Myofibroblastic Transformation Secondary to Epithelial-stromal Interactions in the Keratoconus
NCT ID: NCT03990740
Last Updated: 2020-05-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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WITHDRAWN
OBSERVATIONAL
2019-11-01
2020-05-12
Brief Summary
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Publications suggest that keratoconus is linked to chronic inflammation (increase in pro-inflammatory cytokines and metalloproteinases (MMP). Direct epithelial-stromal interactions (D-ESI) have a role in the induction of metalloproteinases (MMP) and the differentiation of fibroblasts into myofibroblasts via an EMMPRIN membrane glycoprotein (extracellular matrix membran MMP inducer - CD 147). On a healthy cornea, EMMPRIN's effects are prevented by a lack of contact between epithelial and stromal cells through a basement membrane, which is altered in the keratoconus The hypothesis is that stromal thinning of the keratoconus could be related to increased expression of EMMPRIN by epithelial and stromal cells (resulting in increased MMP synthesis), with a preponderance at the most deformed areas.
The main objective is to demonstrate a transformation of fibroblasts to myofibroblasts in the corneal stroma of keratoconus patients.
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Detailed Description
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Conditions
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Cases
Patients suffering from keratoconus and requiring a first optical corneal transplant
Corneal sampling
Corneal samples will be taken during corneal transplants for cases and orbital exenterations for controls. The mRNA (messenger ribonucleic acid) will be extracted and a retrotranscription will be made to obtain cDNA (complementary DNA). A qPCR (quantitative polymerase chain reaction) will be able to quantify the expression of alpha-SMA, MMP 1-2-3 and 9, and EMMPRIN.
Controls
Patients with an indication of orbital exenteration operation due to an orbital tumor
Corneal sampling
Corneal samples will be taken during corneal transplants for cases and orbital exenterations for controls. The mRNA (messenger ribonucleic acid) will be extracted and a retrotranscription will be made to obtain cDNA (complementary DNA). A qPCR (quantitative polymerase chain reaction) will be able to quantify the expression of alpha-SMA, MMP 1-2-3 and 9, and EMMPRIN.
Interventions
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Corneal sampling
Corneal samples will be taken during corneal transplants for cases and orbital exenterations for controls. The mRNA (messenger ribonucleic acid) will be extracted and a retrotranscription will be made to obtain cDNA (complementary DNA). A qPCR (quantitative polymerase chain reaction) will be able to quantify the expression of alpha-SMA, MMP 1-2-3 and 9, and EMMPRIN.
Eligibility Criteria
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Inclusion Criteria
\- Suffering from keratoconus and requiring a first optical corneal transplant
* For the controls:
* Orbital exenteration operation due to an orbital tumor
* Absence of any anomaly of the ocular surface observed during the slit lamp examination at the last preoperative consultation
Exclusion Criteria
* Keratoconus patient requiring a tectonic corneal transplant
* Known pregnancy, or breastfeeding
* For the controls:
* History of orbital radiotherapy
* History of corneal surgery
* History of corneal surface tumour
* Eye surface abnormality noted in the preoperative period
* Known keratoconus
* Known pregnancy, or breastfeeding
* Secondary exclusion if a keratoconus is diagnosed during the immunohistochemical analysis by visualization of Bowman membrane interruption
18 Years
ALL
No
Sponsors
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Fondation Ophtalmologique Adolphe de Rothschild
NETWORK
Responsible Party
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Other Identifiers
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EGN_2017_22
Identifier Type: -
Identifier Source: org_study_id
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