Toll-Like Receptors and Vascular Markers in Ocular Rosacea

*Department of Ophthalmology, Ophthalmic Plastic Surgery, Lions Eye Institute
Ophthalmic plastic and reconstructive surgery (Impact Factor: 0.88). 07/2013; 29(4):290-3. DOI: 10.1097/IOP.0b013e318293764c
Source: PubMed


To delineate signals by which the vascular abnormalities inherent to ocular rosacea arise and to correlate these signals with elements of the innate immune system.
Experimental study. Immunohistochemical staining was performed for a variety of vascular markers and for toll-like receptor-4 on eyelid biopsies taken from patients with ocular rosacea and normal controls. Statistical comparisons were then performed between the 2 groups.
Immunohistochemical staining for CD31 and integrin-β-3 did not demonstrate any statistically significant differences between eyelids from patients with ocular rosacea and normal controls. Cutaneous biopsies from ocular rosacea patients demonstrated statistically significant enrichments of intercellular adhesion molecule-1 and CD105 among arterioles, whereas there were no statistically significant differences in the venules between normal controls and ocular rosacea patients. The correlation between the number of toll-like receptor-4-positive cells and each vascular marker was statistically significant.
Cutaneous biopsies of the eyelid did not demonstrate an increase in the total number of blood vessels. However, the vascular abnormalities that are typical of ocular rosacea represent activated, inflamed vessels, and these phenomena may be mediated by intercellular adhesion molecule and CD105. Furthermore, the strong correlations between toll-like receptor-4 and each vascular marker suggest that the innate immune system may govern the cutaneous effects of ocular rosacea. Intercellular adhesion molecule, CD105, and toll-like receptor-4 may represent important therapeutic targets in the management of this disease.

1 Follower
17 Reads
    • "Finally, from the last decade until present time, many reports reviewing particular aspects of ocular rosacea like, quality-of-life, pathophysiologic mechanisms and treatment modalities have increased the awareness, and improved our knowledge of the disease [28] [29] [30] [31] [32] [33] [34] [35] [36] [37]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Ocular rosacea forms part of the clinical spectrum of rosacea. It is characterized by a chronic and recurrent inflammation of the eyelids, conjunctiva and cornea. Approximately 50% of rosacea patients present ocular manifestations, and the condition is most frequently diagnosed when cutaneous signs and symptoms are present. However in 20% of patients, ocular manifestations may precede the cutaneous disease. Most frequent ocular symptoms are: red eyes, burning, foreign body sensation, photophobia and blurred vision. Chronic blepharitis with meibomian gland dysfunction is the most frequent ocular manifestation of the disease, and produces evaporative dry eye with consequent ocular surface damage. Corneal inflammation and scarring may be a cause of severe visual loss. In addition to therapeutic strategies for the cutaneous disease, ocular rosacea treatment involves, lid hygiene, topical macrolides and tetracyclines as eyelid gels or ointments, lubricant eye drops, and short-term topical steroids, depending on the severity of blepharitis, conjunctivitis and keratitis. Prognosis and visual outcome depend on the severity of the disease, early diagnosis and appropriate treatment.
    Advances in Dermatology Research., First edited by James P. Vega, 04/2015: chapter Ocular Rosacea: Recent Advances in Pathogenesis and Therapy.: pages 175-199.; Nova Biomedical Science Publishers, Inc.., ISBN: 978-1-63482-226-8
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints. One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline. Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes (P<0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs (P=0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group (P<0.05). Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.
    International Journal of Ophthalmology 06/2015; 8(3). DOI:10.3980/j.issn.2222-3959.2015.03.19 · 0.71 Impact Factor