Br J Ophthalmol 2001;85:147-153
( February )
Tear film MMP accumulation and corneal disease
V A Smith, H Rishmawi, H Hussein, D L Easty
University of
Bristol, Division of Ophthalmology, Bristol Eye Hospital, Bristol
BS1 2LX, UK
Correspondence to: Dr V A Smith
Val.Smith{at}bristol.ac.uk
Accepted for publication 1 August 2000
BACKGROUND/AIMS Matrix
metalloproteinases (MMPs) accumulate in the tears of patients with
active peripheral ulcerative keratitis (PUK) but it is unknown whether
these enzymes have a central role in disease progression. The aims of
the present investigation were to determine the source of these enzymes
and to ascertain whether their accumulation in tears is a phenomenon
specific to PUK or a general feature of other anterior segment diseases.
METHODSThe
experimental samples were obtained from the culture media of
conjunctival and corneal epithelial cells, from fractionated blood
plasma and leucocytes of healthy subjects and patients with rheumatoid
arthritis, and from the tears of healthy subjects and patients with a
variety of anterior segment diseases. The MMPs of all samples were
visualised by zymography and tear samples were assayed using
nitrophenol acetate and an MMP-9 susceptible quenched fluorescent
peptide as substrate.
RESULTSThe major MMPs
that accumulate in the tears of patients with rheumatoid arthritis with
active ocular disease are MMP-9 and a species of
Mr 116 000. By comparing the
zymographic activity profiles of the gelatinases present in the samples
obtained, it was deduced that the main source of these MMPs was
granulocytes. Their accumulation in tears was not unique to patients
with PUK; detectable amounts of the enzymes also occurred in the tears
of patients with keratoconus with associated atopic disease, patients undergoing treatment for herpetic eye disease, and patients with systemic and non-systemic dry eye disease.
CONCLUSIONThe MMPs
that accumulate in tears are mainly derived from granulocytes. This may
be effected by autoimmune diseases that involve ocular tissue or by
ocular diseases that induce an inflammatory response.
© 2001 by British Journal of Ophthalmology
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