Immunohistochemical expression of HLA-DR in the conjunctiva of patients under topical prostaglandin analogs treatment.
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.
Rodrigues
Maria de Lourdes Veronese
Mde L
Department of Ophthalmology, Medical School of Ribeirão Preto, University of São Paulo, Brazil. mdlvrodr@fmrp.usp.br
Felipe Crosta
Daniela Pereira da Silva
DP
Soares
Christiane Pienna
CP
Deghaide
Neifi Hassam Saloum
NH
Duarte
Roberta
R
Sakamoto
Fabiano S
FS
Furtado
João Marcello Fortes
JM
Paula
Jayter Silva
JS
Donadi
Eduardo Antonio
EA
Soares
Edson Garcia
EG
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
D000577:Amides; D000959:Antihypertensive Agents; D015415:Biomarkers; D006684:HLA-DR Antigens; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost