Total Anterior Staphyloma Secondary to Acanthamoeba Keratitis.

ABSTRACT There are very few published cases of total anterior staphyloma, all of which have been reported as secondary to fungal keratitis. This study reports the clinical and histopathological findings and subsequent management of a 27-year-old healthy female patient who developed total anterior staphyloma after poor compliance with treatment for clinically diagnosed acanthamoeba keratitis. She underwent a successful evisceration with good long-term results. This case highlights that total anterior staphyloma may also result from untreated keratitis which is not fungal in origin. In cases of fungal and acanthamoeba keratitis, patient compliance with both treatment and follow-up is paramount to avoid vision-threatening sequelae that present significant challenges in their management

CO2-dependent opening of connexin 26 and related beta connexins

We have previously shown connexin mediated CO2-dependent ATP release from the surface of the medulla oblongata. Given the localization of connexin 26 (Cx26) to the chemosensing areas of the medulla, we have tested in a heterologous expression system (HeLa cells) whether Cx26 may be sensitive to changes in P-CO2. Cx26 responded to an increase in P-CO2 at constant extracellular pH by opening and to a decrease in P-CO2 by closing. Furthermore, Cx26 was partially activated at a physiological P-CO2 of around 40 mmHg. Cx26 in isolated patches responded to changes in P-CO2, suggesting direct CO2 sensitivity of the hemichannel to CO2. Heterologous expression of Cx26 in HeLa cells was sufficient to endow them with the capacity to release ATP in a CO2-sensitive manner. We have examined other heterologously expressed connexins for their ability to respond to changes in P-CO2. The closely related beta connexins Cx30 and Cx32 also displayed sensitivity to changes in P-CO2, but with slightly different characteristics from Cx26. The more distant Cx43 exhibited CO2-dependent closing (possibly mediated through intracellular acidification), while Cx36 displayed no CO2 sensitivity. These surprising findings suggest that connexins may play a hitherto unappreciated variety of signalling roles, and that Cx26 and related beta connexins may impart direct sensitivity to CO2 throughout the brain