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2018 ; 13
(7
): e0200704
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Collagen cross-linking impact on keratoconus extracellular matrix
#MMPMID30020979
Sharif R
; Fowler B
; Karamichos D
PLoS One
2018[]; 13
(7
): e0200704
PMID30020979
show ga
BACKGROUND: Keratoconus (KC) is a common multifactorial ectatic corneal disease
with unknown onset. KC most commonly appears in adolescence and affects
approximately 1:400 people worldwide. Treatment options, for advanced KC cases,
are collagen cross-linking (CXL) and corneal transplants. CXL is a new KC
treatment that helps arrest the disease. Unfortunately, only a fraction of KC
patients will qualify for CXL treatment. Our goal, in this study, was to begin to
understand how CXL affects the corneal microenvironment and pave the way towards
a more patient-driven CXL treatment. METHODS: Primary human corneal fibroblasts
from healthy and KC donors were plated on transwell polycarbonate membranes and
stimulated by a stable vitamin C. At 4 weeks, riboflavin was added followed by
UVA irradiation. Transmission Electron Microscopy (TEM) and western blots were
used to assess the effect of CXL on the extracellular matrix (ECM) and the
resident cells, pre- and post CXL. RESULTS: Data shows CXL improved lamellar
organization showing more organized collagen fibrils decorated with proteoglycans
(PGs). The distribution of the collagen fibrils and interfibrillar spacing was
also visibly improved, post-CXL. Lumican, mimecan, and decorin were the dominant
PGs and were significantly upregulated in post-CXL cultures. ECM degradation
proteins, matrix metalloproteinases (MMPs), MMP-1, -3, and -9, but not MMP-2,
were significantly downregulated post-CXL. TIMP-1 and -2 were not modulated by
CXL. CONCLUSION: The unknown effects of CXL on the human corneal microenvironment
have hampered our ability to make CXL available to all KC patients. Our current
study provides a deeper understanding on CXL activity, using our unique 3D in
vitro model.