title: Toll-like receptors and vascular markers in ocular rosacea.
abstract: OBJECTIVE
  To delineate signals by which the vascular abnormalities inherent to ocular rosacea arise and to correlate these signals with elements of the innate immune system.
  
  
  METHODS
  Experimental study. Immunohistochemical staining was performed for a variety of vascular markers and for toll-like receptor-4 on eyelid biopsies taken from patients with ocular rosacea and normal controls. Statistical comparisons were then performed between the 2 groups.
  
  
  RESULTS
  Immunohistochemical staining for CD31 and integrin-β-3 did not demonstrate any statistically significant differences between eyelids from patients with ocular rosacea and normal controls. Cutaneous biopsies from ocular rosacea patients demonstrated statistically significant enrichments of intercellular adhesion molecule-1 and CD105 among arterioles, whereas there were no statistically significant differences in the venules between normal controls and ocular rosacea patients. The correlation between the number of toll-like receptor-4-positive cells and each vascular marker was statistically significant.
  
  
  CONCLUSIONS
  Cutaneous biopsies of the eyelid did not demonstrate an increase in the total number of blood vessels. However, the vascular abnormalities that are typical of ocular rosacea represent activated, inflamed vessels, and these phenomena may be mediated by intercellular adhesion molecule and CD105. Furthermore, the strong correlations between toll-like receptor-4 and each vascular marker suggest that the innate immune system may govern the cutaneous effects of ocular rosacea. Intercellular adhesion molecule, CD105, and toll-like receptor-4 may represent important therapeutic targets in the management of this disease.
authors.affiliation: Department of Ophthalmology, Ophthalmic Plastic Surgery, Lions Eye Institute, Albany, New York, USA. tedwladis@gmail.com
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wladis
authors.forename: J Andrew
authors.initials: JA
authors.lastname: Carlson
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Wang
authors.forename: Devang P
authors.initials: DP
authors.lastname: Bhoiwala
authors.forename: Alejandro P
authors.initials: AP
authors.lastname: Adam
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D001160:Arterioles / Q000276:immunology / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D000071063:Endoglin; D004730:Endothelium, Vascular / Q000276:immunology / Q000473:pathology; D005141:Eyelid Diseases / Q000276:immunology / Q000473:pathology*; D005143:Eyelids / Q000098:blood supply*; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D039661:Integrin beta3 / Q000032:analysis; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011956:Receptors, Cell Surface / Q000378:metabolism; D012393:Rosacea / Q000276:immunology / Q000473:pathology*; D051197:Toll-Like Receptor 4 / Q000378:metabolism*; D014699:Venules / Q000276:immunology / Q000473:pathology
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; C064206:ENG protein, human; D000071063:Endoglin; D039661:Integrin beta3; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D011956:Receptors, Cell Surface; D051197:Toll-Like Receptor 4; D018799:Intercellular Adhesion Molecule-1