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Xingwu Zhong, Jun Yang, Hong He; Morphological Evidence of M Cells in Vernal Keratoconjunctivitis Conjunctival Papilla. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3995.
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To characterize the follicle-associated epithelium (FAE) and organized lymphoid nodules from vernal keratoconjunctivitis (VKC) tarsal giant papillae to determine if VKC conjunctival papilla contains M cells analogous to those described in other regions of mucosa-associated lymphoid tissue (MALT).
Six biopsies of tarsal giant papillae were obtained from vernal keratoconjunctivitis patients as experimental group. The tissues were fixed in 10% formaldehyde and embedded in paraffin. Sections were used for studies of histology and immunohistochemistry of pan-B and pan-T cell distributions. The tissues were fixed in 2.5% glutaraldehyde were used for studies of scanning electron microscope(SEM) and transmission electron microscope(TEM). Superior tarsal conjunctival samples were obtained from eight operation patients without conjunctival congestion, follicle, papilla and scar in their superior tarsal conjunctiva. These eight patients regard as normal control to VKC patients. Specimens were also assessed by histology, immunohistochemistry, and transmission and scanning electron microscopy.
Histopathological studies show marked changes in tarsal conjunctiva, with a prominent inflammatory cellular infiltration in the epithelium and substantia propria. Immunohistochemical analyses demonstrated significantly increased CD3+ T cells and CD20+ B cells in VKC tissues. And it can be observed conjunctival thickening, subepithelial fibrosis, mucus metaplasia, neovascularization and collagen hyperproduction. SEM discovered membranous epithelial cells with longer and irregular microvilli. TEM demonstrated the FAE overlying CALT contain morphology characteristic of M cells, including attenuated apical cell surface with longer and irregular microvilli and microfolds, invaginated basolateral membrane forming a cytoplasmic pocket containing lymphocytes and granulocytes. In control group, we could not found FAE or morphology characteristic M cells in hematoxylin eosin stain, SEM and TEM.
The FAE overlying VKC patients’ conjunctival papillae demonstrated morphology characteristic of M cells, as well as the distribution of T and B lymphocytes subtending this region.
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