In this study, the results of functional enrichment analysis indicated that ECM-receptor interaction, focal adhesion, apoptosis, and PI3K-Akt signaling pathway were involved with significant DEGs. These results were in agreement with previous proteomics study by Hou,
39 in which they compared the protein expression from the conditioned medium of paired pterygium and normal conjunctival fibroblast cells from the same patients by iTRAQ-based proteomics strategy, and they found the differenced protein might serve as extracellular ligands to activate intracellular pathways. Aberrant ECM expressions were found to be a major characteristic feature of pterygium. ECM and its receptors, including fibronectin, versican, collagen III, and SPARC, were shown to be upregulated and remodeled in pterygium,
40–42 and they have turned out to be regulated by matrix metalloproteinase (MMP), an essential enzyme in local proteolysis of the extracellular matrix.
43 UV irradiation may lead to the imbalance of MMPs and its inhibitors TIMP, which enable the pterygial cells to dissolve corneal epithelium and Bowman's layer and invade the corneal stroma.
44–46 Besides, impression cytology specimens of pterygium show fewer apoptotic markers, and PI3K-Akt inhibitor has been proved to reduce the TGF-β-induced synthesis of FN in human pterygium fibroblasts.
47 Moreover, our GSEA-based GO analysis confirmed keratinization and cornification pathway participated in the pathogenesis of pterygium. Previous reports have confirmed that the expression of keratin markers is upregulated in the epithelium of pterygium, and takes effect in the epithelial abnormal differentiation.
48–50 Liu constructed pterygium-related mRNA libraries by using microarray and found upregulated mRNAs were closely related to proliferation and differentiation.
51 If our results were combined with publications mentioned above, we could surmise the underlying mechanisms of pterygium that dysregulation of ECM proteins caused by increased expression of MMP might activate intracellular PI3K-Akt signaling pathway, leading to anti-apoptosis of fibroblast, abnormal matrix protein deposition, and hyperproliferation and keratinization of pterygial cells.