LIMBAL CONJUNCTIVAL LANGERHANS CELL-DENSITY IN OCULAR CICATRICIAL PEMPHIGOID - AN INDIRECT IMMUNOFLUORESCENCE STUDY ON DISPASE-SPLIT CONJUNCTIVA

Purpose. To evaluate limbal conjunctival Langerhans cell density in oc ular cicatricial pemphigoid patients versus normal controls. Langerhan s cells obviously play a major role in T-cell activation and are invol ved in corneal and conjunctival inflammatory diseases. Methods. We use d a protease (Dispase II(R)) on inferior limbal conjunctival biopsies to separate the epithelium from the substantia propria and performed i ndirect immunofluorescence to analyze CD1a+ (a specific Langerhans cel l surface antigen) cell density on flat-mounted epithelial sheets obta ined from 30 normal controls and 11 patients presenting with ocular ci catricial pemphigoid. Results. This technique was quick and reproducib le. The mean Langerhans cell density in normal limbal conjunctiva was 272+/-37 cells/mm(2). It was significantly higher in ocular cicatricia l pemphigoid patients: 386+/-43 cells/mm(2) (p = 0.001). Conclusions. Conjunctival Langerhans cell density in ocular surface inflammatory di seases can best be evaluated by indirect immunofluorescence, following epithelial sheet separation from the substantia propria, using Dispas e II(R).