Peptide growth factors present in the cornea and tear film, such as insulin-like growth factor (IGF), platelet derived growth factor (PDGF), FGF, IL-1α and TGFβ,
8 –11 are postulated to play an important role in modulating the keratocyte phenotype during corneal wound healing. In cell culture, these growth factors differentially regulate keratocyte proliferation, cytoskeletal organization, and ECM synthesis. Keratocytes cultured under serum-free conditions maintain the quiescent, dendritic phenotype normally observed in vivo.
12,13 IGF stimulates keratocyte proliferation without altering cell morphology, cytoskeletal organization, or downregulating keratocan sulfate proteoglycan (KSPG) synthesis.
14,15 In contrast, exposure to serum results in fibroblast differentiation, as indicated by the assumption of a bipolar morphology, formation of intracellular stress fibers, and downregulation of keratin sulfate proteoglycan expression.
13,16 –18 PDGF and basic FGF (FGF2) have also been shown to activate corneal keratocytes in vitro, but have distinct effects on cell morphology, cytoskeletal organization, and proteoglycan synthesis.
14,15,19,20 TGFβ induces myofibroblast differentiation, as indicated by expression of stress fibers containing α-smooth muscle actin (α-SMA),
21 and production of abnormal, fibrotic ECM.
15,20,22 PDGF participates in TGFβ-induced myofibroblast differentiation through an autocrine feedback loop,
23 whereas FGF2 has been shown to reduce expression of α-SMA.
24