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Involvement of Insulin-like Growth Factor-I and Insulin-like Growth Factor Binding Protein-3 in Corneal Fibroblasts during Corneal Wound Healing

¹From the Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; and the ²National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

PURPOSE. The involvement of downstream messengers of transforming growth factor (TGF)-ß in the differentiation of corneal fibroblasts into myofibroblasts was investigated. The effects of insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-3 upregulated by TGF-ß were examined in human corneal fibroblasts, and the possible involvement of IGF axis components in corneal wound healing was assessed in a mouse model.

METHODS. Human corneal fibroblasts were incubated with TGF-ß2 or IGF-I, to investigate IGF-I, IGF-II, IGFBP-3, type I collagen, and -smooth muscle actin (-SMA) mRNA, as well as IGFBP-3 protein expression, during myofibroblast differentiation. DNA synthesis was evaluated with a 5-bromo-2'-deoxyuridine (BrdU) incorporation assay. IGFBP-3 mRNA expression, protein expression, and immunolocalization were investigated in mouse corneas after photorefractive keratectomy (PRK).

RESULTS. TGF-ß2 treatment induced expression of IGF-I and IGFBP-3 mRNA and of IGFBP-3 protein in human corneal fibroblasts. TGF-ß2 and IGF-I both stimulated expression of type I collagen. TGF-ß2 but not IGF-I potently stimulated -SMA mRNA expression. IGF-I potently stimulated basal DNA synthesis, whereas IGFBP-3 inhibited it. IGF-I potently stimulated proliferation of TGF-ß2-activated myofibroblasts without reversing the activated fibrogenic phenotype, whereas IGFBP-3 suppressed IGF-I-induced proliferation of corneal fibroblasts. IGFBP-3 mRNA and protein increased in mouse corneas soon after PRK, when in vivo immunostaining of the corneas showed expression of IGFBP-3 in the deep layer of the corneal stroma.

CONCLUSIONS. These results suggest that during corneal wound healing, TGF-ß stimulates IGF axis components, whereas IGFBP-3 may modulate IGF-I-induced myofibroblast proliferation to suppress corneal mesenchymal overgrowth.

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