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Graefes Arch Clin Exp Ophthalmol. 2017 Sep;255(9):1763-1769. doi: 10.1007/s00417-017-3724-8. Epub 2017 Jun 28.

Isoforms of TGF-β in the aqueous humor of patients with pseudoexfoliation syndrome and a possible association with the long-term stability of the capsular bag after cataract surgery.

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Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bremgartenstrasse 119, CH-3012, Bern, Switzerland.
University of Bern, Bern, Switzerland.
Swiss Eye Institute and Berner Augenklinik am Lindenhofspital, Bremgartenstrasse 119, CH-3012, Bern, Switzerland.
University of Bern, Bern, Switzerland.



Pseudoexfoliation syndrome (PEXS) may go along with capsular bag shrinkage and luxation. In the present study, we focus on an association of isoforms of TGF-β with capsular bag luxation.


Aqueous humor was collected intraoperatively from 20 healthy controls and from 73 otherwise healthy patients with PEXS [PEXS without complications (PEX, n = 33), late PEXS with glaucoma (PEXG, n = 30) and with IOL and capsular bag luxation (PEXL, n = 10)]. The concentrations of TGF-β1, TGF-β2 and TGF-β3 were compared using the Bio-Plex® multiplex beads system based on the non-parametric Kruskal-Wallis H test (p < 0.01).


Concentrations of TGF-β 1, TGF-β 2 and TGF-β 3 were higher in the sub-groups PEX and PEXG than in controls (TGF-β 1; p = 0.009 and 0.0005; TGF-β 2; p = 0.002 and 0.005 and TGF-β 3; 0.0005 and 0.0005; respectively), whereas for TGF β2, no significant difference between controls and PEXL was revealed (p = 1.0). TGF-β2 concentrations were elevated in a similar degree in early PEX and PEXG, but not in PEXL compared to controls (p = 0.002). The concentrations of of TGF-β 1 and TGF-β 3 increased in parallel with the progression of disease. The levels of TGF-β 3, however, did not attain pathophysiological levels (>100 pg/ml) in any group.


A stage-dependent increase in the concentrations of TGF-β1 and TGF-β3, but not of TGF-β2, accords to the shrinkage of the capsular bag. This could increase the tension on the zonular fibers and contribute to luxation of the capsular bag.


Aqueous humor; Biomarkers; Chemokines; Cytokines; Isoforms of transforming growth factor-β (TGF-β); PEX; Pseudoexfoliation glaucoma; Pseudoexfoliation syndrome; TGF-β1; TGF-β2; TGF-β3

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