Angiogenesis in pterygium: study of microvessel density, vascular endothelial growth factor, and thrombospondin-1.
OBJECTIVE
This retrospective study aims to elucidate the role of angiogenesis in the pathogenesis of pterygium. We evaluated microvessel density (MVD), and expression of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1).


METHODS
Fifty-two surgically excised pterygia and seven normal conjunctivae were immunohistochemically studied applying the streptavidin-biotin method in paraffin-embedded tissue sections. Monoclonal antibodies were targeted against CD31, VEGF, and TSP-1 proteins.


RESULTS
Pterygium presented with statistically significant higher average count of microvessels compared to normal conjunctivae (17.97+/-8.5 vs5.72+/-5 per high power field, P=0.001). In 24/52 (46.2%) cases of pterygium, high expression levels for VEGF were demonstrated, whereas the mean percentage of VEGF-positive epithelial cells was 58.03%. Furthermore, normal conjunctival presented statistically significant higher expression levels for VEGF in epithelial cells (83.14+/-36.08 vs58.03+/-31.23%, P=0.007). On the contrary, the presence of VEGF immunoreactivity in vascular endothelial and stromal cells was significantly higher in pterygium tissues (P<0.0001). Stromal staining for TSP-1 was detected in only 29/52 (55.8%) of the cases and no correlation with normal conjunctivae was found. Finally, statistically significant positive correlation between MVD values and stromal VEGF expression was found (P=0.049).


CONCLUSIONS
The angiogenesis-related factors that were studied proved to be highly expressed in pterygium tissue. On the contrary, TSP expression level was low, allowing inducers of angiogenesis to act uninhibited. This phenomenon could provide the pathogenic basis of pterygium formation.
Aspiotis
M
M
Department of Ophthalmology, University of Ioannina, Ioannina, Epirus, Greece. gorezis@hotmail.com
Tsanou
E
E
Gorezis
S
S
Ioachim
E
E
Skyrlas
A
A
Stefaniotou
M
M
Malamou-Mitsi
V
V
D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000098:blood supply / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011625:Pterygium / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D019700:Thrombospondin 1 / Q000378:metabolism*; D042442:Vascular Endothelial Growth Factors / Q000032:analysis*
D019700:Thrombospondin 1; D042442:Vascular Endothelial Growth Factors