{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:36:29Z","timestamp":1792917389078,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pseudoexfoliation syndrome (PXS) is associated with increased lens epithelial cell apoptosis; however, the underlying molecular mechanisms at the protein level remain unclear. This study aimed to investigate apoptotic, nitric oxide, and endothelial signaling-related protein expression (Caspase-3, \u22128, \u22129, eNOS, and VEGF-B) in anterior lens capsule epithelial cells of PXS patients and age-matched controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective comparative study, anterior lens capsule specimens were obtained from 55 patients with PXS and 30 age-matched cataract controls during phacoemulsification surgery. PXS severity was graded (Grades 1\u20133) based on slit-lamp biomicroscopic findings. Caspase-3, Caspase-8, Caspase-9, eNOS, and VEGF-B protein levels were measured by ELISA. Marker levels were compared between PXS and control groups and further analyzed according to disease grade (Grades 1\u20133) within the PXS group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were observed between groups in age, gender distribution, cataract type, visual acuity, or intraocular pressure. Caspase-3, Caspase-9, VEGF-B, and eNOS levels were significantly higher in the PXS group compared to controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Caspase-8 levels did not differ significantly between groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.711). In grade-based analysis, Caspase-3, Caspase-8, Caspase-9, and VEGF-B levels increased progressively from Grade 1 to Grade 3 (all P\u2009\u2264\u20090.003). In contrast, eNOS showed a decreasing profile across grades, with a significant reduction in Grade 3 versus Grade 1 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PXS is associated with significant alterations in apoptosis-related, nitric oxide-related, and endothelial signaling proteins in lens epithelial cells, with a distinct grade-dependent molecular pattern. These findings identify Caspase-3, Caspase-9, VEGF-B, and eNOS as potential severity-associated biomarkers and therapeutic targets in PXS pathogenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721261499891","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:22:46Z","timestamp":1792588966000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Apoptotic, oxidative stress, and endothelial signaling protein expression in lens epithelial cells of patients with pseudoexfoliation syndrome"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3141-0531","authenticated-orcid":false,"given":"Kuddusi","family":"Teberik","sequence":"first","affiliation":[{"name":"Duzce 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