Advanced glycation end products and receptors in Fuchs' dystrophy corneas undergoing Descemet's stripping with endothelial keratoplasty.
OBJECTIVE
To describe the histopathologic features of Descemet's membrane (DM) obtained from Fuchs' endothelial corneal dystrophy (FECD) corneas undergoing Descemet's stripping with endothelial keratoplasty (DSEK) and to assess the presence of advanced glycation end products (AGEs) and their receptors in FECD endothelium and DM.


METHODS
Prospective observational case series.


METHODS
Five eyes of 5 patients undergoing DSEK for FECD and 4 normal control eyebank corneas.


METHODS
Descemet's membrane and corneal endothelium from FECD patients undergoing DSEK were assessed with hematoxylin-eosin staining and immunohistochemistry for AGEs, receptor of AGEs (RAGE), and galectin 3 (AGE-R3).


METHODS
Histopathologic abnormalities and presence of AGEs, RAGE, and AGE-R3 in DSEK specimens.


RESULTS
Histopathologic assessment of DSEK specimens from FECD patients disclosed thickening and nodularity of DM and loss of endothelial cells. Immunohistochemical staining of FECD DM for AGE, RAGE, and AGE-R3 showed an abundance of AGEs in the anterior portion of DM, mild positivity for RAGE, and moderate positivity for AGE-R3.


CONCLUSIONS
Tissue quality after DSEK is sufficient to allow detailed histopathologic analysis. The presence of AGEs, RAGE, and AGE-R3 in DM and corneal endothelium of FECD patients supports a link between accumulation of AGEs, oxidative stress, and corneal endothelial cell apoptosis in the pathogenesis of FECD.
Wang
Zhiyou
Z
Wilmer Eye Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
Handa
James T
JT
Green
W Richard
WR
Stark
Walter J
WJ
Weinberg
Robert S
RS
Jun
Albert S
AS
D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D016039:Corneal Transplantation / Q000379:methods*; D003886:Descemet Membrane / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D004728:Endothelium, Corneal / Q000378:metabolism* / Q000473:pathology / Q000637:transplantation; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D037502:Galectin 3 / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011446:Prospective Studies; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000378:metabolism*; D014019:Tissue Donors
D037502:Galectin 3; D017127:Glycation End Products, Advanced; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic