Transcriptomic and Immunohistochemical Analysis of Progressive Keratoconus Reveal Altered WNT10A in Epithelium and Bowman's Layer

Invest Ophthalmol Vis Sci. 2021 May 3;62(6):16. doi: 10.1167/iovs.62.6.16.


Purpose: To identify global gene expression changes in the corneal epithelium of keratoconus (KC) patients compared to non-KC myopic controls.

Methods: RNA-sequencing was performed on corneal epithelium samples of five progressive KC and five myopic control patients. Selected results were validated using TaqMan quantitative PCR (qPCR) on 31 additional independent samples, and protein level validation was conducted using western blot analysis on a subset. Immunohistochemistry was performed on tissue microarrays containing cores from over 100 KC and control cases. WNT10A transcript levels in corneal epithelium were correlated with tomographic indicators of KC disease severity in 15 eyes. Additionally, WNT10A was overexpressed in vitro in immortalized corneal epithelial cells.

Results: WNT10A was found to be underexpressed in KC epithelium at the transcript (ratio KC/control = 0.59, P = 0.02 per RNA-sequencing study; ratio = 0.66, P = 0.03 per qPCR) and protein (ratio = 0.07, P = 0.06) levels. Immunohistochemical analysis also indicated WNT10A protein was decreased in Bowman's layer of KC patients. In contrast, WNT10A transcript level positively correlated with increased keratometry (Kmax ρ = 0.57, P = 0.02). Finally, WNT10A positively regulated COL1A1 expression in corneal epithelial cells.

Conclusions: A specific Wnt ligand, WNT10A, is reduced at the mRNA and protein level in KC epithelium and Bowman's layer. This ligand positively regulates collagen type I expression in corneal epithelial cells. The results suggest that WNT10A expression in the corneal epithelium may play a role in progressive KC.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blotting, Western
  • Bowman Membrane / metabolism*
  • Collagen Type I / genetics
  • Collagen Type I, alpha 1 Chain
  • Epithelium, Corneal / metabolism*
  • Female
  • Gene Expression Regulation / physiology*
  • Humans
  • Immunohistochemistry
  • Keratoconus / diagnosis
  • Keratoconus / genetics*
  • Keratoconus / metabolism
  • Male
  • Phenotype
  • Plasmids / genetics
  • RNA, Messenger / genetics
  • Real-Time Polymerase Chain Reaction
  • Sequence Analysis, RNA
  • Transcriptome
  • Wnt Proteins / genetics*
  • Wnt Proteins / metabolism*
  • Young Adult


  • Collagen Type I
  • Collagen Type I, alpha 1 Chain
  • RNA, Messenger
  • WNT10A protein, human
  • Wnt Proteins