title: Effect of latanoprost and timolol on the histopathology of the human conjunctiva.
abstract: OBJECTIVE
  To investigate the effect of timolol and latanoprost on the extracellular matrix organisation, inflammatory infiltration, and expression of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the human conjunctiva.
  
  
  METHODS
  Conjunctival biopsies were obtained from the inferior fornix during routine cataract surgery from 20 patients with primary open-angle glaucoma, who had received a monotherapy either with timolol or latanoprost, and from 10 non-glaucomatous patients. Specimens were investigated by light microscopy, immunohistochemistry using antibodies against MMP-1,-3, TIMP-2,-3 and CD 68 antibodies and by quantitative transmission electron microscopy.
  
  
  RESULTS
  The number of collagen fibres was significantly decreased in latanoprost-treated conjunctival specimens compared with timolol-treated eyes (p<0.01) but showed no difference to controls. Amorphous material was increased in both treated groups compared with controls (p<0.001) but was less in latanoprost-treated specimens compared with timolol-treated eyes (p<0.001). Optically clear spaces, probably containing glycosaminoglycans, were significantly reduced in both treated groups-with less of a reduction in latanoprost-compared with timolol-treated eyes (p<0.001). A marked upregulation of MMP-1 and MMP-3 and moderately increased staining for TIMP-2 and TIMP-3 was found in epithelial cells and subepithelial stromal cells of latanoprost-treated eyes. A moderate infiltration with macrophages and inflammatory cells was observed in timolol-treated eyes.
  
  
  CONCLUSIONS
  Latanoprost-treated conjunctival specimens showed a decreased stromal collagen density and a less pronounced inflammatory infiltration. The upregulation of MMP-1 and MMP-3 in latanoprost-treated eyes might explain the reduced extracellular matrix accumulation in the conjunctival stroma. Therefore, latanoprost therapy might have a more favourable effect on the outcome of glaucoma filtering surgery.
authors.affiliation: Department of Ophthalmology, Carl Gustav Carus University Hospital, Fetscherstrasse 74, Dresden, Germany. naim.terai@uniklinikum-dresden.de
authors.forename: N
authors.initials: N
authors.lastname: Terai
authors.forename: U
authors.initials: U
authors.lastname: Schlötzer-Schrehardt
authors.forename: J
authors.initials: J
authors.lastname: Lampel
authors.forename: A G
authors.initials: AG
authors.lastname: Böhm
authors.forename: C
authors.initials: C
authors.lastname: Rummelt
authors.forename: E
authors.initials: E
authors.lastname: Schmidt
authors.forename: L E
authors.initials: LE
authors.lastname: Pillunat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001706:Biopsy; D003094:Collagen / Q000187:drug effects / Q000648:ultrastructure; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D005109:Extracellular Matrix / Q000187:drug effects; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D006801:Humans; D000077338:Latanoprost; D020782:Matrix Metalloproteinases / Q000378:metabolism; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011461:Prostaglandins F, Synthetic / Q000494:pharmacology*; D013999:Timolol / Q000494:pharmacology*; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D000959:Antihypertensive Agents; D003094:Collagen; D000077338:Latanoprost; D020782:Matrix Metalloproteinases; D011461:Prostaglandins F, Synthetic; D013999:Timolol; D019714:Tissue Inhibitor of Metalloproteinases; C067980:CD68 antigen, human; D000097382:CD68 Molecule