title: Tear Matrix Metalloproteinases and Myeloperoxidase Levels in Patients With Boston Keratoprosthesis Type I.
abstract: OBJECTIVE
  To investigate the tear levels of matrix metalloproteinases (MMPs), myeloperoxidase (MPO), and tissue inhibitor of metalloproteinase-1 in eyes after Boston keratoprosthesis type I (B-KPro) implantation and to correlate these markers with the established B-KPro prognostic categories.
  
  
  METHODS
  Tear washes were collected from 40 patients (7 with autoimmune disease, 2 with chemical burn, and 31 with other noncicatrizing diagnoses). Tear levels of MMPs, MPO, and tissue inhibitor of metalloproteinase-1 were quantified using multianalyte bead-based enzyme-linked immunosorbent assays. The total MMP activity was determined using a fluorimetric assay. The analytes were compared to the underlying diagnosis and other clinical factors.
  
  
  RESULTS
  The MMP-8, MMP-9, and MPO levels were markedly elevated in the eyes with B-KPro (80 ± 31, 291 ± 77, and 244 ± 33 pg/μg, respectively). Chemical burn was associated with significantly higher tear MMP-8 (474 ± 376 pg/μg) and MMP-9 levels (1300 ± 635 pg/μg) compared with noncicatrizing diseases (MMP-8: 41 ± 15 pg/μg, P = 0.02 and MMP-9: 196 ± 57 pg/μg, P = 0.02) and higher MMP-9 levels compared with autoimmune diseases (MMP-8: 96 ± 65 pg/μg, P = 0.21 and MMP-9: 306 ± 196 pg/μg, P = 0.04). Similar analyte levels were observed in the B-KPro eye and the contralateral non-B-KPro eye of patients with bilateral diseases. MMP-8, MMP-9, and total MMP activities correlated strongly with each other.
  
  
  CONCLUSIONS
  In the eyes with B-KPro, tear MMP-8 and MMP-9 levels seem to be related to the underlying ocular surface pathology and not significantly influenced by the presence of the prosthesis.
authors.affiliation: *Department of Ophthalmology, Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; †Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA; and ‡Department of Ophthalmology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, QC, Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Robert
authors.forename: Samer N
authors.initials: SN
authors.lastname: Arafat
authors.forename: Sandra
authors.initials: S
authors.lastname: Spurr-Michaud
authors.forename: James
authors.initials: J
authors.lastname: Chodosh
authors.forename: Claes H
authors.initials: CH
authors.lastname: Dohlman
authors.forename: Ilene K
authors.initials: IK
authors.lastname: Gipson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs; D001705:Bioprosthesis; D003315:Cornea; D003316:Corneal Diseases / Q000601:surgery; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D005470:Fluorometry; D006801:Humans; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D009195:Peroxidase / Q000378:metabolism*; D013666:Tears / Q000201:enzymology*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000378:metabolism*
chemical_list: D005136:Eye Proteins; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; C042434:tear proteins; D009195:Peroxidase; D020782:Matrix Metalloproteinases