Tissue and molecular events in human conjunctival scarring in ocular cicatricial pemphigoid

Detailed histomorphometric analysis of human conjunctival biopsy specimens has convincingly demonstrated that tissue remodeling of the extracellular m atrix (ECM) is an essential and dynamic process associated with conjunctiva l scarring in ocular cicatricial pemphigoid (OCP). The conjunctival scarrin g often eventually results in impaired vision and/or blindness. The molecul ar mechanisms of conjunctival scarring are not completely understood. Accum ulating evidence indicates that the early phase of conjunctival fibrosis is linked with an immuno-inflammatory process mediated by cytokines released by activated conjunctival cells and/or by infiltrating cells. Fibrogenic cy tokines secreted by inflammatory cells and fibroblasts might actively be in volved in remodeling of the matrix within the conjunctival stroma, possibly by regulating the altered metabolism of matrix proteins.