title: Oxidized low-density lipoprotein, lipid and calcium aggregates reveal oxidative stress and inflammation in the conjunctiva of glaucoma patients.
abstract: OBJECTIVE
  Conjunctival specimens from primary open-angle glaucoma (POAG), exfoliation glaucoma (ExG) patients and controls were histologically analysed for oxidized low-density lipoprotein (ox-LDL), lipid and calcium aggregates. Our goal was to use them as biomarkers of oxidative stress and inflammation and to evaluate their correlation with glaucoma and impact on surgical outcome.
  
  
  METHODS
  Conjunctival samples were obtained from POAG (n = 14) and ExG (n = 17) patients and from control subjects (n = 11) operated for macular hole, retinal detachment or strabismus. Immunohistochemistry was performed using the antibody against ox-LDL. Lipids and calcium were analysed by histochemical stainings with Nile red and Alizarin red S, respectively.
  
  
  RESULTS
  Immunoreaction for ox-LDL was significantly increased in POAG (p = 0.049) and the number of lipid aggregates was significantly higher in ExG (p = 0.009) when compared to control. When POAG and ExG patients were grouped according to the outcome of deep sclerectomy (DS) surgery, the number of lipid (p < 0.001) and calcium aggregates (p = 0.014) were significantly higher in the conjunctival stroma of patients whose surgery failed within a three-year follow-up period.
  
  
  CONCLUSIONS
  The lipid-mediated alterations suggested the presence of oxidative stress and inflammation in the conjunctiva of glaucoma patients. The present data further support the role of oxidative stress and inflammation in the wound healing process leading to excessive scarring and failure in DS surgery.
authors.affiliation: Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Helin-Toiviainen
authors.affiliation: Faculty of Health Sciences, School of Pharmacy, Pharmaceutical Technology, University of Eastern Finland, Kuopio, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Rönkkö
authors.affiliation: Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Kai
authors.initials: K
authors.lastname: Kaarniranta
authors.affiliation: Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Tuomo
authors.initials: T
authors.lastname: Puustjärvi
authors.affiliation: Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.|Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Rekonen
authors.affiliation: Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Ollikainen
authors.affiliation: Department of Ophthalmology, University of Tampere, Tampere, Finland.|Tampere University Hospital Eye Center, Medical School, University of Tampere, Tampere, Finland.
authors.forename: Hannu
authors.initials: H
authors.lastname: Uusitalo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D003228:Conjunctiva / Q000378:metabolism*; D017889:Exfoliation Syndrome / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008055:Lipids / Q000032:analysis*; D008077:Lipoproteins, LDL / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress
chemical_list: D015415:Biomarkers; D008055:Lipids; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D002118:Calcium
keywords: conjunctiva; deep sclerectomy; exfoliation glaucoma; inflammation; oxidative stress; primary open-angle glaucoma