PURPOSE. Posterior capsule opacification (PCO) is a complication after cataract surgery, particularly in children. Epithelial-mesenchymal transition (EMT) of lens epithelial cells, mediated by transforming growth factor beta (TGF beta), contributes to PCO. However, its pathogenesis in children is poorly understood. We correlated cell growth in culture with patient characteristics, studied gene expression of pediatric lens epithelial cells (pLEC), and examined the effects of TGF beta-2 on these cells in vitro. METHODS. Clinical characteristics of children with cataracts correlated with growth behavior of pLEC in vitro. mRNA expression of epithelial (alpha B-crystallin, connexin-43) and mesenchymal (alpha(V)-integrin, alpha-smooth muscle actin, collagen-I alpha 2, fibronectin-1) markers was quantified in pLEC and in cell line HLE-B3 in the presence and absence of TGF beta-2. RESULTS. Fifty-four anterior lens capsules from 40 children aged 1 to 180 months were obtained. Cell outgrowth occurred in 44% of the capsules from patients <= 12 months and in 33% of capsules from children aged 13 to 60 months, but in only 6% of capsules from children over 60 months. TGF beta-2 significantly upregulated expression of alpha B-crystallin (HLE-B3), alpha(V)-integrin (HLE-B3), collagen-I alpha 2, and fibronectin-1 (in pLEC and HLE-B3 cells). CONCLUSIONS. Patient characteristics correlated with growth behavior of pLEC in vitro, paralleling a higher clinical incidence of PCO in younger children. Gene expression profiles of pLEC and HLE-B3 suggest that upregulation of alpha(V)-integrin, collagen-I alpha 2, and fibronectin-1 are involved in EMT.
