Abstract
Abstract: :
Purpose: In Stevens–Johnson syndrome (SJS) and ocular cicatricial pemphigoid (OCP), prolonged inflammation of the ocular surface occurs. To clarify the pathology of the disease, expression of proteins related to keratinization and infiltration of inflammation cells in the conjunctiva from SJS and OCP patients were examined. Methods: Pathological conjunctival tissues covering cornea were obtained from SJS and OCP patients at surgery. Normal conjunctival tissues were also obtained from volunteers at conjunctival chalasis surgeries. These tissues were embedded in OCT compound and snap–frozen with liquid nitrogen. Frozen tissues were sectioned at 6 µm and subjected to an indirect fluorescent immunohistochemical analysis. Primary antibodies included cytokeratin (1, 4, 6, 10, 13, 16, and 17), keratinization related proteins (loricrin, transglutaminase 1, involucrin, filaggrin, and SPRR2), markers of infiltration cells (CD3, CD4, CD8, CD68, HLA–DR, LFA–1, CD20, CD45, and ICAM–1) and proliferation–related marker Ki67. Antibodies against C3, IgG, and IgA were also used for the detection of immunoprecipitations. Results: Elevated levels of cytokeratin 6/16 and Ki67 were demonstrated in the conjunctival epithelium of SJS and OCP by immunostaining. Most of the conjunctival epithelium of SJS and OCP had elevated levels of keratinization–related proteins (cytokeratin 1/10, transglutaminase 1, involucrin, and filaggrin). CD3 (pan T cell), HLA–DR, and neutrophil elastase positive cells increased in the subepithelium. Conclusions: The conjunctival tissues of SJS and OCP patients exhibit significant level of inflammatory cell infiltration in the substantia propria. Also, the epithelium of these diseases have an inclination of progressive keratinization and accelerated cell proliferation.
Keywords: immunohistochemistry • conjunctiva • pathology: human