Is Keratoconus an Inflammatory Disease? The Implication of Inflammatory Pathways

Purpose Keratoconus is considered a non-inflammatory condition. Recently however, increased proinflammatory cytokines have been detected in the tears of keratoconic patients and clinical and immunohistochemical observations reported infiltration of matured dendritic cells and leukocytes. Our laboratory utilized cytokine antibody arrays to elucidate the inflammatory aspects of keratoconus. Methods Protein was extracted from 42 corneal buttons (14 keratoconic and 28 non-keratoconic) and incubated with cytokine antibody arrays scanning 120 cytokines. Mann Whitney U test with ap-value of Results Pathways for wound healing, neuroprotection, angiogenesis, and inflammation were activated in keratoconic samples with 23 cytokines showing significant elevation. Fifteen were expressed only in keratoconus with 8 cytokines elevated 1.7-42-fold. Conclusion This study identified elevated inflammatory pathways covering immune responses in keratoconus. Our results support the evidence for inflammatory pathway activation in keratoconus and a possible redefinition of keratoconus as a chronic inflammatory corneal disease.

Automated summary

This study utilized cytokine antibody arrays to analyze the inflammatory aspects of keratoconus. The results showed that pathways for wound healing, neuroprotection, angiogenesis, and inflammation were activated in keratoconic samples, with multiple cytokines showing significant elevation.