Open Access Case report

Immunohistochemical localization of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor and α2-antiplasmin in human corneal perforation: a case report

Koji Sugioka1*, Aya Kodama1, Koji Yoshida2, Kiyotaka Okada3, Masahiko Fukuda1 and Yoshikazu Shimomura1

Author Affiliations

1 Department of Ophthalmology, Kinki University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama 589-8511, Japan

2 Department of Biochemistry, Kinki University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, 589-8511, Japan

3 Department of Physiology and Regenerative Medicine, Kinki University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, 589-8511, Japan

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BMC Ophthalmology 2012, 12:60  doi:10.1186/1471-2415-12-60

Published: 28 November 2012



Corneal ulceration leading to perforation is associated with infectious and non-infectious destructive conditions in the cornea. The fibrinolytic (plasminogen/plasmin) system is considered to contribute to tissue remodeling in the wound healing process and it is believed to play an important role in proteolysis and fibrosis. To determine the localization of urokinase-type plasminogen activator (u-PA), u-PA receptor (u-PAR) and α2-antiplasmin (α2AP) in the tissue of a corneal perforation, we investigated immunohistochemical expressions of u-PA, u-PAR, α2AP, CD68, and α-smooth muscle actin (α-SMA) in a patient with corneal perforation that developed from an ulcer of no clear cause.

Case presentation

The patient was a 77-year-old woman who presented with a perforated corneal ulcer in her right eye. The cause of her corneal ulcer was unknown. Double immunohistochemistry was performed for the combinations of u-PA with u-PAR, CD68 or α-SMA and α2AP with CD68 or α-SMA to detect the localization of u-PA and α2AP. u-PA and u-PAR co-localization was seen in the corneal ulceration area. u-PA was mainly observed in CD68-positive cells and in some α-SMA positive cells. On the other hand, α2AP was not expressed in CD68-positive cells, but was expressed in α-SMA positive cells.


We identified expression of the u-PA/u-PAR complex and α2AP in a patient with a corneal ulcer. These two molecules are believed to play a crucial role in inflammatory cell recruitment, ECM synthesis and degradation during corneal wound healing.

u-PA; u-PAR; Corneal wound healing; α2-antiplasmin; Corneal perforation