Rodriguez-Agirretxe Iñaki, Garcia Iker, Soria Javier, Suarez Tatiana Maria, Acera Arantxa
Instituto Clínico Quirúrgico de Oftalmología, Bilbao, Spain.
Hospital Universitario Donostia, San Sebastian, Spain.
PLoS One. 2017 Mar 30;12(3):e0174559. doi: 10.1371/journal.pone.0174559. eCollection 2017.
Excessive subconjunctival scarring is the main reason of failure of glaucoma filtration surgery. We analyzed conjunctival and systemic gene expression patterns after non penetrating deep sclerectomy (NPDS). To find expression patterns related to surgical failure and their correlation with the clinical outcomes. This study consisted of two consecutive stages. The first was a prospective analysis of wound-healing gene expression profile of six patients after NPDS. Conjunctival samples and peripheral blood samples were collected before and 15, 90,180, and 360 days after surgery. In the second stage, we conducted a retrospective analysis correlating the late conjunctival gene expression and the outcome of the NPDS for 11 patients. We developed a RT-qPCR Array for 88 key genes associated to wound healing. RT-qPCR Array analysis of conjunctiva samples showed statistically significant differences in 29/88 genes in the early stages after surgery, 20/88 genes between 90 and 180 days after surgery, and only 2/88 genes one year after surgery. In the blood samples, the most important changes occurred in 12/88 genes in the first 15 days after surgery. Correspondence analyses (COA) revealed significant differences between the expression of 20/88 genes in patients with surgical success and failure one year after surgery. Different expression patterns of mediators of the bleb wound healing were identified. Examination of such patterns might be used in surgery prognosis. RT-qPCR Array provides a powerful tool for investigation of differential gene expression wound healing after glaucoma surgery.
结膜下瘢痕过度增生是青光眼滤过手术失败的主要原因。我们分析了非穿透性深层巩膜切除术（NPDS）后结膜和全身的基因表达模式。以寻找与手术失败相关的表达模式及其与临床结果的相关性。本研究包括两个连续阶段。第一阶段是对6例NPDS术后患者伤口愈合基因表达谱的前瞻性分析。在手术前以及术后15天、90天、180天和360天采集结膜样本和外周血样本。第二阶段，我们对11例患者进行了回顾性分析，将晚期结膜基因表达与NPDS的结果相关联。我们开发了一个针对88个与伤口愈合相关的关键基因的RT-qPCR阵列。结膜样本的RT-qPCR阵列分析显示，术后早期88个基因中有29个存在统计学显著差异，术后90至180天88个基因中有20个存在差异，术后一年只有2/88个基因存在差异。在血液样本中，最重要的变化发生在术后前15天的88个基因中的12个。对应分析（COA）显示，术后一年手术成功和失败患者中88个基因中有20个基因的表达存在显著差异。确定了滤过泡伤口愈合介质的不同表达模式。检查这些模式可能用于手术预后评估。RT-qPCR阵列是研究青光眼手术后伤口愈合中差异基因表达的有力工具。
