title: Immunohistochemical expression of HLA-DR in the conjunctiva of patients under topical prostaglandin analogs treatment.
abstract: OBJECTIVE
  Subclinical inflammation may be observed in patients using topical antiglaucomatous drugs. The objective of this study was to investigate inflammation in conjunctiva of glaucoma patients using prostaglandin analogs, by the detection of an immunogenetic marker (HLA-DR) and compare the effect of 3 different drugs: latanoprost, bimatoprost, and travoprost in the induction of this inflammation.
  
  
  METHODS
  Thirty-three patients with primary open-angle glaucoma were evaluated without and with prostaglandin analogs topical therapy. Imprints of conjunctival cells were obtained, fixed on glass slides, and prepared for immunohistochemical analysis.
  
  
  RESULTS
  Before the use of prostaglandin analogs, 4 of the 33 patients evaluated presented expression of HLA-DR in the conjunctiva (mild). After 1 month on prostaglandin analog treatment, all but 1 patient presented HLA-DR staining. HLA-DR expression of these 32 patients was scored as mild (19 patients), medium (11 patients), or intense (2 patients). The differences were statistically significant both when the presence and the increased expression of HLA-DR were considered (P<0.001). When the 3 different groups were analyzed (latanoprost, bimatoprost, and travoprost) no statistically significant difference was found (P=0.27).
  
  
  CONCLUSIONS
  The use of prostaglandin analogs eye drops provokes a subclinical inflammatory reaction, observed by HLA-DR expression, even after a short period of treatment, independently of the class of the prostaglandin analogs used.
authors.affiliation: Department of Ophthalmology, Medical School of Ribeirão Preto, University of São Paulo, Brazil. mdlvrodr@fmrp.usp.br
authors.forename: Maria de Lourdes Veronese
authors.initials: Mde L
authors.lastname: Rodrigues
authors.forename: Daniela Pereira da Silva
authors.initials: DP
authors.lastname: Felipe Crosta
authors.forename: Christiane Pienna
authors.initials: CP
authors.lastname: Soares
authors.forename: Neifi Hassam Saloum
authors.initials: NH
authors.lastname: Deghaide
authors.forename: Roberta
authors.initials: R
authors.lastname: Duarte
authors.forename: Fabiano S
authors.initials: FS
authors.lastname: Sakamoto
authors.forename: João Marcello Fortes
authors.initials: JM
authors.lastname: Furtado
authors.forename: Jayter Silva
authors.initials: JS
authors.lastname: Paula
authors.forename: Eduardo Antonio
authors.initials: EA
authors.lastname: Donadi
authors.forename: Edson Garcia
authors.initials: EG
authors.lastname: Soares
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069580:Bimatoprost; D015415:Biomarkers / Q000378:metabolism*; D003008:Cloprostenol / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003231:Conjunctivitis / Q000139:chemically induced* / Q000378:metabolism*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects / Q000627:therapeutic use; D000069557:Travoprost
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D015415:Biomarkers; D006684:HLA-DR Antigens; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost