Strong expression of HSP47 in metaplastic nasal mucosa may predict a poor outcome after primary endoscopic dacryocystorhinostomy: a prospective study.

Abstract

PURPOSE:

Dacryocystorhinostomy (DCR) is an effective and safe procedure for patients with post-saccal obstruction of the nasolacrimal pathway. The aim of DCR is to relieve symptoms by creating a bypass between the lacrimal sac and the nasal cavity. The most common reason for failure is stenosis caused by a fibrotic process at the rhinostomy site. In this prospective study we assessed the expression of heat shock protein 47 (HSP47), a regulator of fibrosis, in the biopsies of nasal mucosa isolated from patients undergoing primary endoscopic DCR (EN-DCR).

METHODS:

Thirty consecutive primary EN-DCR procedures in 30 patients were performed using the powered instrumentation technique. The nasal mucosa specimens over the rhinostomy site were collected for histological analysis at the beginning of the operation and the expression of HSP47 was evaluated by immunohistochemistry. The outcome of EN-DCR was estimated in follow-up visits at 1 week, 2 months and 6 months after surgery.

RESULTS:

At the 6-month follow-up, the overall success rate after primary EN-DCR was 83%. A metaplastic change and strong expression of HSP47 in nasal mucosa were associated with EN-DCR failure (p = 0.009).

CONCLUSIONS:

HSP47 may be regarded as a novel marker to predict impaired EN-DCR outcome.

• Authors: Grigori Smirnov, Risto Pirinen, Henri Tuomilehto, Juha Seppä, Markku Teräsvirta, Hannu Uusitalo, Juhani Nuutinen, Kai Kaarniranta
• Journal: Acta ophthalmologica (Acta Ophthalmol) Vol. 89 Issue 2 Pg. e132-6 (Mar 2011) ISSN: 1755-3768 [Electronic] England
• PMID: 19785638 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

Chemical References

• Biomarkers
• HSP47 Heat-Shock Proteins
• SERPINH1 protein, human

Topics

• Aged
• Biomarkers (metabolism)
• Dacryocystitis (metabolism, surgery)
• Dacryocystorhinostomy
• Endoscopy
• Female
• Follow-Up Studies
• HSP47 Heat-Shock Proteins (metabolism)
• Humans
• Immunoenzyme Techniques
• Lacrimal Duct Obstruction (metabolism)
• Male
• Metaplasia
• Middle Aged
• Nasal Mucosa (metabolism, pathology)
• Prospective Studies
• Treatment Outcome