Abstract
Introduction
The aim of our study was to confirm the presence of inflammatory T-lymphocyte subpopulations (CD4 and CD8) in pterygium specimens with regards to clinical severity. Additionally, we examined the effect of topical anti-inflammatory agents on the presence of T-lymphocyte subpopulations.
Methods
Pterygia from nineteen eyes of nineteen patients who underwent surgical excision at Duke University, North Carolina, were included in this study. Normal conjunctiva from one patient was included as a control. Pterygia were pre-operatively graded as mild, moderate or severe based on objective signs of inflammation. Immunohistochemical staining for both CD4 and CD8 subpopulations of T lymphocytes was performed. Distribution of lymphocytes within the epithelium and substantia propria was graded by a masked observer on the following scale: 0 (none/rare), 1+ (mild), 2+ (moderate), or 3+ severe. Statistical analysis was performed using the Fisher exact test and Chi-square test.
Results
A total of 16 (84%) pterygia specimens stained for T lymphocytes displayed approximately equal CD4 and CD8 infiltration of both the epithelium and the substantia propria. The majority of CD4 and CD8 lymphocytes were located in aggregates in the epithelium and upper substantia propria. The control specimen contained scant evidence of lymphocytic infiltration. There was no significant difference in the amount of lymphocytic infiltration between mild, moderate or severe pterygia. There was also no significant difference in lymphocytic infiltration between patients with (n=8) or without (n=11) a history of topical anti-inflammatory use.
Conclusion
The presence of CD4 and CD8 lymphocytes was confirmed in pterygia. There was no significant difference in lymphocytic infiltrate in patients with or without prior topical anti-inflammatory use. Based on these findings, topical immunomodulators may have an adjunctive role in the treatment of pterygia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albert DM, Jacobi FA. Principles and Practice of Ophthalmology. Philadelphia, PA: W.B. Saunders; 1994.
Hill JC, Maske R. Pathogenesis of pterygium. Eye. 1989;3:218–226.
Moran DJ, Hollows FC. Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol. 1984;68:343–346.
Taylor HR, West SK, Rosenthal FS, Munoz B, Newland HS, Emmett EA. Corneal changes associated with chronic UV radiation. Arch Ophthalmol. 1989;107:1481–1484.
Kwok LS, Coroneo MT. A model for pterygium formation. Cornea. 1994;13:219–224.
Weinstein O, Rosenthal G, Zirkin H, Monos T, Lifshitz T, Argov S. Overexpression of p53 tumor suppressor gene in pterygia. Eye. 2002;16:619–621.
Kadayifçilar SC, Orhan M, Irkec M. Tear functions in patients with pterygium. Acta Ophthalmol. 1998;76:176–179.
Tsironi S, Ioachim E, Machera M, Aspiotis M, Agnantis K, Psillas K. Immunohistochemical HLA-DR antigen expression with lymphocyte subsets and proliferative activity in pterygium. In Vivo. 2002;16:299–306.
Ioachim-Velogianni E, Tsironi E, Agnantis N, Datseris G, Psilas K. HLA-DR antigen expression in pterygium epithelial cells and lymphocyte subpopulations: an immunohistochemistry study. German J Ophthalmol. 1995;4:123–129.
Beden U, Irkec M, Orhan D, Orhan M. The roles of T-lymphocyte subpopulations (CD4 and CD8), intercellular adhesion molecule-1 (ICAM-1), HLA-DR receptor, and mast cells in etiopathogenesis of pterygium. Ocul Immunol Inflamm. 2003;11:115–122.
Frucht-Pery J, Siganos C, Solomon A, Shvartzenberg T, Richard C, Trinquand C. Topical indomethacin solution versus dexamethasone for treatment of inflamed pterygia and pinguecula: a prospective randomized clinical study. Am J Ophthalmol. 1999;127:148–152.
Rachmiel R, Leiba H, Levartovsky S. Results of treatment with topical mitomycin 0.02% following excision of primary pterygium. Br J Ophthalmol. 1995;79:233–236.
Foster CS, Rice BA, Dutt JE. Immunopathology of atopic keratoconjunctivitis. Ophthalmology. 1991;98:1190–1196.
Bahn AK, Fujikawa LS, Foster CS. T-cell subsets and langerhans cell in normal and diseased conjunctiva. Am J Ophthalmol. 1982;94:205–212.
Hingorani M, Metz D, Lightman SL. Characterisation of the normal conjunctival leukocyte population. Exp Eye Res. 1997;64:905–912.
Yaisawang S, Piyapattanakorn P. Role of post-operative topical corticosteroids in recurrence rate after ptergyium excision with conjunctival autograft. J Med Assoc Thai. 2003;86:S215–S223.
Frucht-Pery J, Siganos CS, Solomon A, Shvartzenberg T, Richard C, Trinquand C. Treatment of inflamed pterygium and pinguecula with topical indomethacin 0.1% solution. Cornea. 1997;16:42–47.
Hirst LW. The treatment of pterygium. Surv Ophthalmol. 2003;48:145–180.
Carnahan MC, Goldstein DA. Ocular complications of topical, peri-ocular, and systemic corticosteroids. Curr Opin Ophthalmol. 2000;11:478–483.
Tarr KH, Constable IJ. Late complications of pterygium treatment. Br J Ophthalmol. 1980;64:496–505.
Rubinfeld RS, Pfister RR, Stein RM, et al. Serious complications of topical mitomycin-C after pterygium surgery. Ophthalmology. 1992;99:1647–1654.
Borel JF, Baumann G, Chapman I, et al. In vivo pharmacologic effects of cyclosporine and some analogues. Adv Pharmacol. 1996;35:115–246.
Kunert, KS, Tisdale AS, Stern ME, Smith JA, Gipson IK. Analysis of topical cyclosporine treatment on patients with dry eye syndrome. Arch Ophthalmol. 2000;118:1489–1496.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Awdeh, R.M., DeStafeno, J.J., Blackmon, D.M. et al. The presence of T-lymphocyte subpopulations (CD4 and CD8) in pterygia: Evaluation of the inflammatory response. Adv Therapy 25, 479–487 (2008). https://doi.org/10.1007/s12325-008-0056-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12325-008-0056-4