Kinetics of Tear Fluid Proteins after Endothelial Keratoplasty and Predictive Factors for Recovery from Corneal Haze.
Nobuyo YawataSunita AwateYu-Chi LiuShi YuanKaing WoonJay SiakYoh-Ichi KawanoKoh-Hei SonodaJodhbir S MehtaMakoto YawataPublished in: Journal of clinical medicine (2019)
Endothelial keratoplasty (EK) is less invasive with faster recovery as compared to conventional penetrating keratoplasty, however, it relies on the clarity of the host corneal stroma. Corneal transplantation involves the induction of immune tolerance for allogeneic tissues as well as the corneal wound healing process, in which coordinated interactions between cytokines and growth factors are critical. In this study, we profiled the expression of 51 soluble factors in the tear fluid over the course of EK and have provided evidence of dynamic changes in cytokine expression in the ipsilateral and contralateral eyes. Cluster analyses classified the cytokine expression kinetics into five groups. Group 1 proteins included TGF-b1, IL-1b, and innate proinflammatory cytokines, which bilaterally increased after surgery, despite the use of topical corticosteroid in the transplanted eyes. Local corticosteroids suppressed cytokines involved in adaptive immunity in the transplanted eyes but not in the contralateral eyes. We found tear protein expression at baseline and one week post-surgery to be a potential predictive biomarker of delayed recovery after EK in terms of the corneal haze and visual acuity. Furthermore, Group 1 tear proteins were most associated with persistent corneal haze pre-surgery as well as visual acuity at one month-post transplant.
Keyphrases
- optical coherence tomography
- wound healing
- cataract surgery
- poor prognosis
- minimally invasive
- endothelial cells
- immune response
- coronary artery bypass
- binding protein
- clinical trial
- stem cell transplantation
- low dose
- randomized controlled trial
- risk assessment
- stem cells
- coronary artery disease
- atrial fibrillation
- transforming growth factor
- human health
- cell therapy