Clinique Ophtalmologique, Hôpital Edouard Herriot, Lyon, France.
Invest Ophthalmol Vis Sci. 2011 Dec 9;52(13):9411-5. doi: 10.1167/iovs.10-7049.
The aim of this study was to develop a validated, reliable, and minimally invasive technique for diagnosing limbal stem cell deficiency (LSCD) by immunocytochemical detection of conjunctival and corneal keratins on epithelial cells collected by impression cytology (IC).
After validation of labeling techniques on a cohort of 10 healthy control patients, keratins K12, K13, and K19 were labeled on corneal IC of 10 eyes suspected of LSCD. Positive scores for the conjunctival markers K13/K19, coupled with the rarity of the corneal marker K12, were diagnostic proof of LSCD.
IC is a reliable and noninvasive technique for collecting epithelial cells. The labeling validation phase has permitted K3 labeling to be eliminated due to lack of corneal specificity. Among patients with LSCD, nine samples were diagnosed with LSCD (K13+/K19+), which was severe (K12-) in eight cases and mild (K12+) in one case. One sample could not be analyzed due to lack of cells.
K13 has shown to be a new marker of conjunctival differentiation. The immunocytochemical search for the K13/K19 couple by corneal IC provides a simple and reliable method for diagnosing LSCD, whereas the level of K12 could provide a score of disease severity. On the other hand, the authors question the corneal specificity of K3 as conventionally established.
本研究旨在通过免疫细胞化学检测印迹细胞学（IC）收集的上皮细胞中的结膜和角膜角蛋白，开发一种经过验证、可靠且微创的方法来诊断角膜缘干细胞缺乏症（LSCD）。
在 10 名健康对照患者的队列中验证了标记技术后，对 10 只疑似 LSCD 的眼睛的角膜 IC 进行了角蛋白 K12、K13 和 K19 的标记。结膜标志物 K13/K19 呈阳性评分，加上角膜标志物 K12 的罕见性，是 LSCD 的诊断证明。
IC 是一种可靠且非侵入性的上皮细胞采集技术。由于缺乏角膜特异性，标记验证阶段已消除了 K3 标记。在 LSCD 患者中，9 个样本被诊断为 LSCD（K13+/K19+），其中 8 个为严重（K12-），1 个为轻度（K12+）。由于缺乏细胞，有一个样本无法进行分析。
K13 已被证明是结膜分化的新标志物。通过角膜 IC 寻找 K13/K19 对可提供一种简单可靠的 LSCD 诊断方法，而 K12 的水平可提供疾病严重程度的评分。另一方面，作者对 K3 的角膜特异性提出了质疑。
