Abstract
Abstract: :
Purpose: Macrophage accumulation in the conjunctiva is an important histologic feature in ocular cicatricial pemphigoid (OCP). We examined the role of macrophage colony-stimulating factor (m-CSF) in the pathogenesis of OCP. Method: Biopsies from the conjunctiva of 10 untreated patients with OCP and 5 normal subjects were studied for the expression of m-CSF, CD-68 and proliferating cell nuclear antigen (PCNA), by immunohistochemistry. In addition, fibroblasts isolated from conjunctiva of normal individuals and OCP patients were studied for the expression of m-CSF by immuno-staining and quantitative real-time PCR. Role of IL-1 and TNF-α on the induction of m-CSF by conjunctival fibroblasts was also studied. Results: Compared to the weak expression of m-CSF in the normal conjunctiva, a significant increase (p<0.0001) in the expression of m-CSF was noted in biopsies obtained from conjunctiva of OCP patients; similar increase (1.2 fold) in the expression of m-CSF mRNA was also detected by real-time PCR. Increased expression m-CSF significantly correlated (p<0.004) with an increased stromal accumulation of macrophages in conjunctival biopsies of OCP patients. Compared with normal conjunctival fibroblasts, an increased (1.7-fold) expression of m-CSF was detected in fibroblasts isolated from conjunctiva of OCP patients. When normal conjunctival fibroblasts were treated with IL-1 or TNF-α, an increased level of m-CSF was detected both in mRNA and protein level. Conclusion: A positive correlation between m-CSF expression and macrophage accumulation was seen in conjunctival sections biopsied from patients with OCP. Increased expression of m-CSF, mainly by conjunctival fibroblasts and infiltrating inflammatory cells, may play an important role in regulation of local accumulation of macrophages in the conjunctiva of OCP patients. This process could augment or enhance the local inflammatory responses and tissue injuries consequent to it, in the conjunctiva of OCP patients.
Keywords: 365 conjunctiva • 327 autoimmune disease • 434 immunohistochemistry