title: Increased Epithelial Expression of CTGF and S100A7 with Elevated Subepithelial Expression of IL-1β in Trachomatous Trichiasis.
abstract: To characterize the histological appearance and expression of pro-inflammatory mediators, growth factors, matrix metalloproteinases and biomarkers of epithelial-mesenchymal transition (EMT) in healthy control and trachomatous trichiasis (TT) conjunctival tissue.
  
  
  
  Conjunctival biopsies were taken from 20 individuals with TT and from 16 individuals with healthy conjunctiva, which served as controls. Study participants were of varying ethnicity and were living in a trachoma-endemic region of northern Tanzania. Formalin-fixed paraffin-embedded tissue sections were stained using hematoxylin and eosin or by immunohistochemistry using antibodies against: IL-1β, IL-6, IL-17A, IL-22, CXCL5, S100A7, cleaved caspase 1 (CC1), PDGF, CTGF, TGFβ2, MMP7, MMP9, E-cadherin, vimentin, and αSMA.
  
  
  
  Tissue from TT cases had a greater inflammatory cell infiltrate relative to controls and greater disruption of collagen structure. CTGF and S100A7 were more highly expressed in the epithelium and IL-1β was more highly expressed in the substantia propria of TT cases relative to controls. Latent TGFβ2 was slightly more abundant in the substantia propria of control tissue. No differences were detected between TT cases and controls in the degree of epithelial atrophy, the number of myofibroblasts or expression of EMT biomarkers.
  
  
  
  These data indicate that the innate immune system is active in the immunopathology of trachoma, even in the absence of clinical inflammation. CTGF might provide a direct link between inflammation and fibrosis and could be a suitable target for therapeutic treatment to halt the progression of trachomatous scarring.
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.|Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Tamsyn
authors.identifier: 0000-0002-1458-6503
authors.initials: T
authors.lastname: Derrick
authors.affiliation: UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Luthert
authors.affiliation: UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Hodan
authors.initials: H
authors.lastname: Jama
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.|International Centre for Eye Health, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Victor H
authors.initials: VH
authors.lastname: Hu
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
authors.forename: Patrick
authors.initials: P
authors.lastname: Massae
authors.affiliation: UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Essex
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Holland
authors.affiliation: Kilimanjaro Christian Medical Centre, Moshi, Tanzania.|International Centre for Eye Health, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Burton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016022:Case-Control Studies; D003228:Conjunctiva / Q000378:metabolism*; D055513:Connective Tissue Growth Factor / Q000235:genetics / Q000378:metabolism*; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D053583:Interleukin-1beta / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D000075023:S100 Calcium Binding Protein A7; D009418:S100 Proteins / Q000235:genetics / Q000378:metabolism*; D014141:Trachoma / Q000150:complications* / Q000378:metabolism; D058457:Trichiasis / Q000378:metabolism*
chemical_list: D015415:Biomarkers; C526317:CCN2 protein, human; D053583:Interleukin-1beta; D000075023:S100 Calcium Binding Protein A7; D009418:S100 Proteins; C089242:S100A7 protein, human; D055513:Connective Tissue Growth Factor