Coagulation factor XIII: its possible role in corneal wound healing

Z. Z. Orosz1,2, A. Szöőr1, Z. Veréb2, Z. Hassan1, E. Katona1, G. Vereb1, A. Facskó2, L. Muszbek1 (1Debrecen, Hungary, 2Szeged, Hungary)

Clinical Aspects of Factor XIII
Date: 16.02.2017,
Time: 10:45 - 12:15

Objective: The effect of different factor XIII (FXIII) concentrations was investigated on wound healing, in vitro on corneal epithelial cells and in vivo in tears of patients following corneal surgeries with different types of wound: phacoemulsification, penetrating keratoplasty (PKP) and photo-refractive keratectomy (PRK).

Methods: Scratch-wound assay, proliferation and migration assays were applied to detect the effect of FXIII on wound healing of immortalized corneal epithelial cells. Using a hipersensitive chemiluminescent ELISA method, developed in our laboratory, FXIII complex and subunits were detected in tears of patients before and after different surgical interventions of the cornea, and post surgical angiogenesis and re-epithelization was observed.

Results: The addition of recombinant cellular FXIII (cFXIII, rFXIII-A2) resulted in a concentration dependent faster healing of the scratch wound. rFXIII-A2 promoted the proliferation of corneal epithelial cells, but no effect on migration was observed. After corneal surgeries FXIII complex and subunits concentrations increased in tears, then decreased reaching the normal interval at different times after the surgical intervention. After cataract surgery, FXIII concentrations correlated with the inflammation of the eye and the corneal oedema. Slower re-epithelisation of the corneal surface after PRK associated with lower FXIII concentrations. Extremely high FXIII concentrations measured in a few cases after PKP was associated with neovascularization of the normally avascular cornea.

Conclusion: According to our in vitro and in vivo investigations, FXIII present in tear proteome has a beneficial effect on corneal re-epithelisation, which results in decreased period of complaints caused by the corneal erosion. FXIII might be considered as an additional therapy in the treatment of corneal erosions, but long exposition to high FXIII concentrations in tears might induce undesired angiogenesis of the cornea.