HLA-DR Expression in Conjunctival Cells After Latanoprost

Abstract

The purpose of this randomized, controlled, masked study was to evaluate the effects of latanoprost 0.005% (Xalatan, Pharmacia and Upjohn, Milan, Italy) on the ocular surface in patients with ocular hypertension or primary open-angle glaucoma. The study group included 14 patients who underwent latanoprost 0.005% eye drops once a day in both eyes for 4 months. The control group underwent unpreserved substitute tears eye drops (Aquasalina, Bruschettini, Genoa, Italy) with the same posology and the same concentration of benzalkonium chloride (0.02%). Patients were controlled at 1, 3 and 4 months for symptoms, intraocular pressure, corneal sensitivity (Cochet-Bonnet test) and fluorescein staining. At the same control times, they underwent impression cytology and conjunctival brush cytology. Immunohistochemical techniques were used to detect HLA-DR expression in conjunctival cells. At each control, no significant statistical differences were found between the study and the control group, except for a higher expression of HLA-DR in the latanoprost group (p < 0.001). Since HLA-DR is a marker of ocular surface inflammation, this study suggests that a subclinical inflammatory reaction is present in the ocular surface of patients under latanoprost therapy. The pathway by which the inflammation is stimulated is yet unknown.

HLA-DR expression as a biomarker of inflammation for multicenter clinical trials of ocular surface disease

“…While some authors advocate brush histology (Guglielminetti et al , 2002; Pauly et al , 2007; Tsubota et al , 1990), in our hands, impression cytology yielded higher numbers of cells in the samples. Future innovations, such as a standardized sampling technique (OPIA Technologies, Paris, France) which uses a single use device to obtain IC conjunctival impressions of the living eye [presently under development (Roy, 2012)], could be adopted as soon as it is validated and becomes commercially available.…”

In vitro effects of preserved or preservative-free antiglaucoma medications on human complement system

“…6,8,[9][10][11] Recent studies have shown that administration for three months or more of topical glaucoma monotherapy preserved with benzalkonium, irrespective of type (latanoprost, betaxolol or timolol), induced a significant degree of subclinical inflammation detected as increased expression of HLA-DR class II antigens by conjunctival epithelial cells. [12][13][14] An inflammatory cell infiltrate was also observed in trabecular biopsies from multidrug-treated glaucoma patients. 8 It has been suggested that toxic and inflammatory changes of the ocular surface induced by long-term delivery of antiglaucoma drugs may constitute a significant risk factor of failure in glaucoma filtering surgery.…”

Comparative study of topical anti-allergic eye drops on human conjunctiva-derived cells: responses to histamine and IFNγ and toxicological profiles

“…In our experiments, we assayed ophthalmic drugs in their commercial preparations, so we had to take into account the possible effects of preservatives. It has been shown that administration for 3 months or more of a topical glaucoma monotherapy preserved with benzalkonium, irrespective of the type, induced a significant degree of subclinical inflammation detected as increased expression of HLA-DR class II antigens and ICAM-1 [25,39,54] as well as production of IL-6 and IL-8 [8] by conjunctival epithelial cells. Since it participates in the recruitment and migration of inflammatory cells, ICAM-1 is a critical element of the dynamic allergic and inflammatory processes, as illustrated by its overexpression after nasal and conjunctival challenges [7,14,17,18,49,58,61].…”