Transforming growth factor-beta and the bleb scarring after glaucoma filtration surgery

Bleb scarring is the main cause of glaucoma filtration surgery failure. Transforming growth factor-beta (TGF-β) can induce the phenotypic modulation of human Tenon's capsule fibroblasts,then cause further migration,proliferation of the cells,synthesis of extracellular matrix,and eventually lead to the scarring of the bleb.There had been a lot of researchs at cytokine and gene level in antifibrotic area in recent years,which include TGF-β antibodies (such as anti-TGF-β2 antibody,CAT-152),TGF-β inhibitors (such as decorin,chymase inhibitor,SB-431542,etc.) and genetic level reagents (such as TGF-β antisense oligonucleotides,etc.) to inhibit the important target and protein expression in TGF-β signaling pathways (such as ALK5/Smad2/Smad3,MAPK,Rho-ROCK,PI3K-AKT signaling pathways,etc.),so as to achieve the role of reducing bleb scarring.But most of these drugs were lack of clinical trials support and of comparative studies among different drugs.Therefore,in-depth studies are still needed to explore the relationship among TGF-β cell signaling pathways,and find the best target for the regulation of bleb scarring. Key words: glaucoma filtration surgery;  scarring;  transforming growth factor-beta