Endothelial Barrier Function and Na + /K + -ATPase Pump Density in Herpetic Stromal Disease

Purpose. Corneal edema is a significant component of the various forms of herpes simplex virus type 1 (HSV-l)-induced stromal disease. Maintenance of corneal thickness, a reflection of corneal hydration, depends on a physical barrier formed by endothelial cell-cell junctions and by the activity of Na + /K + -ATPase pumps that regulate ion flux and thus influence water movement through this cell layer. These functions were measured in corneas with increased corneal thickness caused by HSV-1-induced stromal disease to determine their contribution to the pathogenesis of the edema. Methods. Stromal disease with corneal edema was induced in rabbits by intrastromal injection of the RE strain of HSV-1. At various times after infection, during the development of and recovery from stromal disease, endothelial barrier function and Na + /K + -ATPase pump sites were measured in excised rabbit corneas. Results. The endothelial permeability coefficient, K^,,,, for l4 C-dextran, 3 H-inulin, and I4 Cmannitol, were not altered significandy during periods of maximal corneal edema and stromal disease. Endothelial Na + /K + -ATPase pump density, as measured by ouabain binding, showed a statistically significant (P < 0.05) decrease in HSV-1-infected corneas during peak edema compared to mock antigen-injected or uninjected control corneas. Pump density returned to baseline values by 24 days after infection, concurrent with the resolution of corneal edema. Conclusions. These results indicate that corneal endothelial barrier function was not altered in this form of HSV-1-induced stromal edema; however, pump density was reduced significantly. Invest Ophthalmol Vis Sci. 1996;37:29-36. iLdema and scarring are the principal causes for loss of vision associated with herpes simplex virus (HSV) infections of the cornea. Herpetic corneal disease can be grouped into two general categories of stromal complications. 1 Herpes simplex stromal keratitis can