Ocular surface and MUC5AC alterations in atopic patients with corneal shield ulcers

Murat Dogru, Naoko Asano-Kato, Mari Tanaka, Ayako Igarashi, Shigeto Shimmura, Jun Shimazaki, Naoko Okada, Yoji Takano, Kazumi Fukagawa, Kazuo Tsubota, Hiroshi Fujishima

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Purpose: To describe MUC5AC alterations and the ocular surface disorder in atopic patients with or without corneal ulcers. Methods: Atopic patients' eyes were divided into two groups according to the presence and absence of corneal ulceration. The subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface and conjunctival impression cytology and brush cytology. Impression cytology samples underwent PAS and immunohistochemical staining for MUC5AC. Brush cytology specimens underwent evaluation for inflammatory cell expression and quantitative real-time PCR for MUC5AC mRNA expression. The differences related to the tear function and ocular surface examination parameters between patients with and without corneal ulceration and healthy control subjects were studied. In addition, the differences of the study parameters related to ocular surface epithelial health and inflammatory status between patient eyes with atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) were investigated. Results: The mean corneal sensitivity and BUT values were significantly lower in atopic patients with corneal ulcers, compared to patients without ulcers and controls (p < 0.001). Brush cytology specimens from patients with corneal ulcers revealed significantly higher expression of inflammatory cells compared to patients without ulcers and controls (p < 0.001). Impression cytology samples from eyes with corneal ulcers showed significant squamous metaplasia and reduction in goblet cell density compared to eyes without ulcers and eyes of control subjects. The mean squamous metaplasia grade was significantly higher in eyes with AKC compared to eyes with VKC (p < 0.02). The mean goblet cell density was significantly lower in eyes with AKC compared to eyes with VKC (p < 0.01). Specimens from eyes with corneal ulcers showed PAS positive mucin pickup and did not stain positive for MUC5AC. MUC5AC mRNA expression was significantly lower in eyes with corneal ulcers compared to eyes without ulcers and eyes of control subjects. MUC5AC mRNA expression was also significantly lower in eyes with AKC compared to eyes with VKC. Conclusions: Ocular surface inflammation, tear film instability, and decreased conjunctival MUC5AC mRNA expression were thought to be important in the pathogenesis of noninfectious corneal shield ulcers in atopic ocular surface disease.

Original languageEnglish
Pages (from-to)897-908
Number of pages12
JournalCurrent Eye Research
Volume30
Issue number10
DOIs
Publication statusPublished - 2005 Oct 1

Keywords

  • Atopy
  • Conjunctival squamous metaplasia
  • Corneal sensitivity
  • Corneal ulcer
  • Goblet cell
  • Impression cytology
  • Tear film

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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