Abstract

Pseudoexfoliation (PEX) syndrome is a common, but little known, systemic degenerative condition manifest by the extracellular deposition of a distinctive fibrillar material (PEX material) in various organs. In the eye, PEX material is characteristically found on the surfaces of structures that line the anterior and posterior chambers, and it is associated with cataract and glaucoma. Although PEX material contains several elements normally present in basement membranes, its precise composition remains obscure. Because the glycoprotein thrombospondin 1 (TSP1) can be shown in some basement membranes, we attempted to define its involvement in the composition of PEX material by immunohistochemical analysis of ocular tissues from patients with PEX syndrome. Although we were unable to detect TSP1 in PEX material, we were surprised to find that iris and corneal stromal fibroblasts expressed TSP1. In age-matched normal eyes, iris and corneal fibroblasts did not contain demonstrable TSP1. These observations indicate that TSP1 is not a significant component of PEX material but suggest that, in PEX syndrome, stromal fibroblasts remote from the principal sites of PEX material deposition are altered at the molecular level. The findings add evidence to the theory that PEX syndrome represents a disorder of connective tissue metabolism and intimate that the syndrome involves anomalous production of proteins other than those found in PEX material.

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