ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1612452
This article is part of the Research TopicNew Concepts, Advances, and Future Trends in Clinical Research on Eye DiseasesView all 53 articles
Extracellular matrix proteins expression in advanced keratoconus and normal human cornea
Provisionally accepted
Prity Sahay1
Fatima Habroosh1,2Perla Filippini1Ahmed Al Saadi2Shady Soliman3
Burcin Kepez Yıldız4Dalia G Said1,3Harminder S Dua1*- 1Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom
- 2Department of Ophthalmology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- 3Research Institute of Ophthalmology, Cairo, Egypt
- 4University of Health Sciences (Turkey), Istanbul, Ankara, Türkiye
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Background: The pre-Descemet's layer (Dua's layer) (PDL/DL) and the Descemet membrane (DM) have the highest expression of elastin in normal corneas. Reduced expression of elastin in the corneal stroma occurs in keratoconus (KC). This study aimed to examine the expression of elastin, other extracellular matrix, and proteoglycan proteins in the PDL/DL and the DM in advanced KC. Methods: The corneal tissue obtained from four subjects with KC after penetrating keratoplasty was compared with tissue from four normal corneas. The tissues were sectioned and analyzed with specific markers for extracellular matrix proteins and proteoglycans namely elastin, collagens I, IV, VI, fibulin-2, and decorin using immunohistochemical analysis. The fluorescence intensity was measured by ImageJ software and compared to controls. Results: The expression of elastin was significantly reduced in the PDL/DL and DM in KC cases compared to controls. Concurrently, increased expression of elastin was noted anteriorly in the subepithelial region. The expressions of collagen IV, collagen VI, and decorin were reduced in the PDL/DL and DM whereas collagens I, and fibulin-2 were unaltered in KC cases compared to controls. Conclusion: The significant reduction of elastin in the PDL/DL and DM in advanced keratoconus with ACH may have a role in the pathology of KC and consequent ACH. could reduce the elasticity of these tissues and render them brittle and susceptible to rupture leading to acute corneal hydrops. Elastin could have an important role in the pathogenesis of keratoconus, which often commences as a posterior elevation involving these two layers.
Keywords: Keratoconus, Descemet Membrane, Elastin, Keratoplasty, Elasticity
Received: 15 Apr 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Sahay, Habroosh, Filippini, Al Saadi, Soliman, Kepez Yıldız, Said and Dua. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Harminder S Dua, Academic Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom
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