Immunologic Basis for the Pathogenesis of Pterygium

doi:10.1016/0002-9394(87)90358-8

American Journal of Ophthalmology

Volume 98, Issue 2, August 1984, Pages 225-228

https://doi.org/10.1016/0002-9394(87)90358-8 Get rights and content

We examined surgically excised pterygial tissues from 26 patients for the various immunoglobulin classes by direct immunofluorescence. Of the 26 patients, 19 (73.1%) showed positive staining with goat anti-human IgG fluorescein-labeled antibody. Direct immunofluorescence with goat anti-human IgE fluorescein-labeled antibody was found in all 26 samples, varying in fluorescent intensity from 1+ to 4+. Routine histologic staining disclosed an infiltration of small lymphocytes and plasma cells into the pterygium. These results suggest that an immunologic mechanism, possibly Type 1 hypersensitivity, may contribute to the pathogenesis of pterygium.

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Pterygium is a vision-threatening conjunctival fibrovascular degenerated disease with a high global prevalence up to 12 %, while no absolute pharmacotherapy has been applied in clinics. In virtue of single-cell RNA sequencing (scRNA-seq) technique, our study investigated underlying pathogeneses and potential therapeutic targets of pterygium from the cellular transcriptional level.
A total of 45605 cells from pterygium of patients and conjunctiva of normal controls (NC) were conducted with scRNA-seq, and then analyzed via integrated analysis, pathway enrichment, pseudotime trajectory, and cell-cell communications. Besides, immunofluorescence and western blot were performed in vivo and in vitro to verify our findings.
In brief, 9 major cellular types were defined, according to canonical markers. Subsequently, we further determined the subgroups of each major cell lineages. Several newly identified cell sub-clusters could promote pterygium, including immuno-fibroblasts, epithelial mesenchymal transition (EMT)-epithelial cells, and activated vascular endothelial cells (activated-vEndo). Besides, we also probed the enrichment of immune cells in pterygium. Particularly, macrophages, recruited by ACKR1⁺activated-vEndo, might play an important role in the development of pterygium by promoting angiogenesis, immune suppression, and inflammation.
An intricate cellular niche was revealed in pterygium via scRNA-seq analysis and the interactions between macrophages and ACKR1⁺ activated-vEndo might be the key part in the development of pterygia.
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Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed.
Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, “sick” building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases.
A systematic review was conducted to answer the following research question: “What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?” Dry eye disease is associated with air pollution (from NO₂) and soil pollution (from chromium), but not from air pollution from CO or PM₁₀.
Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.
Evaluation of transforming growth factor-beta1 gene expression in pterygium tissue of atopic patients
2016, Journal of the Chinese Medical Association
Citation Excerpt :
Although some environmental factors (e.g., wind, dust, heat, infection, smoke, chemicals, dry eye, and pollens) are suggested to play a role in the pathogenesis of pterygium,1–3 the exact etiology of this condition is still not fully understood. Some investigators have proposed an allergic and immunological basis for the pathogenesis of pterygium.4,5 Several growth factors, cytokines, and metalloproteinase enzymes are identified in the cornea during the recovery time after photorefractive keratectomy.
The exact pathogenesis of pterygium is still not fully understood. Growth factors are considered to play an important role in the formation of pterygium. Transforming growth factor (TGF)-β1 is considered to be one of the main mediators of fibroblast stimulation and tissue remodeling in allergic conditions. The objective of the present study was to investigate the association between TGF-β1 gene expression and pterygium in atopic and nonatopic participants.
We used questionnaires to record demographic and clinical information from patients who underwent pterygium excision surgery. Skin prick examination was done to confirm or rule out atopy in 30 patients with atopy (Case Group) and 30 individuals without atopy (Control Group). Additionally, measurement of serum immunoglobulin E, cytokines, including interleukin-4 and interferon-γ, and peripheral blood eosinophil count was performed to confirm atopy in 30 consecutive patients (Case Group). A semiquantitative reverse transcription polymerase chain reaction was performed to determine TGF-β1 gene expression in all individuals.
TGF-β1 mRNA gene expression was significantly higher (p = 0.0001) in atopic patients 2.50 ± 1.11 compared to nonatopic individuals 1.40 ± 0.46. Eosinophil count and serum immunoglobulin E were significantly higher (p = 0.031 and p = 0.001, respectively) in atopic patients compared to the Control Group. Serum interleukin-4 was also significantly higher (p = 0.01) in atopic patients compared with nonatopic individuals.
Excess expression of TGF-β1 gene in pterygium tissue of atopic individuals suggests that growth factors play a role in the pathogenesis of pterygium.
Are inflammation-related diseases risk factors for primary acquired nasolacrimal duct obstruction? A large scale, national case-control study
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Are Periocular and Systemic Allergy Conditions Risk Factors for Pterygium?
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This study was supported by the Pacific Health Research Institute.

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Immunologic Basis for the Pathogenesis of Pterygium

Ophthalmology

Am. J. Ophthalmol.

The aetiology and histopathogenesis of pterygium. A review of the literature and a hypothesis

Doc. Ophthalmol.

Conjunctiva

The surgery of pterygium

Trans. Ophthalmol. Soc. N.Z.

A hypothesis on the pathogenesis of pterygiums

Ann. Ophthalmol.