Supplementary Material for: The p.Gly61Glu Mutation in CYP1B1 Affects the Extracellular Matrix in Glaucoma Patients

<br><strong><em>Purpose:</em></strong> The aim of this work was to assess the possible effects of <i>CYP1B1 </i>mutations on the extracellular matrix (ECM) in glaucoma patients. <i>CYP1B1</i> mutations are the cause of disease in a notable fraction of primary congenital glaucoma (PCG) patients and in a smaller fraction of primary open angle glaucoma (POAG) patients. <b><i>Methods:</i></b> The study was performed on a glaucoma family with the common homozygous p.Gly61Glu <i>CYP1B1 </i>mutation. The father was affected with POAG and three siblings had PCG. Microscopy was performed on the skin of the father and one son, as well as controls. Immunohistochemical studies were done using anti-CYP1B1 and anti-fibrillin-1 antibodies. Fibrillin-1 served as a marker for the ECM, and electron microscopy was also performed. <b><i>Results:</i></b> CYP1B1 expression patterns were the same in the patients and controls. However, microfibrils that are associated with fibrillin-1 were less abundant and more fragmented in both patients. Electron microscopy showed disturbed collagen fibers only in the PCG patient. <b><i>Conclusions:</i></b> The p.Gly61Glu mutation in <i>CYP1B1</i> affects the ECM structure. This implies that the ECM of the trabecular meshwork may also be disrupted in a manner that affects aqueous humor flow resulting in increased intraocular pressure and contributing to the glaucoma phenotype.