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E. Inagaki, Y. Ogawa, Y. Matsumoto, T. Kawakita, S. Shimmura, K. Tsubota; Matrix Metalloproteinase (MMP)-9 is Expressed During Corneal Perforation in Chronic Graft-Versus-Host Disease. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6406.
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To investigate the etiology of corneal perforation in human ocular chronic graft-versus-host disease (cGVHD) following allogenic hematopoietic stem cell transplantation.
Four ocular cGVHD patients (1 female, 3 males; mean age 52.3±21.6 years) suffering from corneal perforation were enrolled in the study. After informed consents were obtained, we examined perforated corneal samples obtained following keratoplasty. Paraffin-embedded and frozen tissue sections were examined by hematoxin-eosin staining and immunohistochemistry. Eye Bank donor corneas were used as controls.
Hematoxin-eosin staining showed that neutrophils were scarcely detected around the perforated ulcerative lesion in cGVHD corneas. However, immunohistochemistry revealed that the number of CD68-positive macrophages surrounding the perforated lesion increased compared to control. Both CD4+ and CD8+ T cells were not detected at the site of corneal perforation in this study. Immunoreactivity for matrix metalloproteinase (MMP)-9 was detected in the corneal stroma and endothelium, but not in control samples. MMP-2 was not detected both cGVHD and control samples.
Both MMP-9 and CD68-positive macrophages may play an important role in the process of corneal perforation in cGVHD.
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