Publication: Phenotypic investigation of regenerated epithelial cells after gonococcal corneal perforation: A clinical, histological, and immunohistochemical study
Issued Date
2015-10-09
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ISSN
15364798
02773740
02773740
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2-s2.0-84944097131
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Mahidol University
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SCOPUS
Bibliographic Citation
Cornea. Vol.34, No.11 (2015), 1508-1512
Suggested Citation
Passara Jongkhajornpong, Takahiro Nakamura, Chie Sotozono, Tsutomu Inatomi, Shigeru Kinoshita Phenotypic investigation of regenerated epithelial cells after gonococcal corneal perforation: A clinical, histological, and immunohistochemical study. Cornea. Vol.34, No.11 (2015), 1508-1512. doi:10.1097/ICO.0000000000000551 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36290
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Title
Phenotypic investigation of regenerated epithelial cells after gonococcal corneal perforation: A clinical, histological, and immunohistochemical study
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Abstract
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Purpose: To determine the characteristics of regenerated epithelial cells after severe gonococcal infection after corneal perforation. Methods: Pathological tissue was obtained from the cornea at the time of surgery. Hematoxylin and eosin staining and immunohistochemical analysis were performed for cytoskeletal keratins (K12, K13, and K15), basement membrane and junctional markers (laminin 5, ZO-1 and Desmoplakin), and proliferative and mesenchymal markers (Ki67, α-SMA, and vimentin). Results: A 42-year-old patient with severe gonococcal keratoconjunctivitis rapidly progressed to corneal perforation during administration of intensive topical and systemic antibiotics. After conservative treatment, the perforation healed and 5- × 3-mm corneal ectasia occurred with localized iris attachment. Complete closure of the cornea was confirmed by a negative Seidel test. After lamellar keratoplasty to improve corneal integrity and to prevent secondary glaucoma, the pathological tissue revealed a poorly organized epithelial layer at the regenerated ectatic area. The regenerated epithelial cells clearly expressed K12, ZO-1, and Desmoplakin with underlying laminin 5 (+) basement membrane. K15 and Ki67 expressions were observed predominantly at the limbal area but not in the regenerated area. α-SMA and vimentin were sporadically expressed in the underlying connective tissue. Conclusions: We speculate that the process of epithelial wound healing at the site of corneal perforation was responsible for migration of the surrounding epithelial cells. Although the regenerated cells expressed several cytokeratins and junctional markers, they remained disorganized and fragile.