Sankara Nethralaya Referral Laboratory, Medical Research Foundation, Chennai, Tamil Nadu, India.
Dr G Sitalakshmi Memorial Clinic for Ocular Surface Disorders, CJ Shah Cornea Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2023 Feb;71(2):458-463. doi: 10.4103/ijo.IJO_1632_22.
Pterygium is a fibrovascular disease that originates in the conjunctiva and commonly spreads to the corneal surface, thereby posing a threat to eyesight. Despite intensive research, the pathophysiology of this disease remains unclear. Recent research suggests that oncogenic viruses, such as human papillomavirus (HPV), cytomegalovirus, and Epstein-Barr virus (EBV), may play a role in pterygia development. Although there are questions concerning the function of oncogenic viruses in pterygium pathogenesis, existing research shows a lack of consensus on the subject, demonstrating the heterogeneity of pterygium pathophysiology. Therefore, we aimed to simultaneously detect the three common viral pathogens that have been reported in pterygium tissue obtained after excision.
Thirty-five tissue specimens of pterygium from patients undergoing pterygium surgery (as cases) were analyzed for evidence of viral infection with multiplex polymerase chain reaction (PCR), and virus-specific real-time quantitative PCR was used for the samples that were detected positive by multiplex PCR.
Of the 35 patients, one sample was positive for EBV and two samples were positive for HPV. Further PCR-based DNA sequencing of the HPV PCR-positive product showed identity with HPV-16. Real-time quantitative PCR on samples that showed EBV or HPV positivity did not yield any detectable copy number.
Our study results confirmed that PCR positivity could be due to transient flora, but it was not quantitatively significant to conclude as the causative factor of pterygium pathogenesis. However, additional studies with larger sample populations are warranted to fully determine the role of the virus in pterygium.
翼状胬肉是一种起源于结膜的纤维血管疾病，通常会蔓延到角膜表面，从而对视力造成威胁。尽管进行了深入研究，但该疾病的病理生理学仍不清楚。最近的研究表明，致癌病毒，如人乳头瘤病毒（HPV）、巨细胞病毒和 Epstein-Barr 病毒（EBV），可能在翼状胬肉的发展中起作用。尽管关于致癌病毒在翼状胬肉发病机制中的作用存在疑问，但现有研究表明，对此问题尚未达成共识，这表明翼状胬肉的病理生理学存在异质性。因此，我们旨在同时检测在切除后的翼状胬肉组织中已报道的三种常见病毒病原体。
对 35 例接受翼状胬肉手术的患者（作为病例）的 35 个翼状胬肉组织标本进行多重聚合酶链反应（PCR）检测病毒感染证据，对多重 PCR 检测阳性的样本进行病毒特异性实时定量 PCR。
35 例患者中，1 例 EBV 阳性，2 例 HPV 阳性。对 HPV-PCR 阳性产物进行基于 PCR 的 DNA 测序，发现与 HPV-16 同源。对 EBV 或 HPV 阳性样本进行实时定量 PCR 检测未检出可检测到的拷贝数。
我们的研究结果证实，PCR 阳性可能是由于一过性菌群，但由于没有定量意义，不能将其作为翼状胬肉发病机制的致病因素。然而，需要进行更大样本量的研究来全面确定病毒在翼状胬肉中的作用。
