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Ding P, Wang R, He Y. Risk factors for pterygium: Latest research progress on major pathogenesis. Exp Eye Res 2024; 243:109900. [PMID: 38636803 DOI: 10.1016/j.exer.2024.109900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/18/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024]
Abstract
A pterygium is a wedge-shaped fibrovascular growth of the conjunctiva membrane that extends onto the cornea, which is the outer layer of the eye. It is also known as surfer's eye. Growth of a pterygium can also occur on the either side of the eye, attaching firmly to the sclera. Pterygia are one of the world's most common ocular diseases. However, the pathogenesis remains unsolved to date. As the pathogenesis of pterygium is closely related to finding the ideal treatment, a clear understanding of the pathogenesis will lead to better treatment and lower the recurrence rate, which is notably high and more difficult to treat than a primary pterygium. Massive studies have recently been conducted to determine the exact causes and mechanism of pterygia. We evaluated the pathogenetic factors ultraviolet radiation, viral infection, tumor suppressor genes p53, growth factors, oxidative stress, apoptosis and neuropeptides in the progression of the disease. The heightened expression of TRPV1 suggests its potential contribution in the occurrence of pterygium, promoting its inflammation and modulating sensory responses in ocular tissues. Subsequently, the developmental mechanism of pterygium, along with its correlation with dry eye disease is proposed to facilitate the identification of pathogenetic factors for pterygia, contributing to the advancement of understanding in this area and may lead to improved surgical outcomes.
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Affiliation(s)
- Peiqi Ding
- The Second Clinical Medical College of Jilin University, Changchun, 130012, Jilin Province, China
| | - Ruiqing Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China
| | - Yuxi He
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, Jilin Province, China.
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Ghosh S, Arora R, Hariani A, Saran R, Jain P. Study of biomarkers p53, Ki-67, Bcl-2, and VEGF in pterygium. Indian J Ophthalmol 2024; 72:S448-S452. [PMID: 38324633 DOI: 10.4103/ijo.ijo_2148_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To study the biomarkers present in primary pterygium samples of patients of Indian ethnicity and compare it with the samples obtained from the unaffected conjunctiva of the same eye. METHODS A prospective case-control study of 17 eyes in patients above 10 years of age with primary pterygium who underwent pterygium excision using limbal conjunctival autograft technique. The pterygium samples (cases) and conjunctival samples (controls) were sent for immunohistochemical (IHC) staining for the following biomarkers: p53, Bcl-2, Ki-67, and vascular endothelial growth factor (VEGF). RESULT The immunohistochemistry of the samples and the controls revealed p53 positivity in 47.05% of pterygium samples and 29.4% of controls ( P < 0.587). Nine cases each in pterygium and control samples were positive for Ki-67 expression. Differences in the staining pattern between the two groups were not statistically significant ( P < 1.000). Bcl-2 positivity was seen in 10 pterygium samples (58.8%) and 12 controls (70.5%), with no statistical difference between the two groups ( P < 0.455). VEGF expression was seen in both epithelial and endothelial cells of the samples and controls, with no statistical difference between the two groups, with P = 1.000 for the epithelial staining and P = 0.637 for endothelial staining. CONCLUSION The expression of biomarkers was comparable in both groups. We conclude that pterygium, against common belief, might not be a localized disease process but a global ocular phenomenon where the apparently healthy tissue also has some ongoing disease process at a molecular level.
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Affiliation(s)
- Shilpa Ghosh
- Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India
| | - Ritu Arora
- Cornea and Refractive Services, Shroff Eye Centre, New Delhi, India
| | - Avani Hariani
- Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India
| | - Ravindra Saran
- Department of Pathology, G B Pant Hospital, Maulana Azad Medical College, New Delhi, India
| | - Parul Jain
- Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India
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Liu H, Cheng J, Zhuang X, Qi B, Li F, Zhang B. Genomic instability and eye diseases. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:103-111. [PMID: 37846358 PMCID: PMC10577848 DOI: 10.1016/j.aopr.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 10/18/2023]
Abstract
Background Genetic information is stored in the bases of double-stranded DNA. However, the integrity of DNA molecules is constantly threatened by various mutagenic agents, including pollutants, ultraviolet light (UV), and medications. To counteract these environmental damages, cells have established multiple mechanisms, such as producing molecules to identify and eliminate damaged DNA, as well as reconstruct the original DNA structures. Failure or insufficiency of these mechanisms can cause genetic instability. However, the role of genome stability in eye diseases is still under-researched, despite extensive study in cancer biology. Main text As the eye is directly exposed to the external environment, the genetic materials of ocular cells are constantly under threat. Some of the proteins essential for DNA damage repair, such as pRb, p53, and RAD21, are also key during the ocular disease development. In this review, we discuss five ocular diseases that are associated with genomic instability. Retinoblastoma and pterygium are linked to abnormal cell cycles. Fuchs' corneal endothelial dystrophy and age-related macular degeneration are related to the accumulation of DNA damage caused by oxidative damage and UV. The mutation of the subunit of the cohesin complex during eye development is linked to sclerocornea. Conclusions Failure of DNA damage detection or repair leads to increased genomic instability. Deciphering the role of genomic instability in ocular diseases can lead to the development of new treatments and strategies, such as protecting vulnerable cells from risk factors or intensifying damage to unwanted cells.
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Affiliation(s)
- Hongyan Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
| | - Jun Cheng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
| | - Xiaoyun Zhuang
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Benxiang Qi
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
| | - Fenfen Li
- The Eye Hospital of Wenzhou Medical University, Hangzhou, China
| | - Bining Zhang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- School of Ophthalmology, Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, China
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Casciano F, Zauli E, Busin M, Caruso L, AlMesfer S, Al-Swailem S, Zauli G, Yu AC. State of the Art of Pharmacological Activators of p53 in Ocular Malignancies. Cancers (Basel) 2023; 15:3593. [PMID: 37509256 PMCID: PMC10377487 DOI: 10.3390/cancers15143593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
The pivotal role of p53 in the regulation of a vast array of cellular functions has been the subject of extensive research. The biological activity of p53 is not strictly limited to cell cycle arrest but also includes the regulation of homeostasis, DNA repair, apoptosis, and senescence. Thus, mutations in the p53 gene with loss of function represent one of the major mechanisms for cancer development. As expected, due to its key role, p53 is expressed throughout the human body including the eye. Specifically, altered p53 signaling pathways have been implicated in the development of conjunctival and corneal tumors, retinoblastoma, uveal melanoma, and intraocular melanoma. As non-selective cancer chemotherapies as well as ionizing radiation can be associated with either poor efficacy or dose-limiting toxicities in the eye, reconstitution of the p53 signaling pathway currently represents an attractive target for cancer therapy. The present review discusses the role of p53 in the pathogenesis of these ocular tumors and outlines the various pharmacological activators of p53 that are currently under investigation for the treatment of ocular malignancies.
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Affiliation(s)
- Fabio Casciano
- Department of Translational Medicine and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy
| | - Enrico Zauli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Massimo Busin
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", 47122 Forlì, Italy
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), 47122 Forlì, Italy
| | - Lorenzo Caruso
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Saleh AlMesfer
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh 12329, Saudi Arabia
| | - Samar Al-Swailem
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh 12329, Saudi Arabia
| | - Giorgio Zauli
- Research Department, King Khaled Eye Specialistic Hospital, Riyadh 12329, Saudi Arabia
| | - Angeli Christy Yu
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", 47122 Forlì, Italy
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), 47122 Forlì, Italy
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Okumus S, Ozcan E, Erbagci I. High-throughput screening of cytochrome P450 (CYP) family of genes in primary and recurrent pterygium. Exp Eye Res 2023:109522. [PMID: 37271310 DOI: 10.1016/j.exer.2023.109522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/15/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Pterygium is a common degenerative disease characterized fibrovascular outgrowth towards cornea. Around 200 million people have been reported to be affected by the pterygium in the world. Although the risk factors for pterygium are well documented, the molecular pathogenesis of pterygium seems to be very complex and remains highly elusive. However, the common sense for the development of pterygium appears to be deregulation of growth hemostasis due to aberrant apoptosis. In addition, pterygium shares many features with human cancers, including dysregulation of apoptosis, persistent proliferation, inflammation, invasion, and relapse following resection. Cytochrome P450 (CYP) monooxygenases are a superfamily of heme-containing enzymes with a wide range of structural and functional diversity. In the present study, we aimed to identify significant expression signatures of CYP gene in pterygium. For the study, a total number of 45 patients (30 primary and 15 recurrent pterygium) were included. For the high-throughput screening of CYP gene expression, Fluidigm 96.96 Dynamic Array Expression Chip was used and analyzed with BioMark™ HD System Real-Time PCR system. Remarkably, CYP genes were identified to be significantly overexpressed in both primary and recurrent pterygium samples. Most prominent overexpression was observed in CYP1A1, CYP11B2 and CYP4F2 in primary pterygium and CYP11A1 and CYP11B2 in recurrent pterygium. Consequently, present findings suggest the significant involvement of CYP genes in the development and progression of pterygium.
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Affiliation(s)
- Seydi Okumus
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey.
| | - Eyup Ozcan
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey
| | - Ibrahim Erbagci
- Ophthalmology Clinic, Netgoz Medical Center, Gaziantep, Turkey
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Omar AR, Ibrahim M, Jaafar H, Siti-Azrin AH, Zunaina E. Evaluation of Cyclooxygenase-2 and p53 Expression in Pterygium Tissue Following Preoperative Intralesional Ranibizumab Injection. Front Med (Lausanne) 2022; 8:733523. [PMID: 35004714 PMCID: PMC8739785 DOI: 10.3389/fmed.2021.733523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Overexpression of vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), and p53 are the postulated aetiopathogenesis in pterygium. VEGF is responsible for the induction of COX-2 expression, whereas p53 plays an important role in the regulation of VEGF. This study aimed to evaluate the immunohistochemistry of COX-2 and p53 expressions from excised pterygium tissue from patients who received intralesional ranibizumab (anti-VEGF) injection 2 weeks prior to pterygium surgery. Materials and Methods: An interventional comparative study involving patients presenting with primary pterygium was conducted between September 2015 and November 2017. The patients were randomized into either the intervention or control group. Patients in the intervention group were injected with intralesional ranibizumab (0.5 mg/0.05 ml) 2 weeks prior to surgery. Both groups underwent pterygium excision followed by conjunctival autograft. Immunohistochemistry staining was performed to evaluate COX-2 and p53 expressions in the excised pterygium tissue. Results: A total of 50 patients (25 in both the intervention and control groups) were recruited. There were 34 (68%) patients with grade III pterygium and 16 (32%) patients with grade IV pterygium. There was statistically significant difference in reduction of COX-2 expression in the epithelial layer [84.0% (95% CI: 63.9, 95.5)] (p = 0.007) and stromal layer [84.0% (95% CI: 63.9, 95.5)] (p < 0.001) between intervention and control groups. There was no significant difference in the reduction of p53 expression between the two groups. Conclusion: This study demonstrated the possible use of intralesional anti-VEGF treatment prior to pterygium excision as a potential future modality of adjunctive therapy for pterygium surgery.
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Affiliation(s)
- Ahmad Razif Omar
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Mohtar Ibrahim
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Hasnan Jaafar
- Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Ab Hamid Siti-Azrin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Embong Zunaina
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia
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The Role of the Stromal Extracellular Matrix in the Development of Pterygium Pathology: An Update. J Clin Med 2021; 10:jcm10245930. [PMID: 34945227 PMCID: PMC8707182 DOI: 10.3390/jcm10245930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 12/31/2022] Open
Abstract
Pterygium is a benign fibrovascular lesion of the bulbar conjunctiva with frequent involvement of the corneal limbus. Its pathogenesis has been mainly attributed to sun exposure to ultraviolet-B radiation. Obtained evidence has shown that it is a complex and multifactorial process which involves multiple mechanisms such as oxidative stress, dysregulation of cell cycle checkpoints, induction of inflammatory mediators and growth factors, angiogenic stimulation, extracellular matrix (ECM) disorders, and, most likely, viruses and hereditary changes. In this review, we aim to collect all authors’ experiences and our own, with respect to the study of fibroelastic ECM of pterygium. Collagen and elastin are intrinsic indicators of physiological and pathological states. Here, we focus on an in-depth analysis of collagen (types I and III), as well as the main constituents of elastic fibers (tropoelastin (TE), fibrillins (FBNs), and fibulins (FBLNs)) and the enzymes (lysyl oxidases (LOXs)) that carry out their assembly or crosslinking. All the studies established that changes in the fibroelastic ECM occur in pterygium, based on the following facts: An increase in the synthesis and deposition of an immature form of collagen type III, which showed the process of tissue remodeling. An increase in protein levels in most of the constituents necessary for the development of elastic fibers, except FBLN4, whose biological roles are critical in the binding of the enzyme LOX, as well as FBN1 for the development of stable elastin. There was gene overexpression of TE, FBN1, FBLN5, and LOXL1, while the expression of LOX and FBLN2 and -4 remained stable. In conclusion, collagen and elastin, as well as several constituents involved in elastic fiber assembly are overexpressed in human pterygium, thus, supporting the hypothesis that there is dysregulation in the synthesis and crosslinking of the fibroelastic component, constituting an important pathogenetic mechanism for the development of the disease.
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Mahesh M, Mittal SK, Kishore S, Singh A, Gupta N, Rana R. Expression of p53 and Ki-67 proteins in patients with increasing severity and duration of pterygium. Indian J Ophthalmol 2021; 69:847-850. [PMID: 33727444 PMCID: PMC8012974 DOI: 10.4103/ijo.ijo_1034_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose: Pterygium is a triangular fibrovascular subepithelial ingrowth of degenerative bulbar conjunctival tissue over the cornea. It is now considered to be a result of uncontrolled cellular proliferation as overexpression of p53 protein and Ki-67 nuclear protein was found in the epithelium. This study was done to find the expression of p53 and Ki-67 with the severity and duration of the pterygium to explain the etiopathogenesis. Methods: Data were analyzed from 43 Indian participants of all age groups. All patients were divided according to the severity of pterygium (mild, moderate, and severe groups) and according to the duration of pterygium (<4 years and >4 years). The samples were studied by immunohistochemistry by using antibodies against p53 and Ki-67 proteins considering >5% expression as significant. Results: Of 43 cases, p53 and Ki-67 expression were positive in 33 cases. In mild, moderate, and severe cases p53 positivity was 33.3%, 78.4%, 100%, respectively. P53 expression increased with duration, 79.3% positive in <4 years, and 92.9% positive in >4 years. With increasing severity of pterygium, mild, moderate, and severe cases, Ki-67 positivity was 66.7%, 78.37%, 66.7%, respectively. Ki-67 expression with duration, 79.3% positive in <4 years, and 85.7% positive in >4 years of the duration of pterygium with no statistical significance. Conclusion: Our study revealed that with increasing duration and severity of pterygium, p53 expression was observed to be increasing. Ki-67 expression increased with the duration of pterygium but not with the severity.
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Affiliation(s)
- Mood Mahesh
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev K Mittal
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anupam Singh
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neeti Gupta
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rimpi Rana
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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An Unexpected Incidence of Ocular Surface Neoplasia on Pterygium Surgery. A Retrospective Clinical and Histopathological Report. Cornea 2020; 40:1002-1006. [PMID: 33201056 DOI: 10.1097/ico.0000000000002586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/14/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the unexpected finding of ocular surface neoplasia (OSSN) on conjunctival tissue removed during pterygium surgery and subjected to histopathology analysis. METHODS This is an observational, descriptive retrospective study in which all the samples removed during surgery between 1997 and 2020 with a clinical diagnosis of pterygium were sent for histopathology analysis in which an unexpected OSSN was found. RESULTS There were 461 cases with a preoperative diagnosis of pterygium, with a mean age of 30.14 ± 10.6 years. In this group, there was an unexpected finding of OSSN in 69 cases (14.96%) of the surgical samples, with a mean age of 46 ± 8.2 years (31.86 ± 12.13). CONCLUSIONS The unexpected coincidence of pterygium and OSSN is frequent, although varies depending on the geographical location. We recommend performing a histopathology analysis on every pterygium removed.
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Turan M, Turan G. Bcl-2, p53, and Ki-67 expression in pterygium and normal conjunctiva and their relationship with pterygium recurrence. Eur J Ophthalmol 2020; 30:1232-1237. [PMID: 32703006 DOI: 10.1177/1120672120945903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Pterygium is a common lesion of the ocular surface, and its etiology and pathogenesis are still uncertain. This study aimed to investigate the role of apoptosis and proliferation in pterygium formation and recurrence. MATERIALS AND METHODS In this study, p53, Bcl-2, and Ki-67 expression levels were evaluated in primary pterygium (n = 35) and recurrent pterygium (n = 32) tissue samples and compared with normal conjunctiva (n = 30) tissue samples. In addition, recurrent pterygiums were divided into three groups based on recurrence time, and their p53, Bcl-2, and Ki-67 expression levels were compared. RESULTS The results show that p53, Bcl-2, and Ki-67 expression levels were significantly higher in the pterygium tissue samples as compared to the control group (p < 0.001, p < 0.001, and p < 0.001, respectively). When primary and recurrent pterygium tissues were compared, bcl-2 expression was higher in recurrent pterygium tissue samples (p = 0.003). However, when Ki-67 and p53 expression levels were evaluated, no significant difference was found between primary and recurrent pterygium (p = 0.215, p = 0.321, respectively). Also, p53 and Ki-67 expression were correlated in pterygium tissue samples, and Bcl-2 expression was significantly higher in pterygium that recurrence in the first 6 months after surgery. There was no difference between groups 1, 2, and 3 in terms of p53 and Ki-67 expression. CONCLUSION Antiapoptotic mechanisms and proliferation play an important role in the etiopathogenesis of pterygium. Furthermore, Bcl-2 expression may be important in pterygium recurrence.
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Affiliation(s)
- Meydan Turan
- Ophthalmology Clinic, Balikesir Ataturk City Hospital, Balikesir, Turkey
| | - Gulay Turan
- Department of Pathology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
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Denis E, Pauline A, Charity Z, Pius M, Jacob N, Agaba CA. Pterygium in Uganda: A hospital-based study. COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1724602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Erima Denis
- Department of Ophthalmology, Makerere University College of Health Science Uganda
| | - Ayebare Pauline
- Department of Ophthalmology, Mulago National Referral Hospital Uganda
| | - Zalwango Charity
- Department of Ophthalmology, Mulago National Referral Hospital Uganda
| | - Mwanja Pius
- Department of Ophthalmology, Mulago National Referral Hospital Uganda
| | - Ntende Jacob
- Department of Ophthalmology, Mulago National Referral Hospital Uganda
| | - C. Ateenyi Agaba
- Department of Ophthalmology, Mulago National Referral Hospital Uganda
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12
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Zaheryani SMS, Ebrahimi ME, Kasaei A, Roointan A, Nejabat M, Dianatpour M, Meisam M, Talebnejad MR, Naghibalhossaini F. Expression of Inflammatory-Related NFκB Genes in Iranian Patients with Pterygium: A Case-Control Study. INTERNATIONAL JOURNAL OF MOLECULAR AND CELLULAR MEDICINE 2018; 7:169-175. [PMID: 31565648 PMCID: PMC6744617 DOI: 10.22088/ijmcm.bums.7.3.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/18/2018] [Indexed: 12/02/2022]
Abstract
Pterygium is one of the most common eye conditions without any clear etiology. Some studies have suggested an association between sun exposure and pterygium, but others have proposed the role of genetic variations in its pathogenesis. To date, no study has investigated the association of inflammatory transcription factor, NFκB genes with pterygium in the Middle East. We examined the changes in expression of 3 inflammatory related NFκB1, NFκB2, and RELA genes in patients with pterygium. Thirty patients with pterygium and 30 age and sex-matched controls were enrolled in this case-control study. None of the participants showed any clinical signs of inflammation in their conjunctiva. Demographic information was obtained and the expression levels of three genes including NFκB1, NFκB2, and RELA were measured in their conjunctiva by real-time RT-PCR using gene-specific primers. Mean expression level of NFκB1, NFκB2 and RELA genes in patients were 2.4±0.3, 1.9± 0.5, and 1.8±0.4 times higher than normal subjects, respectively. Higher levels of gene expression were observed in individuals with more outdoor activity and sun exposure. Moreover, a significant correlation was observed between the expression levels of NFκB2 and RELA genes, suggesting a possible NFκB2- RELA heterodimer formation in patients with pterygium. This study has indicated a significant association between expressions of inflammatory-related NFκB1, NFκB2 and RELA genes, and pterygium. Further studies to verify the role of inflammation in the pathogenesis of pterygium, may provide new targets for managing pterygia.
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Affiliation(s)
| | | | - Abdollah Kasaei
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Roointan
- Department of Medical Biotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Nejabat
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Dianatpour
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Meisam Meisam
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
PURPOSE To demonstrate the long-term outcome of pterygium surgery with adjunctive amniotic membrane transplantation (AMT) and intraoperative mitomycin C (MMC) in a large case series. METHODS Medical records were retrieved for this noncomparative retrospective study of all patients who had pterygium excision with adjunctive AMT and intraoperative MMC, from October 2010 to June 2016 with at least 6 months of follow-up. RESULTS There were a total of 556 eyes of 535 patients (291 males and 244 females) with average age of 51.9 ± 13 years who had pterygium excision (527 primary and 29 recurrent). For an average follow-up period of 17.3 ± 0.8 months (range 6-74 months), corneal recurrence occurred in 20 eyes (3.6%) and conjunctival recurrence in 12 (2.2%) in a total of 32 eyes (5.8%). Eleven eyes (2%) underwent reoperation. Other complications included granuloma (0.5%), diplopia (1.1%), and steroid-induced ocular hypertension (4.3%). CONCLUSIONS Adjunctive use of AMT and short exposure of MMC can reduce recurrence after pterygium surgery. The procedure is less tedious and less time consuming, resulting in early recovery while saving the conjunctiva for future surgeries.
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14
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Lan W, Hou A, Lakshminarayanan R, Lim Y, Tong L. Linc‐9432 is a novel pterygium linc
RNA
which regulates differentiation of fibroblasts. FEBS Lett 2018. [DOI: 10.1002/1873-3468.13027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Wanwen Lan
- Ocular Surface Research Group Singapore Eye Research Institute Singapore
| | - Aihua Hou
- Ocular Surface Research Group Singapore Eye Research Institute Singapore
- Duke‐NUS Graduate Medical School Eye‐Academic Clinical Program Singapore Singapore
| | | | - Yoon‐Pin Lim
- Department of Biochemistry Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Louis Tong
- Ocular Surface Research Group Singapore Eye Research Institute Singapore
- Duke‐NUS Graduate Medical School Eye‐Academic Clinical Program Singapore Singapore
- Department of Cornea and External Eye Disease Singapore National Eye Center Singapore
- Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore
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15
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Onur C, Orhan D, Orhan M, Dizbay Sak S, Tulunay O, Irkeç M. Expression of p53 Protein in Pterygium. Eur J Ophthalmol 2018; 8:157-61. [PMID: 9793769 DOI: 10.1177/112067219800800307] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The pathogenesis of pterygium is still not completely understood and many environmental factors, including ultraviolet (UV) radiation, play an important role in its etiology. Chronic exposure to UV radiation causes mutations in the p53 tumor suppressor gene, eventually leading to tumor formation. We analyzed the immunohistochemical expression of p53 proteins in pterygial tissues to determine the role of the p53 tumor suppressor gene in the development of pterygium. Methods Pterygial specimens were studied immunohistochemically using antibodies against p53 protein. Results Out of 38 specimens studied, 35 (92.1%) had conjunctival epithelial cells without p53 specific nuclear staining. Only three specimens (7.9%) had a few p53 stained cells. The role of UV radiation in the pathogenesis of pterygium is supported by epidemiological, geographical and microscopic findings. However, our results are not consistent with these data on a genetic basis. Conclusions We conclude that defective p53 tumor suppressor gene function seems to have no role in the pathogenesis of pterygium.
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Affiliation(s)
- C Onur
- Department of Ophthalmology, University of Hacettepe, Ankara, Turkey
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16
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Teng Y, Yam GHF, Li N, Wu S, Ghosh A, Wang N, Pang CP, Jhanji V. MicroRNA regulation of MDM2-p53 loop in pterygium. Exp Eye Res 2018; 169:149-156. [PMID: 29360447 DOI: 10.1016/j.exer.2018.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/12/2017] [Accepted: 01/17/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The pathogenesis of pterygium has been linked to limbal stem cell damage, abnormal apoptosis and cellular proliferation. In this study, we investigated the epigenetic regulation through microRNA expression in the pathogenesis of pterygium. METHODS Human full-length primary pterygia were microdissected into head and body regions. Specific microRNA and mRNA expression was assayed by TaqMan® real-time quantitative polymerase chain reaction (qPCR). Tissue localization of target microRNAs was performed by LNA-based in situ hybridization. MicroRNA-145 (miR-145) mimics were transfected to primary culture of human pterygial cells, followed by analyses of cell cycle changes, apoptosis, p53 and MDM2 expression using flow cytometry and qPCR. RESULTS The expression of miR-145 was markedly higher in primary human pterygium than in limbus and conjunctiva. Both miR-143 and miR-145 were predominantly expressed in the basal pterygial epithelium. Oncogene MDM2 expression was abundant in pterygial epithelium and stroma, while the expression pattern was opposite to that of miR-145. Ectopic expression of miR-145 in pterygial cells induced G1 arrest, down-regulated MDM2 and elevated p53 expression. CONCLUSIONS Our study showed that miR-145 suppressed MDM2 expression, which subsequently influenced the p53-related cell growth pattern in pterygial epithelium. The regulatory miR-145/MDM2-p53 loop can serve as a potential target for treatment of pterygium.
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Affiliation(s)
- Yufei Teng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Gary Hin-Fai Yam
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore
| | - Na Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Shen Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Arkasubhra Ghosh
- GROW Research Laboratory, NarayanaNethralaya Foundation, Narayana Health City, Bommasandra, Bangalore, Karnataka, India
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
| | - Chi-Pui Pang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Vishal Jhanji
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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17
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Maxia C, Murtas D, Corrias M, Zucca I, Minerba L, Piras F, Marinelli C, Perra MT. Vitamin D and vitamin D receptor in patients with ophthalmic pterygium. Eur J Histochem 2017; 61:2837. [PMID: 29313597 PMCID: PMC5686448 DOI: 10.4081/ejh.2017.2837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 02/06/2023] Open
Affiliation(s)
- Cristina Maxia
- University of Cagliari, Department of Biomedical Sciences.
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18
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Mantagos IS, Kleinman ME, Kieran MW, Gordon LB. Ophthalmologic Features of Progeria. Am J Ophthalmol 2017; 182:126-132. [PMID: 28756152 DOI: 10.1016/j.ajo.2017.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE To establish the natural history of ophthalmic characteristics in Progeria patients and to determine incidence of ocular manifestations. DESIGN Retrospective case series of patients with Progeria who were seen between 2007 and 2016. METHODS Setting: Tertiary-care academic center. PATIENT POPULATION Fourteen patients (28 eyes) with Hutchinson-Gilford Progeria syndrome were included for statistical analysis from a total of 84 patients who have been enrolled in clinical trials for Progeria at Boston Children's Hospital. Clinical treatment trial patients who were not seen at the Department of Ophthalmology at our hospital, but for whom we had detailed clinical ophthalmologic records, were also included. This essentially represents an estimated 20% of the world's known patients with Progeria. Interventions or Observation Procedures: Complete ophthalmic examination. MAIN OUTCOME MEASURES Visual acuity, stereoacuity, refraction, clinical findings of slit-lamp and dilated fundus examinations. RESULTS Ophthalmic manifestations noted were hyperopia and signs of ocular surface disease owing to nocturnal lagophthalmos and exposure keratopathy. Additional ophthalmic manifestations included reduced brow hair, madarosis, and reduced accommodation. Most patients had relatively good acuity; however, advanced ophthalmic disease was associated with reduced acuity. CONCLUSIONS Children with Progeria are at risk for serious ophthalmic complications owing to ocular surface disease. Children with Progeria should have an ophthalmic evaluation at the time of diagnosis and at least yearly after that. Aggressive ocular surface lubrication is recommended, including the use of tape tarsorrhaphy at night.
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19
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Abstract
Pterygium is a degenerative condition characterized by fibrovascular outgrowth of conjunctiva over the cornea. Many theories exist that try to explain its pathogenesis. The current belief is that this disease is multifactorial with ultraviolet radiation being the most important trigger. Attention is also paid to such factors as tear film changes, cytokines and growth factors disbalance, immunologic disturbances, genetic mutations, and viral infections. Modern classifications consider the rate of fibrovascular growth, its progressive potential, and histological features. In the beginning pterygium is usually asymptomatic, however, dry eye manifestations may be present, such as burning, itching, and/or tearing. As the lesion grows toward the optical zone, visual acuity gets compromised, and thus, surgical treatment is required. Because of recurrences and repeated surgeries, the growth of the lesion may become more aggressive and cause irregular astigmatism. Comprehensive surgery of pterygium is aimed at not only removing the lesion, but also preventing recurrences. Advisable are modified bare sclera techniques with subsequent transposition of the conjunctival flap, conjunctival autotransplantation, amniotic membrane transplantation, and peripheral lamellar keratoplasty (in cases of significant ingrowth). In some cases, antirecurrent adjuvant therapy may be considered that involves the use of mitomycin C, 5-fluoruracil, and VEGF inhibitors. However, the search for the best treatment for pterygium, i.e. an easy to perform, cosmetically-friendly method associated with minimal risk of recurrences and/or complications, remains an interest of modern ophthalmology.
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Affiliation(s)
- S A Malozhen
- Research Institute of Eye Diseases, 11A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - S V Trufanov
- Research Institute of Eye Diseases, 11A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - D A Krakhmaleva
- Research Institute of Eye Diseases, 11A, B, Rossolimo St., Moscow, Russian Federation, 119021
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20
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Gasser T, Romano V, Seifarth C, Bechrakis NE, Kaye SB, Steger B. Morphometric characterisation of pterygium associated with corneal stromal scarring using high-resolution anterior segment optical coherence tomography. Br J Ophthalmol 2016; 101:660-664. [DOI: 10.1136/bjophthalmol-2016-308685] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/20/2016] [Accepted: 07/17/2016] [Indexed: 11/04/2022]
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21
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Pajic B, Vastardis I, Rajkovic P, Pajic-Eggspuehler B, Aebersold DM, Cvejic Z. A mathematical approach to human pterygium shape. Clin Ophthalmol 2016; 10:1343-9. [PMID: 27555741 PMCID: PMC4969044 DOI: 10.2147/opth.s106611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Pterygium is a common lesion affecting the population in countries with high levels of ultraviolet exposure. The final shape of a pterygium is the result of a growth pattern, which remains poorly understood. This manuscript provides a mathematical analysis as a tool to determine the shape of human pterygia. MATERIALS AND METHODS Eighteen patients, all affected by nasal unilateral pterygia, were randomly selected from our patient database independently of sex, origin, or race. We included all primary or recurrent pterygia with signs of proliferation, dry eye, and induction of astigmatism. Pseudopterygia were excluded from this study. Pterygia were outlined and analyzed mathematically using a Cartesian coordinate system with two axes (X, Y) and five accurate landmarks of the pterygium. RESULTS In 13 patients (72%), the shape of the pterygia was hyperbolic and in five patients (28%), the shape was rather elliptical. CONCLUSION This analysis gives a highly accurate mathematical description of the shape of human pterygia. This might help to better assess the clinical results and outcome of the great variety of therapeutic approaches concerning these lesions.
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Affiliation(s)
- Bojan Pajic
- Eye Clinic ORASIS, Swiss Eye Research Foundation, Reinach AG, Switzerland
- Department of Physics, Faculty of Sciences, University of Novi Sad, Novi Sad
- Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
- Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Iraklis Vastardis
- Eye Clinic ORASIS, Swiss Eye Research Foundation, Reinach AG, Switzerland
| | - Predrag Rajkovic
- Department of Mathematics, Faculty of Mechanical Engineering, University of Niš, Niš, Serbia
| | | | - Daniel M Aebersold
- Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Zeljka Cvejic
- Department of Physics, Faculty of Sciences, University of Novi Sad, Novi Sad
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22
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Zhou WP, Zhu YF, Zhang B, Qiu WY, Yao YF. The role of ultraviolet radiation in the pathogenesis of pterygia (Review). Mol Med Rep 2016; 14:3-15. [PMID: 27176595 DOI: 10.3892/mmr.2016.5223] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 04/01/2016] [Indexed: 11/06/2022] Open
Abstract
Pterygium is a common ophthalmic disease affecting humans only. Extensive epidemiological data have demonstrated a causative effect of chronic ultraviolet (UV) radiation on pterygia. Progress has been made in determining the origin of pterygia, their nasal predilection and wing‑shaped appearance, and the roles of UV radiation in the initiation and the development of pterygia. In the present review, the current understanding of the involvement of UV radiation in the pathogenesis of pterygia is summarized. This involvement includes the alteration of limbal stem cells and fibroblasts that contribute to the initiation of pterygia and the induction of various pro‑inflammatory cytokines, growth factors and matrix metalloproteinases that promote the progression of pterygia. Further elucidation of the roles of UV radiation in the pathogenesis of pterygia may help to encourage individuals at risk of developing pterygia to take preventive measures and aid researchers in the development of novel targeted therapeutic agents to treat pterygia.
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Affiliation(s)
- Wei-Ping Zhou
- Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Yuan-Fang Zhu
- Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Bei Zhang
- Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Wen-Ya Qiu
- Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
| | - Yu-Feng Yao
- Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
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23
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Cardenas-Cantu E, Valenzuela J, Zavala J, Valdez-Garcýa JE. Basis of Pterygium Development. ACTA ACUST UNITED AC 2016. [DOI: 10.5005/highlights-44-6-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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24
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Fibroblast biology in pterygia. Exp Eye Res 2016; 142:32-9. [DOI: 10.1016/j.exer.2015.01.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 01/08/2015] [Accepted: 01/12/2015] [Indexed: 12/31/2022]
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25
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Tsim NC, Young AL, Jhanji V, Ho M, Cheng LL. Combined conjunctival rotational autograft with 0.02% mitomycin C in primary pterygium surgery: a long-term follow-up study. Br J Ophthalmol 2015; 99:1396-400. [DOI: 10.1136/bjophthalmol-2014-305817] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 03/14/2015] [Indexed: 11/03/2022]
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26
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Kaji Y, Oshika T, Nejima R, Mori S, Miyata K, Fujii N. Immunohistochemical localization of D-β-aspartic acid-containing proteins in pterygium. J Pharm Biomed Anal 2015; 116:86-9. [PMID: 25749304 DOI: 10.1016/j.jpba.2015.01.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 01/22/2015] [Accepted: 01/31/2015] [Indexed: 11/26/2022]
Abstract
Biologically uncommon D-β-aspartic acid (D-β-Asp) residues have been reported to accumulate in organs affected by age-related disorders. In the present study, we investigated the localization of D-β-Asp-containing proteins in cases of pterygium, one of the most prominent age-related ocular conditions. Immunohistochemical localization of D-β-Asp-containing proteins was investigated in surgical specimens of pterygium from 20 patients and control specimens from 10 patients. Strong immunoreactivity to D-β-Asp-containing proteins was observed in subepithelial elastotic lesions and surrounding collagenous lesions from all surgical specimens with pterygia. In contrast, no immunoreactivity to D-β-Asp-containing proteins was seen in pterygium-free specimens. D-β-Asp-containing proteins are produced in organs as they are affected by the aging process. In addition, conversion of L- to D-aspartyl residues is accelerated by ultraviolet (UV) irradiation. Since pterygia can form due to aging or UV exposure, it is reasonable to find D-β-Asp-containing proteins in specimens with pterygia. Furthermore, since D-β-Asp is a non-native amino acid, D-β-Asp-containing proteins may be recognized as allogeneic antigens. Therefore, D-β-Asp-containing proteins in pterygia may responsible for the fibrovascular changes seen in the disorder.
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Affiliation(s)
- Yuichi Kaji
- Department of Ophthalmology, Institute of Clinical Sciences, University of Tsukuba, Ibaraki, Japan.
| | - Tetsuro Oshika
- Department of Ophthalmology, Institute of Clinical Sciences, University of Tsukuba, Ibaraki, Japan
| | | | | | | | - Noriko Fujii
- Research Reactor Institute, Kyoto University, Osaka, Japan
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27
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Abstract
Pterygium pathogenesis is mainly related to UV light exposure. However, the exact mechanisms by which it is formed have not been elucidated. Clinical advances in surgical treatment use conjunctival autografts and amniotic membranes in combination with adjuvant therapies, including mitomycin C, β-radiation, and 5-fluoroacil, to reduce recurrence. Several studies aim to unveil the molecular mechanisms underlying pterygium growth and proliferation. They demonstrate the role of different factors, such as viruses, oxidative stress, DNA methylation, apoptotic and oncogenic proteins, loss of heterozygosity, microsatellite instability, inflammatory mediators, extracellular matrix modulators, lymphangiogenesis, cell epithelial-mesenchymal transition, and alterations in cholesterol metabolism in pterygium development. Understanding the molecular basis of pterygium provides new potential therapeutic targets for its prevention and elimination. This review focuses on providing a broad overview of what is currently known regarding molecular mechanisms of pterygium pathogenesis.
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Affiliation(s)
- Eduardo Cárdenas-Cantú
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Judith Zavala
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Jorge Valenzuela
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and
| | - Jorge E Valdez-García
- a Ophthalmology Research Chair, School of Medicine and Health Sciences, Tecnologico de Monterrey , Monterrey , Mexico and.,b Ophthalmology Institute, Tec Salud, Tecnologico de Monterrey , Monterrey , Mexico
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28
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Unusual large uniocular elastoid and collagenous pinguecula. Graefes Arch Clin Exp Ophthalmol 2014; 252:1173-5. [DOI: 10.1007/s00417-014-2649-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/09/2014] [Accepted: 04/12/2014] [Indexed: 10/25/2022] Open
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29
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Sun LP, Lv W, Liang YB, Friedman DS, Yang XH, Guo LX, Peng Y, Wang NL, Wang JJ. The prevalence of and risk factors associated with pterygium in a rural adult Chinese population: the Handan Eye Study. Ophthalmic Epidemiol 2013; 20:148-54. [PMID: 23662799 DOI: 10.3109/09286586.2013.763991] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for pterygium in a rural adult Chinese population. METHODS A total of 7557 people aged 30 years and over were randomly selected from 13 villages in a rural county, Yongnian, within Handan district, Hebei Province of China. All eligible subjects were invited to undergo a comprehensive eye examination. A slit-lamp was used to examine the anterior segment for evidence of pterygium. Pterygium was graded for severity (G1 to G3) by visibility of episcleral vessels. RESULTS Of 6685 participants (88.5% of 7557) included in this study, pterygium was present in 401 (6.0%). Using direct standardization to the 2000 China population census for rural residents, the prevalence of pterygium was 7.1% (95% confidence interval [CI], 6.5-7.8%) among subjects aged 40+ years, and 4.8% (95% CI 4.3-5.3%) when including those aged 30-39 years. Pterygium was more common in men than in women (age-adjusted odds ratio [OR] 2.0, 95% CI 1.4-2.8). Prevalence increased with age (OR 1.8, 95% CI 1.6-2.1 per decade increase in age). Current smoking appeared to be protective (OR 0.5, 95% CI 0.4-0.7). Of eyes with any pterygium, 4.6% (95% CI 1.9-7.3%) had low vision. CONCLUSION Approximately one in ten adults had pterygium in this rural Chinese population. Age and male sex were positively, and current smoking negatively associated with the prevalence of pterygium.
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30
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Sebastiá R, Ventura MP, Solari HP, Antecka E, Orellana ME, Burnier MN. Immunohistochemical detection of Hsp90 and Ki-67 in pterygium. Diagn Pathol 2013; 8:32. [PMID: 23432803 PMCID: PMC3599841 DOI: 10.1186/1746-1596-8-32] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the immunohistochemical expression of heat shock protein 90 (Hsp90) and Ki-67 protein in human pterygium. MATERIALS AND METHODS Tissues obtained during pterygium surgery of 15 patients who underwent the bare-sclera procedure and 10 normal conjunctivae were studied. All of these pterygia were primary ones. Recurrent pterygia were excluded. Normal bulbar conjunctivas (2 x 2 mm) were obtained from the nasal region close to the limbus from patients during their cataract and retina surgeries. Immunohistochemical detection of Hsp90 and Ki67 was done using the streptavidin-biotin method in paraffin embedded tissue sections. RESULTS The percentage of cells stained for Hsp90 was greater for pterygium epithelium (76 ± 10.8) than for normal conjunctiva (1.4 ± 0.8). In each pterygium sample more than 60% of cells were positive. The differences in positive cells between normal and pterygium epithelium were highly significant for Hsp90 (P < 0,001).Pterygium epithelium also showed a higher percentage of cells that stained for Ki67 (10.1 ± 9.5) than for normal conjunctiva (2.1 ± 1.9). The differences in positive cells were also statistically significant for Ki67 (P < 0.01). Although there were significant differences in the majority of samples observed. It was noted that in some samples there was no difference between normal and pterygium epithelium for Ki67. CONCLUSION Our results indicate an abnormal expression of Hsp90 and ki-67 in pterygium samples when compared to normal conjunctiva.The finding of abnormal expression of levels of Hsp90 in pterygium samples can stimulate new research into pterygium and its recurrence. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1128478792898812.
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Affiliation(s)
- Roberto Sebastiá
- Department of Ophthalmology, Universitary Hospital Federal Fluminense University, Rio de Janeiro, Brazil
| | - Marcelo Palis Ventura
- Department of Ophthalmology, Universitary Hospital Federal Fluminense University, Rio de Janeiro, Brazil
| | - Helena Parente Solari
- Department of Ophthalmology, Universitary Hospital Federal Fluminense University, Rio de Janeiro, Brazil
| | - Emilia Antecka
- Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Canada
| | | | - Miguel N Burnier
- Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Canada
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31
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Gu BY, Lee SB. Effects of Temporary Amniotic Membrane Patch after Surgical Excision of Primary Pterygium. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.6.749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Byoung Young Gu
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang-Bumm Lee
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
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Di Girolamo N. Association of human papilloma virus with pterygia and ocular-surface squamous neoplasia. Eye (Lond) 2011; 26:202-11. [PMID: 22134594 DOI: 10.1038/eye.2011.312] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
There are more microorganisms that colonize the human body than resident cells; some are commensal whereas others are pathogenic. Pathogenic microorganisms are sensed by the innate or adaptive immune system, an immune response is initiated, and the infection is often cleared. Some microorganisms have developed strategies to evade immune defenses, ensuring their long-term survival with potentially devastating consequences for the host. Approximately 18% of all cancers can be attributed to infective agents; the most common being Helicobacter pylori, Human papilloma virus (HPV) and Hepatitis B and C virus in causing stomach, cervical and liver carcinoma, respectively. This review focuses on whether HPV infection is necessary for initiating pterygia, a common benign condition and ocular-surface squamous neoplasia (OSSN), a rare disease with metastatic potential. The search engine PubMed was used to identify articles from the literature related to HPV and pterygium or conjunctival neoplasia. From 34 investigations that studied HPV in pterygia and OSSN, a prevalence rate of 18.6% (136/731) and 33.8% (144/426), respectively, was recorded. The variation in HPV prevalence (0-100%) for both disease groups may have arisen from study-design faults and the techniques used to identify the virus. Overall, the data suggest that HPV is not necessary for initiating either condition but may be a co-factor in susceptible hosts. Currently, over 60 million people worldwide have been immunized with HPV vaccines, but any effect on pterygium and OSSN development may not be known for some time as these lesions can evolve over decades or occur in older individuals.
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Affiliation(s)
- N Di Girolamo
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
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Khalfaoui T, Mkannez G, Colin D, Imen A, Zbiba W, Errais K, Anane R, Beltaief O, Zhioua R, Ben Hamida J, Lizard G, Ouertani-Meddeb A. Immunohistochemical analysis of vascular endothelial growth factor (VEGF) and p53 expression in pterygium from Tunisian patients. ACTA ACUST UNITED AC 2011; 59:137-41. [DOI: 10.1016/j.patbio.2009.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
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Chui J, Coroneo MT, Tat LT, Crouch R, Wakefield D, Di Girolamo N. Ophthalmic pterygium: a stem cell disorder with premalignant features. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 178:817-27. [PMID: 21281814 DOI: 10.1016/j.ajpath.2010.10.037] [Citation(s) in RCA: 187] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 10/09/2010] [Accepted: 10/14/2010] [Indexed: 12/13/2022]
Abstract
Pterygia are common ocular surface lesions thought to originate from limbal stem cells altered by chronic UV exposure. Traditionally regarded as a degenerative condition, pterygia also display tumor-like features, such as a propensity to invade normal tissue and high recurrence rates following resection, and may coexist with secondary premalignant lesions. This study was initiated to determine the rate of concurrent ocular surface diseases in patients with pterygia recruited from the practice of a single surgeon operating in a Sydney metropolitan hospital. One hundred pterygium specimens were histopathologically reviewed and selected cases were immunohistochemically assessed to confirm diagnosis. Along with previously documented typical features including epithelial proliferation, goblet cell hyperplasia, angiogenesis, inflammation, elastosis, stromal plaques, and Bowman's membrane dissolution, we identified five cases of ocular surface squamous neoplasia, six cases of primary acquired melanosis, two compound nevi (one suspect invasive melanoma), and one dermoid-like lesion. In 18 specimens, clusters of basal epithelial cells that coexpressed cytokeratin-15/-19 and p63-α were identified at the head of the pterygium, coinciding with clinical observation of Fuchs' flecks. Our data show that significant preneoplastic lesions may be associated with pterygium and that all excised pterygia should undergo histological examination. The presence of p63-α-positive epithelial cell clusters supports the hypothesis that pterygia develop from limbal epithelial progenitors.
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Affiliation(s)
- Jeanie Chui
- Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia
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Viso E, Gude F, Rodríguez-Ares MT. Prevalence of pinguecula and pterygium in a general population in Spain. Eye (Lond) 2010; 25:350-7. [PMID: 21183945 DOI: 10.1038/eye.2010.204] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine the prevalence of pinguecula and pterygium and to investigate their associations in a general adult population in North-Western Spain. METHODS An age-stratified random sample of 1155 subjects ≥ 40 years was selected in O Salnés (Spain). From 937 eligible subjects, 619 (66.1%) participated (mean age (SD): 63.4 (14.5) years, range: 40-96 years, 37.0% males). An interview to collect history of systemic diseases and lifestyle details and a comprehensive ophthalmic evaluation in which pinguecula and pterygium were recorded was carried out. The prevalence of pinguecula and pterygium and their relationship with lifestyle factors and ocular and systemic diseases was investigated. RESULTS The prevalence of pinguecula was 47.9% (95% confidence interval (CI): 43.9-51.9). This prevalence increased significantly with aging (P = 0.002) and was higher in men (56.4%; 95% CI: 50.0-62.7) than in women (42.7%; 95% CI: 37.8-47.8) (P=0.001). The prevalence of pterygium was 5.9% (95% CI: 4.3-7.9). This prevalence also increased significantly with aging (P = 0.005) and was 4.8% (95% CI: 2.6-8.4) in men and 6.5% (95% CI: 4.5-9.3) in women (P = 0.346). After controlling for age and sex, pinguecula was associated with alcohol intake (adjusted odds ratio (OR(a)): 3.08; 95% CI: 1.60-5.95), pterygium with fluorescein staining (OR(a): 2.64; 95% CI: 1.08-6.46) and both disorders with outer activity (OR(a): 2.07; 95% CI: 1.36-3.15 and 2.28; 95% CI: 1.04-4.98, respectively). CONCLUSIONS Pinguecula is far more common than pterygium. Alcohol consumption is strongly associated with pinguecula. Fluorescein staining is highly prevalent in subjects with pterygium. Both disorders increase with age and are associated with outer activity.
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Affiliation(s)
- E Viso
- Department of Ophthalmology, Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
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Abstract
PURPOSE To determine the prevalence of pinguecula and pterygium in patients with thyroid orbitopathy (TO) and to evaluate its correlation with clinical findings. METHODS All patients underwent a thorough ophthalmic examination, including tear function analysis using tear film breakup time (BUT) measurement. For patients with TO, lid retraction, Hertel exophthalmometry, and clinical activity scores were also measured. All patients were evaluated for the presence of pinguecula and pterygium. RESULTS The groups were age (P = 0.15) and gender matched (P = 0.2). The prevalence of pinguecula was significantly higher in group 1 (196 patients, 98%) than in group 2 (23 patients, 46%) and group 3 (64 patients, 32%) (P < 0.001). In group 1, lid retraction was significantly correlated with pinguecula prevalence (P < 0.001), whereas there was no correlation between pinguecula prevalence and BUT values (P = 0.624), clinical activity score levels (P = 0.325), or exophthalmometer findings (P = 0.155) In groups 2 and 3, pinguecula was seen more frequently in patients with subnormal BUT measurements (P < 0.001). Pterygium was seen at very low rates in all groups and analysis could not be performed. CONCLUSIONS Pinguecula was seen more frequently in patients with TO than in both control groups. Lid retraction was the only clinical factor determined with significant impact on the prevalence of pinguecula in patients with TO. Impaired tear function did not influence pinguecula prevalence in patients with TO, in contrast to both control groups. Increased exposure to UV light because of lid retraction may be the major underlying causative factor on pinguecula prevalence in patients with TO, compared with tear dysfunction in both control groups.
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Abstract
PURPOSE To evaluate the prevalence and possible role of human papillomavirus (HPV) in the formation of pterygia in patients in Taiwan, a tropical country with high prevalence of pterygium. METHODS A total of 62 patients with 65 pterygia were retrospectively examined. Ten normal conjunctiva, 8 conjunctival nevi, and 2 malignant conjunctival melanomas served as controls. HPV detection and typing were accomplished using polymerase chain reaction amplification of the viral sequences. HPV-positive specimens underwent further investigation with fluorescence in situ hybridization. Clinical histories were recorded for each patient. RESULTS Based on polymerase chain reaction analysis, 2 of 65 pterygia harbored HPV type 18, and they were also fluorescence in situ hybridization positive. No conjunctival control had HPV. There was no statistically significant correlation between pterygium and the presence of HPV. The presence of HPV was not significantly different between primary and recurrent pterygia. CONCLUSIONS The limited presence of HPV DNA in pterygium does not conclude that HPV is necessary or acting alone in the formation of pterygium, but HPV may still be implicated to play a role in some pterygia in Taiwan.
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Shiroma H, Higa A, Sawaguchi S, Iwase A, Tomidokoro A, Amano S, Araie M. Prevalence and risk factors of pterygium in a southwestern island of Japan: the Kumejima Study. Am J Ophthalmol 2009; 148:766-771.e1. [PMID: 19664753 DOI: 10.1016/j.ajo.2009.06.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Revised: 06/02/2009] [Accepted: 06/02/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine the prevalence and risk factors for pterygium in a Japanese population aged 40 years or older on Kumejima Island, Japan. DESIGN Cross-sectional, population-based study. METHODS All residents of Kumejima Island, Japan, located in Southwestern Japan (Eastern longitude 126 degrees, 48 feet and Northern latitude 26 degrees, 20 feet), aged 40 years and older were asked to undergo a comprehensive questionnaire and ocular examination. RESULTS Of the 4,632 residents, 3,762 (81.2%) underwent the examination. The presence of pterygium could not be determined in 15 subjects. Of the 3,747 eligible subjects, 1,154 (30.8%; 95% confidence interval [CI], 29.3% to 32.3%) had pterygium in at least 1 eye and 491 subjects (13.1%; 95% CI, 12.1% to 14.3%) had pterygium in both eyes. In the logistic regression analysis, older age (P < .001), male gender (P = .024), hyperopic refraction (P = .001), lower intraocular pressure (P = .002), and outdoor job experience (P < .001) were independently associated with a higher risk of pterygium. CONCLUSION The prevalence of pterygium is 30.8% among adult Japanese aged 40 years and older in Kumejima. Older age, male gender, hyperopic refraction, lower intraocular pressure, and outdoor job history were independently associated with a higher risk of pterygium.
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Xue C, Huang Z, Wang J, Dong Y, Zhou X. EphrinB2 and EphB4 expression in pterygia: new insights and preliminary results. CANADIAN JOURNAL OF OPHTHALMOLOGY 2009; 44:185-8. [PMID: 19491953 DOI: 10.3129/i09-005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Pterygium is a growth of fibrovascular tissue onto the cornea, in which the mechanisms of cell proliferation and vascularization are unknown. The ephrin-Eph system, especially ephrinB2 and its receptor EphB4, has been shown to play an important role in tumor angiogenesis. EphrinB2 and EphB4 have also been reportedly involved in the pathogenesis of ocular angiogenesis. This study was designed to investigate the expression of ephrinB2 and its receptor EphB4 in pterygia. DESIGN Experimental study of the expression of ephrinB2 and its receptor EphB4 in pterygia. PARTICIPANTS Twenty-three primary pterygia, 5 recurrent pterygia, and 11 normal conjunctiva were studied. METHODS Immunohistochemistry studies were used to assess ephrinB2 and EphB4 protein expression levels and the tissue distribution in the samples. RESULTS EphrinB2 and EphB4 staining was present at a dense level in the total epithelium of the head portions of both primary and recurrent pterygial specimens, although just in the basal and parabasal layer of the epithelium of most of the normal conjunctivae. CONCLUSIONS EphrinB2 and EphB4 appear to be overexpressed in pterygium, and they may play important roles in its development.
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Affiliation(s)
- Chunyan Xue
- Department of Ophthalmology, Jinling Hospital, School of Medicine, Nanjing University, China
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Young AL, Tam PMK, Leung GYS, Cheng LL, Lam PTH, Lam DSC. Prospective Study on the Safety and Efficacy of Combined Conjunctival Rotational Autograft With Intraoperative 0.02% Mitomycin C in Primary Pterygium Excision. Cornea 2009; 28:166-9. [DOI: 10.1097/ico.0b013e318187544d] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Karahan N, Baspinar S, Ciris M, Baydar CL, Kapucuoglu N. Cyclooxygenase-2 expression in primary and recurrent pterygium. Indian J Ophthalmol 2008; 56:279-83. [PMID: 18579985 PMCID: PMC2636169 DOI: 10.4103/0301-4738.39663] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Pterygia are common, benign, fibrovascular, and infiltrative processes of the corneo-
conjunctival junction of unknown pathogenesis. Cyclooxygenase-2 (COX-2) mediates the rate-limiting step
in arachidonic acid metabolism. Extensive evidence indicates that the COX-2 prostanoid pathway is involved
in inflammation. The aim of the study was to document the immunohistochemical expression of COX-2 in
primary and recurrent pterygia. Materials and Methods: In this study, 21 primary pterygia and 12 recurrent pterygia from subjects undergoing
pterygium surgery and six normal corneal-scleral tissue specimens were studied immunohistochemically for
COX-2 expression. Results: COX-2 was expressed in primary pterygia and recurrent pterygia specimens. There was a statistically
significant difference in COX-2 expressions in fibroblasts between primary and recurrent pterygium cases
(P = 0.001). There were statistically significant differences in COX-2 expressions in surface epithelium
(P = 0.028) and stromal inflammatory cells (P=0.000) between control tissues and primary pterygia
tissues. We also detected statistically significant differences in COX-2 expressions in surface epithelium (P=0.000),
stromal fibroblasts P=0.000 (stromal fibroblasts and inflammatory cells), vessels (P = 0.027) and
inflammatory cells (P=0.001) between control tissues and recurrent pterygia tissues. Conclusions: This is the first study to document the expression of COX-2 in primary and recurrent pterygia. In
our opinion after excision of pterygia, fibroblastic proliferation continues and this contributes to recurrence.
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Affiliation(s)
- Nermin Karahan
- Department of Pathology, Suleyman Demirel University School of Medicine, Isparta, Turkey.
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Lin W, Wang SL, Wu HJ, Chang KH, Yeh P, Chen CJ, Guo HR. Associations between arsenic in drinking water and pterygium in southwestern Taiwan. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:952-955. [PMID: 18629320 PMCID: PMC2453166 DOI: 10.1289/ehp.11111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2007] [Accepted: 04/07/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Pterygium is a fibrovascular growth of the bulbar conjunctiva and underlying subconjunctival tissue that may cause blindness. The mechanism of pterygium formation is not yet fully understood, but pterygium has some tumorlike features. OBJECTIVES The objective of this study was to evaluate the association between arsenic exposure through drinking water and the occurrence of pterygium in southwestern Taiwan. METHODS We recruited participants > 40 years of age from three villages in the arseniasis-endemic area in southwestern Taiwan (exposure villages) and four neighboring nonendemic villages (comparison villages). Each participant received an eye examination and a questionnaire interview. Photographs taken of both eyes were later graded by an ophthalmologist to determine pterygium status. RESULTS We included 223 participants from the exposure villages and 160 from the comparison villages. The prevalence of pterygium was higher in the exposure villages across all age groups in both sexes and increased with cumulative arsenic exposure. We found a significant association between cumulative arsenic exposure and the prevalence of pterygium. After adjusting for age, sex, working under sunlight, and working in sandy environments, we found that cumulative arsenic exposure of 0.1-15.0 mg/L-year and > or = 15.1 mg/L-year were associated with increased risks of developing pterygium. The adjusted odds ratios were 2.04 [95% confidence interval (CI), 1.04-3.99] and 2.88 (95% CI, 1.42-5.83), respectively. CONCLUSIONS Chronic exposure to arsenic in drinking water was related to the occurrence of pterygium, and the association was still observed after adjusting for exposures to sunlight and sandy environments.
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Affiliation(s)
- Wei Lin
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Shu-Li Wang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Taiwan
- Institute of Environmental Medicine, College of Public Health, China Medical University Hospital, Taichung, Taiwan
| | - Horng-Jiun Wu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kuang-Hsi Chang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Taiwan
| | - Peter Yeh
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
- Department of Ophthalmology, Pingtung Hospital, Department of Health, Pingtung, Taiwan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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Maxia C, Perra MT, Demurtas P, Minerba L, Murtas D, Piras F, Corbu A, Gotuzzo DC, Cabrera RG, Ribatti D, Sirigu P. Expression of survivin protein in pterygium and relationship with oxidative DNA damage. J Cell Mol Med 2008; 12:2372-80. [PMID: 18266976 PMCID: PMC4514115 DOI: 10.1111/j.1582-4934.2008.00256.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Ultraviolet radiation is known to cause oxidative DNA damage and is thought to be a major factor implicated in the pathogenesis of pterygium. Among all the photo-oxidative DNA products, the 8-hydroxydeoxyguanosine (8-OHdG) is regarded a sensitive and stable biomarker for evaluating the degree of DNA damage. The protein p53 is a major cell stress regulator that acts to integrate signals from a wide range of cellular stresses. UV radiation has a carcinogenic effect resulting in DNA damaged cells with loss of normal growth control. This assumption is supported by the association between UV-B exposure and activation of survivin, a member of the inhibitor of apoptosis protein family (IAP), highly up-regulated in almost all types of human malignancy. In this study we demonstrate, for the first time in pterygium, the immunohistochemical presence of survivin, and investigate the correlation between survivin, p53 and 8-OHdG. Our results demonstrate that oxidative stress could lead to a significant activation of survivin expression, suggesting that this might be an important event in the development of pterygium, inducing and supporting a hyperproliferative condition. Survivin expression in pterygium would counteract UV-B-induced apoptosis and would cooperate with loss of p53. The co-operation between survivin and functional loss of p53 might provide a general mechanism for aberrant inhibition of apoptosis that could be responsible for the development of pterygium and its possible progression to neoplasia.
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Affiliation(s)
- C Maxia
- Department of Cytomorphology, University of Cagliari Medical School, Cagliari, Italy
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Chui J, Girolamo ND, Wakefield D, Coroneo MT. The Pathogenesis of Pterygium: Current Concepts and Their Therapeutic Implications. Ocul Surf 2008; 6:24-43. [DOI: 10.1016/s1542-0124(12)70103-9] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kato N, Shimmura S. Epithelial-mesenchymal transition in the pathogenesis of pterygium. Inflamm Regen 2008. [DOI: 10.2492/inflammregen.28.434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Naib-Majani W, Breipohl W, Shazli EE, Theuerkauf I, Pleyer U, Hahne JC, Wernert N. The Ets-1 transcription factor is involved in pterygial angiogenesis. Anat Histol Embryol 2007; 36:107-10. [PMID: 17371382 DOI: 10.1111/j.1439-0264.2006.00730.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pterygial pathology is characterized by abnormal corneal epithelial proliferation, stromal modulation, matrix degradation and a strong tendency for otherwise absent corneal vascularization. As the proto-oncogene Ets-1 is known to play a key role in angiogenesis and matrix degradation in other tissues, its involvement in corneal vascularization was investigated. Fifteen pterygia representing two groups were studied. Group 1 consisted of five clinically active pterygia, and group 2 consisted of 10 samples of clinically non-active pterygia. (35)S-labelled ets-1 antisense and sense riboprobes were used for in-situ hybridization of Ets-1 transcription factor in all pterygia. The cytoplasm of blood vessel endothelial cells showed strong expression of ets-1 mRNA in all group 1 pterygia. In contrast, no expression of ets-1 was found in group 2 pterygia. Proto-oncogene ets-1 expression has been shown for the first time in the metaplastic pterygium, an eye tissue of unknown pathogenesis.
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Affiliation(s)
- W Naib-Majani
- Department of International Medical Education and Development, Bonn, Germany
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Abstract
PURPOSE Pterygia have been reported to share some of the genetic defects seen in cancers, including microsatellite instability (MSI). We examined pterygia for the presence of proteins typically missing or defective in adenocarcinomas with MSI. We also performed microsatellite analysis on DNA from pterygia to test for instability in the size of the microsatellites, using markers conventionally used to characterize MSI in tumors (Bethesda convention markers). METHODS We examined 13 pterygia by immunohistochemistry for MLH1 and MSH2, 2 proteins involved in DNA mismatch repair. In addition, we amplified the pterygial DNA with primers specific for 5 Bethesda markers (BAT25, BAT26, D2S123, D5S346, and D17S250). RESULTS MLH1 staining was present at low levels in the basal cells of the cornea and migrating limbal cells of the pterygia. MSH2 staining was present in basal and in maturing epithelial cells of the cornea and migrating limbal cells of pterygia. We observed no reproducible examples of MSI or loss of heterozygosity (LOH). CONCLUSIONS We were unable to confirm the presence of MSI and LOH by using the markers we examined. MSH2 staining appeared to be normal in pterygia. MLH1 staining was present but in reduced amounts compared with that seen in the conjunctiva.
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Affiliation(s)
- Barbara G Schneider
- Division of Gastroenterology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
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Peiretti E, Dessì S, Mulas MF, Abete C, Galantuomo MS, Fossarello M. Fibroblasts isolated from human pterygia exhibit altered lipid metabolism characteristics. Exp Eye Res 2006; 83:536-42. [PMID: 16696971 DOI: 10.1016/j.exer.2006.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Revised: 02/03/2006] [Accepted: 02/08/2006] [Indexed: 10/24/2022]
Abstract
To determine whether the fibrovascular proliferation observed in pterygium, may be, at least in part, mediated by an increased activity of cholesterol metabolism. The correlation between lipid metabolism and rate of growth was studied in human normal conjunctival (NCF) and primary pterygium fibroblasts (PFs) in primary culture. The expression of two proliferation markers (Ki-67 and p53) was evaluated by immunohistochemical staining techniques. Proliferation was evaluated by [(3)H]thymidine incorporation and by immunohistochemical assays. Lipid metabolism was evaluated by (14)C-oleate incorporated into cholesterol esters as well as by oil red O staining. Moreover, the cultures of pterygium fibroblasts were supplemented with two antiproliferative drugs in order to confirm the effective alterations in cholesterol metabolism related to proliferation. Immunohistochemistry of frozen sections from primary pterygium demonstrated an increased staining in Ki-67 and p53 compared with staining observed in normal conjunctiva. A dramatically increased activity of intracellular cholesterol metabolism was demonstrated in pterygium fibroblasts obtained from four different patients. This finding was confirmed by the reduction of cholesterol metabolism in pterygium fibroblasts treated with antiproliferative drugs. Collectively, these data support the hypothesis that alterations of cholesterol metabolism are involved in the development of pterygia. This finding may represent a target of new therapeutic approaches for treatment and prevention of pterygium.
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Affiliation(s)
- Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Via Ospedale, I-09124 Cagliari, Italy
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