title: Altered expression of matrix metalloproteinases and their tissue inhibitors as possible contributors to corneal droplet formation in climatic droplet keratopathy.
abstract: OBJECTIVE
  Climatic droplet keratopathy (CDK) is an acquired corneal disease characterized by progressive scarring of the cornea. In several corneal diseases, matrix metalloproteinases (MMPs) are upregulated during the degradation of epithelial and stromal tissues. We investigated the levels, degree of activation and molecular forms of MMP-2, MMP-9, MMP-8 and MMP-13 and their tissue inhibitors TIMP-1 and TIMP-2 in tear fluid of patients with CDK.
  
  
  METHODS
  Seventeen CDK patients and 10 controls living in Argentine Patagonia received a complete eye examination, and MMPs and TIMP-1/2 were determined by immunofluorometric assay (IFMA), gelatin zymography and quantitative Western immunoblot analysis in tear samples.
  
  
  RESULTS
  The MMPs were detected mostly in their latent forms. The levels of MMP-9 and MMP-2 were found to be significantly elevated in CDK patients, whereas latent and active MMP-8 levels were significantly enhanced in controls. There was no significant difference in the level of MMP-13. TIMPs were found as part of complexes, and the TIMP-1 levels were significantly lower in patients than controls.
  
  
  CONCLUSIONS
  Elevated MMP-2 and MMP-9 levels have been implicated in the failure of corneal re-epithelialization, and enhanced MMP-2 and MMP-9 levels in CDK patients suggest that these MMPs may play a role in corneal scarring in CDK. Elevated levels of MMP-8 suggest a defensive role for this MMP in inflammatory reactions associated with recurring corneal traumas. Decreased expression of TIMP-1 in CDK patients suggest deficient antiproteolytic shield likely to render the corneas of CDK patients vulnerable to enhanced MMPs. Overall, these data suggest a mechanistic link between MMPs and TIMP-1 level in cornea and tears with corneal scarring in CDK.
authors.affiliation: Department of Ophthalmology, University of Helsinki, Helsinki, Finland. juha.holopainen@hus.fi
authors.forename: Juha M
authors.initials: JM
authors.lastname: Holopainen
authors.forename: Horacio M
authors.initials: HM
authors.lastname: Serra
authors.forename: María C
authors.initials: MC
authors.lastname: Sánchez
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.forename: Waldir N
authors.initials: WN
authors.lastname: Zalentein
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Barcelona
authors.forename: Jukka A O
authors.initials: JA
authors.lastname: Moilanen
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: Timo M T
authors.initials: TM
authors.lastname: Tervo
authors.forename: Thamara A
authors.initials: TA
authors.lastname: Cafaro
authors.forename: Ismo
authors.initials: I
authors.lastname: Virtanen
authors.forename: Enrique A
authors.initials: EA
authors.lastname: Urrets-Zavalia
authors.forename: Sanjoy K
authors.initials: SK
authors.lastname: Bhattacharya
authors.forename: Julio A
authors.initials: JA
authors.lastname: Urrets-Zavalia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D003316:Corneal Diseases / Q000201:enzymology*; D005260:Female; D015200:Fluoroimmunoassay; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D013666:Tears / Q000201:enzymology*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism*; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000378:metabolism*
chemical_list: D019715:Tissue Inhibitor of Metalloproteinase-1; D019716:Tissue Inhibitor of Metalloproteinase-2; D020782:Matrix Metalloproteinases