title: Association of hemopexin in tear film and conjunctival macrophages with vernal keratoconjunctivitis.
abstract: OBJECTIVE
  Vernal keratoconjunctivitis (VKC) is a chronic allergic inflammatory disease with unclear etiology and pathogenesis. We investigated the tear film proteome of patients with VKC to understand the pathologic characteristics of VKC.
  
  
  METHODS
  Tear samples were collected from healthy volunteers and patients with VKC. Electrophoresis was performed to display the tear proteomic profiles according to VKC severity. The identities of differentially expressed proteins were analyzed by mass spectrometry and quantified by enzyme-linked immunosorbent assay. Impression cytology was performed on VKC conjunctival samples to demonstrate the cellular protein expression. Allergic sensitization was performed in mice to study the pathologic role of these proteins in VKC.
  
  
  RESULTS
  Hemopexin, an inflammatory protein, was elevated in the tear film of patients with VKC. The increased hemopexin concentration in VKC tears was significantly associated with disease severity. Impression cytology showed specific high hemopexin expression in dekeratinized conjunctival epithelium and necrotic macrophages in patients with VKC. Immunohistochemical examination of normal lacrimal tissues from mice showed that hemopexin was not expressed in any lacrimal apparatus. Under systemic and topical sensitization and challenge using hemopexin in mice, the affected eye had mild to moderate bead discharge, chemosis, and edema with excessive macrophage infiltration and conjunctival necrosis.
  
  
  CONCLUSIONS
  An association exists between tear hemopexin and the development and pathologic effects of VKC.
  
  
  CONCLUSIONS
  Increased hemopexin may have a role in the development of VKC.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle St, Kowloon, Hong Kong.
authors.forename: Jeffrey Chiu Fai
authors.initials: JC
authors.lastname: Pong
authors.forename: Ching Yan
authors.initials: CY
authors.lastname: Chu
authors.forename: Wai Ying
authors.initials: WY
authors.lastname: Li
authors.forename: Ling Yin
authors.initials: LY
authors.lastname: Tang
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.forename: Wai Ting
authors.initials: WT
authors.lastname: Lui
authors.forename: Terence Chuen Wai
authors.initials: TC
authors.lastname: Poon
authors.forename: Srinivas K
authors.initials: SK
authors.lastname: Rao
authors.forename: Dennis Shun Chiu
authors.initials: DS
authors.lastname: Lam
authors.forename: Chi Chiu
authors.initials: CC
authors.lastname: Wang
authors.forename: Chi Pui
authors.initials: CP
authors.lastname: Pang
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D003228:Conjunctiva / Q000378:metabolism*; D003233:Conjunctivitis, Allergic / Q000378:metabolism*; D015180:Electrophoresis, Gel, Two-Dimensional; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D006466:Hemopexin / Q000378:metabolism*; D006801:Humans; D008264:Macrophages / Q000378:metabolism*; D008297:Male; D013058:Mass Spectrometry; D051379:Mice; D020543:Proteome; D013666:Tears / Q000378:metabolism*; D055815:Young Adult
chemical_list: D005136:Eye Proteins; D020543:Proteome; C042434:tear proteins; D006466:Hemopexin