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. 2017 Aug 23;18(9):1831. doi: 10.3390/ijms18091831

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© 2017 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Role of corneal fibroblasts in bacterial keratitis. LPS released from bacteria binds to LBP and sCD14 in tear fluid, and the LPS-LBP-sCD14 complex then activates corneal fibroblasts. The activated fibroblasts promote inflammatory cell recruitment through expression of chemokines and adhesion molecules. Infiltrated neutrophils are activated by corneal stromal collagen and secrete inflammatory mediators including IL-1 that stimulate pro-MMP secretion by fibroblasts. The released pro-MMPs are activated by bacterial proteases such as Pseudomonas aeruginosa elastase, and the active MMPs then degrade stromal collagen, leading to corneal melting.