Corneal scarring is a major cause of decreased visual quality and vision loss worldwide. Scarring follows disruption to normal corneal structure and function, whether from infection, laser refractive surgery, corneal transplantation, ocular trauma (chemical or physical) or corneal dystrophies. There is no suitable means of controlling corneal scaring despite more than 25 years trying to characterize cytokine signaling during wound healing. Our long-term objective is to understand mechanisms of corneal wound healing and our goal is to design effective therapies to treat or prevent corneal scarring. Our overall hypothesis is that peroxisome proliferator activated receptor gamma (PPAR3) ligands prevent corneal fibrosis and can be targeted as a therapy for this condition, with significantly greater efficacy than current clinical treatments or than blocking the activity of single cytokines.
Aim 1 : Test the hypothesis that PPAR3 ligands inhibit key pro-fibrotic activities of cultured corneal keratocytes. We use immunohistochemistry, proliferation assays, wounding assays, western blots, slot blots and Q-PCR to assess the relative effectiveness of PPAR3 ligands at modulating proliferation, migration, expression of CTGF, 1SMA, Thy-1, collagen I, collagen III, fibronectin and their mRNAs in cultured keratocytes stimulated by optimal doses of TGF2.
Aim 2 : Test the hypothesis that PPAR3 ligands inhibit key pro-fibrotic activities in cultured corneal keratocytes through both PPAR3-dependent and -independent pathways. We will use both pharmacological and genetic approaches to test our prediction that PPAR3 ligands act both by activating PPAR3 and by inhibiting TGF2-regulated pathways. Knowing the relative strengths of these mechanisms in corneal keratocytes is critical if we are to develop PPAR3 ligands as optimally-targeted therapies for corneal fibrosis.
Aim 3 : Test the hypothesis that PPAR3 ligands are more efficient inhibitors of fibrosis in PRK-induced corneal wound healing than anti-TGF2 antibodies, steroids or Mitomycin C. We will perform binocular PRK in cats followed by the topical administration of select PPAR3 ligands, anti-TGF2 antibodies, steroids or Mitomycin C. We will use immunohistochemistry to contrast key cellular aspects of the wound healing reaction. We predict that PPAR3 ligands will be associated with lower cell death, faster wound healing, less haze and lower induction of higher-order optical aberrations than use of anti-TGF2 antibodies, steroids or Mitomycin C post-operatively.

Public Health Relevance

Current approaches to reduce corneal fibrosis and preserve visual quality following eye injury or surgery are only partially effective and carry significant side effects. The proposed experiments test the hypothesis that peroxisome proliferator activated receptor gamma (PPAR3) ligands prevent corneal fibrosis by activating multiple pro-fibrotic intracellular pathways. The results will provide significant theoretical insights into the molecular mechanisms that control corneal fibrotic activity and allow us to test PPAR3 ligands as a novel in situ therapy for corneal fibrosis, with significantly greater clinical effectiveness and fewer side-effects than current treatments or than blocking the activity of single cytokines.

National Institute of Health (NIH)
Research Project (R01)
Project #
Application #
Study Section
Anterior Eye Disease Study Section (AED)
Program Officer
Mckie, George Ann
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Rochester
School of Medicine & Dentistry
United States
Zip Code
Savage, Daniel E; Brooks, Daniel R; DeMagistris, Margaret et al. (2014) First demonstration of ocular refractive change using blue-IRIS in live cats. Invest Ophthalmol Vis Sci 55:4603-12
Jeon, Kye-Im; Kulkarni, Ajit; Woeller, Collynn F et al. (2014) Inhibitory effects of PPAR? ligands on TGF-?1-induced corneal myofibroblast transformation. Am J Pathol 184:1429-45
Huxlin, Krystel R; Hindman, Holly B; Jeon, Kye-Im et al. (2013) Topical rosiglitazone is an effective anti-scarring agent in the cornea. PLoS One 8:e70785
Hindman, Holly B; Huxlin, Krystel R; Pantanelli, Seth M et al. (2013) Post-DSAEK optical changes: a comprehensive prospective analysis on the role of ocular wavefront aberrations, haze, and corneal thickness. Cornea 32:1567-77
Weis, Adam J; Huxlin, Krystel R; Callan, Christine L et al. (2013) Keratocyte apoptosis and not myofibroblast differentiation mark the graft/host interface at early time-points post-DSAEK in a cat model. PLoS One 8:e75623
Kuriyan, A E; Lehmann, G M; Kulkarni, A A et al. (2012) Electrophilic PPARýý ligands inhibit corneal fibroblast to myofibroblast differentiation in vitro: a potentially novel therapy for corneal scarring. Exp Eye Res 94:136-45
Xu, Lisen; Knox, Wayne H; DeMagistris, Margaret et al. (2011) Noninvasive intratissue refractive index shaping (IRIS) of the cornea with blue femtosecond laser light. Invest Ophthalmol Vis Sci 52:8148-55
Cui, Liping; Huxlin, Krystel R; Xu, Lisen et al. (2011) High-resolution, noninvasive, two-photon fluorescence measurement of molecular concentrations in corneal tissue. Invest Ophthalmol Vis Sci 52:2556-64
Lehmann, Geniece M; Xi, Xia; Kulkarni, Ajit A et al. (2011) The aryl hydrocarbon receptor ligand ITE inhibits TGF?1-induced human myofibroblast differentiation. Am J Pathol 178:1556-67
Xi, Xia; McMillan, David H; Lehmann, Geniece M et al. (2011) Ocular fibroblast diversity: implications for inflammation and ocular wound healing. Invest Ophthalmol Vis Sci 52:4859-65

Showing the most recent 10 out of 19 publications