Dear Editor:
In response to the article titled “Mechanisms and biomarker candidates in pterygium development”, published in your esteemed journal, which is a well thought out and written paper, I would like to raise few points regarding this study.
Pterygium may have among its causes factors such as: changes in cholesterol metabolism, inflammation, viral infection, oncogenic proteins, lymphangiogenesis, and epithelial-mesenchymal cell transition(11 Wanzeler AC, Barbosa IA, Duarte B, Borges D, Barbosa EB, Kamiji D, et al. Mechanisms and biomarker candidates in pterygium development. Arq Bras Oftalmol. 2019;82(6):528-36.). We would like to add one more factor that may be related to the pathophysiology of pterygium.
Healthy conjunctival tissues may have Nod-like receptor pyrin3 (NLRP3). In pterygium, the NLRP3/caspase-1 pathway may be abnormally activated, accompanied by aberrant expression of IL-18 and IL-1β. There is a correlation between the number of fibroblasts and NLRP3. Activation of the NLRP3/caspase-1 pathway may be a cause of angiogenesis and fibroblast proliferation, which could induce pterygium recurrence. Nod-3 (NLRP3), caspase-1, IL-18 and IL-1β pyrodynamic receptors are common markers of pyroptosis, which is a form of programmed cell death that includes the release of inflammatory factors(22 Lamkanfi M, Dixit VM. Inflammasomes and their roles in health and disease. Annu Rev Cell Dev Biol. 2012;2:137-61.
3 Martinon F, Burns K, Tschopp J. The inflammasome: a molecular platform triggering activation of inflammatory caspases and processing of proIl-beta. Mol Cell. 2002;10(2):417-26.-44 Im H, Ammit AJ. The NLRP3 inflammasome: role in airway inflammation. Clin Exp Allergy. 2014;44(2):160-72.).
Mitomycin C use in pterygium surgery reduces the recurrence rate, suppressing angiogenesis and fibroblast proliferation, inhibiting NLRP3/caspase-1 pathway activation and the expression of inflammatory factors such as TGF-β1, VEGF, and IL-6(22 Lamkanfi M, Dixit VM. Inflammasomes and their roles in health and disease. Annu Rev Cell Dev Biol. 2012;2:137-61.
3 Martinon F, Burns K, Tschopp J. The inflammasome: a molecular platform triggering activation of inflammatory caspases and processing of proIl-beta. Mol Cell. 2002;10(2):417-26.-44 Im H, Ammit AJ. The NLRP3 inflammasome: role in airway inflammation. Clin Exp Allergy. 2014;44(2):160-72.).
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Funding: This study received no specific financial support.
REFERENCES
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1Wanzeler AC, Barbosa IA, Duarte B, Borges D, Barbosa EB, Kamiji D, et al. Mechanisms and biomarker candidates in pterygium development. Arq Bras Oftalmol. 2019;82(6):528-36.
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2Lamkanfi M, Dixit VM. Inflammasomes and their roles in health and disease. Annu Rev Cell Dev Biol. 2012;2:137-61.
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3Martinon F, Burns K, Tschopp J. The inflammasome: a molecular platform triggering activation of inflammatory caspases and processing of proIl-beta. Mol Cell. 2002;10(2):417-26.
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4Im H, Ammit AJ. The NLRP3 inflammasome: role in airway inflammation. Clin Exp Allergy. 2014;44(2):160-72.
Publication Dates
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Publication in this collection
29 May 2020 -
Date of issue
May-Jun 2020
History
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Received
10 Dec 2019 -
Accepted
23 Dec 2019