Pathogenesis of Keratoconus: The intriguing therapeutic potential of Prolactin-inducible protein

Rabab Sharif, Sashia Bak-Nielsen, Jesper Hjortdal, Dimitrios Karamichos

Research output: Contribution to journalReview articlepeer-review

72 Scopus citations


Keratoconus (KC) is the most common ectatic corneal disease, with clinical findings that include discomfort, visual disturbance and possible blindness if left untreated. KC affects approximately 1:400 to 1:2000 people worldwide, including both males and females. The aetiology and onset of KC remains a puzzle and as a result, the ability to treat or reverse the disease is hampered. Sex hormones are known to play a role in the maintenance of the structure and integrity of the human cornea. Hormone levels have been reported to alter corneal thickness, curvature, and sensitivity during different times of menstrual cycle. Surprisingly, the role of sex hormones in corneal diseases and KC has been largely neglected. Prolactin-induced protein, known to be regulated by sex hormones, is a new KC biomarker that has been recently proposed. Studies herein discuss the role of sex hormones as a control mechanism for KC onset and progression and evidence supporting the view that prolactin-induced protein is an important hormonally regulated biomarker in KC is discussed.

Original languageEnglish
Pages (from-to)150-167
Number of pages18
JournalProgress in Retinal and Eye Research
StatePublished - Nov 2018


  • Bodily fluids
  • Human cornea
  • Keratoconus
  • Prolactin-induced protein
  • Sex hormones


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