Aims To examine the expression of Toll-like receptor (TLR) 5 in the conjunctival epithelium of patients with severe ocular surface diseases.

Methods Immunohistochemical study of TLR5 was performed on conjunctival tissues obtained from patients undergoing surgical reconstruction of the ocular surface to treat Stevens-Johnson syndrome (SJS) (n=4), ocular cicatricial pemphigoid (OCP) (n=3), chemical eye burn (n=3), and pterygium (n=2), and on nearly normal conjunctival tissues obtained during surgery for four cases of conjunctivochalasis as a control.

Results TLR5 protein was consistently and abundantly expressed in the conjunctival epithelium and detected only at the basal and wing cells. However, in the conjunctival epithelium obtained from the patients with SJS, OCP and chemical eye burns, the TLR5 protein was detected at not only the basal and wing cells but also at the superficial cells. TLR5 protein detected in the pterygium patients mirrored that detected in the controls.

Conclusions Although TLR5 was normally present on the basal and wing cells of conjunctival epithelium with spatially selective presence, it was expressed on not only the basal and wing cells but also the superficial cells in the conjunctival epithelium of patients with SJS, OCP or chemical eye burns, suggesting that TLR5 might be upregulated in the conjunctival epithelium of these diseases.