IMMUNOHISTOCHEMICAL STUDY OF VARIOUS TYPES OF PTERYGIUM IN PATIENTS OF THE SOUTHERN URALS

Pterygium is a fibrous neoplasm of the conjunctiva, which may have different pathomorphological characteristics depending on the region of residence. It is necessary to take into account regional factors that serve as local predictors of the risk of occurrence, course of the disease and relapse of the disease. Risk factors include insolation, harmful working conditions, climatic conditions. The purpose of the study was to study the morphological features of pterygium, determine the spectrum of cytokines and growth factors in biopsy tissues of patients with pterygium in the Southern Urals. A total of 68 eyes with a diagnosis of primary pterygium were operated for the period 2005 to 2025. Patients of both sexes aged 41 to 80 years. Morphological (hematoxylin and van Gieson staining) and immunohistochemical (Fgf-b, Nf-h, PCNA, TGF-b, Mmp-9, Timp-2, c-kit, Pro-col3, Col 1, Hla dr, Cd206, TNF-a, VEGF-R, p-53) studies of biopsy specimens were performed. Statistical analysis of cell counts was performed using nonparametric methods in Statistica 10.0 software. It was found that the ratio of the fibrous component to the vascular-cellular component varied. In some tissues of the primary pterygium, signs of active collagenogenesis were detected, while in others, active proliferative activity was observed. Thus, in some pterygium tissues, the ratio of stromal elements to the vascular-cellular component shifted towards the latter. The stroma contained a large number of blood and lymphatic vessels with dilated lumens, intense tissue infiltration by stromal (fibroblastic) and inflammatory (macrophages, leukocytes, lymphocytes) cells, thin bundles of collagen fibers with a large amount of amorphous substance. Morphologically, pterygia were divided into three types: proliferative, fibromatous and atrophic-sclerotic. The proliferative group of pterygia contained more M2 macrophages of the CD206 phenotype, mesenchymal stem cells c-kit, MMP-9⁺ and VEGF-R⁺ cells than in fibromatous and atrophic-sclerotic types. Expression of FGF-b, HLA-DR, p-53 by cells was observed in all types of pterygium to the same equal extent. In proliferative pterygium, the amount of mature collagen type 1 exceeded the quantitative values of fibromatous and atrophic-sclerotic types. And the amount of immature reticular collagen type III and profibrogenic growth factor TGF-b in cells, on the contrary, significantly statistically significantly increased as tissue fibrosis progressed. Therefore, it is necessary to level or correct immunodeficiency, eliminate autoimmune complexes, reprofile macrophages from growth-stimulating M2 to proinflammatory M1, stimulate TIMP-2, and inhibit conjunctival vasculogenesis.

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