Pathobiology of wound healing after glaucoma filtration surgery
| Autor: | Peter S. Reinach, Ai Kitano-Izutani, Osamu Yamanaka, Katsuo Tomoyose |
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| Rok vydání: | 2016 |
| Předmět: |
TGF-β
Pathology medicine.medical_specialty medicine.medical_treatment Inflammation Trabeculectomy Conjunctival Diseases Proinflammatory cytokine Postoperative Complications Fibrosis medicine Glaucoma surgery Humans Cytokine Intraocular Pressure Wound Healing business.industry Glaucoma General Medicine Growth factor medicine.disease Ophthalmology Proceedings Filtering Surgery Cytokines Fibroblast medicine.symptom Wound healing business Myofibroblast Conjunctiva |
| Zdroj: | BMC Ophthalmology |
| ISSN: | 1471-2415 |
| Popis: | Conjunctival and subconjunctival fibrogenesis and inflammation are sight compromising side effects that can occur subsequent to glaucoma filtration surgery. Despite initial declines in intraocular pressure resulting from increasing aqueous outflow, one of the activated responses includes marshalling of proinflammatory and pro-fibrogenic cytokine mediator entrance into the aqueous through a sclerostomy window and their release by local cells, as well as infiltrating activated immune cells. These changes induce dysregulated inflammation, edema and extracellular matrix remodeling, which occlude outflow facility. A number of therapeutic approaches are being taken to offset declines in outflow facility since the current procedure of inhibiting fibrosis with either mitomycin C (MMC) or 5-fluorouracil (5-FU) injection is nonselective. One of them entails developing a new strategy for reducing fibrosis induced by wound healing responses including myofibroblast transdifferentiation and extracellular matrix remodeling in tissue surrounding surgically created shunts. The success of this endeavor is predicated on having a good understanding of conjunctival wound healing pathobiology. In this review, we discuss the roles of inappropriately activated growth factor and cytokine receptor linked signaling cascades inducing conjunctival fibrosis/scarring during post-glaucoma surgery wound healing. Such insight may identify drug targets for blocking fibrogenic signaling and excessive fibrosis which reduces rises in outflow facility resulting from glaucoma filtration surgery. |
| Databáze: | OpenAIRE |
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