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Gupta M, Arya S, Agrawal P, Gupta H, Sikka R. Unravelling the molecular tapestry of pterygium: insights into genes for diagnostic and therapeutic innovations. Eye (Lond) 2024:10.1038/s41433-024-03186-y. [PMID: 38907016 DOI: 10.1038/s41433-024-03186-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/23/2024] Open
Abstract
Pterygium, an ocular surface disorder, manifests as a wing-shaped extension from the corneoscleral limbus onto the cornea, impacting vision and causing inflammation. With a global prevalence of 12%, varying by region, the condition is linked to UV exposure, age, gender, and socioeconomic factors. This review focuses on key genes associated with pterygium, shedding light on potential therapeutic targets. Matrix metalloproteinases (MMPs), especially MMP2 and MMP9, contribute to ECM remodelling and angiogenesis in pterygium. Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis and is elevated in pterygium tissues. B-cell lymphoma-2, S100 proteins, DNA repair genes (hOGG1, XRCC1), CYP monooxygenases, p53, and p16 are implicated in pterygium development. A protein-protein interaction network analysis highlighted 28 edges between the aforementioned proteins, except for VEGF, indicating a high level of interaction. Gene ontology, microRNA and pathway analyses revealed the involvement of processes such as base excision repair, IL-17 and p53 signalling, ECM disassembly, oxidative stress, hypoxia, metallopeptidase activity and others that are essential for pterygium development. In addition, miR-29, miR-125, miR-126, miR-143, miR-200, miR-429, and miR-451a microRNAs were predicted, which were shown to have a role in pterygium development and disease severity. Identification of these molecular mechanisms provides insights for potential diagnostic and therapeutic strategies for pterygium.
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Affiliation(s)
- Mahak Gupta
- Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University, Mathura, Uttar Pradesh, India
| | - Shubhang Arya
- Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University, Mathura, Uttar Pradesh, India
| | | | - Himanshu Gupta
- Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University, Mathura, Uttar Pradesh, India.
| | - Ruhi Sikka
- Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University, Mathura, Uttar Pradesh, India.
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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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Yıldırım H, Turan G, Turan M. Expression of CD44, PCNA and E-cadherin in pterygium tissues. Indian J Ophthalmol 2024; 72:S501-S504. [PMID: 38648458 PMCID: PMC467005 DOI: 10.4103/ijo.ijo_2579_23] [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: 09/23/2023] [Revised: 01/18/2024] [Accepted: 02/07/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE Pterygium is a common ocular surface disease defined by fibrovascular conjunctival growth extending onto the cornea. However, its pathogenesis remains unclear. This study aimed to determine the role of CD44, proliferating cell nuclear antigen (PCNA), and E-cadherin in pterygium formation and recurrence. METHODS Sixty patients with pterygium participated in the study, and we collected conjunctival samples from 30 patients to form a control group. CD44, PCNA, and E-cadherin expressions in surgically excised pterygium were compared with tissue samples from the control group. RESULTS We observed that the percentages of CD44 and PCNA were statistically higher in the primary pterygium group and recurrent pterygium group than in the control group (P < 0.001 and P < 0.001, respectively). Conversely, E-cadherin values were statistically higher in the control group than in the primary and recurrent pterygium groups (P = 0.013 and P < 0.001, respectively). CONCLUSION Cell proliferation and cell adhesion factors may play important roles in the pathogenesis of pterygium.
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Affiliation(s)
- Humeyra Yıldırım
- Department of Ophthalmology, Balıkesir University, Faculty of Medicine, Balıkesir, Türkiye
| | - Gulay Turan
- Department of Pathology, Balıkesir University, Faculty of Medicine, Balıkesir, Türkiye
| | - Meydan Turan
- Balikesir Ataturk Cıty Hospital, Ophthalmology, Balikesir, Türkiye
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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 PMCID: PMC467017 DOI: 10.4103/ijo.ijo_2148_23] [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: 08/10/2023] [Revised: 12/01/2023] [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 W, Lin T, Gong L. ZD6474 Attenuates Fibrosis and Inhibits Neovascularization in Human Pterygium by Suppressing AKT-mTOR Signaling Pathway. J Ocul Pharmacol Ther 2023; 39:128-138. [PMID: 36576784 DOI: 10.1089/jop.2022.0127] [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] [Indexed: 12/29/2022] Open
Abstract
Purpose: To investigate the antifibrotic effect of ZD6474 in human pterygium fibroblasts (HPFs) and angiogenesis in human umbilical vein endothelial cells (HUVECs) compared with mitomycin C (MMC). Methods: Pterygium and tenon fibroblasts were isolated from patients undergoing surgery to culture HPFs and human tenon fibroblasts (HTFs). The effects of ZD6474 on HPF, HTF, and HUVEC proliferation and migration were detected using CCK8 and wound-healing assays, respectively. Fibrosis and epithelial-mesenchymal transformation (EMT) were evaluated by western blotting [transforming growth factor beta (TGF-β)1/2 and snail] and immunofluorescence (vimentin and α-smooth muscle actin). The antiangiogenic effect of ZD6474 on HUVECs was assessed using a tube formation assay. To determine the potential mechanism, the expression of phosphorylated AKT (p-AKT) and phosphorylated mTOR (p-mTOR) was evaluated by treatment with ZD6474 via western blotting. Results: ZD6474 robustly inhibited the proliferation and migration of HPFs rather than HTFs compared with those in the MMC group (**P < 0.01). In HPFs, fibrosis and EMT (vimentin, TGF-β1/2, and snail) were significantly reversed by ZD6474. MMC (>50 μg/mL) significantly reduced HTF viability, whereas ZD6474 (<5 μM/mL) did not decrease HTF viability. HUVEC proliferation and migration were clearly decreased, and tube formation was notably interrupted by ZD6474. Activation of p-AKT and p-mTOR was inhibited by ZD6474 treatment of HPFs and HUVECs. Conclusion: ZD6474 is more effective than MMC in reducing fibrosis and EMT in HPFs. In addition, ZD6474 was less toxic to HTFs. ZD6474 also exhibited antiangiogenic effects in HUVECs. This study may aid in the development of novel agents to prevent pterygium recurrence after pterygium excision.
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Affiliation(s)
- Wenting Liu
- Department of Ophthalmology and Vision Science, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Department of Ophthalmology, Huadong Hospital of Fudan University, Shanghai, China
| | - Tong Lin
- Department of Ophthalmology and Vision Science, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
| | - Lan Gong
- Department of Ophthalmology and Vision Science, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
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Maxia C, Isola M, Grecu E, Cuccu A, Scano A, Orrù G, Di Girolamo N, Diana A, Murtas D. Synergic Action of Insulin-like Growth Factor-2 and miRNA-483 in Pterygium Pathogenesis. Int J Mol Sci 2023; 24:ijms24054329. [PMID: 36901760 PMCID: PMC10002351 DOI: 10.3390/ijms24054329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
Pterygium is a multifactorial disease in which UV-B is speculated to play a key role by inducing oxidative stress and phototoxic DNA damage. In search for candidate molecules that are useful for justifying the intense epithelial proliferation observed in pterygium, our attention has been focused on Insulin-like Growth Factor 2 (IGF-2), mainly detected in embryonic and fetal somatic tissues, which regulate metabolic and mitogenic functions. The binding between IGF-2 and its receptor Insulin-like Growth Factor 1 Receptor (IGF-1R) activates the PI3K-AKT pathway, which leads to the regulation of cell growth, differentiation, and the expression of specific genes. Since IGF2 is regulated by parental imprinting, in different human tumors, the IGF2 Loss of Imprinting (LOI) results in IGF-2- and IGF2-derived intronic miR-483 overexpression. Based on these activities, the purpose of this study was to investigate the overexpression of IGF-2, IGF-1R, and miR-483. Using an immunohistochemical approach, we demonstrated an intense colocalized epithelial overexpression of IGF-2 and IGF-1R in most pterygium samples (Fisher's exact test, p = 0.021). RT-qPCR gene expression analysis confirmed IGF2 upregulation and demonstrated miR-483 expression in pterygium compared to normal conjunctiva (253.2-fold and 12.47-fold, respectively). Therefore, IGF-2/IGF-1R co-expression could suggest their interplay through the two different paracrine/autocrine IGF-2 routes for signaling transfer, which would activate the PI3K/AKT signaling pathway. In this scenario, miR-483 gene family transcription might synergically reinforce IGF-2 oncogenic function through its boosting pro-proliferative and antiapoptotic activity.
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Affiliation(s)
- Cristina Maxia
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
- Correspondence:
| | - Michela Isola
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Eleonora Grecu
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Alberto Cuccu
- Department of Surgical Science, Eye Clinic, Azienda Ospedaliero-Universitaria (AOU), 09123 Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Sciences, Molecular Biology Service Laboratory, University of Cagliari, 09123 Cagliari, Italy
| | - Germano Orrù
- Department of Surgical Sciences, Molecular Biology Service Laboratory, University of Cagliari, 09123 Cagliari, Italy
| | - Nick Di Girolamo
- Department of Pathology, School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 4385, Australia
| | - Andrea Diana
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
| | - Daniela Murtas
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy
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Fan J, Wei S, Zhang X, Chen L, Zhang X, Jiang Y, Sheng M, Chen Y. Resveratrol inhibits TGF-β1-induced fibrotic effects in human pterygium fibroblasts. Environ Health Prev Med 2023; 28:59. [PMID: 37866886 PMCID: PMC10613557 DOI: 10.1265/ehpm.23-00020] [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: 01/28/2023] [Accepted: 09/02/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Resveratrol is a polyphenolic phytoalexin which has the properties of anti-oxidant, anti-inflammatory and anti-fibrotic effects. The aim of this study was to investigate the anti-fibrotic effects of resveratrol in primary human pterygium fibroblasts (HPFs) and elucidate the underlying mechanisms. METHOD Profibrotic activation was induced by transforming growth factor-beta1 (TGF-β1). The expression of profibrotic markers, including type 1 collagen (COL1), α-smooth muscle actin (α-SMA), and fibronectin, were detected by western blot and quantitative real-time-PCR after treatment with various concentrations of resveratrol in HPFs to investigate the anti-fibrotic effects. Relative signaling pathways downstream of TGF-β1 were detected by Western blot to assess the underlying mechanism. Cell viability and apoptosis were assessed using CCK-8 assay and flow cytometry to evaluate proliferation and drug-induced cytotoxicity. Cell migration and contractile phenotype were detected through wound healing assay and collagen gel contraction assay. RESULTS The expression of α-SMA, FN and COL1 induced by TGF-β1 were suppressed by treatment with resveratrol in dose-dependent manner. The Smad3, mitogen-activated protein kinase (p38 MAPK) and phosphatidylinositol-3-kinase (PI3K) / protein kinase B (AKT) pathways were activated by TGF-β1, while resveratrol attenuated those pathways. Resveratrol also inhibited cellular proliferation, migration and contractile phenotype, and induced apoptosis in HPFs. CONCLUSIONS Resveratrol inhibit TGF-β1-induced myofibroblast activation and extra cellular matrix synthesis in HPFs, at least partly, by regulating the TGF-β/Smad3, p38 MAPK and PI3K/AKT pathways.
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Affiliation(s)
- Jianwu Fan
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
- Center for Clinical Research and Translational Medicine, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Shuang Wei
- Department of Ophthalmology, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201600, China
| | - Xiaoyan Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Li Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Xin Zhang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Yaping Jiang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
| | - Minjie Sheng
- Department of Ophthalmology, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201600, China
| | - Yihui Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai 200090, China
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Wan Q, Wan P, Liu W, cheng Y, Gu S, Shi Q, Su Y, Wang X, Liu C, Wang Z. Tear film cytokines as prognostic indicators for predicting early recurrent pterygium. Exp Eye Res 2022; 222:109140. [DOI: 10.1016/j.exer.2022.109140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/04/2022]
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Shen J, Li H, Chen Y, Jiang B, Zhu M, Feng S, Cui H. MiR-15a Participated in the Pathogenesis of Pterygium via Targeting BCL-2:An Experimental Research. Curr Eye Res 2021; 47:32-40. [PMID: 34225531 DOI: 10.1080/02713683.2021.1952603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: To compare the expression levels of miR-15a between pterygium and normal conjunctiva, and further investigate the potential role of miR-15a in the progression of pterygium.Methods: 21 cases of primary pterygium were enrolled in our study. The length of the pterygium invaded into the cornea and the total thickness of the pterygium were measured with anterior segment optical coherence tomography (AS-OCT). The pterygial and adjacent normal conjunctival samples of the 21 patients were collected. Expressions of miR-15a, BCL-2, Bax in both pterygium and normal conjunctiva were measured, and correlations between miR-15a and BCL-2, miR-15a and Bax, miR-15a and clinical parameters were made. Pterygium epithelial cells (PECs) were isolated, cultured and transfected with miR-15a mimic or miR-15a inhibitor to interfere the miR-15a expression levels. The regulation of BCL-2 expression by miR-15a was examined with Real-Time PCR (RT-PCR), Western blot and immunofluorescence. The regulation of Bax expression by miR-15a was also examined with Real-Time PCR (RT-PCR) and Western blot. The cell viability of the transfected PECs was measured with the CCK-8 assay and the apoptosis in these cells was detected using the TUNEL assay.Results: The expression of miR-15a, Bax were significantly decreased while the BCL-2 was significantly increased in pterygium (p < .05). There was a negative correlation in expression between miR-15a and BCL-2 in pterygium tissues (r = -0.516, p < .05). We also found that relative miR-15a level was positively correlated with the length of pterygium invaded into the cornea (r = -0.570, p < .05). In cultured PECs, miR-15a could downregulate the expression of BCL-2 and upregulate the expression of Bax. Promotion of miR-15a could suppress cell proliferation and promote cell apoptosis in cultured PECs.Conclusions: Our study demonstrated that decreased expression of miR-15a in pterygium might be associated with the apoptosis and proliferation of abnormal cell via regulating BCL-2, which could subsequently contribute to the development of pterygium. Downregulation of miR-15a might also contribute to the pathogenesis of pterygium by other mechanisms including abnormal proliferation and neovascularization, which remain to be investigated.
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Affiliation(s)
- Jianqin Shen
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Huiyan Li
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Yanhong Chen
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Bo Jiang
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Miaomiao Zhu
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Shi Feng
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
| | - Hongguang Cui
- Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, P.R.China
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Van Acker SI, Van den Bogerd B, Haagdorens M, Siozopoulou V, Ní Dhubhghaill S, Pintelon I, Koppen C. Pterygium-The Good, the Bad, and the Ugly. Cells 2021; 10:cells10071567. [PMID: 34206333 PMCID: PMC8305200 DOI: 10.3390/cells10071567] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pterygium is a multifaceted pathology that displays apparent conflicting characteristics: benign (e.g., self-limiting and superficial), bad (e.g., proliferative and potentially recurrent) and ugly (e.g., signs of preneoplastic transformation). The natural successive question is: why are we lacking reports showing that pterygium lesions become life-threatening through metastasis, especially since pterygium has considerable similarities with UV-related malignancies on the molecular level? In this review, we consider how our pathophysiological understanding of the benign pterygium pathology overlaps with ocular surface squamous neoplasia and skin cancer. The three UV-related disorders share the same initial insult (i.e., UV radiation) and responsive repair mechanisms to the ensuing (in)direct DNA damage. Their downstream apoptotic regulators and other cellular adaptations are remarkably alike. However, a complicating factor in understanding the fine line between the self-limiting nature of pterygium and the malignant transformation in other UV-related diseases is the prominent ambiguity in the pathological evaluation of pterygium biopsies. Features of preneoplastic transformation (i.e., dysplasia) are used to define normal cellular reactions (i.e., atypia and metaplasia) and vice versa. A uniform grading system could help in unraveling the true nature of this ancient disease and potentially help in identifying the earliest intervention point possible regarding the cellular switch that drives a cell’s fate towards cancer.
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Affiliation(s)
- Sara I. Van Acker
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Correspondence: ; Tel.: +32-3-265-2851
| | - Bert Van den Bogerd
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
| | - Michel Haagdorens
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
| | - Vasiliki Siozopoulou
- Department of Pathology, Antwerp University Hospital, University of Antwerp, 2650 Edegem, Belgium;
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, 2610 Wilrijk, Belgium
| | - Sorcha Ní Dhubhghaill
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Department of Ophthalmology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Isabel Pintelon
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, 2610 Wilrijk, Belgium;
| | - Carina Koppen
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Department of Ophthalmology, Antwerp University Hospital, 2650 Edegem, Belgium
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Hatsusaka N, Yamamoto N, Miyashita H, Shibuya E, Mita N, Yamazaki M, Shibata T, Ishida H, Ukai Y, Kubo E, Cheng HM, Sasaki H. Association among pterygium, cataracts, and cumulative ocular ultraviolet exposure: A cross-sectional study in Han people in China and Taiwan. PLoS One 2021; 16:e0253093. [PMID: 34129614 PMCID: PMC8205177 DOI: 10.1371/journal.pone.0253093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/27/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Pterygium is an ocular surface disorder mainly caused by ultraviolet (UV) light exposure. This study explored the relationships between six cataract types with pterygium and UV exposure. Methods We have previously studied cataracts in residents of three regions in China and Taiwan with different UV intensities. From that study, we identified 1,547 subjects with information on the presence or absence of pterygium. Pterygium severity was graded by corneal progress rate. Cataracts were graded by classification systems as three main types (cortical, nuclear, posterior subcapsular) and three subtypes (retrodots, waterclefts, fiber folds) with high prevalence in middle-aged and elderly people. We calculated the cumulative ocular UV exposure (COUV) based on subject data and National Aeronautics and Space Administration data on UV intensities and used logistic regression to calculate odds ratios for the associations of COUV, cataract, and pterygium. Results We found an overall pterygium prevalence of 23.3%, with significant variation among the three regions. Four cataract types (cortical, nuclear, posterior subcapsular, and retrodots) were significantly associated with the presence of pterygium. Conclusions There was a significant association between COUV and pterygium, indicating that COUV is associated with the risk of pterygium development and that pterygium is useful as an index of UV exposure. Furthermore, the type of cataract in eyes with pterygium may indicate the level of UV exposure.
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Affiliation(s)
- Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Naoki Yamamoto
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hisanori Miyashita
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Eri Shibuya
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Norihiro Mita
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Teppei Shibata
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hidetoshi Ishida
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Yuki Ukai
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | | | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
- * E-mail:
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Arora R. Commentary: Expression of p53 and Ki-67 proteins in patients with increasing severity and duration of pterygium. Indian J Ophthalmol 2021; 69:851. [PMID: 33727445 PMCID: PMC8012916 DOI: 10.4103/ijo.ijo_3098_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ritu Arora
- Guru Nanak Eye Center, Maulana Azad Medical College, New Delhi, India
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