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M. F. Chan, R. A. Sack, S. Sathe, T. Vijmasi, S. Li, E. C. Strauss, D. S. Holsclaw, D. Quigley, N. A. McNamara; Protein Array Analysis of Immune and Angiogenic Modulators in Ocular Cicatricial Pemphigoid. Invest. Ophthalmol. Vis. Sci. 2008;49(13):818.
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Ocular Cicatricial Pemphigoid (OCP) is a chronic, inflammatory, and neovascular disease process that can progress to permanent visual disability. Current diagnosis and evaluation of active disease relies on conjunctival biopsies which can lead to further inflammation and scarring. The study was designed to determine if tears collected from OCP patients can be used to evaluate the regulation of immune and angiogenic proteins in active and treated disease.
Tears samples were collected from 3 patients with biopsy-proven OCP during their clinically active state and after systemic immunosuppression. Tear samples were also collected from 3 control subjects with no prior ocular or systemic disease. The tear samples were screened for 43 cytokines, growth factors, angiogenic factors, and immune and inflammatory modulators using membrane arrays.
Array analysis allowed the detection of several proteins in human tears using clinically obtainable samples. The signals for several entities including IL-8, MMP-9, MCP-1 and IL-6 were up-regulated in all of the three newly diagnosed OCP samples. Up-regulation of IL-8 was particularly strong. After systemic immunosuppression, a modest decrease in the expression of most proteins was observed. IL-8 and MMP-9 showed a dramatic post-treatment decrease in two of the three OCP patients, while IL-6 and MCP-1 showed more modest decreases. Changes in protein expression after treatment paralleled clinical observations of the patients.
Our results suggest that protein array analysis of tear samples from OCP patients can be used to evaluate clinical response. IL-8, MMP-9, MCP-1 and IL-6 are upregulated during active disease and may be key factors to study as part of a protein expression signature for OCP. Observed levels of these proteins may be useful for assessing disease severity and therapeutic response. Further study is necessary to determine the validity of tear proteins as clinical biomarkers and their functional significance in the pathogenesis of OCP.
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