Decorin, Tenascin C, Total Antioxidant, and Total Oxidant Level Changes in Patients with Pseudoexfoliation Syndrome

Pseudoexfoliation syndrome (PEX) is a systemic disease with a 5–25% prevalence in all societies worldwide (genetically linked and influenced by race, age, and environmental factors). PEX is characterized by a grayish-white, bran-like fibrillar extracellular material in the intraocular and extraocular structures such as the pupillary flank, lens anterior capsule, iridocorneal angle, ciliary body and zonules, anterior hyaloid face, trabecular meshwork, corneal endothelium, and lid conjunctiva [1–3]. However, although the abovementioned features of PEX are known, the definitive etiopathology has not been fully elucidated. Studies to date have reported that this condition is associated with extreme accumulation of abnormally structured extracellular material in intraocular and ectodermal tissues [4]. )erefore, associations between molecules such as elastin, fibronectin, amyloid, fibrilin-1, and PEX were investigated, and their relationship was revealed. In addition, other studies have reported increased growth factors in the aqueous humor of patients with PEX. Another study group (Schlotzer-shrehud et al.) reported that the concentrations of matrix metalloproteinases and their inhibitors in the aqueous humor of PEX patients were increased [5].
Purpose. Pseudoexfoliation syndrome (PEX) is an eye disease that develops under the influence of regional population differences, genetic factors, age, and environmental factors and is characterized by visualization of a gray-white fibrogranular substance in the lens anterior capsule and/or pupil margin during anterior segment examination. )e underlying biochemical mechanisms of the disease have not yet been fully elucidated. )erefore, this study was designed to show the changes in aqueous humor and blood serum levels of matrix metalloproteinases (decorin and tenascin C), total antioxidants (TAS), and total oxidants (TOS) in both cataract patients who have unilateral PEX material and cataract patients who do not have unilateral PEX material. Methods. Biological samples were simultaneously collected from 22 cataract patients who had unilateral pseudoexfoliation (PEX patients) and 22 cataract patients who did not have unilateral pseudoexfoliation (control patients). From the collected biological samples, decorin (DEC) and tenascin C (TN-C) were measured with the enzyme-linked immunosorbent assay (ELISA) method, and TAS and TOS were measured with an autoanalyzer. Results. When decorin, tenascin C, and TOS values of PEX patients were compared with those of control patients, there was a statistically significant increase in all three parameters. Conversely, TAS values showed a statistically significant decrease in PEX patients compared to controls. DEC, TN-C, TAS values, and TOS values were significantly higher in aqueous fluid than in blood in both the PEX patient and control groups. Conclusions. We suggest that parameters such as DEC, TN-C, TAS, and TOS play a role in the etiopathology of pseudoexfoliation syndrome. )us, bringing these increased levels of extracellular proteins and TOS and decreased levels of TAS back to within physiological limits can mediate the reorganization of the blood-aqueous fluid barrier and slow the progression of pseudoexfoliation syndrome.