Keratokonus is the most common corneal distrophy that leads to severe visual alterations. Its pathogenesis is still unknown, and corneal transplantion is the only terapeuthic approach. Many classifications of keratoconus have been proposed but no one has still been accepted definitely.
Recent studies have shown how Nerve Growth factor (NGF) and the elements of its pathway are involved in corneal trophism.
The aim of our study is to investigate the clinical use of NGF pathway assessment to early diagnosis and monitoring of keratoconus.
Patients with different stage of KC will be included and studied. Completed ocular examination and conjunctival and tear sample collection will be performed at baseline and 1 year follow-up. The level of NGF,Sp3 TrkA and p75 will be evaluated with Western-Blot and correlated to disease progression as demonstrated by clinical evaluation and corneal topography and pakimetry.
The results of this study can be an important base for considering these elements as biomarker for keratoconus, to better understand its pathogenesis and to plan a more specific therapeutic strategy.
Keratoconous represents an unmet medical need affecting young population with severe impairment of visual function and quality of life. It is unkown the pathogenic mechanism leading to disease development and progression and currently treatment are based on symptomatic improvement of quality of vision by contact lens application, or surgical approaches, such as corneal transplantation. KC has an high socio-economic impact in term of ophthalmological exams, productivity loss and hospitalization. Novel therapeutic strategy are required to improve patients management. Recently, the crucial role of neurotrophin in maintaining corneal trophism has been demonstrated. No data exist on the correlation between alteration of cornea morphology and changes in neurotrophins. The results of this project will demonstrate the role of NGF pathway in determining keratoconus progression. Indeed the demonstration that NGF, TrkA, p75 or Sp3 expression can represent useful marker of KC may anticipate the diagnosis and improve patients management. Moreover, novel therapeutic strategy may be evidenced by the results of the study showing specific target. This novel prospective should be evaluated considering that a recombinant human NGF has been recently developed and will be quickly available for clinical use since 2 phase II clinical trials on patients with neurotrophic keratitis have been succssfully concluded.