TY - JOUR
T1 - Anterior pituitary, sex hormones, and keratoconus
T2 - Beyond traditional targets
AU - Karamichos, Dimitrios
AU - Escandon, Paulina
AU - Vasini, Brenda
AU - Nicholas, Sarah E.
AU - Van, Lyly
AU - Dang, Deanna H.
AU - Cunningham, Rebecca L.
AU - Riaz, Kamran M.
N1 - Funding Information:
EDS's ocular features include prominent upper eyelids, kyphoscoliosis, xerophthalmia, and pathologic myopia (Gharbiya et al., 2012). EDS-related ocular complications include conjunctiva abnormalities (Whitaker et al., 2012), abnormal retinal vessels (Chikamoto et al., 2007), retinal detachment (Bodanowitz et al., 1997), and KCN (Cameron, 1993; Robertson, 1975). Some studies suggest that KCN patients have hypermobility in their joints, supporting the association with EDS (Al-Hussain et al., 2004; Cameron, 1993; Robertson1975). Others argue against those findings (Street et al., 1991). The truth lies somewhere in the middle, as our knowledge of the underline mechanisms between KCN and EDS is extremely limited. Biochemical defects of connective tissues, causing weakness and wound healing dysfunction in the cornea, are probably partially responsible for the association (Cameron, 1993; Kuming and Joffe, 1977; Segev et al., 2006).The authors would like to give thanks to the National Eye Institute (NEI) and the National Institutes of Health (NIH) for providing research support (EY028888 & EY030038).
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2022/5
Y1 - 2022/5
N2 - "The Diseases of the Horny-coat of The Eye", known today as keratoconus, is a progressive, multifactorial, non-inflammatory ectatic corneal disorder that is characterized by steepening (bulging) and thinning of the cornea, irregular astigmatism, myopia, and scarring that can cause devastating vision loss. The significant socioeconomic impact of the disease is immeasurable, as patients with keratoconus can have difficulties securing certain jobs or even joining the military. Despite the introduction of corneal crosslinking and improvements in scleral contact lens designs, corneal transplants remain the main surgical intervention for treating keratoconus refractory to medical therapy and visual rehabilitation. To-date, the etiology and pathogenesis of keratoconus remains unclear. Research studies have increased exponentially over the years, highlighting the clinical significance and international interest in this disease. Hormonal imbalances have been linked to keratoconus, both clinically and experimentally, with both sexes affected. However, it is unclear how (molecular/cellular signaling) or when (age/disease stage(s)) those hormones affect the keratoconic cornea. Previous studies have categorized the human cornea as an extragonadal tissue, showing modulation of the gonadotropins, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Studies herein provide new data (both in vitro and in vivo) to further delineate the role of hormones/gonadotropins in the keratoconus pathobiology, and propose the existence of a new axis named the Hypothalamic-Pituitary-Adrenal-Corneal (HPAC) axis.
AB - "The Diseases of the Horny-coat of The Eye", known today as keratoconus, is a progressive, multifactorial, non-inflammatory ectatic corneal disorder that is characterized by steepening (bulging) and thinning of the cornea, irregular astigmatism, myopia, and scarring that can cause devastating vision loss. The significant socioeconomic impact of the disease is immeasurable, as patients with keratoconus can have difficulties securing certain jobs or even joining the military. Despite the introduction of corneal crosslinking and improvements in scleral contact lens designs, corneal transplants remain the main surgical intervention for treating keratoconus refractory to medical therapy and visual rehabilitation. To-date, the etiology and pathogenesis of keratoconus remains unclear. Research studies have increased exponentially over the years, highlighting the clinical significance and international interest in this disease. Hormonal imbalances have been linked to keratoconus, both clinically and experimentally, with both sexes affected. However, it is unclear how (molecular/cellular signaling) or when (age/disease stage(s)) those hormones affect the keratoconic cornea. Previous studies have categorized the human cornea as an extragonadal tissue, showing modulation of the gonadotropins, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Studies herein provide new data (both in vitro and in vivo) to further delineate the role of hormones/gonadotropins in the keratoconus pathobiology, and propose the existence of a new axis named the Hypothalamic-Pituitary-Adrenal-Corneal (HPAC) axis.
KW - Biomarkers
KW - Eye
KW - Gonadotropins
KW - Keratoconus
KW - Sex hormones
UR - http://www.scopus.com/inward/record.url?scp=85118854732&partnerID=8YFLogxK
U2 - 10.1016/j.preteyeres.2021.101016
DO - 10.1016/j.preteyeres.2021.101016
M3 - Short survey
C2 - 34740824
AN - SCOPUS:85118854732
VL - 88
JO - Progress in Retinal and Eye Research
JF - Progress in Retinal and Eye Research
SN - 1350-9462
M1 - 101016
ER -