Zhengxuan Jiang

Central and Midperipheral Corneal Thickness Measured with Scheimpflug Imaging and Optical Coherence Tomography

Purpose To compare corneal thickness measurements using Pentacam (Oculus, Germany), Sirius (CSO, Italy), Galilei (Ziemer, Switzerland), and RTVue-100 OCT (Optovue Inc., USA). Methods Sixty-six eyes of 66 healthy volunteers were enrolled. Three consecutive measurements were performed with each device. The mean value of the three measurements was used for subsequent analysis. Central corneal thickness (CCT), thinnest corneal thickness (TCT), and midperipheral corneal thickness (MPCT; measured at superior, inferior, nasal, and temporal locations with a distance of 1 mm (CT2mm) or 2.5 mm (CT5mm) from the corneal apex) were analyzed. Differences and agreement between measurements were assessed using the repeated-measures analysis of variance (ANOVA) and Bland-Altman analyses, respectively. Results Statistically significant differences (p<0.001) among the four devices were revealed in CCT, TCT and CT2mmmeasurements. The CCT, TCT, and CT2mm values were ranked from the thickest to the thinnest as follows: Galilei>Sirius>Pentacam>RTVue OCT. For these measurements, agreement between measurements by Sirius and Pentacam was good, whereas Galilei overestimated and RTVue underestimated corneal thickness compared to Sirius and Pentacam. As regards CT5mm measurements, Pentacam provided the largest values, whereas RTVue OCT yielded the smallest values. Agreement of the CT5mm measurements was good between the Pentacam, Sirius, moderate between Galilei and the other two Scheimpflug systems, and poor between the RTVue OCT and the remaining devices. Conclusions The Pentacam and Sirius can be used interchangeably for CCT measurements, while the Galilei and RTVue systematically over- and underestimate CCT, respectively. The three Scheimpflug cameras, but not the RTVue, may be used interchangeably for MPCT measurements.

The association between toll-like receptor 4 polymorphisms and diabetic retinopathy in Chinese patients with type 2 diabetes.

Purpose Diabetic retinopathy (DR) is one of the secondary microvascular complications of type 2 diabetes mellitus. Persistent inflammation and impaired neovascularisation may be important contributors to the development of DR. A recent study showed that toll-like receptor 4 (TLR4) polymorphisms were associated with DR. The present study was designed to determine whether single-nucleotide polymorphisms (SNPs) in the TLR4 gene were associated with DR in a Chinese Han population. Materials and methods Three SNPs (rs10759931, rs1927911 and rs1927914) in the TLR4 gene were chosen as candidate SNPs. Genomic DNA from type 2 diabetes patients and healthy controls were genotyped for the above-mentioned genetic variations through the use of PCR restriction fragment length polymorphism assay. Data were analysed by χ2 analysis. Results The results showed that the three analysed polymorphisms in the TLR4 gene were in Hardy–Weinberg equilibrium, both in the patients and in the controls. In the type 2 diabetes group, a significantly higher frequency of the C allele of rs1927914 was observed in patients with type 2 diabetes than that in controls. The result showed that the frequencies of the TT genotype and the T allele of rs1927914 were significantly decreased in patients with type 2 diabetes. Significantly increased frequencies of the CC genotype and the C allele of rs1927911 were observed in patients with type 2 diabetes. In the DR group, the C allele of rs1927914 was significantly increased in the DR group compared with that of the control. The frequencies of the CC genotype and the C allele of rs1927911 tended to be higher in patients with DR than in the healthy controls. However, no difference was found when the Bonferroni correction was applied. No difference was detected between patients and controls with regard to all haplotypes. Conclusions This study suggested that rs1927914 and rs1927911 were associated with type 2 diabetes mellitus and that rs1927914 was associated with susceptibility to DR in a Han Chinese population.

Hepatocyte Growth Factor Genetic Variations and Primary Angle-Closure Glaucoma in the Han Chinese Population

Purpose The aim of this study is to examine whether or not hepatocyte growth factor (HGF) genetic variations are associated with susceptibility to primary angle-closure glaucoma (PACG) in the Han Chinese population. Methods Three single-nucleotide polymorphisms (SNPs)–rs5745718, rs17427817, and rs3735520–in the HGF gene were genotyped in 238 adult patients with PACG and 287 age-, sex-, and ethnically matched healthy controls by using a polymerase chain reaction restriction fragment length polymorphism assay. Data was analyzed by χ2 analysis. Results The three tested analyzed polymorphisms in the HGF gene were in Hardy-Weinberg equilibrium, in all the subjects. The frequencies of the genotype and allele of rs5745718 and rs1742817 in the HGF gene were significantly different between the PACG patients and the controls. On one hand, the frequencies of the CC genotype and C allele of rs5745718 were significantly decreased in PACG patients compared with controls (Pc = 1.40×10−3; Pc = 3.21×10−4, respectively); however, on the other hand, significantly decreased frequencies of the GG genotype and the G allele of rs17427817 were observed in PACG patients compared with the controls (Pc = 0.006,; Pc = 6.06×10−4, respectively). A comparison of the distributions of the genotypes and alleles of rs3735520 showed no statistically significant differences between the PACG patients and the controls (pc>0.05). The haplotype analysis results showed that the CGC haplotype frequency was significantly decreased in the patients with PACG compared with the controls (pc<0.001). No difference was detected between the patients and the controls with regard to the other haplotypes. Conclusions Our study suggests that rs5745718 and rs17427817 are associated with a decreased risk of PACG in the Chinese Han population. The CGC haplotype was demonstrated to possibly play a protective role against PACG in this population.

Elevated serum monocyte chemoattractant protein-1 levels and its genetic polymorphism is associated with diabetic retinopathy in Chinese patients with Type 2 diabetes.

Previous studies have reported that monocyte chemoattractant protein–1 (MCP–1) is involved in inflammatory and metabolic diseases. The purpose of this study is to investigate the role of MCP–1 in the pathogenesis of diabetic retinopathy (DR) in Han Chinese patients with Type 2 diabetes.

The expression of vascular endothelial growth factor in mast cells promotes the neovascularisation of human pterygia

Aims To analyse the relationship between mast cells and vascularisation in pterygia and to determine whether mast cells play an important role in the vascularisation of pterygia through the secretion of vascular endothelial growth factor (VEGF). Methods Fifty-two pterygia and forty-four normal conjunctiva samples were obtained. Formalin-fixed, paraffin wax-embedded tissues were analysed by immunohistochemistry with CD31 and VEGF antibodies. Dual-immunofluorescence was used to see the location of mast cells and microvessels. To prove that mast cells have the function of secreting VEGF, we used dual-immunofluorescence, toluidine blue stain and immunohistochemisty study. Results Mast cells are located near the microvessels. The numbers of mast cells in pterygia (10.8±2.7) were significantly higher compared with those in conjunctiva (4.7±2.4, p<0.01). The numbers of microvessels in pterygia (20.7±5.4) were also significantly higher than those in conjunctiva (9.3±2.9, p<0.01). There was an association between mast cell count and microvessel density in pterygia (r=0.77, p<0.001). The cells were positive for toluidine blue staining and could express VEGF through a serial section stain. Dual-immunofluorescence showed that VEGF and mast cell tryptase (MCT) were expressed in the same cell. Conclusion The results suggest that mast cells have a function in the vascularisation of pterygia through the secretion of VEGF.

Interleukin-23 Receptor Gene Polymorphism May Enhance Expression of the IL-23 Receptor, IL-17, TNF-α and IL-6 in Behcet's Disease.

Purpose Recent studies identified an association between Behcet’s disease (BD) and the IL-23R gene polymorphism (rs17375018) in different populations. This study examined whether this IL-23R gene polymorphism is associated with enhanced inflammatory responses. Methods We recruited 27 BD patients and 32 controls with three genotypes. Peripheral blood mononuclear cells (PBMCs) were seeded with or without anti-CD3 and CD28. Cells were incubated for 24 hours, and then supernatants were collected and stored at −20◦C until analyzed. Levels of interferon (IFN)-γ, tissue necrosis factor (TNF)-α, interleukin (IL)-17 and IL-6 were detected by ELISA. IL-23R expression was assessed by quantitative real-time polymerase chain reaction (RT-PCR). Results The expression of IL-23R was significantly higher in both BD patients and healthy controls with the GG genotype compared to the AG and AA genotype with anti-CD3 and CD28 stimulation (all P-value < 0.05). Among the PBMCs cultured with anti-CD3 and CD28 stimulation, there was an elevated secretion of TNF-α, IL-6 and IL-17 in BD patients and healthy controls with the GG genotype. However, there was no significant change in secretion of IFN- γ in BD patients and healthy controls among the genotype of this IL-23R gene polymorphism. Conclusions The results suggest that the GG genotype of the rs17375018 variant in the IL-23R gene enhances pro-inflammatory cytokine responses.

Comparison of Surgical Outcome After Ahmed Valve Implantation for Patients With and Without Fluocinolone Intravitreal Implant (Retisert).

Purpose:To determine whether long-term, slow-release exposure to corticosteroids with Retisert promotes better surgical outcomes after Ahmed valve implantation. Patients:This comparative retrospective cohort study included 17 study eyes (10 patients) with uncontrolled uveitis requiring Retisert and Ahmed implantation, and 55 control eyes (51 patients) with other types of medically uncontrolled glaucoma that only received Ahmed. Materials and Methods:Main outcome measures were intraocular pressure (IOP), glaucoma eye drops per day, best-corrected visual acuity, early complications, and late complications at 1, 3, 6, and 12 months. Linear mixed effects models were used to model IOP, glaucoma drops per day, and visual acuity at 1 year after surgery. Results:At 1 year, the study eyes had a mean IOP of 12.24, which was lower than that for control eyes at 15.17 (P=0.04). At 1 year, the average number of glaucoma eye drops used per day for study eyes was 1.4, which was lower than that for control eyes at 2.3 (P=0.03). At 1 year, there were no statistically significant differences in change in visual acuity, early complications, and late complications between study and control eyes. Conclusions:Patients who received a Retisert implantation had lower IOP and used fewer glaucoma eye drops compared with control eyes at 1-year post-Ahmed valve surgery. This study suggests that long-term, slow-release corticosteroid medication from Retisert (fluocinolone acetonide) may improve the surgical outcome for patients with an Ahmed valve implantation and/or Retisert helps control uveitis in patients with uveitic glaucoma receiving Ahmed valves.

Protein Enables Conformation Transition of a Hydrogel Based on Pentapeptide and Boosts Immune Response in Vivo

We report a supramolecular hydrogel based on dihistidine containing pentapeptides serving as a novel vaccine delivery system. Protein encapsulated into the hydrogel not only enhances the mechanical property up to 15-fold but also changes the conformation of the resulting nanostructure from a β-sheet to an α-helix. The resulting hybrid hydrogel enhances antigen uptake and moderately promotes dendritic cell (DC) maturation in vitro. More importantly, the pentapeptide hydrogel promotes antigen-specific antibody production in vivo and splenocyte proliferation ex vivo.