Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Kolozsvári, Bence Lajos; Petrovski, Goran; Gogolák, Péter; Rajnavölgyi, Éva; Tóth, Flóra; Berta, András; Fodor, Mariann

doi:10.1159/000351626

Cited by 40 publications

(49 citation statements)

References 23 publications

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“…58 56 We are only beginning to understand the complexity of the interactions of all these mediators in several inflammatory pathways in KC.…”

Section: Discussionmentioning

confidence: 99%

“…The levels of IL-6 are increased in KC corneas. 30,33,56,57 Keratocytes produce IL-6 upon stimulation with IL-1. 57 Interestingly, eye rubbing and contact lens wear, which are closely associated with KC, increase the levels of IL-6 in tear fluid in KC.…”

Section: B Interleukin-6mentioning

confidence: 99%

“…69 Indeed, the levels of IL-17A were shown to be associated with center Keratoconus-Index and Index-of-Surface Variance after CXL. 56 Although IL-17 is the principle cytokine produced by T helper17 (Th17) cells (Th17 cells are upregulated by TGF-ß and IL-6, which are themselves both upregulated in keratoconus cornea [31][32][33]70,71 ), it can be produced by many other cell types. 72,73 Curiously, in herpetic stromal…”

Section: Interleukin-17mentioning

confidence: 99%

“…87 NGF, a normal constituent of the tear film, is increased in KC corneas. 56 The cornea is a naturally avascular and highly innervated organ. NGF is considered to play a role in wound healing of the cornea, and it affects corneal epithelial cell proliferation.…”

Section: F Vascular Endothelial Growth Factor and Nerve Growth Factormentioning

confidence: 99%

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Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review

et al. 2015

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“…58 56 We are only beginning to understand the complexity of the interactions of all these mediators in several inflammatory pathways in KC.…”

Section: Discussionmentioning

confidence: 99%

Section: B Interleukin-6mentioning

confidence: 99%

Section: Interleukin-17mentioning

confidence: 99%

Section: F Vascular Endothelial Growth Factor and Nerve Growth Factormentioning

confidence: 99%

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Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review

et al. 2015

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“…Their findings suggest that some mediators might have different effects on the severity of disease in an agedependent manner. 107 Low levels of lactoferrin, IgA, ZAG (zinc-α2-glycoprotein), and IGKC (immunoglobulin κ-chain) have also been found in tears of patients with keratoconus. 19,108 Lactoferrin and IgA seem to have the greatest impact on the disease because of their immunomodulatory and antiinflammatory properties (lactoferrin inhibits IL-1, IL-2, IL-6, and TNF-α; IgA inhibits the immune response through FcαRI receptor).…”

Section: Corneal Stroma Compositionmentioning

confidence: 99%

Keratoconus: an inflammatory disorder?

Galvis

Sherwin

Tello

et al. 2015

Eye

291

199

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Keratoconus has been classically defined as a progressive, non-inflammatory condition, which produces a thinning and steepening of the cornea. Its pathophysiological mechanisms have been investigated for a long time. Both genetic and environmental factors have been associated with the disease. Recent studies have shown a significant role of proteolytic enzymes, cytokines, and free radicals; therefore, although keratoconus does not meet all the classic criteria for an inflammatory disease, the lack of inflammation has been questioned. The majority of studies in the tears of patients with keratoconus have found increased levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase (MMP)-9. Eye rubbing, a proven risk factor for keratoconus, has been also shown recently to increase the tear levels of MMP-13, IL-6, and TNF-α. In the tear fluid of patients with ocular rosacea, IL-1α and MMP-9 have been reported to be significantly elevated, and cases of inferior corneal thinning, resembling keratoconus, have been reported. We performed a literature review of published biochemical changes in keratoconus that would support that this could be, at least in part, an inflammatory condition.

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Tear Film and Ocular Surface in Keratoconus

Hamada

Matsou

2021

Keratoconus

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Keratoconus (KC) is an ectatic corneal disorder, characterised by progressive stromal thinning and structural weakening with apical cone-like protrusion, leading to progressive myopia, irregular astigmatism, scarring and decreased vision. It is a leading cause of corneal transplantation in the developed world. While keratoconus has been traditionally considered a predominantly degenerative, non-inflammatory disease of multivariate origin, the exact aetiology remains largely unknown. There is now evidence of genetic inheritance and possible association with systemic disease, as well as substantial evidence that certain environmental factors, such as ocular surface disease, atopy and contact lens wear, and behaviours, such as excessive eye rubbing, may play a key role. The factors that determine or affect the progression or stabilisation of the disease are not well characterised or understood.A number of studies suggest a pivotal role of inflammation in the pathogenesis and progression of KC, contradicting the dogma that traditionally classified keratoconus as a non-inflammatory condition. Elevated levels of inflammatory mediators, such as pro-inflammatory cytokines, tumour necrosis factor, interleukins, cell adhesion molecules, and matrix metalloproteinases (MMPs) have been detected in keratoconic eyes compared to normal, implying that chronic inflammatory events are involved in the manifestation and progression of the disease. Many studies have attempted to investigate in depth the pathogenesis of keratoconus. And while it is widely accepted that complex interactions between genetic and environmental factors, both mechanical and biochemical, influence the development and course of

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Association between Mediators in the Tear Fluid and the Severity of Keratoconus

Cited by 40 publications

References 23 publications

Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review

Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review

Keratoconus: an inflammatory disorder?

Tear Film and Ocular Surface in Keratoconus

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