Journal of the Korean Ophthalmological Society 2006;47(9):1472-1480.
Published online September 30, 2006.
Circulating Endothelial Progenitor Cells and Vasculogenic Factors in Pterygium Pathogenesis.
Young Soo Song, Jeong Kyu Lee, Jae Chan Kim
Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea. jck50ey@kornet.net
익상편 발생기전에서 말초혈액의 내피전구세포 및 혈관신생인자의 관여
송영수,이정규,김재찬
Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea
Correspondence:  Young Soo Song, M.D.
Abstract
PURPOSE
We investigated whether endothelial progenitor cells (EPCs) and vasculogenic factors are involved in the pathogenesis of pterygium and the mechanism underlying the selective recruitment of EPCs during this process. METHODS: We studied 13 normal controls and 28 pterygium patients [ primary (n=15), recurrent (n=13)]. Substance-P, vascular endothelial growth factor (VEGF), and stem cell factor (SCF) were measured in plasma and tears using ELISA, and circulating CD34+ and c-kit+ mononuclear cells (MNCs) by flow cytometry. Anterior segment fluorescein angiography (FAG) was performed to evaluate hypoxic conditions in the early stage of pterygium. Surgically removed pterygial tissues were analyzed immunohistochemically using the progenitor cell markers, CD34, c-kit, VEGFR-1 and VEGFR-2. RESULTS: Anterior segment FAG findings showed an increase in non-perfusion areas and attenuated vessels in the nasal limbus during early stage pterygium. Circulating CD34+ MNCs and c-kit+ MNCs were increased in pterygium groups compared with normal controls. Systemic and local cytokines including SP, VEGF and SCF in pterygium groups were also elevated and showed positive correlations with CD34+ and c-kit+ MNC numbers. Immunohistochemical analysis of pterygium showed strong progenitor cell marker immunoreactivities. CONCLUSIONS: EPCs might be involved in pterygium development, and ocular hypoxia triggers this neovascualrization by recruiting EPCs derived from the bone marrow via the production of systemic and local cytokines.
Key Words: Endothelial progenitor Cells;Pterygium;Stem cell factor;Substance-P;Vascular endothelial growth factor


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