gms | German Medical Science

Cicatricial pemphigoid is a disease of the basement membrane zone (BMZ) involving the skin and mucosae including the conjunctiva. It is often associated with glaucoma. Typically, the skin is used as a model for the BMZ without taking into consideration possible differences between skin and conjunctiva. Moreover, it is not known whether glaucoma itself or glaucoma treatment leads to changes in the antigen distribution of the BMZ.

We examined 20 normal conjunctival biopsies of patients aged 16-92 years and 10 conjunctival biopsies of glaucoma patients aged 10-90 years by immunohistochemistry and compared the results to normal skin. Antibodies to Collagen IV and VII, Laminin a1, a2, b1, b3, g1, g2, g3, Kalinin and b4-Integrin were used.

The BMZ of normal skin showed a distinct positivity for antibodies against CIV, Laminin b1, g1, Kalinin and b4-Integrin. In comparison, the conjunctival BMZ was negative for Laminin b1, and the distribution of Laminin g1 and b4-Integrin was diffusely in the epithelium with increased staining of the basal epithelium and the BMZ. A delicate staining of the BMZ with antibodies against CIV was observed in normal conjunctiva, whereas CIV staining was heavily positive in glaucoma specimens. Results for Collagen VII, Laminin a1, a2, b3, g2 and g3 are pending.

There are distinguished differences in the antigenicity of the BMZ of normal skin, healthy conjunctiva and conjunctiva obtained form patients with glaucoma. These differences could explain the varying manifestations of diseases of the BMZ in skin and conjunctiva and may be responsible for the increased incidence of these disorders in glaucoma patients.