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Alcohol-induced changes of corneal endothelium: comparison between morphology and extent of aspartic acid racemization
G. Grütters1, J. A. Reichelt1, S. Ritz-Timme2, B. Nölle1
Background: In our cornea bank it could be noticed that corneas from donors with alcohol history seemed to be of lower quality than corneas from other donors. Having measured alcohol concentrations in blood, urine, aqueous humour and vitreous in a patient having died of alcohol intoxication we started in-vitro experiments with human and pig corneas.
Method: The corneas were stored at 37°C in our standardized culture medium including different alcohol concentrations (1, 2, 3, and 4). During cultivation of four weeks endothelial morphology and extent of aspartic acid racemization in stromal proteins were evaluated. The extent of racemization served as a biochemical parameter of alcohol-induced changes of the quality of the corneas.
Results: In the dead 53-year-old female alcoholic we found an alcohol concentration of 4.13 (blood), 4.40 (urine), 3.73 (aqueous humour) and 4.11 (vitreous). The corneal endothelium revealed a cell density of 2240 and was charactzerized by polymorphism, polymegatism and abundant Descemet folds.
In the in-vitro experiments it could be noticed that decreasing endothelial cell counts during the four weeks culture period was dependent on the alcohol concentration in the culture medium. An alcohol-dependent change of the extent of aspartic acid racemization could not be found. However, the extent of racemization was clearly different from normal values.
Conclusion: After death high concentrations of alcohol can be detected in vitreous and aqueous humour. Obviously, these concentration have a direct toxic effect on the corneal endothelium. Evaluating the extent of aspartic acid racemization of corneal proteins we found premature ageing respectively degradation of stromal proteins
1
Department of Ophthalmology, Christian Albrechts University Kiel, Hegewischstrasse 2, D-24105 Kiel, Germany