Characterization of Corneal Epithelial Cells in Keratoconus.

PURPOSE

We studied the cellular characteristics of epithelial cells in the cone and extraconal periphery of corneas in keratoconus eyes.

METHODS

This prospective observational study was conducted at Narayana Nethralaya Eye Institute. A total of 83 and 42 eyes with keratoconus and normal topography, respectively, were included in the study. Corneal epithelial cells were collected and analyzed for apoptosis, proliferation, epithelial-mesenchymal transition, and differentiation status using molecular and biochemical tools. Statistical analysis was performed using the Student's -test.

RESULTS

Corneal epithelial cells from the cone showed significantly higher expression of proapoptotic marker BAX ( < 0.005) compared to controls. Significantly elevated expression of cell cycle markers CYCLIN D1 ( < 0.005) and Ki67 ( < 0.005) were noted in the extraconal region compared to controls. Cells of the cone showed significantly higher ZO-1 ( < 0.005) and lower vimentin ( < 0.005) compared to controls. Significantly lower expression of the differentiation marker CK3/12 ( < 0.05) was observed in cones compared to controls.

CONCLUSIONS

Cones of keratoconic corneas show enhanced cell death, poor differentiation, proliferation and epithelial-mesenchymal transition. The cellular changes of the corneal epithelial cells in the cone and extraconal region differ significantly in a keratoconus corneas.

TRANSLATIONAL RELEVANCE

Characterization of patient-specific corneal epithelial cellular status in keratoconus has the potential to determine the optimal treatment and therapeutic outcomes paving the way towards personalized treatment in the future.