J. Čejková

Histochemical study of alkali-burned rabbit anterior eye segment in which severe lesions were prevented by aprotinin treatment.

SummaryActivities of different enzymes (acid glycosidases, phosphatases, Na+−K+-dependent ATPase, proteases, dehydrogenases) and acid glycosaminoglycans were studied by histochemical methods in sections of rabbit anterior eye segments after experimental alkali burn and treatment with aprotinin, an inhibitor of plasmin and other serine proteinases. Solutions of sodium hydroxide (0.25–1.0M) were applied on corneas using 12-mm-diameter plastic tube for 15–60 s. After wiping with cotton and rinsing with tap water, aprotinin solutions were applied in saline (in experimental animals) and saline (in control animals) dropwise in 12-h intervals for a month. Within the first two weeks aprotinin was used at a concentration of 5000 IU/ml. During the subsequent two weeks the aprotinin concentration was reduced to 2500 IU/ml.Striking differences in enzyme activities and in the healing between treated and untreated eyes were found. Without aprotinin, ulcers developed in most corneas within 3 weeks and plasmin was regularly demonstrated in tears and in the aqueous. When aprotinin treatment was started within 24 h after the burn, the number of enzymatically active inflammatory cells was significantly lower, not only in the cornea itself but also in the whole anterior eye segment. With aprotinin treatment no ulcerations and no plasmin in tears and the aqueous were observed and the corneas healed within a month. The healing process started from the zone of enzymatically activated corneal cells in the unburned zone at the corneal periphery. In the regenerating epithelium and endothelium high activities of Na+−K+-dependent ATPase, γ-glutamyltransferase, lactate and succinate dehydrogenases appeared very soon. Keratocytes displayed high activities of all enzymes studied. The restoration of corneal transparency depended on concentration of alkali used and parallelled the regeneration of the stroma and normalization of corneal hydration. Our results demonstrate that aprotinin is a potent therapeutic agent in the treatment of experimentally induced corneal ulcers, presumably due to its inhibitory action on plasmin and other serine proteases present in the alkali-burned anterior eye segment.

Histochemical changes in the rabbit cornea and plasmin activity in the tear fluid during contact lens wear. Favourable influence of protease inhibitors (aprotinin, PC5, elastatinal).

SummaryPlasmin activity in the tear fluid of the rabbit eye was examined during the wearing of soft contact lenses (SCL) and compared with the occurrence of corneal disturbances assessed in cryostat sections. Plasmin activity was determined with a semiquantitative method using dry punches of filter paper previously soaked in 0.1 M Tris-HCl buffer solution containing mmol/l d-Val-Leu-Lys-FCA (trifluoromethylaminocoumarine), pH 7.2. Punches were applied to the corneal surface for 5 s (tear collection) and incubated in wet chamber. The time of appearance of the bright yellow fluorescence in UV light was recorded and taken as a measure of plasmin activity. For calibration punches soaked in solutions containing plasmin in various concentrations, and processed in the same manner were used. Changes in the cornea were examined histochemically using methods of choice for acid glycosidases, proteases, dehydrogenases, and Na+-K+-ATPase. SCL with high and low water content were worn in rabbits in 1, 2, 4, 7, 14, 21 and 28 days.Decreased activity of Na+-K+-ATPase, GGT, and SDH in the corneal endothelium and epithelium were not accompanied by detectable plasmin activity in the tear fluid. Pronounced damage of the corneal epithelium (increased activities of acid glycosidases, acid proteases, LDH, markedly decreased activity of SDH) was accompanied by low concentration of plasmin (0.4–1.0 μg/ml) in the tear fluid. Middle activity of plasmin (1.0–2.0 μg/ml) was detectable when PMNs were present in the corneal stroma. High plasmin activity (2.0–3.0 μg/ml) correlated with corneal ulceration and vascularization. The occurrence of both — plasmin activity and corneal disturbances was highly dependent on the water content of SCL (which goes parallel with oxygen permeability), duration of SCL wear, mechanical stress, and bacterial contamination. Mechanical irritation is considered to be the main factor leading to the appearance of plasmin activity in the tear fluid. The local application of aprotinin which inhibits plasmin and some other serine proteases, enables us to prolong the harmless wear of SCLH (approximately one week). The combination of aprotin-in with leukocyte elastase inhibitors (elastatinal and particularly PC5), prevents ulceration of the cornea and inhibits corneal vascularization after SCLL wear. Vascularization of the cornea does not occur if protease inhibitors are combined with flurbiprofen, an anti-inflammatory drug of cyclooxygenase pathway of arachidonic acid. Protease inhibitors also improved the course of bacterial keratitis.

Histochemistry of some proteases in the normal rabbit, pig and ox corneas

SummaryThe distribution of activities of membrane aminopeptides (aminopeptidases M (APM), aminopeptidase A (APA), dipeptidyl peptidase IV (DPP IV), γ-gluamyltransferase (GGT) and lysosomal exopeptidases (dipeptidyl peptidase I (DPP I), dipeptidyl peptidase II (DPP II) was investigated in rabbit, ox and pig corneas. Cryostat sections of snap-frozen corneas treated with chloroform-acetone (4°C) were used for the demonstration of membrane-bound enzymes and sections of corneas fixed in 4% paraformaldehyde (4°C) for the demonstration of lysosomal enzymes.In activities of proteases species differences were found. The rabbit cornea was most active, followed by ox and pig corneas. Individual corneal layers reacted differently. Of membrane proteases a high APM activity was found in keratocytes, whereas epithelium and endothelium were negative. On the other hand APA and GGT were active in the epithelium and endothelium. Their activities in keratocytes were less pronounced. DPP IV activity was demonstrated in some keratocytes beneath the epithelium only. Lysosomal enzymes DPP I and DPP II were active in all corneal layers. The epithelium displayed the highest activity.Differences in activities in the centro-peripheral and epithelio-endothelial directions were found. DPP I, DPP II, and APM were most active in the limbal region in all corneal layers.

The histochemical pattern of mechanically or chemically injured rabbit cornea after aprotinin treatment: relationships with the plasmin concentration of the tear fluid.

SummaryPlasmin, a serine protease, was recently found to be involved in corneal ulcerative processes in humans and rabbits. In our experiments, plasmin activity was found in the tear fluid after mechanical and chemical damage of the rabbit cornea, such as de-epithelization and burning with alkali. The plasmin concentrations in the tear fluid were dependent on the severity of injury. The highest plasmin activity (2.0–3.0 μg ml−1) occurred after severe alkali damage to large areas of the cornea, and the lowest activity (0.4–1.0 μg ml−1) after mechanical injury (de-epithelization).Plasmin concentrations up to 1.0 μ ml−1 were associated with increased activities of lysosomal hydrolases in epithelial cells and keratocytes beneath the epithelium. Plasmin activities increased as the inflammatory reaction developed. When plasmin activity in the tear fluid was higher than 1.0 μg ml−1, inflammatory cells were found in the corneal stroma. Levels of 1.5–2.0 μg ml−1 were connected with higher numbers of inflammatory cells (particularly polymorphonuclear leukocytes) with increased activities of lysosomal hydrolases. Very high plasmin activities (2.5–3.0 μg ml−1) accompanied corneal ulcerative processes.The local application of aprotinin (Trasylol, Bayer), an inhibitor of plasmin, and also of some other proteases, was found to be necessary for the healing of severe corneal injuries in which highly elevated plasmin activity in the tear fluid and inflammatory cellulization of the cornea occurred (severe damage). It was beneficial in cases in which medium plasmin activity occurred in the tear fluid and inflammatory changes in the cornea were not too extensive. If used very early after injury, aprotinin prevents the appearance of high plasmin activity in the tear fluid, reduces the invasion of inflammatory cells into the corneal stroma, and accelerates the healing. Even the corneal transparency is restored in many cases.

Alkali burns of the rabbit cornea

SummaryIn alkali burned rabbit cornea the stainability of glycosaminoglycans in cold microtome setions was investigated. Staining by Alcian blue in 3% acetic acid, Alcian blue in various MgCl2 concentration and toluidine blue (pH 4.5) was employed. From the 1 st to the 4th experimental day the intensity of reactions was decreased. This is most probably due to an increased hydration of the corneal stroma. On the 7th day hydration was markedly suppressed and reached nearly the normal level. In this time interval a decreased stainability of glycosaminoglycans was seen accompained by a complete loss of staining in the marginal zone. On the 14th day the stainability in the traumatized area began to restore and in the marginal zone appeared. On the 32nd day the staining intensity of both areas was normalised, however when lower concentrations of MgCl2 were used; in the presence of higher concentrations of MgCl2 the decreased staining intensity persisted and points to a lower sulfatation of glycosaminoglycans. This was particularly remarkable in the area bordering the injured zone. This decrease runs parallel to the increased acitvities of acid glycosidases (especially of acid β-galactosidase) which were reported previously.

Distribution of acid phosphatase, β-glucuronidase, N-acetyl-β-D-glucosaminidase and β-galactosidase in cornea of albino rabbit

SummaryActivities of acid phosphatase, β-glucuronidase, N-acethyl-β-D-glucosaminidase and acid β-galactosidase were investigated histochemically in rabbit corneas. Frozen sections after block fixation in cold 4% formaldehyde with 1% CaCl2 followed by washing in cold physiological saline as well as cold microtome sections of corneas quenched in petroleter chilled with acetone-dry ice mixture, transferred to nonprecooled slides or semipermeable membranes were used. Standard aqueous media were employed in the case of free-floating frozen sections of fixed corneas as well as of cold microtome sections (postfixed in cold 4% formaldehyde). Agar media were used in connection with the technic of semipermeable membranes. Gomori method (in the case of acid phosphatase), simulataneous azocoupling methods (substrates derivated of naphthol-AS-BI with hexazonium-p-rosanilin) in the case of acid phosphatase, β-glucuronidase and N-acetyl-β-D-glucosaminidase and the indigogenic method in the case of acid β-galactosidase were applied. Enzyme activities in sections of fixed corneas were minimal in comparison with those in cold microtome sections of unfixed material revealed particularly with the technic of semipermeable membranes which is to be preferred. This technic is recommended in studies concerned with lysosomal enzymes in the cornea, particularly in keratocytes. All enzymes investigated were in corneal epithelium, keratocytes and endothelium. Acid phosphatase displayed the highest activity followed by β-glucuronidase and acetyl-β-D-glucosaminidase. The activity of β-galactosidase was the lowest. For the demonstration of activities in keratocytes sections parallel to the surface are very suitable. In these sections enzyme activities were demonstrated in small granules (apparently lysosomes) present in the central part of their cytoplasm as well as in projections. Diffuse staining was also seen, being the highest in the case of acid phosphatase.

The effect of hydration of the rabbit cornea on the histochemical demonstration of acid mucopolysaccharides

SummaryThe influence of hydration on the histochemical staining of acid mucopolysaccharides (AMPS) in the rabbit cornea was studied. The rabbit cornea was immersed in distilled water for 4, 8, 12 and 16 hour intervals, and the water content of the hydrated stroma was investigated. Simultaneously the hexosamine content was examined. For the histochemical identification of AMPS the corneae were fixed with formol-calcium chloride and embedded in paraffin.Various degrees of the corneal hydration were without influence on the content of AMPS determined by biochemical methods. On the other hand the results of all histochemical staining reactions for AMPS were extremely dependent on the state of hydration. The quantitative evaluation of the content of AMPS in the corneal stroma on the basis of staining reactions is thus impossible.

A study of acid mucopolysaccharides in cold microtome sections of normal and experimentally hydrated bovine corneas.

SummaryAcid mucopolysaccharides were investigated in cold microtome sections of normal and experimentally hydrated bovine corneas. Staining methods using cationic dyes were used for the detection.A 10 min fixation of cold microtome sections in absolute alcohol did not change the stainability of acid mucopolysaccharides substantially. The staining was only a little fainter (as against unfixed sections). After 10 min fixation with formol-cetylpyridinium chloride the staining of sections was diminished and after 30 min fixation in this fluid completely abolished. After formol-calcium chloride fixative the staining was decreased in dependence on the time of fixation due to the elution of acid mucopolysaccharides in the fixative (acid mucopolysaccharides in the fixative were demonstrated by means of paper electrophoresis). Formolcalcium chloride is likewise unsuitable.Experimental hydration of corneas in distilled water did not substantially alter the staining properties of acid mucopolysaccharides in cold microtome sections. Only quantitative differences were found in comparison with untreated corneas. These differences were due to hydration causing an increase in the distance of acidic groups among individual molecules of acid mucopolysaccharides.