title: Cytokine Expression in Keratoconus and its Corneal Microenvironment: A Systematic Review.
abstract: Keratoconus (KC) is a progressive corneal ecstasia characterized by thinning and weakening of the cornea that leads to a cone-like appearance, scarring, and decreased vision. Despite the well-described clinical signs, the cause of KC is unknown. Nevertheless, various genes, proteinases, and environmental factors (eye-rubbing, contact lens wear, tear film composition) have been implicated in its etiology. Although classically defined as a predominantly degenerative disease, with mechanically induced trauma accelerating its course, accumulating evidence suggests a pivotal role for inflammation in the pathophysiology of KC. Several reports have linked various inflammatory mediators (cytokines) with KC, but with contradictory findings. The methods and materials used in these studies vary considerably and warrant critical evaluation to decipher the role of inflammatory mediators in KC. We performed a systematic review of current literature on cytokine expression studies in KC and discuss critical soluble and cellular inflammatory mediators that are implicated in its pathogenesis.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, The Netherlands. Electronic address: r.p.l.wisse@umcutrecht.nl.
authors.forename: Robert P L
authors.initials: RP
authors.lastname: Wisse
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, The Netherlands; Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, The Netherlands.
authors.forename: Jonas J W
authors.initials: JJ
authors.lastname: Kuiper
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, The Netherlands.
authors.forename: Renze
authors.initials: R
authors.lastname: Gans
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: Imhof
authors.affiliation: Laboratory of Translational Immunology, Department of Immunology, University Medical Center Utrecht, The Netherlands.
authors.forename: Timothy R D J
authors.initials: TR
authors.lastname: Radstake
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, The Netherlands.
authors.forename: Allegonda
authors.initials: A
authors.lastname: Van der Lelij
mesh_terms: D000818:Animals; D060833:Cellular Microenvironment / Q000502:physiology*; D003315:Cornea / Q000378:metabolism* / Q000473:pathology; D016207:Cytokines / Q000096:biosynthesis*; D006801:Humans; D007640:Keratoconus / Q000378:metabolism* / Q000473:pathology; D013666:Tears / Q000378:metabolism*
chemical_list: D016207:Cytokines
keywords: Cellular inflammatory mediators; cytokine; cytokine receptor; keratoconus; soluble inflammatory mediators; tear film