Background/Aims:Stevens Johnson syndrome (SJS), ocular cicatricial pemphigoid (OCP), and alkali burns are associated with chronic, severe inflammation of the ocular surface which occasionally lead to corneal stem cell deficiencies. The corneal stroma in these diseases has not been studied comprehensively. The purpose of this study was to determine whether the keratocytes in the stroma were normal and the stroma remained inflamed in the chronic phase of these diseases.
Methods:Five pathological corneas, two with SJS, two with OCP, and one with an alkali burn were examined. Corneal specimens were obtained during lamellar keratoplasty, and histological sections were immunostained with antibodies against CD34 and several cell surface antigens. The level of expression of proteoglycans (lumican, keratocan, biglycan) and chemokines (MCP1, MIP1α, MIP1β) were examined by quantitative real time RT-PCR.
Results: The number of CD34 positive cells in the stroma was decreased, and the expression level of biglycan increased in all of the pathological corneas. The numbers of CD45-positive and CD14-positive cells were increased in 4 of the 5 pathological corneas. The expression level of MIP1α and MIP1β were markedly increased in all of the pathological corneas.
Conclusions: These findings indicate that the keratocytes are abnormal and inflammation is still present in the corneal stroma at the chronic phase of SJS, OCP and alkali burns.
- Ocular surface
- corneal stroma
- severe ocular surface diseases with stem cell deificiency