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Editors Selection IGR 8-4
Surgical treatment: Conjunctiva
Comment by Mark Sherwood on:
15219 Trefoil factor family 1, MUC5AC and human leucocyte antigen-DR expression by conjunctival cells in patients with glaucoma treated with chronic drugs: could these markers predict the success of glaucoma surgery?, Souchier M; Buron N; Lafontaine PO et al., British Journal of Ophthalmology, 2006; 90: 1366-1369
In this prospective, observational, case-control study by Souchier et al. (987) impression cytology specimens were taken from 77 eyes of 77 caucasian, POAG patients who had received one or more topical glaucoma medications for a minimum of six months. Preservative-free drops were used in 11 of the patients. Of the 77 patients, 56 underwent trabeculectomy, and for this procedure surgical success was defined as an IOP of < 15 mmHg without therapy at 6 months.
Impression cytology specimens were also obtained from a further 43 healthy subjects on no topical treatment as a control, although as a group these were significantly younger than the glaucoma patients.
Trefoil factor family peptides are secretory products of mucous epithelia thought to be involved with protection and healing of mucosal tissue, and MUC5AC is a goblet cell derived gel-forming mucin. TFF1, MUC5AC and human leukocyte antigen-DR (HLA-DR) expression were analyzed using flow cytometry and were significantly higher in the glaucoma patients than controls. Previous studies have also shown an increased expression of HLA-DR in the conjunctival cells of treated glaucoma patients reflecting a low-grade inflammation A higher MUC5AC expression and a lower HLA-DR expression was found in successful surgical patients than in the failures. The effect of BAK preservative on inflammatory markers could not be clearly defined in this study because of the low number of patients in the preservative-free group but of interest MUC5AC expression was higher in patients who had received the preserved drops rather than preservative-free.
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