Safety profile of accelerated corneal cross-linking versus conventional cross-linking: a comparative study on ex vivo-cultured limbal epithelial cells

Br J Ophthalmol. 2015 Feb;99(2):272-80. doi: 10.1136/bjophthalmol-2014-305495. Epub 2014 Dec 8.

Abstract

Aim/background: To compare the effects of accelerated corneal collagen cross-linking (ACXL) and corneal collagen cross-linking (CXL) on ex vivo-cultured limbal epithelial cells (LECs).

Methods: Day 14 cultured LECs were either unexposed (control) or exposed to different intensities of ultraviolet-A (UV-A) irradiance for different durations (3 mW for 30 min, 9 mW for 10 min, 18 mW for 5 min and 30 mW for 3 min) in the presence and absence of riboflavin. These cells were further processed for quantitative real-time PCR, vital staining, immunofluorescence staining and fluorescence-activated cell sorting (FACS) staining to evaluate the apoptotic status. Statistical analysis was performed using a Student t test.

Results: Vital staining showed a significantly higher (p=0.004) dead cell population with 3 mW for 30 min when compared with 30 mW for 3 min exposure (p=0.225). Quantitative PCR results revealed significantly reduced abcg2 and Δnp63 mRNA levels, while FACS analysis showed an increase in ABCG2-Annexin V positive population in cells exposed to 3 mW for 30 mins. Neither reduction of mRNA expression of abcg2 and Δnp63 nor increase in FACS-stained ABCG2-Annexin V positivity was detected in cells exposed to 30 mW for 3 min. Additionally, enhanced caspase activity was detected with fluorochrome inhibitor of caspases staining and mRNA expression of caspase 3 and 9 was upregulated in cells exposed to 3 mW for 30 min, but not at 30 mW for 3 min.

Conclusions: The 30 mW UV-A irradiation used in ACXL appears to be safe on cultured LECs in comparison with 3 mW used in CXL.

Keywords: Apotosis; Cornea; Ocular surface; Stem Cells.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • ATP-Binding Cassette Transporters / genetics
  • ATP-Binding Cassette Transporters / metabolism
  • Annexin A5 / metabolism
  • Apoptosis
  • Caspase 3 / genetics
  • Caspase 9 / genetics
  • Cells, Cultured
  • Collagen / metabolism*
  • Corneal Stroma / metabolism*
  • Cross-Linking Reagents / therapeutic use*
  • Epithelial Cells / drug effects*
  • Epithelial Cells / metabolism
  • Epithelial Cells / pathology
  • Flow Cytometry
  • Fluorescent Antibody Technique, Indirect
  • Humans
  • Limbus Corneae / cytology*
  • Neoplasm Proteins / genetics
  • Neoplasm Proteins / metabolism
  • Photosensitizing Agents / therapeutic use*
  • RNA, Messenger / genetics
  • Real-Time Polymerase Chain Reaction
  • Riboflavin / therapeutic use
  • Transcription Factors / genetics
  • Transcription Factors / metabolism
  • Tumor Suppressor Proteins / genetics
  • Tumor Suppressor Proteins / metabolism
  • Ultraviolet Rays

Substances

  • ABCG2 protein, human
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • ATP-Binding Cassette Transporters
  • Annexin A5
  • Cross-Linking Reagents
  • Neoplasm Proteins
  • Photosensitizing Agents
  • RNA, Messenger
  • TP63 protein, human
  • Transcription Factors
  • Tumor Suppressor Proteins
  • Collagen
  • Caspase 3
  • Caspase 9
  • Riboflavin