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C. Garcher, N. Buron, P.O. Lafontaine, M. Souchier, S. Arnavielle, E. Solary, F. Brignolle, C. Baudouin, A.M. Bron; TFF1, MUC5AC and HLA–DR Expression by Conjunctival Cells in Chronically Treated Glaucomatous Patients. Could These Markers Predict the Success of Antiglaucomatous Surgery? . Invest. Ophthalmol. Vis. Sci. 2005;46(13):63.
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Purpose: Conjunctival inflammation may impair the outcome of glaucoma surgery and topical antiglaucomatous treatment could lead to conjunctival inflammation. TFF1 are secretory products of mucous epithelial cells which have protective and healing properties in mucosal tissues. They are co–expressed and act in concert with MUC5AC. HLA–DR expression is a marker of local inflammation. Our aim was to assess conjunctival expression of HLA–DR, TFF1 and MUC5AC in chronically treated glaucomatous patients and to see whether these parameters could predict the outcome of glaucoma surgery. Methods: We performed 77 conjunctival impressions cytologies in glaucomatous patients (66 receiving drops with preservative, 11 preservative free) and in 43 controls. TFF1, MUC5AC and HLA–DR expression were analyzed by flow cytometry. Trabeculectomy or deep–sclerectomy were performed one day after the impression cytology in 56 patients; success was defined as an IOP<15 mm Hg without any lowering IOP drug at three months. Results: The expression of TFF1, MUC5AC and HLA–DR expression was statistically higher in chronically treated patients vs controls (p=0.01, 0.05, 0.004 respectively). A higher expression of MUC5AC was found in patients having treatment with preservative vs non preserved drops (p=0.04). Successful glaucoma surgeries had a higher MUC5AC and lower HLA–DR expression vs failure surgeries. Conclusions: TFF1 and MUC5AC secretion is probably a response to surface ocular alterations due to a long term topical treatment. Their increased expression could be a predicting factor of a successful antiglaucomatous surgery.
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