Inflammation and Keratoconus

McMonnies, Charles W.

doi:10.1097/opx.0000000000000455

Cited by 113 publications

(68 citation statements)

References 56 publications

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“…It is possible that these findings correspond to epiphenomena, a possibility already suggested by Lema et al 22 As suggested by McMonnies, 25 should a new category of diseases be established: quasi-inflammatory or inflammatory-related conditions?…”

Section: Resultsmentioning

confidence: 96%

“…As Mcmonnies 25 recently highlighted, another argument supporting the role of proinflammatory chemokines in corneal thinning is that in ocular rosacea several cases of pseudo-keratoconus have been reported. 121,122 Afonso et al 123 found higher concentration of IL-1 α and greater activity of MMP-9 in the tear fluid of patients with ocular rosacea than in control subjects.…”

Section: Corneal Stroma Compositionmentioning

confidence: 99%

“…Recent technological advances have enabled more sophisticated molecular studies of the keratoconic condition, which changed some of the previously conceived theories for its pathogenesis. 3,24,25,[73][74][75][76] Pathophysiologic components of keratoconus can be largely classified into the following: alterations of the stroma composition, imbalance of pro-inflammatory and anti-inflammatory molecules, imbalance of the enzymes that cause extracellular matrix degradation and their corresponding inhibitors, oxidative stress, and cellular hypersensitivity. These events occur simultaneously and may present positive feedback between one another.…”

Section: Pathophysiologymentioning

confidence: 99%

“…More recent studies have proved significant action of inflammatory mediators and a possible effect of oxidative stress, thus questioning the noninflammatory status of the disease. 3,[18][19][20][21][22][23][24][25] In 2002, Tachibana et al 26,27 reported that they established an inbred line of spontaneous mutant mice with keratoconus-affected corneas (SKC mice) resembling corneas of human eyes with keratoconus, but which were often associated with a red punctum at the apex.. They found that the red puncta seen in the center of the corneas were due to vascular infiltration and extravasations of blood cells, and the corneas showed lymphocyte infiltration.…”

Section: Introductionmentioning

confidence: 99%

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Keratoconus: an inflammatory disorder?

Galvis

Sherwin

Tello

et al. 2015

Eye

302

199

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Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition.

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Section: Resultsmentioning

confidence: 96%

Section: Corneal Stroma Compositionmentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Keratoconus: an inflammatory disorder?

Galvis

Sherwin

Tello

et al. 2015

Eye

302

199

View full text Add to dashboard Cite

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“…A family history of ocular manifestations of atopy or seasonal allergies may have more significance. 24 22 However, atopy may have other implications for the etiology of KC.…”

Section: Atopymentioning

confidence: 99%

Epigenetic Mechanisms Might Help Explain Environmental Contributions to the Pathogenesis of Keratoconus

McMonnies

2014

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

Self Cite

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The etiology of keratoconus (KC) seems to involve genetic and/or environmental factors such as rubbing and/or contact lens trauma and/or exposure to ultraviolet radiation. An examination of the possibility that epigenetic mechanisms could contribute to the tissue changes in KC has been considered in this review. The tissue changes in KC result in thinning and/or other forms of mechanical weakening of the cornea, which cause it to become more susceptible to the distending forces of intraocular pressure with associated development of a cone. Rather than being caused by a single gene mutation, a complex or multifactorial disease such as KC involves multiple genes plus lifestyle and environmental factors. The epigenome of a cell is highly dynamic, being governed by a complex interplay of genetic and environmental factors. The full range of epigenetic marks is currently unknown but is potentially enormous. Although further elucidation of the genetic determinants of KC is important, there is now increasing interest in exploring how non-genetic variants, such as epigenetic factors, could influence complex disease etiology. Studies of epigenetic processes in KC may help explain the relationship between the genome and the environment and provide new clues for modifying these processes with the possibility of preventing the development of KC or stabilizing its progress. Epigenetic linking may be relevant to other complex ocular diseases that involve environmental factors including those that involve exposure to ultraviolet radiation.

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Keratoconus at a Molecular Level: A Review

Volatier

Figueiredo

Connon

2019

The Anatomical Record

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Keratoconus is the most common ectatic disease of the cornea. The disease is usually detected between ages 15 and 25. Incidence is estimated at one out of every 2000 individuals, with some specific ethnic groups being more at risk. Keratoconus manifests itself as a progressive stromal thinning and deformation of the corneal tissue into a conical shape. The etiology of keratoconus is uncertain, although several studies have associated the disease to environmental factors, behavioral conditions and certain genetic disorders. In an effort to better understand how the corneal stroma becomes compromised, multiple experiments have been conducted over the last few years looking at the cells themselves and the factors they produce. The secretion pathways and levels of inflammatory molecules, growth factors, digestive enzymes, and apoptotic factors are all relevant to keratoconus. This review describes the current knowledge of keratoconic pathological signaling pathways within the cornea that may help future developments in disease prevention, treatment and modeling.

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Inflammation and Keratoconus

Cited by 113 publications

References 56 publications

Keratoconus: an inflammatory disorder?

Keratoconus: an inflammatory disorder?

Epigenetic Mechanisms Might Help Explain Environmental Contributions to the Pathogenesis of Keratoconus

Keratoconus at a Molecular Level: A Review

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