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L. Motterle, V. Saez, C. Garcia, Y. Diebold, A. Enriquez de Salamanca, J.M. Herreras, M.E. Stern, A. leonardi, M. Calonge; Expression of Neurotransmitter Receptors and Vip in Conjunctival Biopsies of Vernal Keratoconjunctivitis Patients . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3743.
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Purpose: There is growing evidence proving that autonomic innervation is involved in the pathogenesis of atopic disorders, such as mucus hypersecretion, goblet cell hyperplasia, and conjunctival non-specific hyperreactivity. We have recently described the expression of muscarinic, α and ß-adrenergic receptor subtypes in normal conjunctival biopsies. In the present study, the expression of muscarinic and adrenergic neurotransmitter receptors and the parasympathetic neurotransmitter VIP was evaluated in conjunctival biopsies of inflamed vernal keratoconjunctivitis (VKC) patients. Methods: Biopsies of upper tarsal conjunctiva from eight VKC patients with active inflammation and from four healthy subjects were processed for immunoperoxidase staining. Frozen sections were incubated with primary antibodies against M1-, M2- and M3- muscarinic, and ß1-adrenergic receptors, and VIP. Sections were subsequently incubated with a secondary biotinylated-antibody. Results: M2-muscarinic and ß1-adrenergic receptor and VIP expression (but not M1- or M3-muscarinic receptors) were increased in the epithelium (goblet and non-goblet cells) of VKC patients compared to normals. All neurotransmitter receptors studied and VIP were expressed in the inflammatory infiltrate invading the substantia propria of inflamed VKC patients, while there was no expression in control biopsies. Conclusions: Inflamed conjunctiva from VKC patients showed a clear alteration in muscarinic and ß1-adrenergic receptor, and VIP expression. These results further support the involvement of autonomic disfunction in the pathogenesis of VKC.
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