatment group exhibited significantly greater increases in CT compared to controls. Such an increase may indicate an improvement in the integrity of the ocular surface and resolution of the underlying inflammation as a consequence of topical CsA treatment. Corneal thickness (CT) measurements provide valuable information on the physiological status of the cornea and its alterations associated with tear film changes, trauma and hypoxia. The tear film plays an important role in keeping the anterior surface of the cornea in an adequate physiological condition and in forming a smooth optical surface. The maintenance of a normal tear film depends on the maintenance of a normal ocular surface.The aqueous layer of the tear film is normally isotonic or slightly hypotonic. In all forms of dry eye, there is an increase in the osmolarity of the tear film, and the hypertonic tear film causes a decrease in CT.

show abstract

A Survey of Trachoma: The Histopathology and the Mechanism of Progressive Cicatrization of Eyelid Tissues

Cited by 47 publications

References 13 publications

Conjunctival Transcriptome in Scarring Trachoma

Conjunctival Transcriptome in Scarring Trachoma

Innate Immune Responses and Modified Extracellular Matrix Regulation Characterize Bacterial Infection and Cellular/Connective Tissue Changes in Scarring Trachoma

The effect of topical cyclosporine A treatment on corneal thickness in patients with trachomatous dry eye

Contact Info

Product

Resources

About