Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1996 May;49(5):407–410. doi: 10.1136/jcp.49.5.407

The pathology of cornea in Tangier disease (familial high density lipoprotein deficiency).

A F Winder 1, R Alexander 1, A Garner 1, D Johnston 1, D Vallance 1, G McCreanor 1, J Frohlich 1
PMCID: PMC500482  PMID: 8707957

Abstract

AIMS: To clarify the underlying causes of corneal opacification in Tangier disease. METHODS: Both corneas were removed at death from a 62 year old man with Tangier disease, and were examined by direct and transmission electron microscopy, histochemistry, biochemical analysis by thin-layer and gas-liquid chromatography after extraction, and by differential scanning calorimetry. RESULTS: Membranous inclusions in the stroma were seen on transmission electron microscopy. Direct analysis confirmed enrichment with phospholipids and cholesterol, with acyl patterns and proportions as ester broadly similar to those of normal cornea. Tangier cornea showed major thermotropic phase transitions in the range 28-37 degrees C, peak 30-33 degrees C, extending above profiles of normal clear cornea and without the complexity of those seen with cornea with heavy arcus involvement. CONCLUSIONS: Lipid accumulation underlies corneal opacification in Tangier disease. The excess material is mainly phospholipid and cholesterol esters. As at other sites which are below body core temperature, notably tonsil, accumulation may be enhanced by local impaired mobilisation of material as the phase transitions of the excess lipid present extend above ambient corneal temperatures.

Full text

PDF

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Deckelbaum R. J., Shipley G. G., Small D. M. Structure and interactions of lipids in human plasma low density lipoproteins. J Biol Chem. 1977 Jan 25;252(2):744–754. [PubMed] [Google Scholar]
  2. Frohlich J., Fong B., Julien P., Despres J. P., Angel A., Hayden M., McLeod R., Chow C., Davison R. H., Pritchard H. Interaction of high density lipoprotein with adipocytes in a new patient with Tangier disease. Clin Invest Med. 1987 Sep;10(5):377–382. [PubMed] [Google Scholar]
  3. Katz S. S., Small D. M., Brook J. G., Lees R. S. The storage lipids in Tangier disease. A physical chemical study. J Clin Invest. 1977 Jun;59(6):1045–1054. doi: 10.1172/JCI108727. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Mautner S. L., Sanchez J. A., Rader D. J., Mautner G. C., Ferrans V. J., Fredrickson D. S., Brewer H. B., Jr, Roberts W. C. The heart in Tangier disease. Severe coronary atherosclerosis with near absence of high-density lipoprotein cholesterol. Am J Clin Pathol. 1992 Aug;98(2):191–198. doi: 10.1093/ajcp/98.2.191. [DOI] [PubMed] [Google Scholar]
  5. Philipson B. T. Fish eye disease. Birth Defects Orig Artic Ser. 1982;18(6):441–448. [PubMed] [Google Scholar]
  6. Pressly T. A., Scott W. J., Ide C. H., Winkler A., Reams G. P. Ocular complications of Tangier disease. Am J Med. 1987 Nov;83(5):991–994. doi: 10.1016/0002-9343(87)90667-x. [DOI] [PubMed] [Google Scholar]
  7. Robenek H., Schmitz G. Abnormal processing of Golgi elements and lysosomes in Tangier disease. Arterioscler Thromb. 1991 Jul-Aug;11(4):1007–1020. doi: 10.1161/01.atv.11.4.1007. [DOI] [PubMed] [Google Scholar]
  8. Schaefer E. J. Clinical, biochemical, and genetic features in familial disorders of high density lipoprotein deficiency. Arteriosclerosis. 1984 Jul-Aug;4(4):303–322. doi: 10.1161/01.atv.4.4.303. [DOI] [PubMed] [Google Scholar]
  9. Schmitz G., Assmann G., Bowyer D. E. A quantitative densitometric method for the rapid separation and quantitation of the major tissue and lipoprotein lipids by high-performance thin-layer chromatography. I. Sample preparation, chromatography, and densitometry. J Chromatogr. 1984 Apr 13;307(1):65–79. doi: 10.1016/s0378-4347(00)84073-6. [DOI] [PubMed] [Google Scholar]
  10. Schmitz G., Fischer H., Beuck M., Hoecker K. P., Robenek H. Dysregulation of lipid metabolism in Tangier monocyte-derived macrophages. Arteriosclerosis. 1990 Nov-Dec;10(6):1010–1019. doi: 10.1161/01.atv.10.6.1010. [DOI] [PubMed] [Google Scholar]
  11. Serfaty-Lacrosniere C., Civeira F., Lanzberg A., Isaia P., Berg J., Janus E. D., Smith M. P., Jr, Pritchard P. H., Frohlich J., Lees R. S. Homozygous Tangier disease and cardiovascular disease. Atherosclerosis. 1994 May;107(1):85–98. doi: 10.1016/0021-9150(94)90144-9. [DOI] [PubMed] [Google Scholar]
  12. Sheraidah G. A., Winder A. F., Fielder A. R. Lipid-protein constituents of human corneal arcus. Atherosclerosis. 1981 Aug-Sep;40(1):91–98. doi: 10.1016/0021-9150(81)90127-1. [DOI] [PubMed] [Google Scholar]
  13. Walter M., Gerdes U., Seedorf U., Assmann G. The high density lipoprotein- and apolipoprotein A-I-induced mobilization of cellular cholesterol is impaired in fibroblasts from Tangier disease subjects. Biochem Biophys Res Commun. 1994 Nov 30;205(1):850–856. doi: 10.1006/bbrc.1994.2742. [DOI] [PubMed] [Google Scholar]
  14. Winder A. F., Borysiewicz L. K. Corneal opacification and familial disorders affecting plasma high-density lipoprotein. Birth Defects Orig Artic Ser. 1982;18(6):433–440. [PubMed] [Google Scholar]
  15. Winder A. F., Bruckdorfer K. R., Fielder A. R. Thermal transition studies of a mature xanthelasma by differential scanning calorimetry. Clin Chim Acta. 1985 Oct 15;151(3):253–257. doi: 10.1016/0009-8981(85)90088-9. [DOI] [PubMed] [Google Scholar]
  16. Winder A. F., Garner A., Sheraidah G. A., Barry P. Familial lecithin:cholesterol acyltransferase deficiency. Biochemistry of the cornea. J Lipid Res. 1985 Mar;26(3):283–287. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES