Elgouhary Sameh Mohamed, Elmazar Hesham Fouad, Naguib Mariana Ibrahim, Bayomy Noha Rabie
Department of Ophthalmology, Menoufia University, Shibin Elkom, Egypt.
Benha Ophthalmic Hospital, Benha, Egypt.
Int Ophthalmol. 2020 Oct;40(10):2593-2606. doi: 10.1007/s10792-020-01440-2. Epub 2020 Jun 6.
To assess the roles of oxidative stress and vascular endothelial growth factor (VEGF) in pterygium pathogenesis and prevention of pterygium recurrence after surgical excision.
Surgically removed pterygium tissue from 35 pterygium patients and normal conjunctival samples from 15 patients matched for age and sex (used as controls) constituted the study samples. The conjunctival samples were preserved at - 80 °C until analysis. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH) and total antioxidant (TAO) enzymatic activity and the levels of nitric oxide (NO), malondialdehyde (MDA) and VEGF were studied in both groups. To evaluate the recurrence rate after surgical excision, the pterygium patients were further subdivided into three groups according to the adjuvant therapy used to prevent recurrence. Group 1 consisted of 10 patients who were treated with 0.2 mg mitomycin-c (MMC) for 2 min. Group 2 consisted of 12 patients treated with subconjunctival bevacizumab injection after surgical removal of the pterygium. Group 3 consisted of 13 patients who underwent combined treatment with 0.2 mg of MMC for 2 min and subconjunctival bevacizumab injection. The follow-up of patients in the three groups ranged from 7 to 15 months.
The activities of CAT, SOD, GSH and TAO were significantly lower in pterygium samples than in normal conjunctival samples (p < 0.0001 each). The levels of MDA (p = 0.046), NO (p < 0.0001) and VEGF (p < 0.0001) were significantly higher in pterygium patients than in controls. The lowest recurrence rate after surgical excision was that of the third group.
Oxidative stress and VEGF could play a role in the pathogenesis of pterygium as indicated by decreased antioxidant enzymatic activity and increased levels of VEGF in the pterygium tissue and the role of MMC and anti-VEGF therapy in decreasing the recurrence rate after surgical excision.
评估氧化应激和血管内皮生长因子（VEGF）在翼状胬肉发病机制以及手术切除后预防翼状胬肉复发中的作用。
35例翼状胬肉患者手术切除的翼状胬肉组织以及15例年龄和性别匹配的正常结膜样本（用作对照）构成研究样本。结膜样本保存在-80°C直至分析。研究了两组中过氧化氢酶（CAT）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH）和总抗氧化剂（TAO）的酶活性以及一氧化氮（NO）、丙二醛（MDA）和VEGF的水平。为了评估手术切除后的复发率，根据用于预防复发的辅助治疗方法，将翼状胬肉患者进一步分为三组。第1组由10例用0.2mg丝裂霉素C（MMC）治疗2分钟的患者组成。第2组由12例在手术切除翼状胬肉后结膜下注射贝伐单抗治疗的患者组成。第3组由13例接受0.2mg MMC治疗2分钟并结膜下注射贝伐单抗联合治疗的患者组成。三组患者的随访时间为7至15个月。
翼状胬肉样本中CAT、SOD、GSH和TAO的活性显著低于正常结膜样本（每项p<0.0001）。翼状胬肉患者中MDA（p=0.046）、NO（p<0.0001）和VEGF（p<0.0001）的水平显著高于对照组。手术切除后复发率最低的是第三组。
翼状胬肉组织中抗氧化酶活性降低和VEGF水平升高表明氧化应激和VEGF可能在翼状胬肉发病机制中起作用，以及MMC和抗VEGF治疗在降低手术切除后复发率中的作用。
