title: Extracellular matrix alterations in human corneas with bullous keratopathy.
abstract: OBJECTIVE
  To uncover abnormalities of extracellular matrix (ECM) distribution in human corneas with pseudophakic and aphakic bullous keratopathy (PBK/ABK).
  
  
  METHODS
  Indirect immunofluorescence with antibodies to 27 ECM components was used on frozen sections of 14 normal and 20 PBK/ABK corneas.
  
  
  RESULTS
  Fibrillar deposits of an antiadhesive glycoprotein tenascin in the anterior and posterior stroma, epithelial basement membrane (BM), bullae and subepithelial fibrosis (SEF) areas, and posterior collagenous layer (PCL) were revealed in disease corneas. Tenascin in midstroma, which was observed in some cases, correlated with decreased visual acuity. In normal central corneas, tenascin was never found. Other major ECM abnormalities in PBK/ABK corneas compared to normals included: discontinuous epithelial BM straining for laminin-1 (alpha 1 beta 1 gamma 1), entactin/nidogen and fibronectin; accumulation of fibronectin and alpha 1-alpha 2 type IV collagen on the endothelial face of the Descemet's membrane; and abnormal deposition of stromal ECM (tenascin, fibronectin, decorin, types I, III, V, VI, VIII, XII, XIV collagen) and BM components (type IV, collagen, perlecan, bamacan, laminin-1, entactin-nidogen, fibronectin) in SEF areas and in PCL.
  
  
  CONCLUSIONS
  The study provides a molecular description of an ongoing fibrosis on the epithelial, stomal, and endothelial levels in PBK/ABK corneas. These fibrotic changes may follow initial endothelial damage after cataract surgery, may be caused by the upregulation of fibrogenic cytokines, and may play a significant role in the progression of bullous keratopathy.
authors.affiliation: Ophthalmology Research Laboratories, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
authors.forename: A V
authors.initials: AV
authors.lastname: Ljubimov
authors.forename: R E
authors.initials: RE
authors.lastname: Burgeson
authors.forename: R J
authors.initials: RJ
authors.lastname: Butkowski
authors.forename: J R
authors.initials: JR
authors.lastname: Couchman
authors.forename: R R
authors.initials: RR
authors.lastname: Wu
authors.forename: Y
authors.initials: Y
authors.lastname: Ninomiya
authors.forename: Y
authors.initials: Y
authors.lastname: Sado
authors.forename: E
authors.initials: E
authors.lastname: Maguen
authors.forename: A B
authors.initials: AB
authors.lastname: Nesburn
authors.forename: M C
authors.initials: MC
authors.lastname: Kenney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000378:metabolism / Q000473:pathology; D002387:Cataract Extraction / Q000009:adverse effects; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D003316:Corneal Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D016039:Corneal Transplantation; D005109:Extracellular Matrix / Q000378:metabolism / Q000473:pathology*; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005260:Female; D005355:Fibrosis; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D016326:Extracellular Matrix Proteins