Abstract
Purpose: :
To identify changes in levels of gene expression associated with wound healing and bleb failure after glaucoma surgery.
Methods: :
This study was performed in 6 patients with uncontrolled open angle glaucoma (POAG) treated by nonpenetrating deep sclerectomy (NPDS). Total RNAs were isolated from conjunctiva obtained from impression cytology and peripheral blood at different moments (surgery, 15 days, 1, 3, 6 and 12 months after the NPDS). The total RNA was reversely transcribed to cDNA. We performed a RT-PCR Array based on differences between profile expressions of 88 genes previously related to wound healing. Statistical comparisons with baseline were performed with non parametric tests, correlation between IOP and gene expression was analysed with the Pearson's correlation test. Correlation between the gene expression pattern and the surgical success/failure was explored with the principal component analysis (PCA). Level of significance was P < 0.05.
Results: :
When compared with baseline, 13 of 88 blood genes and 29 of 88 conjunctival genes showed expression changes. The most significant changes occurred in the conjunctiva in the first two weeks after the surgery: up-regulation of CDKN1A and 2A (4.08 fold and 5.96 fold), IL-8 (140.17 fold), TGFA (3.08 fold) and VEGFA (7.01 fold). One year after the surgery, the conjunctiva and blood recovered their baseline levels in gene expression profiles. One blood gene and 15 conjunctival genes showed an expression that correlated with IOP. The only patient with surgical failure one year after the NPDS, showed a preoperative conjunctival gene expression profile that differed from the remaining patients.
Conclusions: :
Different expression patterns of mediators of the bleb wound healing process were identified. RT-PCR Array provided a powerful tool for investigating differential gene expression in wound healing in glaucoma surgery.
Keywords: gene/expression • wound healing • conjunctiva