ABSTRACT
Amniotic membrane transplantation (AMT) leads to reduction of inflammatory symptoms and causes faster epithelisation in corneal ulcers and persistant epithelial defect. 21 patients with corneal ulcer (n = 18) or non-healing epithelial defect (n = 3) unresponsive to conventional treatment were included in the study. All patients were treated by AMT. Corneal epithelial cells in patients suffering from corneal ulcer secreted 3.51 +/- 1.79 of IL-1alpha, 64.27 +/- 31.53 pg/mL of TNFalpha and 209.07 +/- 201.82 pg/mL of VEGF. Levels of all 3 investigated cytokines were significantly higher as compared to controls (p < 0.005). Amniotic membranes that were used contained 775.69 +/- 613.98 pg/mL of IL-1alpha, 0.036 +/- 0.033 pg/mL of sTNF and 175.01 +/- 166.63 pg/mL of VEGF-R. Supporting effect of the AMT could be explained by the fact that AM secretes its natural antinflammatory antagonists IL-1ra, sTNF and VEGF-R.
Subject(s)
Amnion/transplantation , Corneal Ulcer/surgery , Graft Survival/immunology , Keratitis/surgery , Amnion/immunology , Amnion/metabolism , Corneal Ulcer/immunology , Humans , Interleukin 1 Receptor Antagonist Protein/immunology , Interleukin 1 Receptor Antagonist Protein/metabolism , Keratitis/immunology , Prospective Studies , Receptors, Vascular Endothelial Growth Factor/immunology , Receptors, Vascular Endothelial Growth Factor/metabolism , Tumor Necrosis Factor-alpha/immunology , Tumor Necrosis Factor-alpha/metabolismABSTRACT
Bullous keratopathy (BK) is a chronic corneal edema with or without subepithelial bullae as a result of a loss of the endothelial cells. 15 patients with BK after cataract surgery with intraocular lens implantation, due to Fuchs dystrophy (n = 3) or corneal endothelial trauma (n = 12) were included in the study. All patients were treated by amniotic membrane transplantation (AMT). Corneal epithelial cells in patients suffering from BK secreted 3.91 +/- 3.09 pg/mL of IL-1 alpha, 4446 +/- 16.8 pg/mL of TNF and 81.43 +/- 37.81 pg/mL of VEGF-I. Levels of all 3 investigated cytokines were significantly higher as compared to controls (p < 0.005). Amniotic membranes that were used to treat investigated patients contained 638.98 +/- 613.98 pg/mL of IL-1ra, 0.026 +/- 0.009 pg/mL of sTNF and 81.39 +/- 21.01 pg/mL of VEGF-R. Beneficial clinical effect of the AMT in treating BK could be explained by its natural production of pro-inflammatory cytokine antagonists such as IL-ra, sTNF antagonist and VEGF-R.
Subject(s)
Amnion/transplantation , Corneal Edema/surgery , Fuchs' Endothelial Dystrophy/surgery , Interleukin-1alpha/immunology , Receptors, Vascular Endothelial Growth Factor/immunology , Tumor Necrosis Factor-alpha/immunology , Amnion/immunology , Amnion/metabolism , Cornea/immunology , Cornea/metabolism , Cornea/surgery , Corneal Edema/immunology , Fuchs' Endothelial Dystrophy/immunology , Graft Survival/immunology , Humans , Interleukin-1alpha/metabolism , Prospective Studies , Receptors, Vascular Endothelial Growth Factor/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
Considering that VEGF is the key factor for angiogenesis stimulation, we wanted to establish if VEGF level is increased in aqueous humor of patients with open globe eye injury. The study included 20 patients with open globe injury. During the surgery, aqueous humor samples were taken out and VEGF levels were measured by ELISA. VEGF levels were significantly higher in the aqueous humor of patients with open globe eye injury and uveitis, in patients with wound bigger than 2 mm and in patients where from injury to surgery passed more than 4 hours. VEGF levels were also higher, but not significantly, in patients with intrabulbar foreign body. Considering that VEGF levels were significantly higher in patients with open globe eye injury with uveitis, wound larger than 2 mm and in patients where from injury to surgery passed more than 4 hours, anti VEGF therapy might have application in these conditions.
