title: TFF peptides and mucins are major components of dacryoliths.
abstract: OBJECTIVE
  The study was performed to determine whether trefoil factor peptides (TFF) and/or mucins are components of dacryoliths and to gain further insight into dacryolith composition and formation.
  
  
  METHODS
  Twenty dacryoliths found in lacrimal surgery in patients suffering from primary acquired nasolacrimal duct obstruction were analyzed for the presence of TFF peptides (TFF1, 2, 3), mucins (MUC1, 2, 3, 4, 5AC, 5B, 6, 7, 8), defense cells (T- and B lymphocytes, macrophages, neutrophils), and antimicrobial substances (alpha defensins 1-3, secretory phospholipase A(2)) by means of light microscopy, histochemistry, immunohistochemistry, reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR.
  
  
  RESULTS
  All dacryoliths except one revealed clear immunoreactivity for all three TFF peptides. The immunohistochemical distribution of mucins was inhomogeneous throughout the different dacryoliths. However, in some dacryoliths all mucins investigated were detected. MUC8 showed reactivity in 14 out of 15 dacryoliths analyzed by immunohistochemistry. Most dacryoliths contained alpha defensins 1-3 as the secretory product of neutrophils. T and B lymphocytes, macrophages and secretory phospholipase A(2) were only present in single dacryoliths. Quantification of TFF peptide expression supported the immunohistochemical finding that all three TFF peptides are augmented in dacryoliths.
  
  
  CONCLUSIONS
  Dacryoliths consist partly of secreted mucins comparable with the mucin spectrum of the epithelium of healthy nasolacrimal ducts. Beside TFF1 and TFF3, both of which are produced under healthy circumstances, TFF2 is additionally induced and secreted in cases of dacryolithiasis. All three TFF peptides appear to be augmented in dacryoliths. With regard to their rheologic properties, TFF peptides may play a functional role in dacryolith formation. However, our results raise the question of whether TFF peptides per se influence dacryolith formation or whether their secretion, as in secretion of mucins and alpha defensins 1-3, is merely a secondary phenomenon.
authors.affiliation: Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Grosse Steinstr 52, 06097, Halle (Saale), Germany. friedrich.paulsen@medizin.uni-halle.de
authors.forename: Friedrich P
authors.initials: FP
authors.lastname: Paulsen
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schaudig
authors.forename: Alexander
authors.initials: A
authors.lastname: Fabian
authors.forename: Dirk
authors.initials: D
authors.lastname: Ehrich
authors.forename: Saadettin
authors.initials: S
authors.lastname: Sel
mesh_terms: D000328:Adult; D000368:Aged; D002137:Calculi / Q000235:genetics / Q000378:metabolism*; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007767:Lacrimal Duct Obstruction / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D009301:Nasolacrimal Duct / Q000378:metabolism* / Q000601:surgery; D010455:Peptides / Q000235:genetics / Q000378:metabolism*; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism*
chemical_list: D009077:Mucins; D010455:Peptides; D012333:RNA, Messenger; C051838:TFF1 protein, human; C000604007:TFF2 protein, human; C082495:TFF3 protein, human; D000071163:Trefoil Factor-1; D000071164:Trefoil Factor-2; D000071165:Trefoil Factor-3; D025521:Tumor Suppressor Proteins