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Updated: Jul 15, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Tumour necrosis factor-alpha in conjunctivae affected by ocular cicatricial pemphigoid
Miguel Cordero Coma1, Taygan Yilmaz, C Stephen Foster
1Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts, USA.
Purpose:
The presence of tumour necrosis factor-alpha (TNF-alpha) in conjunctivae affected by ocular cicatricial pemphigoid (OCP) was investigated.
Methods:
Biopsy specimens from the conjunctivae of eight patients with OCP, three patients with atopic keratoconjunctivitis (AKC) and two normal subjects were studied for the expression of TNF-alpha by immunohistochemistry. Two independent, masked investigators evaluated the specimens. All samples were similarly processed by a third investigator.
Results:
No TNF-alpha was discerned in the normal conjunctival sections; small amounts of TNF-alpha were observed in the atopic keratoconjunctivitis specimens. TNF-alpha was present in substantial amounts in conjunctival sections of patients with OCP. The expression of TNF-alpha was detected in both epithelial and stromal cells of conjunctivae from OCP patients.
Conclusions:
The presence of TNF-alpha in conjunctivae affected by OCP may indicate that this cytokine plays an important role in the production and maintenance of conjuctival inflammation response and subsequent conjunctival scarring in patients with OCP. Further studies clarifying this potential role are warranted.
